7»	1-&
> $;	**^.|
■ '■*■■''■.	
^
'<*-•.*.
a
,VL*-
?*#.'•*'
•%*:< 
NATIONAL LIBRARY OF MEDICINE
          Washington 
->'  * 
 
Jtfarried Lady^s  Companion,
OR
POOR  MAN'S  FRIEND.
              IN FOUR PARTS.

1. An address to the Married Lady, who is the Moth*
  er of Daughters.
II. An address to the newly Married Lady.
III. Some important hints to the Midwife.
IV. An essay on the management and common dis-
  eases of children.  To which will be added a shoct
  note on fever
BY SAMUEL K. JENNINGS.
Second edition, revised,  corrected and enlarged by
                the Author.
The fear of the Lord prolongeth days ; but the years of
  the wicked shall be shortened.—Pro v. x. 27.


           COPY-RIGHT SECUBED.
       PUBLISHED BY  LORENZO DOW.

J. C. Tottan, printer, No. 155 Chatham-street, Ne\tfi
                   York.
^1808. 
k^'^-^'J 
ADVERTISEMENT.
  AS the medical part of this compilation v,\i9 prirtcrV
pally intended for the poor,  and such, other families
as cannot conveniently obtain the aid of physicians,
the author did not think it necessary to name the work
from which each thought is extracted—He  cheerfully
and  thankfully acknowledges himself indebted to the
writings of Doctors Cullen,  Rush,  Darwin and oth-
ers ; and in a very special manner to Dr.  Denman's
treatise on the diseases of women.   It was his chief
ambition, to feel himself conscious of benevolent in-
tentions,  whatever might be the  reception of his
work.
  Since  the publication of the first edition of this
work,  a copy has been submitted to the inspection of
Dr.  Rush.  The Doctor thought proper to speak fa-
vorably of the performance, and to  recommend it to
such families as live  in country places,  or in places
where  skilful physicians are not easily obtained.
  As the author has  no pecuniary interest whatever
in the edition which is now offered to the  public, he
iv;els himself at liberty to make an apology to the pur-
chasers of the first.
  In the first place, he was  in greater  haste in ush
ering it into the world than he  would have  been,  had
fame or  interest  been his principal object.  But he
was  too  often obliged to  be  an eye-witness  to the
dreadful ravages committed on the health and lives
of women and children, by a number of self-conceited
wretches, who seemed to  be ignorant of the mischief
they were doing in the world.  These he wished to
correct without delay. 
                        IV.

   In the second and last place he would observe, that
Ws professional  engagements were so considerable,
that it was impossible for him to avoid delay, and yet
be minutely correct—He  was therefore  contented
with setting forth, in an intelligible manner, the great
truths he intended, without much regard to elegance
of style.
   The present edition is  intended to be a good deal
more correct.than the former, and is enriched wit-fc
considerable addition^1. 
Addrcmed to the married  Lady  who  is  the
           mother of daughters.
             CHAPTER  I.

               INtRODUCTIOX.

  Madak,
     AS a person much in the habit of think-
ing, you have often pitied the silly creatures,
who rush into the bands of wedlock without
duly considering the consequences.   You are
deeply sensible,, that, on  the  mother's con-
duct and  example is depending not only her
own happiness, but  also the well being of her
children, and of her children's children, down
to the latest generation.
  I ;mi secure of your attention then, while
I state a few things,  intended to assist you,
in the important business  of rightly instruct*
ing your daughters  in the  way to health and
happiness. 
e
  If every woman  were properly qualified,
and  would, faithfully  perform her  duty in
bringing up her children ; their virtuous af-
fections might be so confirmed, their dispo-
sition to vice so effectually subdued, that, the
greatest revolution in the morals and health
of the world,  would be the consequence.
  " Train up a child  in the  way  he should
go, and when he is old, he-will not depart
from it," says Solomon.
  A sound mind in a sound body, will never
fail to  make her who is blest with them, as
happy  as is allowed of God to man in  this
world.
  That these may be the lot  of your daugh-
ters, is much more in your power than many
are willing to believe.   To bring them about
however,  it requires  much pains and  never
ceasing diligence.
  The weight of the task is thought by some,
a sufficient excuse for neglecting it.   But I
hope  the  sincerity of your  regard for your
daughters' happiness has long since led yon
to undertake it as far as you were able, and
prepared your mind,  glacllv  to receive any
assistance which may be offered you for its.
accomplishment^ 
n
            CHAPTER II.

       FUNDAMENTAL  PROPOSITION'S.

   1. Health, Morality, and  Religion,
are mutually  and essentially dependent  on
each other.    For as sound health cannot be
continued without good  morals,  so neither
can sound morals be preserved without reli-
gious sentiment.
   2.  Our children are committed to our care
in a state of infancy, that, we  may so regu-
late their food, cloathing,  exercise, and man-
ner of thinking, as most effectual^ to prepare
them for health and happiness.
   3.  While yet in their infant state, we per-
ceive, they have all the passions to urge them
into  action,  but they require much time and
pains to gain that experience, which is neces-
sary for the regulation of passion, which is
too seldom gained even with riper years.
   4.  Hence I draw the two  following con-
clusions, First,  God  wisely designed, that
the reason and experience of parents,  should
be employed in the government of their chil-
dren  through  the whole  course of their in-
fancy.
   5.  2d, If parents do not use every possible
exertion, and  through  neglect, their children
sjhould take a wrong  direction,  as parents 
8
they are accountable for the injury done t«
thsir  offspring,  and as  trustees,  they are
bound to answer to that society of which they
are members, for all the consequent mischief
brought upon the public.
  6. The little bodies of cur  children first
demand  our care, in as  much  as a certain
growth  must take place before the mind un-
folds itself.
  7* We proceed however,  but a short dis-
tance with our  charge, before  the  task be-
comes  a complicated one.    Their mind6
quickly claim attention.
  8. It is merefore important, that we should
set out on such  a plan, as may readily adapt
itself to both these considerations,  viz. The
establishment of a sound constitution of the
body, and the formation of the virtuous affec-
tions of the mind.


             CHAPTER  III.
IMPORTANCE  OF  EXERCISE FOR ESTABLISHING
           A GOOD CONSTITUTION.
  The propensity of children to be  in constant
action, as well as the experience of mankind
in all ages, sufficiently proves the importance
of exercise of body, for establishing and pre-
serving a good constitution. 
•9*
  The same experience has proved, that this
exercise must be regularly continued, in or-
der to make  it effectual to such an important
end.
  I must therefore urge upon you the neces-
sity of using  all proper means, for forming
in your daughter habits of  industry.   Look
around among your female acquaintance, and
see where is the greatest share of good health.
Is it the lot of the  rich and luxurious, who
spend much of their time in bed, who take
no exercise,  but that of  an occasional flight
in the chariot or coach  i Let their pale coun-
tenance,  their feeble arm, and bloated flesh
answer for them !
   No madam, the  God of nature has fixed
his firm decree, that indolence' and  health
shall not dwell together.  Shall I direct you
in your search after health ?
  Go  see  the blooming maid,  dextrously
whirling the  useful wheel, cleaning and ad-
justing the  furniture,  regulating  the ward-
robe, directing in the  kitchen, superintend-
ing the dairy. How cheerfully does she spend
the day ! How sweet is her food ! How soft
and pleasant her bed, when at an early hour
she reclines herself to rest !
   Not tired  of inaction, her time hangs not
heavy  on her hand.  She  seeks  no  party to
hide her from herself.   Conscious of having
                    A 2. 
w
 spent the day in Useful employment, she feels
 a sweet  composure  which  the  idler never
 knew.
   Let these reflections  suffice to prove, that
 industry best secures the greatest  share  of
 health.
   But how are you to establish this indus-
 trious disposition ? It is not enough for you
 occasionally to say in your daughters' hearing
 " Industry  is a fine thing? « Every body
 ought to rvork," tk Indolence is stutmefid and
 is justly followed by beggary." These are
 all true,  but nothing is more common with
 the most indolent, than frequent declamation
 of this sort.
   You  must  set  the example madam, you
 must diligently employ yourself in some val-
 uable business, and  then  encourage your
 daughter to imitate yoa.
   How often you  have been pleased to exta-
 cy, when the little creature, even  at  three
 years old, would set down, patiently endeav-
 ouring to handle your scissors, your needles,
 or your thimble ! How you  have been amu-
 sed,  to see htr little  fingers  trying faithfully
 to work up a bit of pastry !
   Might not these  hints be considered strong
 intimations of what is your duty ? The cas^
is plain.   If you will take proper advantage 
11
of this imitative disposition,  you may readily
form in your child what habit you please.
   Have you never seen an instance, where
this favorable  time for instruction was  lost
through neglect,  through  slothfulness,  or
through ldve of pleasure i Can you, madam,
lay your hand upon your  own heart, and in
candor ^nd truth say  you have not been re-
miss ? Wnat followed ? The little pratler for
want of proper  employment,  turned her at-
tention wholly from the business of the house,
to sport at large in the field, and to indulge
in dissipating plrrys.   She lost her  fondness
for every thing useful, and  would regret the
loss of a few minutes from  her play, even if
called upon to prepare her own dress !
   I do not mean that misses should be con-
stantly kept in the house, nor too closely con-
fined to the same thing.   Nothing  could be
more pernicious to their health.  Such con-
duct would subject them  to vapours, hys-
terics, and  all the  train of  hypochondriacal
affections.
   The design  of  the argument is, to urge
upon you the propriety of introducing early
into your family,  habits of regularity.  So
soon as your daughter can perform any kind
of business,  fix for her regular times, and let
her perform her task duly  and daily.   And
#? often as you can do it xvith any shadow of 
12
 truth, you xvillfnd it beneficial to give her «
 certain degree of praise.   It  is  highly im-
proper to degrade tier, either publicly or pri-
 vately.
   When exercise out of doors is thought ne-
 cessary,  let her  be engaged  in  something
 which will keep up her attention, and yet let
 it be entirely agreeable.
   I know it is advised  by some, that girls
 should be indulged to sport and romp  about
 at pleasure.  It is not mv design  at present
 pointedly to deny it.   But  after they arrive
 at a certain age,  I  must  inrist on  a proper
 regulation of those sports, both  as to time
 and duration.   And this of course will be the
 mother's task.   Now  what lady of discre-
 tion will neglect useful employment, to reg-
 ulate  the plays of children ? Would  it not be
much more convenient, and consistent with
her interest, to superintend some profitable
 engagement ?
   Suppose, for instance, your daughter were
xjccasionally led  to the garden, where she
khoul fr have her proper lot of ground assign-
ed her, for the  cultivation of plants and flow-
ers ;  and were thus taught so  much of bota-
ny, as has reference to kitchen and ornamen-
tal  purposes  while she  was  exercising her
body.
   Might not this be a tolerable substitute for 
13
 romping and tearing about ? Might not judi-
 cious mothers, who would make it their study,
 devise  many plans  like this, for forming
 habits of business and industry, to the exclu-
 sion of indolence and dissipation ?
   The  greatest  attention is necessary if you
 would succeed in this important business.—
 Do not object and say, the engagements of
 your  family will not afford time or leisure for
 these things.  Pray, tell me if you are able,
 what mighty xvork you have to do, which is of
 more importance than that of rightly bringing
 up jour children.
   Suppose you are able, by your neglect of
 this duty, to lay  up  a  few more pounds.—
 When she comes to be a woman, a mistress
 of a family, and a mother of children, will
 that pittance of saving  be of as  much  conse-
 quence to her, as a knowledge of business,
 and a willingness and ability to  perform such
 business would have  been ?
   But I am not disposed  to grant that any
 such addition  will be gained.   Suppose  for
 instance, you  were willing to adopt the plan
 proposed, regularly dividing the time, so as
 to devote a  certain number of  hours  daily,
 to reading  and  improving your daughter's
 mind ; a certain  number of hours to sewing,
 knitting or spinning ; a  certain number  of
hours  to the business of the kitchen, dairy, 8cc. 
14
keeping her constantly with you, and instruct-
ing her as you  proceed in every  branch  of
your engagements.  Would you not execute
more useful business in  the  course of the
year, than you now do in  the common  bust-
ling way ? And  even granting,  that,  some
less was executed at the first, would not the
aid  of  your daughter,  who  would on this
plan quickly be prepared to assist you,  more
than make good the loss ? Certainly it would:
But it must also be granted, that your daugh-
ter's happiness will be infinitely more enhan-
ced, by  the effects which regularity will  have
on the state of  her mind,  than by  any pecu-
niary consideration.   However   important
therefore, you may think your business, eve-
ry instance of neglect in h&r education is a
proof, either of your want of information in-
ducing an error in judgment,  your want of
industry,  or your want of maternal affection.
   It is true there are some in the world, who
think much of themselves,  and who may be
highly esteemed  by  others like themselves,
whose chief study it is, how to be genteelly
idle, and who of course consider it a disgrace
to be thus regularly  employed.    I expect
however you will join  me ih pitying  their
weakness, for you cannot  withhold your ad-
miration, when you see  a sweet  little miss,
regularly employed, handsomely preparing a 
is1
 room, dressing a table, and  as your phrase
 is putting  things to  rights, taking pleasure
 chiefly in her  business !  For my own part I
 confess, she seems to me as far superior to
 the ignorant, indolent, whining fool, as real
 worth and usefulness, is to insignificance and
 emptiness.
   Inasmuch then, as regular exercise is im-
 portant to the establishment and preservation
 of good health, as  it is conducive  to wealth
 and respectability, you surely are determined
 to  adopt some  plan to keep your daughter
 constantly employed.   If you are  not, and
 the sweet child should be cursed with a sick-
 ly constitution, merely from the want of suf-
 ficient firmness and  attention on your part,
 how will you answer for it ?  As  a friend to
 mankind, I charge you to consider well the
 •onsequences.   Do  your duty as a  mother,
 and you shall receive your just reward.


            CHAPTER IV.
 IMPORTANCE OF  THE VIRTUOUS AFFECTIONS^
  How great soever the pains  necessary for
oonfirming habits of industry, equal care must
be taken for the  cultivation of the virtuous
affections.   For without  them, nothing can
secure happiness to your daughter. 
re
  Alildness, Clieerfulness, Benevolence, Affec-
tion, &c. are so essential to  the character of
an amiable woman, that she who is destitute
of these must be intolerable.
  However  severe you may think the sen*
tence, you are responsible for the disposition
of your child ; because by patient attention,
and proper example, you may form it aright.
  " Tou are acquainted xvith an elderly lady,
xvho  is very peevish, ill-natured, restless,  en-
vioiis and unhappy.  She has daughters too ;
and they are as much like their mother  as they
can be."  The thing is common, there is as
much a family  temper  as  there is a family
likeness.  An ill tempered woman, in almost
every instance, shall have ill tempered chil-
dren, and so the plague is handed down from
generation to  generation.
  I perceive you will ask leave to excuse the
poor woman,  who  is unhappy  in an ill na-
tured husband.  This is indeed a serious dif-
ficulty.   But the iniquity of the man, can by
no means make atonement for the fault of his
wife.  She mav do a  great deal by  a strict
observance  of her  duty.   The business of
the man, frequently calls him abroad.  The
mother has the best opportunity to mould the
tempers of her children.  The same position
of course still recurs upon you, " that every
mother  is in a very great degree responsible 
17
for the disposition of her children."   To give
vou as special aid on this head as possible, I
will offer a  short essay on some of the most
important passions.



             CHAPTER V.

                 OF LOVE.

   Love indulged without success, sometimes
produces  hypochondriacal affections, hyste-
rics, fevers and death.  Custom  forbids the
female to make suit to  the male.   Whether
such a custom may not be founded in error,
is not my business at present to enquire.   It
is now so firmly established, that the ladies
are under the  necessity of accommodating
themselves to it.
   They should therefore  be able at all times
to govern themselves with prudence.  And
every thing which  may have a tendency to
inflame this passion, ought to be cautiously
avoided. Two things I will mention as being
particularly pernicious.
   And first, Idleness.   "  Every person  who
recollects his past conduct, may be satisfied,
that, the hours of idleness have always  pro-
ved  the  hours most dangerous to virtue.—■
They provoke the rise of  criminal  passions, 
18
lead to the suggestion of guilty pursuits, and
to the  formation  of designs which in their
issue bring disquiet and bitterness to the re-
mainder of life.
   " Sloth is like  a  slowly  flowing,  putrid
stream which stagnates in the marsh,  breeds
venomous animals, and poisonous plants, and
infects with pestilential  vapours  the whole
country round it.   Having  once  tainted the
soul, it leaves no part of it sound."*
   Idleness constantly nourishes the passions,
and  it must be very difficult, if not impossu-
bit-,  for her who is pampered in idle  luxury
to regulate that powerful propensity of which'
this  chapter treats.  The importance  of in-
dustry for the preservation of health,  has al-
ready been urged.  I must however again
speak of it as of the greatest moment for the
government of ptfssion.   By forming those
habits of order at which I have hinted, every
thing may be met in its own place,  and your
daughter  mav constantly find innocent and
useful employment for time.  She will never
be at a loss how to dispose of her hours, or to
fill up  life agreeably.
   S\jch a plan only, can answer well the sit-
uation of an unmarried lady.  On any other,
she  must be constantly  perplexed, with  all
* J)i'- Blaift 
19
 ue imaginations, which attend idleness and
 dissipation.
   Secondly,  Reading novels and romances.
 The  unwarrantable  amours and  intrigues,
 which fill up  most works of this kind, cannot
 fail to raise propensities the most unfriendly
 to virtuous continence.  u Evil communica-
 tion corrupts good  manners,"   And to in-
 dulge  the imagination in contemplating such
 amours, cannot differ but in degree, from
 associating with, the hero or heroine of  the
 play.  Besides, the examples of human  ex-
 cellence, as displayed in most  of their fine
 characters, do  no where exist in real life.—
Of course the unfortunate girl, who has form-
ed an opinion of her lover from one of those
highly coloured pictures, is at  length disap-
pointed, disgusted and miserable.
  Better sentiments may  be collected from
other books,  and you will  be  wise to com-
mit your novels to the flames, rather than to
the hands of your daughter.
  Furthermore, when you seriously consid-
er,  that it is possibb your  daughter should
run away with some worthless fellow, if her
inclination should not accord with your judg-
ment and  advice, you  will  see  that every
precaution ought to be taken to regulate her
fain J on this important  subject.
  Begin in time to inculcate sentiments prop* 
so
ev for her safety.  Teach her that, it is ma
possible  for  a' young impassioned miss to
judge of man's  merit.  That it is far more
properly the province of the parent.
   Make it a rule of your  house, That m
man shall pay his addresses to your daughter,
xvithout first explicitly obtaining permission
from her father and yourself.  Impress on
her mind the necessity and propriety  of such
a rule, that she may learn  to consider any
man  an enemy,  who would .presume to speak
on the subject of  love without having regu-
larly submitted to it.
   Be careful  also to secure  your daughter's
confidence.  It  is frequently the case, that,
young ladies  by confiding in their acquain-
tance, receive bad advice, are led to adopt
dangerous measures, and  are  involved in
ruin.  Sometimes too, not having a confidant
acquaintance, and not being disposed to con-
fide in their mothers, thev languish in secret,
to the destruction of their health and happ^
ness.  These evils might be prevented, W
mothers would take the proper steps  to gain
such confidence with  their daughters, as  to
know all  their  distresses, and hear all their
secret?.
    It is furthermore  possible, notwithstand-
 ing every precaution, that, a young lady
'should fix her affection upon some gentleman 
21
who has never thought proper to place him-
self within her power.   Should this happen
to your daughter, what could be done, if she
dare not intrust you with a knowledge of her
case ?  Whereas if you knew her inclination,
you might adopt measures either to prevent
or accomplish her wishes, as might be tho't
most prudent.   An  instance  of  this  sort
may happen without disgrace.
   u In one of the lower counties of  Virginia,
a young gentleman of agreeable address, ex-
cellent  morals,  and charming disposition,
happened to reside in the family of a wealthy
and respectable man, who was blessed with
an  amiable daughter.  Although  his great
worth had secured to him the esteem of the
whole family,  whilst the young lady seemed
to repose  the utmost confidence in his friend-
ship ; yet as his fortune was very moderate,
he dare not indulge a thought of gaining her
affection.   Several gentlemen of the first dis-
tinction waited on her with offers of marriage,
but she very politely dismissed them all, 'till
at length her  parents were anxiously appre-
hensive, that, she must have formed a reso-
lution never to marry.  This worthy young
man was particularly solicitous on  her ac-
count,  for  he  had considered some of the
offers to be very advantageous.   At the re-
quest of her friends, he therefore cheerfully, 
83
Undertook to  enquire into the cause of hei
 conduct,  so apparently strange.   With diffi-
 culty he extorted from her a confession, that
 her love was  fixed upon another.  It was
 then determined that he  should continue the
 negociation,  and if possible  obtain a know-
 ledge of the person.   For some days she per-
 sisted  to withhold  the desired information*
 But at length  yielding to his solicitude, she
 directed  him to the 7th verse of the XII ch.
 of the second book of Samuel for a determi-
nate answer.   With haste he ran to his bible,
and opening  the place,  to his astonishment
 and joy, he read,  " and Nathan said unto
 David thou art the man.v  Thev were  har>
pay married a  short time after the discovery,
and perhaps to thi3 day are living in harmc*
ny."
  Should a similar case occur, in which the
young gentleman is  not so easily gained, the
friends of the young lady might use the influ-
ence of some  worthy acquaintance to bring
about a match, and  there could be no impro-
priety  in the measure.*
  But if the object cannot  be obtained, and
  * From having-  still more maturely considered the
delicacy of such a case,  I  am the more persuaded of
the propriety of this instruction.  It too often happens,
that ladits failing- of their own proper chi.ice, are at
length married from considerations of prudence, and
what not, and are ever afterwards unhappy. 
23
the passion is of the more  violent kind, a
fever will be the consequence.   For the re-
moval of this fever,  blood letting and blister-
ing are advised.   These  remedies frequent-
ly remove the passion together with the fever-
   If the case be of  the more moderate sort,
the  patient will probably  talk incessantly of
the beloved object, or will be too cautiously
silent.  Will sigh often.  Will  be unable to
sleep.   And will frequently  retire into soli-
tude, especially by mdbn  light.
   For the cure here, let the  company of the
object of affection be carefully avoided.  A
long journey through some pleasant country,
would most  effectually answer this purpose.
All hope of success must  be removed, and a
decent resentment should be raised in its
stead.   In  the mean  time, her condition
should be carefully concealed  from all persons-
mot immediately interested.



            CHAPTER VB

                  GRIEF.

  Excessive grief is seldom the lot of misses.
But the associations which most  effectually
prevent it in maturer years, are to be formed
in infancy and  youth.   If you use every ex- 
24
ertion to raise your  daughter's  expectations
of the pleasures of the world, the  first con-
siderable disappointment will be sufficient to
destroy her health,  peace, and perhaps her
life.
   But if you begin early to teach her, that
earthly things are fleeting.   That " God has
stamped the mark of uncertainty on  all the
comforts of this life, to teach  man that his
true happiness dwells not here, but is risen."
By such lessons properly  inculcated,  her
mind  will be prepared to meet  the loss of a
friend, or any other misfortune, with com-
posure.
  Perhaps you may say this is preaching.—
Call it by what name you please, it is truth,
and therefore deserves your regard.   It im-
plies  the  necessity of Religion, and" of the
prospects which religion brings to view, for
support under the  calamities of life.   Your
daughter is  now  a  blooming maid, but  if
your wishes are accomplished, she will short-
ly be  a wife, and the mothei; of children.—
She must of course, be liable  to  become a
widow, and to be bereft of those children—
Even granting it as a certain thing, that she
shall  live and be blest  to see them grow up
and multiply around  her, yet she must suffer
eonsiderable  apprehension in every instance
©f her pregnancy.  And  if she have  the af- 
25
fection  for her children, necessary to  make
her happy in them, as often as any one  of
them complains, she  anticipates  the  pangs
she would feel on its death.  Add to  these,
the certainty of being at last separated from
the whole at  a  stroke.   How  gloomy  the
prospect! How destructive to her bliss !—
Let her be taught, that in this world we have
but the beginning of our existence.  That
friends must part for a season here, but part
to meet again, where all sorrow shall be done
away.   Then  she will  rationally  enjoy  the
comforts of life.  "Using  the xvorld as  not
abusing it, remembering daily  that the fash-
ions thereof pttss  away.''''   This view  of
things,  and  this  only, can  sustain her  in the
time of distress, and is therefore of the  great-
est importance to her health.
   For grief indulged, spoils  digestion and
destroys the appetite, hence from want of
proper nourishment, the whole system is re-
laxed,  the spirits sink, the circulation  be-
comes irregular,  inducing a train of formida-
ble diseases ; as fainting,  swooning, falling-
sickness, apoplexy, palsy and the whole, train
of hypochondriacal affections,  madness,  and
death.
  Should anv misfortune happen to your
daughter, as the loss of a friend, or a  disap-
pointment in  love, begin  speedily to bring
                      B 
•26
  consolation to her mind.   Place her among
  cheerful, but sober companions.   Levity in-
  stead of lessening, will  but increase her dis-
  tress.  The conversation should turn upon
  important,  yet  interesting  subjects.   Her
  employment should be calculated to keep  up
  attention.   If it be convenient have her  in-
  structed in some art, which will employ her
 skill to the utmost.  Sleep  may be procured
 by the help of the tincture of  opium.  Her
 appetite and strength may be restored by ex-
 ercise, and the medicines proper for strength-
 ening the stomach ; as bark, wine, steel, &c.



            CHAPTER  VII.

                  ANGER.

   Anger  of all the passions, least becomes
 female delicacy.   And  one would  expect,
 the  love of  beauty, so common to the sex,
 would induce them to guard against an emo-
 tion, so unfrierrdly to the symmetry of the hu-
 man countenance.  That fulness and redness
 of the face  and eyes, that foaming of the
 mouth, and unequaled volubility of the tongue,
 that clenching  of  the fists  and stamping  of
 the feet, attendant on excessive anger, may
correspond with the character of a drunken 
mi
 Wily, a waggoner, or sailor, but ne\er with.
 the angelic sweetness, which we  expect to
 meet  in the amiable woman.  " Be angry
 and sin not.  Let not the sun go down upon
 thv wrath," is an express command of God
 by Paul.
   Be  careful often to  represent to  your
 daughter,  the sinfulness of excessive anger.
 Shew her how impolite it is!  How degrading
 to the dignity of a lady !  How destructive to
 her beauty  ! How pernicious to  her  respec-
 tability and happiness.  Prevail with her, at
 all times to reflect when  her anger is about
 to rise and  be silent.   For every indulgence
 In loud scolding and railing against the offen-
 der, will serve to increase  her rage.   To ef-
 fect these things, it will be necessary for you
 to gain her highest respect in time of her in-
 fancy, by setting before her proper examples.
 Parents, and especially you who are a moth-
 er, cannot  possibly be too particular  on this
 point.
   You  ought never to  let your daughter
 know, that you can be excited by any means
 to  indulge this  hateful • passion.  Shew her,
 that no offence can transport you beyond the
 bounds of a descreet woman.   That you con-
sider it more noble to forgive, than to resent
 :m offence.
   Inform her, that in many  instances angei 
28
has brought on the most dangerous diseases,
as  hysterics, convulsion, paleness, tremors,
sickness, puking of bile,  fainting, syncope,
apoplexy and death.
   Aid surely, when she is taught,  that her
beauty, her respectability,  her happiness and
her very life may be destroyed by this indeli-
cate passion,  she will strive to prevent its in-
dulgence from becoming habitual.
  To  succeed the more effectually, if she
should be of  an irrascible constitution,  she
should be put upon a milk and vegetable diet
only.*



            CHAPTER  VIII.

                    FEAR.

  Fear perhaps, has injured the health of the
ladies  more frequently than  any  of the pas-
sions.   It is  indeed  ridiculous  to hear the
screams of a modern fine lady, at the appear-
ance of  a  catterpillar, spider, anv insect or
   * The benefit to be derived from abstinence was
 considered by the Great Author of the Christian re-
 ligion and his disciples.  Temperance in all things is.
 stated as being" essential in forming true happiness- —
, And fasting and prayer were found effectual in keep-
 ing- the body, that is the passions, in proper subjection. 
zv
 other harmless and insignificant object.  Yet
 I believe, if once the  habit of being easily
 affrighted  is  completely  formed,  any such
 trivial object, may prove sufficient to bring
 on hysterics, convulsions, madness and death.
   How  injudiciously ! How unfriendly  do
 mothers act towards their daughters, v hen
 they retail to them stories of ghosts, hobgob-
 lins, and faries ?  of the mighty feats wrought
 of witches in the form of cats ? Their strange
 power to injure their fellow creature,  &c. ! !
 And how dangerous to join in tricks to give
 them alarm !!
   Instead of these things, the greatest care
 should be taken, to moderate and  subdue a
 timorous disposition.  I am  induced  to be-
 lieve, that if children were never told there
 is danger in the  dark,  they  would have  no
 more fear in the night than in the  day.   In
 proof of this opinion, I state  it as a fact, that
 the children of hunters and  others towards
 the west, will turn out into the wild forest at
 any time of the night, fearing nothing.
   The great importance of these precautions
 will furthermore appear, when you  refl cl on
 the peculiar condition of a delicate lady with
 a cowardly imagination, in a state of preg-
 uancy.   The  terrible  apprehensions  which
haunt her day and night have brought about
more  deaths, than  parturition itself.  By
                    B2 
o«
such  continual terror, they  seldom  escape
abortion,  and if they do escape such debility
is induced, as exposes them to actual danger
in childbed, and sometimes to a consumption
xvhich always has debility for its predisposing
cause.
  But the peculiar diseases of ladies of this
description, are not confined  to  the times of
pregnancy.   The very possibility of sickness
and death, is a continual source of the most
destructive terror, so  that through fear1 of
death, they are  all their life-time subject to
bondage.
  Wisdom requires, that we should  adapt
our conduct and our feelings to our condition.
In this consists our chief happiness, and our
capacity for this, is the foundation of our ac-
countability.  To prepare your daughter for
this great work, daily impress on her mind,
the importance of a firm reliance  on the pro-
tection of Providence.   Use  your  utmost
ability, both by precept and example, to en-
gage her in the cultivation of such devout
sentiments and religious practices as are  ne-
cessary, for acquiring and preserving confi-
dence in  God's mercy and favor.  By these
means and by these only, she will be able to
overcome'the fear of death, and gain that
state of composure so important to the ladies.
I once heard a  physician of some note de- 
SI
clare, (himself being very irreligious at the
same time)  * that religion  was an essential
part of a lady's education.'   Their particular
ills,  make particular aid necessary for their
support.
             CHAPTER  13^

                    yor.

   Joy is an emotion,  which  seldom  produ-
ces any ill effects.   In some  instances how-
ever, when great and sudden,  it  produces
fainting  and  swooning.   In a case of this
kind, let the patient be erected in a sitting
posture, then sprinkle cold water, or vinegar
and water in  her face, and apply strong vin-
egar to her nose, and she will- in  most  in-
stances be speedily recovered.  Such an ac-
cident might generally be  prevented, if  the
absent fritnd, or joyful message, be prudent-
ly and gradually introduced.*

  * Friction with the hand or  flesh brush applied to
the naked stomach, would sometimes be found use-
fcl, especially if ordinary means fail.. 
3fi
             «HAPTER X.

                  s.Nvr.

  Envy is a certain painful sensation, felt at
Seeing another's happiness.  This is a base
passiom and never fails to make wretchedly
miserable, every lady over whom it has gain-
ed ascendency.
  " Thou shalt love thy neighbor as thyself.**,
The benevolence taught by this excellent pre-
cept of the gospel, is  the proper preventative
and cure for this hateful emotion.
  If  you will cultivate in yourself a disposer
tion to feel, and of course  to express congrat-
ulation, as often as  you see your neighbor
happy ; your  daughter will readily drink  in
the same  spiric.   But if you indulge  an en-
vious disposition, she will learn with  you,  to
be miserable as often  as any one of  her  ac-
quaintance is h.tppy.
  It is \ our privilege " to rejoice with those
who rejoice."   Possessing a benevolent  dis-
position, you may enjoy the e motion attendant
on any happy event,  although it should not
turn up in your favor  exclusively.   You may
in this sense, partake of all your neighbor's
success.   If this temper of mind were made
universal, what a vast addition would  it bring;
to the present stock of human bliss ! 
•33
             CHAPTER Xh

                  MALICE.

   Malice is defined, 4 a sincere wish for the
injury of a fellow creature.'   ' A thirst for
vengeance.'
   This emotion  is a horrid departure from
humanity.  If you will cultivate a disposition
to forgive  any offence   that may  be offered
you ;  if you will use words and  actions ex-
pressive of pity and compassion, towards ev-
ery one who may injure your person, reputa-
tion, or property  ; such a continued display
of this virtuous affection, will insensibly lead
your daughter into a similar forgiving tem-
per.  All malice,  that  passion  so character-
istic of the devil himself, would of course be.
excluded.


            CHAPTER  XII.

   With these hints  on  the several passions^
as a faithful mother strictly attentive to your
daughter's happiness, you may  pursue the
subject at your leisure,  and collect such fur-
ther information  as  occasion  may require,
and as opportunity may serve.
   By diligent observation,  you may readily
discover whether  any of the  passions have 
'o4
 Become too strong.  Which ever it may be,
 use every exertion until it be properly sub-
 dued. By patient attention and perseverance,
 you will at length enjoy a daughter, who will
 Be at once the delight  of her acquaintance,
 the desire of men of worth, and an honor to
 her family.  Blessed with happiness in  her-
 self, she will assist you in diffusing that ines-
 timable  treasure  aU around  you,  to  your
 great consolation  and unspeakable  joy.   If
 however, in consequence of neglect on your
 part, or of an incorrigible disposition on the
 part of your daughter,  her passions are al-
 ready  become boisterous, bringing upon her
 criminality in the  sight of God and man, ad-
 vise her to betake herself to repentance  and
 prayer.   And  if,  through the rich mercy
 and grace of God, her sins be forgiven,  and
 she be enabled  under  the  influence of the
 spirit of truth,  to  bring her unruly passions
 into subjection, she will have abundant cause
to rejoice in the God of salvation.  I must
 conclude these  observations on the passions,
With a recommendation of the Holy Scrip-
tures,  as the best  guide and source of infor-
 mation, in bringing about that happy disposi-
 tion of soul, which  will secure peace within
 your own breast,  and respectability among
your friends.  In  one word, without an  ex-
perimental knowledge of  the  truths as con 
S£
Gained in that book,  I have  no expectation^
that you will  set before your daughter the
examples necessary to give you  the  weight
and influence with your family, which are ne-
cessary for its successful instruction and hap-
py government.   Jf your  daughter hrough
your  neglect  or  want of  moral excellence,
should be cursed with vicious disposition and
habits, remember you will answer for it »$
the bar of God in the  great day*
            CHAPTER  XIII.

        TEMPERANCE IN  EATING, &C.

   A  certain delicacy of person, is thoughf
desirable by most women of fashion.  They
cannot bear the complexion of health because
marked with grossnt-$s.  To secure this del-
icate  appearance, they are in  the habit o£
starving their daughters, or compelling them
to use such food as doe6 not afford sufficient
nourishment.
   This is cruel and ridiculous conduct.  It is
truel to deprive your child of the  greatest
earthly blessing, by conforming to a ridicu-
lous  opinion.   As if  a  pale sickly  counte-
nance, is more beautiful than  the bloom ©f
health.  The grand  object I  suppose is to 
3G
Imarry her respectably.  Now what man  of
common sense, would not more  cheerfully
connect himself with a healthful constitution,
than enlist a nurse  for  life ? Which  is the
more rational choice ? A lady who has ability
to take charge of a family, and assist  in the
management of an estate, or a valetudinarian,
for the preservation of whose life, it would
be necessary to expend an estate  in the pay-
ment of nurses and doctors fees ?  Let com-
mon sense direct your conduct in this matter.
Give your daughter enough  of  wholesome
food.
   But while you avoid one extreme, do not
fall into another.  Too full meals are always
injurious.  A plain simple manner of  living
is most safe and salutary.   It will seldom
happen that any decent person will  eat too
much of one dish.  The desserts introduced
for the second or third course of a feast, gen-
erally do the mischief.   If  therefore, this
kind of parade be important to support the
dignity of your  table,  take  the  necessary
pains to prevent your daughter from injuring
her health by loading her stomach with such
a dangerous composition.  It is far best for
health,  and would soon become most agrea-
ble,  to make each meal of one dish only.—
This kind of simplicity is  unfashionable  I 
3?
acknowledge, but I must confine myself to
truth whatever be the fate of fashion.
   Dr. Buchan in his essay on  this  subject
introduces the following quotation.   ' For
my part,' says Addison,  * when I behold a
fashionable table, set out in  all its magnifi-
cence, I fancy I see gouts, and  dropsies, fe-
vers and lethargies,  with other  innumerable
distempers, lying in ambuscade among  the
dishes."

            CHAPTER  XIV.;
   Having given you some directions, for se-
curing to your daughter a  sound mind in  a
sound body,  so far as  it can be. effected by
management,  &c.  I now proceed,  to con-
sider the diseases to which  she may some-
times be  subject from accident,  from consti-
tutional defect, and the like, notwithstanding
all your care.  But that the instruction may
be clear and distinct as possible,  I must con*
aider each one in a separate chapter.



            CHAPTER  XV.

                 MENSES.
   There  is a  certain periodical  evacuation
which takes place  with all healthy females be-
                    C 
38
ginning when they arrive at twelve or fifteen
years of age, and continuing on  till they arc
forty-five or fifty.  This I shall call the men-
ses.   Perhaps this cannot properly be called
a disease, as it is universal to the sex and as
there cannot be health without it.  You should
begin in due time, to instruct your daughter
in the conduct and management of  herself
at this critical time of life.   A few lessons
seasonably  given may  prevent  much mis-
chief.
   But  little attention is necessary,  to know
when this discharge is about to' commence.
There are particular symptoms which go be-
fore  it and  foretel its approach ; as a sense
of heat and weight,  with a dull pain in  the
loins, a swelling and  hardness of the breasts,
headache, less of appetite, uncommon weak-
ness  of the  limbs, paleness of' the  counte-
nance, and sometimes a slight degree of fe-
ver.    Whenever  these  symptoms   appear
about the age  at  which the menstrual flux
usually begins to flow, every thing that might
obstruct it,  must be  carefully  avoided,  and
such  means should be used  as tend to bring
it forward.
   She should sit over the steams  of warm
water, bathing her feet at the same time in a
vessel filled with the same, and so deep as to
reach up to her knees. And she should drink 
                     39

,  freely of warm diluting liquors, such aq weak
  flax-seed tea, mallows or  balm teas.  The
  most proper time for these things, is the eve-
  ning, so that she may cover herself up warm-
  ly in bed after  the  bathing, and afterwards
  continue the drinks until bed time.
    Some precautions,  however, are necessa-
  ry before the symptoms which  usher in this
  discharge present themselves.  For if she be
  closely confined about this time, and be not
  engaged in  som - active employment,  which
  may give proper exercise to her whole body,
  she will become  weak, relaxed,  and sickly ;
  her countenance will be pale and sallow, her
  spirits will /mk,  her vigor decline,  and she
  becomes p. valetudinarian for the remainder
  of her lifi,-.
   It is afifcn the case  that the daughters of
  the fasl/ion-j'jle and wealthy, who according
  to custom r tave been much indulged, entirely
  give them' iclves up to indolence at this critical
 time,  anr t bring upon  themselves such irreg-
 ularity a s renders them miserable for life.
  ; *Ve  seldom  meet  with  complaints from
eold :ip  it is cemmonly called, among  active
indu >i rious  girls, while  on the contrary, the
mdol ent aad, slothful are  seldom freed  from
their j.
.   I\  sprightly disposition,  and  an  habitual
ch/ erfuln <> ^, ought  to be cultivated with all 
                    40
 possible attention, not only as conducive to
 prevent obstructions,  but as the best defence
 against vapours and hysterics.   *      ♦
   The cheerfulness however  which  I here
 recommend, is not mere mirth and laughter.
 It  is  a calm and  uniform serenity,  which
 prepares a rational being thankfully and hear-
 tily to enjoy the real comforts of life.   It is a
 peculiar spring which  gives to the mind as
 much activity when in retirement or in the
 midst of daily engagements, as when in a ball
 room.
   Towards this time,  every thing which has
 a tendency to impair digestion, and derange
 the regular  motions of the system,  ought to
 be avoided ; such as,  eating largely of trash,
 tight clothes, loss of sleep, and excessive ex-  ;
 ercise.   To this  last we may  generally affix
 dancing.  Change of clothes, without proper
 regard being had to their degree of warmth,
 is frequently productive of mischief.   Occa-
 sional exposure of the skin to cool air, if con-
 tinued for a short time only, seldom docs in-
jury.  But a great change in the clothes from
 warm to cool,  is frequently very pernicious.
 Changes of this  kind  ought to be brcught
 a^out in a  gradual manner.   I have known
 serious effects from too long exposure of the
 feet to wet and cold.   Country girb frequent-
 ly wade through the water, walk  barefoot in, 
41
 the dew of the  morning, and sit without
 doors for hours together in the evening, &c.
 Either of these acts may do irreparable dam-
 age, whether about the time of the first flow-
 ing of the menses, or at any time  of its r *
 turn.
   Indeed such exposure,  as at another time
 might  produce no ill effects, may at  this
 juncture be followed by irretrievable damage
 to her health.



            CHAPTER XVI.

         DETENTION OF THE MENSES,

   After all your care it will sometimes  hap-
 pen, that the menses  will not  begin to flew
 at that period of life when they usually make
.their appearance.   Should this be the case,
 and in consequence  of their  retention  her
^health and spirits  begin  to decline, by no
 means be persuaded  to confine her to  her
 room, nor expect to restore her by  heat and
 medicine only.  Instead of confinement, car-
 ry her abroad into agreeable company., turn
 her attention to some interesting employment,
 let her eat plentifully of wholesome food, and
 promote its digestion by  taking regularly a
 sufficient portion of exercise; and in most in- 
42
stances nature will do her own work, without
any other assistance than that recommended
at chap. XV.
  Having pursued this plan a sufficient length
of time without success, you will be at liber-
ty to have recourse to  medicines, and with
this intention you  may  observe  the advice
under the head of obstructed menses, chap.
XIX.  Sometimes  the  retention is the con-
sequence of an imperforated hymen.   When
this is the case, it may be felt with the finger,
and  must be pierced with a proper  instru-
ment.   For this  purpose a surgeon  should
be employed.


           CHAPTER  XVII.

DIFFICULTY OF MENSTRUATION V/lTH PAIN, iSfC;

  W7hen the monthly complaint comes on too
slowly, attended with pain, the menstruation,
may be said to be difficult.   In this case the
patient commonly is subject to a coldness of
the extremities,  particularly of the feet, and
to  great general weakness.  The cause  of
this complaint is nearly the same as that of an
entire  obstruction,  and  will therefore yield
to the same treatment.   Which see in the
following chapter.   But when the  painful 
4J
 symptoms come on, bathe her lower extrem-
 ities in warm water of about  blood heat, to
 be continued half an hour, just before going
 to bed.   On lying down, give from twenty-
 five to fifty drops of the tincture of opium.—
 Repeat this plan  every  night  till  the pains
 abate.  Afterwards in the intervals, between
 the times *>f the discharge, pursue one of the
 plans advised in the following chapter,  regu-
 lating your choice according to the prevailing
. symptoms of her case.


             CHAPTER XVIII.

             OBSTRUCTED MENSES.

    If by alternate exposure to heat  and cold,
 or by any other accidental means, the menses
 cease to flow,  they are said to be obstructed.
    There are  different appearances in  this
 disease, according to the state of the general
 system.  I shall  mark three  variations for
 the sake of distinction.
    The first is generally brought on by some
 kind of exposure or accident.   In this case,
 there will be  a sensible fullness or increased
 motion of the blood,  producing a swimming
 and dull heavy pain of  the head, which are
 increased on stooping down, a redness,' a 
  fullness, with a sense of weight  across the
  eyes,  an  aversion to motion,  an  unusual
  sense of weakness and heaviness  of ail the
  limbs, and sometimes a bleeding at the nose,
  &c.
    Where these, or most of these symptoms
  occur,
    1st. Let blood from  the foot ten or twelve
  ounces, to be repeated as occasion may re-
  quire.
   2d.  Bathe her feet half an hour on going
 to bed.
   3d. Then give a  portion  of calomel  and
 aloes three grains of each.  Syrrup of some
 kind may be added so as to form it into a pill
 or two, or so much as to  make it of the con-
 sistence of honey.   Continue the bath and
 calomel and aloes, for three successive nights.
   If the disorder came on suddenly, and es-
 pecially if she was a healthy girl, before the
 attack,  you may use  the lancet  the more
 freely.
   There is no  danger from the use of calo-
 mel.  The only necessary  precautions  are,
 to avoid improper exposure  to cold and wet
 and abstain from large  draughts of  cold wa-
ter.   And these would  be equally necessary
jt no calomel were used.   At the  next pe-
riod  proceed a second time through the same
course,  viz. bleed,  bathe, and give calomel 
43
and  aloes for three successive nights, and if
there be not something more amiss than what
you  call a common cold, she will probably be
relieved.  It might not be  amiss however to
repeat it a third time if necessary.


            CHAPTER  XIX.
     OBSTRUCTION OF MENSES CONTINUED*
  The second  variation of this complaint is
not  in general so suddenly  induced as the
former, and for the most part seizes upon
the indolent.  The symptoms are, great pale-
ness or rather yellowness and bloating of the
face,  difficulty  or shortness of breathing,
loathing of food, indigestion, disposition to
eat chalk  or marie, great  weakness, quick
and weak pulse, swelling of the feet and an-
kles, and in some instances a bloating of the
whole bodv.  Sometimes these symptoms at-
tend a retention of the  menses.  In either
case observe the following plan.
   1. A dose of  calomel at night.   Say six
grains.  Afterwards repeat smaller doses, as
three or four grains, two or three times, let-
ting  a few days intervene between each dose.
  2. Bitters  of camomile  and  orange  peel
steeped in boiling water, may be used a few
days, gradually increasing their strength.
                   C  2 
46
   3. Then take  rust  of iron prepared, ont
ounce ; gum myrrh  one  ounce ;*  nutmegs
No. 2.  or  cinnamon  half an ounce.-  The
whole to be  finely powdered, carefully mixed,
and kept in a close vessel.   If rust of iron
cannot be had,  the salt of steel will answer,
using half the quantity.  Of this preparation,
if made  with the rust of iron,  six or eight
grains may be taken from four to  six times a
day.   If prepared with the salt of steel, four
to six  grains will be the dose.  The portion
of either ought to be varied according to cir-
cumstances.   It  excites  a little sickness  of
the stomach.  But if a puking or  too violent
sickness be excited, the dose may be lessened.
On the other hand, if  no considerable effects
are observed, it may be enlarged."}*
  4. Regular exercise.   As  friction with a
flesh brush or flannel,  riding  in a carriage or
on horse-back, &c.
   5. Rhubarb five grains united with opium
half a  grain, given every night  when great
costiveness does not forbid their use.
   6. Flesh  diet  with wine and water, when
no fever exists.
  * If the gum myrrh be offensive rt may be omitted,,
regulating- the dose accordingly.
  ■f Advantage is sometimes gained from enlarging
the dose of iron to  five ^r six times the quantity here.
stated.                                 - 
47
  7. And  when  she  begins  to  regain her
strength and colour, at every  appearance  of
the pains which usher in the menstrual evac-
uation use  the aid advised in chapter XVII.
            CHAPTER XX.

    OBSTRUCTION OF  MENSES CONTINUED.

  A third distinction is a mixed state of the
disease.   It is the consequence of debility in-
duced by a complaint of some kind which
goes before it.   The discharge gradually les-
sens in quantity ; becomes irregular,  and at
length disappears.   It is a common mistake
in cases  of  this kind, that all  the existing
complaints  are the effects of the deficiency
or absence of the  menses.   But the reverse
of this is true.   The obstruction is merely a
symptom.   In all these  mixed cases, there
is difficulty in making the proper distinctions,
and therefore if convenient, it will be best to
employ some  physician  of  approved judg-
ment.  If .however she decline in a gradual
manner ; is subject  to dejection of spirits ;
to a want of appetite; to flashings of heat
over the skin ; to a small cough ; to occa-
sional flushings of one or both cheeks ;  and
.fco a smarting or burning sensation in the ex- 
18
 ternal. parts of generation, &c.   You might
 be safe in introducing the  following  plan of
 treatment.
   1.  Draw a blister on  the region of  the
 stomach or  between  the  shoulders, and re-
 peat it after some days.
   2.  In the  mean time let her drink freely
 of warm camomile t?a, made pretty strongs
 beginning early in the morning  while yet in
 bed, and continuing it the greater part of the
 day.
   S. Having  continued  the  camomile  a
 week or two, give bitters made of orange
 peel steeped in boiling water.
   4.  Friction with flesh  brush  or flannel,
with other moderate exercise as soon as she
 is able ; as riding on horseback,  or in a car-
riage, he.
   5. As she strengthens, add to the bitters a
portion of the peruvian bark.
   6. And finally the preparation of iron with
wine and water as recommended in chap.
 XIX.
   It may be observed however, that if iron
in any case produces  the headache attended
with a sense of heat,  and pain in  the breast
or side, it must be omitted.   In that case it
will probably become indispensably necessary
to use the calomel in this case  also, as advised
in the preceding chapter. 
  1. When her strength  is  recovered  and
ihe  symptoms indicating the approach of the
menses present themselves, proceed as advis-
ed at chap.  XVII.
  8. Where there is smarting in the external
parts of  generation, bathe frequently with
warm milk and water,  and anoint with fresh
butter or sweet oil.   If by.these or any other
means her health is  restored, her menses will
return as a thing of course.
           CHAPTER  XXI

           IMMODERATE MENSES.

   When the  menses  continue too long or
come on too often for the strength of the pa-
tient, they are said to  be immoderate.  This
most frequently  happens to women of a soft
delicate habit ;  to such as use tea and coffee
too freely,  and who do not  take sufficient ex-
ercise.  It is sometimes brought on by ex-
cessive fatigue, and this may happen to tem-
perate  and industrious women.   In either
case, its approach may be known by a pain
in the loins and  hips.  Observe this symp-
tom Carefully and on  its first appearance let
a little blood from the arm, and it will gene-
rally prevent the  attack for that time.  But 
5#
for the entire removal of it, observe the fol-
lowing directions.
   1. So soon  as it is  known that this com-
plaint is formed, it will be proper to bleed a
little from the arm.  There are but few in-
stances  in which .this might not be proper, in
greater  or lesser quantities.
   2. If excessive ■ labour brought on the dis-
ease, rest comes in as  an essential remedy.
   3. Cool air is highly proper.   This may
be  applied by placing  the patient in such a
situation, that a current from  a door or win-
dow may blow upon her.
   4. Cloths weted in cold vinegar and water
maybe applied all over the groins, &c. to be
changed as they become warm.
   5. Cold flour in a large  quantity  applied
immediately to the  parts has sometimes suc-
ceeded in dangerous cases.
   6. Cool drinks, as the  decoction of netde
roots or of the greater comfry, &c,
   7. If all these fail, repeat the bleeding.
   8. Where  too strong  a motion of the ar-
teries can be ascertained as the cause,  it may
generally  be  entirely  removed  by  gentie
bleeding and  purging  occasionally repeated.
   9. If much weakness,  paleness, and a dis-
position to bloat attend, give  half a grain of
opium every  six hours, and  at intervals of
three and  four hours, give twelve or fifteen 
51
grains of an equal mixture of allum and gum
kino.
   10. Nauseate the stomach with small do-
ses, from one to five  grains of ipecacuanha.
   11. Apply blisters to the wrists and ankles
alternately.
   12. In  all delicate cases, after the remo-
val of the disease for the time being, have
recourse to the  cold bath, exercise, friction
with a flesh brush  or flannel, &c.  till her
health is confirmed.
           CHAPTER  XXII.

         FLOUR ALBUS, OR  WHITES.

  When a discharge of whitish matter flows
instead  of the menses,  it  is called the flour
albus, or whites.   If it be of long standing,
it sometimes assumes a  greenish  or yellow
complexion, becomes acrid, sharp, and cor-
roding,  and is highly offensive to  the smell.
When it  happens to young women, it is in
most cases a local disease.  I mean by this,
that it is  seldom brought on by any general
effection of the system, but is chiefly confined
to the parts  which are its seat.   Indeed it is
sometimes the case, that the menses are dis»
charged entirely iu this way- 
   For the  cure, give her  iron  as in chap*..
 XIX. but in most cases the gum  myrrh may
 be left out of the composition.  A decoction
 of pine buds, or the roots of pine, or what is
 better, turpentine in its soft state mixed with
 an equal quantity of honey.  Of this mixture
 a teaspoonful may be taken three times a day.
 Or for those who can procure it, balsam ca-
 psevi, twenty drops, in a  little  new milk,
 three times a day.   Frequently cleanse  the
 parts with  milk  and water. Sometimes an
 injection, made of sixty grains of white vitriol
 dissolved in  a  pint  of spring or  rain water,
 and thrown  into the  passage by the help of a
 syringe,  three or four times a day, is a most
 effectual  remedy.
   And lastly, if  ulcers attend, give two or
 three grains of calomel every third night, and
 touch the ulcers with a liuie blue mercurial
 ointment, or with an ointment of white or
 red percipitate of mercury.
   Here it might  be well to observe, that a
 disease in some decree similar to flour albus*
 or more commonly of a mixed kind, between
 this and immoderate menses, is  sometimes
 the effect of  a polypus, or excrescence from
 the inner surface of the womb.  If therefore'
 the discharge should continue after using the
proper remedies,  a  polypus ought to be sus- 
                    vo

pected, and a  physician or surgeon should
be called in to your aid.
           CHAPTER XXIII.

                HYSTERICS.

   Missess are sometimes subject to hysteric
 ;ffections, about the time of their first men-
sturation.  This  is, an  unfortunate circum-
stance whenever it occurs, inasmuch as such
will be liable to similar complaints for many
years afterwards.   A  complete cure of this
disease is seldom obtained, but there is some
ground to hope for a recovery if the proper
remedies be employed on the first attack, or
before it is too deeply rooted  in the  system.
This  truly distressing complaint, puts on a
great variety of shapes.   It is called a'proteus
of diseases, imitating almost every disorder,
to which the human body is  subject.    But I
shall confine myself to the description of those
symptoms which are most remarkable. The
principal and discriminating marks,  are  the
three following.
   1.  A peculiar kind  of suffocation.  This
generally begins with a perception of a globe
or ball rolling round,  seemingly among  the
bowels,  and rising up to the stomach and 
 throat,  and there inducing strangling.   This
 generally excites  great alarm, with the most
 excruciating fear of immediate death.   Con-
 sequently it will be attended with great pale-
 ness, and a profuse discharge of limpid urine..
   2.  An unusual gurgling of the bowels, as
 if some  litde animal were there in actual mo-
 tion,  with  wandering   pains,  constituting
 eholic of a peculiar kind.
   3. Frequent  efforts to vomit  without any
 evacuation.  This is sometimes mistaken for
 a symptom of an iaflamatory aff.ction of the
 stomach, and other intestines.   In  this case
 there is always a great weakness of the  stom.
 ach  ; a  considerable degree  of  indigestion,
 and  anxiety ; and  sometimes a  difficulty of
 breathing, with alternate flashings of heat and
 chilly sensations,  over different parts of the
 body.   To these particular distinctions may
 be  added alternate laughing and weeping,
 without any known or adequate cause,  faint-
 ings, convulsions,  and palpitation or flutter-
 ing of the heart.  Hysterical convulsions may
be distinguished  from those of epilipsy, or
common convulsions, by the great fear of
dying, which is peculiar to  hysterics.
  For the  cure observe the  following plan.
  1. On the first attack,  if  it be the co&se.\j
quence of difficult  or  obstructed menstrua-
tion, let  blood freely from the foot,  and this 
1  the more certainly,  if she  was strong and
'  healthy before the attack.
!    2. If the sense of suffocation be violent,
*  apply strong vinegar or spirits  of hartshorn
■  to her  nose.  Bathe her feet in warm water,
;  apply pretty severe friction  to  the  region of
8  her stomach, with  a flesh  brush or flannel.
[  And in some instances a glyster of  very cold
  water,  affords instant relief.
:    3. After the fit goes off,  have recourse to
  the instructions given in chaps. XVI, XVII,
;:  XVIII, Sec.   For if the difficulty or obstruc-
  tion of the menses be the cause of the com-
:  plaint,  let the cause  be removed and the ef-
  fect will follow.
    4. But if she were delicate and feeble be-
■  fore the attack, use the vinegar, or spirits of
<  hartshorn, and warm bath to the feet, &c. as
  above, according to circumstances ; but be
I  aautious  about letting blood.
     5. For the  radical cure  in this  last  case,
  apply  a  blister  to  the stomach, use friction
  nearly  all over the  skin.  Give  strong ca-
•  momile tea to drink.  Wine, bark  and steel,
'  as  at  chap.  XIX.   Riding on horseback,
  cheerful  company,  and interesting engage-
  ments, each in their place may be  proper.
     6. And in many instances, I have  found
  great  benefit from  the  use of  the  following
  pills, via.  Take assafetida half an ounce, 
56\
Russian castor quarter  of an ounce, opium
quarter of an  ounce.   Carefully beat  and
thoroughly mix them together, and of the
whole,  make two hundred pills of equal size
as nearly as may be.   Of these,  two or  three
may be given at night, and one or two in the.
morning.
   7. Where the patient is subject to a costive
habit,  I have found  advantage from the fol-
lowing composition.   Aloes one ounce, assa-
fetida half an ounce,  Russian castor-quarter
of an ounce.   The  whole  to make  two hui>
dred pills and taken as  before, increasing or
lessening the number, according to the state1
of the  bowels.
   8. The vitriolic  ether,  given from thirty
to fifty drops in a cup of some kind of drink,
sometimes affords  instant relief, when the
suffocation is considerable and distressing.—
This article  must be  given speedily, to pre-
vent its loss by evaporation, and must not be
opened too near to a candle, because of its
great readiness to take fire. 
            CHAPTER  XXIV.

1         CESSATION OF  THE MENSES.*
t
is   All women are alarmed  at the  time of the
 final cessation of the menses,  believing that
>some ill consequences may  follow.   The
:truth is, that scarce one of a  great number
tof women, suffer more than temporary incon-
venience on that account.  It  must  be ac-
knowledged however,  that if there be a dis-
position to disease  in the constitution, and
(especially in the womb, it will  proceed more
 rapidly when the menses cease, by being de-
li prived of that local discharge by which they
;wet*e before relieved.  Many remedies have
been advised to prevent, and correct the mis-
chief, expected  or  suppo3ed to exist.   But
the present mode of practice is, to bleed oc-
casionally and give gentle cooling purges, as
manna,  cream of tartar or common purging
salts, &c.  avoiding all kinds of medicines and
diet which are heating.
   This  practice is both rational and success-
ful.   I have  found it a good way, to lessen
  * Although it may seem a little irregular, to treat
of the cessation of the menses, a disease of advanced
life, in that part of the work designed for misses on-
ly, yet as it is under the head of menses, it must he
admitted on the whole as regulars 
58
the quantity of blood to be taken, in a gradual,
manner, so as to  imitate as nearly as possi-
ble, the most regular  cessation in the natural
way.
END OF THE FIRST PART; 
-J-I'U-".........■......■!■■■«!      I        ____________Ml

      $att  ikronu.
Addressed to the Nexvly Married Lady.
            CHAPTER  I.

             introduction.

  Ma»au,
    YOU have happily allied yourself to the
man for whom you leave your father's house,
for whom you cheerfully forsake all the world
besides.  With him, as your protector and
bosom friend, you promise  yourself many
endearing pleasures.  You  perceive that
" Innocence, candor, sincerity, modesty, gen-
erosity, heroism and piety,  express them-
selves with grace ineffable  in  every attitude,
in every feature of the man you love."* Yqu
are therefore highly concerned how you may
secure an equal  share, and a permanent con-
tinuance of his affection and esteem.  On
• St. Pierre. 
6d
this  point  turns  your future  happiness or
misery.  Mutual love and  tenderness pro-
perly preserved, secures to you the greatest
earthly blessing.  In proportion to the. want
or loss of these,  vou are miserable for life.—
Although this consideration very much con-
cerns your husband as well as yourself,  yet I
must be permitted to assure  you, that yotf
are  most deeply interested.   His  engage*1
ments as a  man, will  necessarily  keep up*
his attention.   He  will have  frequent occa-
sion  to  mix with agreeable and interesting'
company.  His acquaintance  will be exten-
ded,  his amusements multiplied.  He of
course will have an asylum, should home be-
come tiresome  or  disagreeable.  But  your
house is your only refuge,  your husbantfi
your only companion.  Should he abandon'
you, solitude,  anxiety  and tears,  must be
your unhappy  lot.   You cannot fly for
amusement to the race ground, to the chase,
to the card  table,  or to the  tavern.   You
cannot look out for a gallant,  to whom you"
may  impart your slighted love.  You must5
eitker languish in bitterness, or learn to com-
pose your feelings, by stoical indifference. 
6f
             CHAPTER II.

PROPER CONDUCT OF THE  WIFE TOWARDS HER
                 HUSBAND.

   1.  As it is your great wish and interest,
to enjoy much of your husband's  company
and conversation,  it will be  important to ac-
quaint yourself with his temper,  his inclina-
tion,  and his manner, that  you may render
your house,  your person and your disposi-
tion quite agreeable to him.  By observing
with accuracy, and guarding your words and
actions with prudence, you may quickly suc-
ceed according to your  wishes.
   2.  Here perhaps you  ask, why so jnuch
pains necessary on my part ?  I  will answer
your  question candidly.  Your  choice  in
forming the connexion,  was at best a passive
one.   Could  you have  acted the  part of a
courtier and  made choice of a man whose
disposition might have corresponded precise-
ly with yours, there would  have been less
to do afterwards.  But under present cir-
cumstances,  it is your interest to adapt your-
self to your husband,  whatever  may  be his
peculiarities^  Again, nature has made man
the stronger, the consent of mankind has
given him superiority over his wife, his in-
clination is, to claim his natural and acquired 
62
rights.   He of course  expects from you a
degree of condescension, and he feels himself
the  more confident of  the propriety  of hia
elaim, when he is informed, that St. Paul
adds his authority  to  its support.   " WiveB |
submit yourselves  unto  your own husbands,
as unto the  Lord, for the husband is the head
of his wife."
   3. In obedience  then to this precept of the
gospel,  to the laws of custom and of nature^
you ought to cultivate a cheerful and happy
submission.   " The way of virtue is the way
of  happiness."   The truth  of  this maxim
will be verified  to  you in your  conformity to
this duty.   By such submission, you will se-
cure to  yourself the  advantages of  a willing
obedience on the part of your husband to the
counter part of Paul's command, " Husbands
love your wives as your own flesh," &c*
   4. The  great attention  and submission!
practised by most men in  time of courtship,
are  well calculated ro  raise in  the female

  * There are some women, who pluming themselves
upon their great spirit, spurn at this  instruction, and
claim the right of " superior equality" with  their hus«
bands.  In most instances they pay very  dearly fof
their arrogance.   If they secure a  degrading obe.
dieire. the) necessarily loose that tender and enga*
g\\% fondness  and attention, which every condescend-
ing w'fr is  sure to receive from  the man of goorf
stense, taste and refinements. 
G3
  mind,  false expectation of an uniform  con-
t  tinuance of the same officiousness after mar-
;  ria;<;.   For the honey moon you may not be
;  disappointed.  But the charge of a family will
•  soon teach any man, that  he  has something
,  more to do than live a life  of courtship.  The
.  discharge  of his duty as  a father,  a friend,
  and a citizen,  will gradually  divert him in
  some degree  from that punctilious attention
  to your person, with which you are so highly
  pleased.
    5.  Should  you  begin  to discover this
  change, be careful to conduct yourself with
  discretion.  By no means upbraid him,  nor
  suffer  jealousy to take possession* of your
  breast.  If you once  admit this  passion, it
  may terminate in your ruin.   It will  lead
  you to  consider every  seeming inattention, as
  a proof of his want  of affection.   You will
  conclude,  he is tired of his toy and is looking
  out for another. This thought once admitted,
..>> will  have  an infatuating influence  over your
*^mind.   Not only your actions will  express
  your suspicion, but  you  will unguardedly
  speak it out, perhaps  in terms of reproach.-—
  Your  good husband, stabbed to the  very
  heart,  mav possibly with  eyes full of tears
  clasp you  "in  his  arms and assure you of his
  lovr. "  But all will be vain, jealousy once ad.
  TOitted  contaminates  the  soul.   He  wiH 
64
 scarcely turn his back, before the old impres-
 sion will revive.                      v.
   His tears and entreaties will be considered
 as evidence of his gu'dt, and you will wretch-
 edly settle upon this conclusion.   " lam dis-
 agreeable,  he is gone to carress tkf ha/rpij
fair one xvhose company is preferred."
   6.  As you regard your own bliss, speedily
 check all thoughts  of' this kind, as soon as
 they arise in your mind.   If indulged, they
 will have a baneful effect upon  your temper,
 and spread a gloom over your countenance,
 so as to strip  you  of every charm.  Your
 husband repelled  from time to  time,  will at
 length .become  indifferent,  and  leaving you
 to languish in your distress, he will seek for
 amusement  where it  may  be found.   And
 thus you  will bring upon yourself the very
 evil, against which you  would make your
 mistaken defence.
   7.  If you have  already  proved the truth
 of these reflections by sad experience, I knova
 you are ready  to  excuse  yourself, because)!
 the whole proceeded from the  most sincere
 affection.   But you  should  consider that the
 anxiety and distress which are so often de-
 picted in your countenance, might with equal
 propriety, lead your companion to doubt  the
 sincerity of your love.   And for any thing
 you kno.v to th;; contrary, a suspicion of this 
t>5
  kind is at the bottom of the  whole mischief.
  Do not act like stubborn children, rejecting
  that happiness  which is entirely in your own
  power.
    8. If he do  not come in, the very hour or
  day that you expect him, instead of accusing
  him with neglect, be the considerate woman,
  and take into view the various and unavoida-
  ble delays.with which he must meet in trans-
  acting his  business.  And be assured,  for I
  speak  from experience,  that in many instan-
  ces he sacrifices his most sincere wishes to be
  with you,  for  what he considers necessary
  for the present.  He is bound to provide for
  you and your children.   In easy circumstan-
  ces  there is mos: satisfaction,  and he feels a
  strong  desire  to  secure this foundation  for
  your future happiness.  Receive him then,
  with gladness as often as he comes in, shew
  him that you are happy in his company, and
  let the preparations  made  for his reception*
  nrove  to him,  that  he  holds a considerable
*^hare in your  thoughts  and affections when
  he is absent.   Such conduct will endear you
  to his  heart, and secure to you all the atten-
  tion and regard you so ardently desire.
    9. Do not  suppose,  that my plan implies
  that the husband has nothing  to do.  So  far
  from this he is bound " To love and cherish
  im wife, as his own  flesh."  But I repeat it,
                     D 9 
66
 this obligation seems in a great degree,  t»
 rest on the condition of a loving and cheerful
 submission on the part of the wife.   Here
 again perhaps you  object  and say, " W7hy
 not the husband, first shew a little condescen-
 sion as  well as  the  wife ?"  I answer for
 these plain reasons.  It is not his disposi-
 tion ; it is not the  custom but with the hen-
 pecked  ; it is not his duty ;  it is not implied
"in the marriage contract ; it  is not required
 by law  or gospel.
   10.  I presume you  are  not one of those
 ladies who indulge a mean  opinion of  their
 companions,   and  are  indeed ashamed  of
 them.   This  can happen in  no case where
 there is not a want of  information and judg-
 ments  if you stooped in marrying him, do
not indulge  the thought, that you  added to
his respectability.   Never  tell  him " you
lifted him out of the ashes."   For  it  will be
hard for you  to extricate yourself from this
difficulty.  " If yoi> stooped of necessity, bc-l
cause you could get  no one else,  the  obliged
tion is on your own side.  If you stooped of
choice,  who  ought  to  be blamed but your-
self?  Besides it  will  be well  to remembefl|
that  when you became  his wife,  he became
your htad, and your  supposed superiority
was buried in that voluntary act. 
6?
            CHAPTER  III.
WIFE OUGHT NOT TO APPEAR IN THE HUSBAND^   '
                 BUSINESS.

   There are women in the world, who arro-
gate to themselves, superior skill in the man-
agement of an estate, suppose they have great
judgment in the value of property, and there-
fore wrest every thing  Out  of the  hands of
their husbands, and convert  the poor  men
into perfect cyphers.  I hold the disposition
and conduct  of such women  in great con-
tempt,  and I pity the poor inoffensive crea-
ture of a man, who  can submit to be so de-
graded.  Tet  it must be acknOxvledged,  that
xvhere the man falls into the hands of a terma-
gant, he mav find it necessary  to  purchase
peace on any terms.
   Men and women  appear to best advantage
each  in their  own  proper station.   Had it
b-:n my lot, to have taken one of those man-
like ladies, wh never there  happened to  be
Company at my h hipc,  I  should have made
it  my  business, to  brush the floor, rub the
furniture,  wash the :ea.equip ige,  scold  ie
maids,  talk" about the kichen and dairy, &c.
and apologize  as I procedeed, by giving ca-
rnation, that I had made an exchange of pro-
vinces with my good wife, by way of mutual
accommodation. 
68
   Such conduct would  at  least shew, how
aukwardlj  a man appears in  acting the part
of a woman,  and of course would lead a wo-
man of common sense to conclude, that she
could not appear to much better advantage,
when engaged in the capacity of a man.
   If it were  to  save  appearances only, the
husband ought at least to seem to be the head.
And therefore if vou are determined to rule
him,  adopt the following plan.  **• When any
article of property is to  be bought  or  sold,
take him aside, teach him the  price to be^
given or received, point out the V'nd of pay-
mert,  the time when to  be  paid, &c. &c.  let
the whole business be'properly adjusted, and,
then let the poor fellow go forward and seem
to act like a man."   It is  shocking to every
man of sense, to see a woman interfere pub-
licl\,  fly into a passion, ?nd declare points
blank the thing shall not be.  Indeed if she
had the true spirit of a woman, she would
blush  to a-knowledge herself the wife of such
a  dastardly  man as would submit  t$ #ucb
treatment.
./¥ 
69
             CHAPTER  IV.

■iHZ ..?:;- WAT OF HAPPINESS IN THE MARRIE6
                  STATE.

  The great point for securing happiness in
the married state, is,  to be mutually accom-
modating.  The parties should look over one
another's faults, and  contemplate one anoth-
er's excellencies.  Nothing  else will  do—
We all have  our defects, and it is much bet-
ter to dwell on y jur own faults, than on those
of your husband.  For by so doing,  you
gradually correct yourself,  to your own ad-
vantage.   But if  you  pry  deeply into his
faults, you may make discoveries, which v, ill
serve only to lessen your  esteem, and of
course to detract from your happiness.
  " A certain man bought a farm, and after
a year or two, in conversation with his neigh-
bour, he  made heavy complaints how much
he had been disappointed.   Did you not see
this  land (says  his  neighbour)  before  you
bought it i Oh yes, I saw it often.   Do you
not understand soils?  I thiuk I do tolerably.
'Did^younot examine it with care ?  Not so
much as  I should have done.   Standing at a
certain place, it looked admirably, the fences
were new  and looked exceedingly neat, the
Iiquvj had been just  painted a stone colour 
y#
with panneling,  the windows were large and
elegant ; but  I  neglected entirely, to exam.
ine the sufficiency of the  materials, or the
disposition of the  apartments.   There were
in the  month of April, two beautiful springs,
but since I have lived here, they have been
diy every year before die middle of June.—
Did you not enquire of those who lived on
the place of  the permanence of the spripgs j
No indeeo I omitted it.   Had  you the full
measure you were  promised ?  Yes every
acre,   W*s  the right complete and valid i
Yes, yt s, perfectly good, no man in Ameri'
ca can teke it from me.   Were you obliged
to teke it up in part of a bad debt ?   No, no*
thing like it.   I  took such a fancy for it all aj
once, that, 1 pestered the man from v\ etk  to
Week  to let  me have it.  Why really then,
says his neighbour,  I think you had better
keep your complaints to yourself.   Cursing
and fretfulness  will  never turn stone  into
earth,  or sand into loam ; but I can  assure
you, that frugality, industry, and  good cul>
ture, will make  a bad farm very  tolerable,
and an indiff* rert one truly good."*
   The  application is  easy, and you may oc-
casionally read this story of the  land purcha-
ser to your husband ;  and  if  you  will set
* Withersnoc©. 
n
1 wisely ^ you will consider on either side, th<&
 you are bound to be companions for life.
    How foolish it is to indulge in disputation
' and petty quarrels! Whoever may have been
\ in fault, do not wait one for the other to shew
 marks of contrition.  Let it rather be the em-
\ ulation between you,  who shall  have the
1 credit of making the first advances towards a
*■ reconciliation.   After having slept in sepa-
 rate beds, and like two foolish  children, re-
' fused to speak for a  week or two, or more,
* you  must  at length  make peace.   Better
1 then,  to do  it immediately.  It ha3  been a
i rule with me for some years, that as often as
l! tiny little jar may happen in my  family, not a
1 single night shall pass without a restoration
" of peace.
^    Do you  so  too, and some  eight or tea
1 years hence, you will thank me for the hint.
&    Should you  be at a loss how to introduce
 the negotiation of the peace, you might just
s say to each other, " let us remember die fol-
'■  ly of Doctor Witherspoon's land purchaser.'*


,, ,.x,          CHAPTER V.

       CNE WORD  IN FAVOUR  OF ECONOMY.
    Strict  adherence to  the  conduct recom-
 mended in ths former chapters, is highly im- 
7"2
portant.   But I must inform you, that good
economy  and judicious house-wifery must
also be added,  or  your happiness can by no
means be complete.   It  affords a  dismal
prospect to a  man who wishes to make a
living, to find  a double and tripple quantity
of every article of family consumption ne-
cessary,  to meet  his  wife's regulations and
management.
   Although  happiness is not made up of
weakh, yet a certain ease of circumstances
contributes very much towards it.  Hence it
is,  that "through all  the  lower or middle
ranks of life, there is generally a good meas-
ure  of  matrimonial or domestic  comfor^
where their circumstances  are easy, or their
estate growing.  Not  only  from their being
freed from one of  the  most usual causes of
peevishness and discontent, but also, became.
the affairs of a family  are  very  seldom in a
thriving  state, unless both contribute their
share of diligence  ; so that they have not on-
ly a common happiness to share, but a joint
merit in procuring their estate."   Men may
talk in raptures, and  women may be puffed
up with vain conceit, of youth, beauty, wit,
sprightliness, and  a hundred other shining
qualities ! " but after  seven years cohabita-
tion, not one of them  is to be compared, to
;jpod family management, whiyh is seen at 
73
 every meal, and felt every hour in the hus-
 band's purse.*
    But as something more may be said of the
: duties of  wives and husbands when I come
 to treat  of the management of  children,  I
* shall proceed to consider some of the diseas-
 es,  to which you may be subject in conse-
 quence of marriage.
              CHAPTER VI.

           SIGNS OF CONCEPTION, iSTC.
;.                                  '         '
     On  various accounts it is considered ne»
t  cessary for married ladies  to know' when
  conception takes place.   This  point is not
  easily  ascertained.   Yet by proper observa-
  tion most women may  obtain  a  knowledge
  of it, sufficient to  answer every necessary
i  purpose.   Many changes take place through
I  the course of pregnancy ; these  I  will state
}  with the degree of certainty to be ascribed to
i  them.
}     The breasts are  commonly more or less
i  affected.   They are in some degree  enlarged,
  and at the same time shooting pains are  felt
  in them.   As this enlargement advances the
* Witherspoom 
M
 dark coloured ring which surrounds the nijp>
 pie sometimes puts on a deeper hue.   -*.»
    Some  unusual sensations will also be" felt
 about the region of the womb.   But neither
 of these marks are to be considered infallible
 and  necessary, because  there  are .frequent
 instances in which they do not occur at all.
    Another appearance is the  rising of the
 navel.   The  little cavity which this makes
 gradually  fills up, so  as to"t)ecome an even
i surface.  This is a pretty  common and al-
'most certain mark of pregnancy.
    The stomach is affected with great sick-
 ness which is followed with  vomiting and
 heartburn,  loss of appetite and indigestion*
 IThis is a very general symptom.
 1   The bowels do not escape the effects of
 this grand revolution.  A considerable changf'
 from the  usual  condition  commonly takes
 place.  Those who have been habitually cos-
 tive, will  be  troubled with a looseness, and
 those subject  to diarrhea, will mostly be-
 came costive.   But as these changes do alio
 attend the times of menstruation they are not
 certain evidences of a stale of pregnancv.
    A feverish disposition attended widi weaV
 ness and loss of fl sh frequently aff  cts those
 Women who were before in pretty good hc;u.h.
 But this is by no means universal, because 
7S
 there are some who  fatten an 1 become more
 Khilthy than at other times.
    I.i some  instances an universal fretfulnesS
 and impatience take place.   If these tempers
 are not  indulged in health, and befall you
 merely as symptoms of pregnancy your hus-
■ band and friends will  meet them with com-
 passion.  Resentment would indeed be cruel
1 and unpardonable.
    The head seldom escapes complaint, it is
> ©ommonly so affected as to produce pain, gid-
 diness, dimness of sight, sleepiness,  and in
  some instances,  though rarely,  convulsion
  and palsy.
    Sometimes a strange fluttering at the heart
  is felt which gives needless alarm as it implies
' no danger.
i    An entire suppression of the  menses, at-
i  tends almost every case of pregnancy.*  But
:  as suppressions may be brought on by other
  •auses this  cannot be an infallible mark.
    Difficult  and even  painful  evacuations of
  the urine must not be omitted, because they
:  frequently take place.
    A peculiar  loathing of animal  food, and
.  particularly of some favorite -4ish is one very
:.  common symptom.
    Some new  passion  sometimes springs up.
•I have myself known exceptions. 
^6
This, whenever it happens, is a very certain
mark.   Doctor Rush  in his  lectures at the
University of Pennsylvania gives an instance
of one lady who feels a strange inclination to
theft every time of her pregnancy.
   At some time  of gestation  the child will
move itself so strongly as to be felt  by  its
mother.   The first perception of this motion,
is called the quickening.   Most women sup-
pose that this circumstance takes  place at a
certain and invariable  stage of pregnancy.-*-
But in fact it varies from the end of the tenth
to the twenty-fifth week.  The most common
time however is  about  the  sixteenth.  At
this time a few drops of blood pretty generally
appear,  without injury.
   With the delicate in the first time of their
pregnancy the quickening  frequently excites
considerable  agitation with fainting and hys-
terics. For the fainting see part I. chap. IX.
            CHAPTER  VII.

THE PAINS ATTENDANT ON PREGNANCY PERHAPS
                NECESSARY.

  Although the  symptoms  attendant on a
state of pregnancy vary in different  women,
and although the  same woman  is seldom af* 
                   rr

fected the same way with her different chil-
dren, yet in almost every  instance the case
will be troublesome and distressing.  But as
the God of nature does nothing in vain, these
distresses seem to be directed to an intended
valuable end.   For it  is a fact  that such of
the ladies as are most subject to them do not
often miscarry, and  in the end  fare better
than those who escape.  This consideration
may afford you some consolation, when you
meet with the  common lot of your sex.   I
shall however distinctly re-consider the pain-
ful symptoms of gestation, and make known
to  you the  conduct  proper to  be' pursued,
 and the remedies to be employed when they
occur.
           CHAPTER  VIII.

           EXERCISE, DIET, &C.

  It is a common opinion, that breeding wo-
men ought to live indolently and feast luxu-
riously as they are able, lest by e:;er -ise they
should injure, or by abstinence debilitate the
expected  child.   The conduct to which ibis
opinion leads may happen to be proper.  But
it is possiHe it should be extremely wrong.—
Those ladies  who  are accustomed to idle- 
rs
ness and who of course cannot take any con-P
siderable degree of  exercise without  great1'
consequent soreness or even fever, ought by'1
no means to indulge  in riding on  horseback,
running or  romping, in any stage of preg-
nancy.  Such too if of a full habit and feveivJ
ish, ought not to take full meals nor too rich
diet.   It is worthy  of  remark, that,  those
who enjoy all the advantages of fortune, and
who on this account  are envied by the  com-
mon  people, are  more  subject to  miscar-
riages and all the  painful symptoms of ges-
tation, than those who are under the necessi-
ty of labouring  hard  fcr a living.   The poor
man's house  is  filled with  healthy children,
while  the  rich  with difficulty  raises up an
helpless heir, on whom  to confer his estate
and his diseases. The female slave is healthy
and prolific,  while the mistress is sickly and
barren.  Women of a full habit, when preg-
nant, ought  to  let blood at proper intervals.
Some say  particularly about the  third and
seventh month.  It must be improper to fix
upon any particular  month for the purpose.1
But as  often as pain and  swimming of the
head,  giddiness and dimness of sight,  rams
in the loins and hips, with  a sense of fulness
of blood occur, six  or eight ouncs or more
should be drawn from the arm.   In the mean
time she should avoid wine and spiritcus li* 
79
: «[Uor3 of every kind, rich sauces and  flesh
! diet.   Nature herself  seems to favour this
' intention, by  bringing  about a  loathing of
i food, and a due degree of abstinence  will
! frequently prevent the necessity of blood-let-
! ting.   Those  who happen to be in a low state
! of  health, and  much emaciated about the
 time of conception, may  find it necessary to
: take all the  nourishment they can well  bear,
 and at the same  time to use friction of the
 flesh brush  or flannel,  with moderate exer-
 cise, for  the  improvement of their  appetite
 and strength.   Those who have been subject
 to obstructed  or immoderate menses, attend-
 ed  with paleness,  debility,  and  a disposition
 to bloat, may use wine, bark, steel, &c. with
 4s much exercise as can be taken without fa-
 tigue.   I met with a case in the year 1800,
  Mrs. F. W. who had  six times  miscarried
  irom debility, and never had borne a living
  cYdd.   On application to me, I advised bark,
 sleel, exercise,  &c.  the next pregnancy  was
 nearly successful.  The same plan was con-
 tinued, and the eighth  time of her gestation,
 die  bore a  fine girl, and her health was re-
 stored.
   The  happier class of women, who  are in
 tie habit of daily labour and continued exer-
 cise, may continue their engagements as ber
 rn-c, except only, that it ma" be necessary to 
80
abate from their common fatigue, in a gradual
manner,  as  they advance  in  pregnancy.-^
They should abstain from those things which
are disagreeable, and eat moderately of such
as are still pleasant ;  and in  most instances
little else will be wantirg.  If however, any
of the  symptoms threatening danger should
present themselves, a little blood should be
drawn  from the arm, and repeated  as oftea
as necessary.
            CHAPTER IX.

  SICKNESS OF THE STOMACH AND VOMITING1.

  Great sickness of the stomach and vomit'
ing are very common complaints in the earh
parts  of pregnancy.  In some instances thj
vomiting continues through the whole course
of gestation, and in  others disappears after
some  weeks, but to  return again towards Its
close.
  If the vomiting should happen only in thj
early part of the day and is not too violen,
although an inconvenience it w;H  seldom be
injurious.   Indeed  it will  generally prevent
the  necessity  of employing a puke.   But
when the vomiting is violent in a case where
there  is full habit of body, it  is often nece* 
51
sary to let blood  from eight to  ten  Ounces
from the arm.  After the  bleeding, and in
casce, where through  the weakness of the pa-
tient no blood can be spared, the vomiting
may be  removed by some of the following
remedies.                                 /
   1. Magnesia two  teaspoonfulo in a cup of
peppermint tea, to be repeated every one,
two or three hours.
   2. Salt of tartar 20 grains, lime juice or
good vinegar half an ounce, spring water one
and a half ounces, common syrrup a spoon-
ful : to be speedily  mixed together and ta-
ken while in a state of evervescence.  It may-
be repeated once in three or four hours if ne-
cessary.
   3. Or elixer vitrol, fifteen or twenty  drops
in a little water,  or  weak  spirit and  water
made  pleasant with sugar,  to  be  repeated
several time3 in the day.
   4. Or an infusion of columbo or camomile
with orange peel in  boiling wa.er.  The co-
lumbo '13 thought most effectual.  It may be
so managed, as  to take from ten to twenty
grains, for* every two or three hours if neces-
sary.
   5.  Or where  the vomiting is  excessive,
opium from  half a gram to a grain, to  be re-
v.. &, 
82
 peated every  one or two hours till the coot*
 plaint abates.*
   6. Or in many instances a cloth folded so
 as to be four inches square, and moistened
 with the tincture of opium,  and applied ex-
 ternally  to the region of the stomach, gives
 great relief.
   7. Where  there  is great and distressing
 efforts to vomit,  without any evacuation, it
 will be proper to make use of small doses of
 ipecacuanha,  from ten to twenty grains ac-
 cording to circumstances, and to be  repeated
 as often as it may be found necessary.  There
 is no kind of danger in administering a gentle
 puke to a pregnant woman.
   8. A  change  of posture, whether from
 lying down  to  sitting  up,  or the contrary,
 ought to  be brought about  in a very gradual
 manner.  Simple as this direction  may ap-
 pear, it  will be  attended  with considerable
 benefit.
  9.  Some  find  relief  from the sickness of
 the  stomach  by chewine  fresh. barH well
 made, water                          ying
 much of thei                           air ;
riding out on a peasant gaited horse, or in a
carriage ; eating at such times,  and so often
  * Where there is fever, opium is improper without
some previous evacuation.  In most cases  blood-let-
 %g" should he premise^ 
m
as t© avoid an empty stomach,  whether day
or night:   And for this purpose some have
used gingerbread with advantage.
            CHAPTER  X;

               HEART'BURN.

   Breeding women are also frequently sub*
ject to a painful sense of heat in the throat,
with belching of a hot and sour liquid, which
is very distressing.  This affection  is com-
monly called heart burn.  If the  complaint
be violent, nothing perhaps  is  better than a
small dose of ipecacuanha, so as to procure a
motion or two.  After  the puke use the fol-
lowing preparation.
   Magnesia a d spirits of sal ammoniac, or
spirits of heartshorn, of each the eighth  of
an ounce ; cinnamon water, or a  strong in-
fusion  of cinnamon, three  eighths of  an
ounce ;  pure spring water five ounces.   Of
this, twn or three table snoonfuts to the dose,
                           distressing.   If
                          the consequence
ot a loss ot aigestive  power, the strength of
the stomach must be restored  by the use of
some  bitter infusion, as orange  peel, cama-
mile, columbo, bark, &c.  Some preparation 
                    84

 of steel, with exercise,  might  also  be en**
 ployed.

             CHAPTER XI.

               COSTlVENESSm

   Great costiveness  frequently  attends the
 advanced stages of pregnancy,  and in  many
 instances passes unnoticed without any con-
 siderable  injury.  Where it is found neces«
 sary, the bowels may be kept gently open by
 the help of a little manna, magnesia, senna,
 castoroil, the purging salts, or Lee's pills.—
 But any of the other articles may be prefered
 before the pills,  if they can be  conveniently
 obtained.
   There is one species of this complaint, oc-
 casioned by a collection of hardened feces in
 the lower part of the intestines.   This some-
 times  requires  the  use  of an  instrument,
 somewhat in the form of a scoop, to break the
clod.  When broken, it may be washed  away
with repeated glysters.


           CHAPTER  XII.
               TOOTH-ACHE.
  Tooth-ache is a very distressing symptom,
and may be removed  by applying small blis- 
8J
iei'3  behind the ears, or repeated doses of
opium,  or  finally  by having  the defective
tooth drawn out.   If however, it be the con-
sequence of fever, blood-letting may be ne-
cessary.  And if it  should take place at the
same time with a sicknesss of the stomach, a
puke will most likely afford relief.
           CHAPTER  XIII.

                  PILES.

  Most fleshy women, and more commonly
those who lead sedentary lives, are subject to
the distressing  complaint called the piles.—-
Such too as are much troubled with costive-
ness, seldom escape this disorder.  By what-
ever means the  disposition  to  the piles is
formed, it generally is more troublesome in
the last months of pregnancy, than at other
times.   If the attack be of the more mode-
rate  kind, a gentle dose of cream of tartar
and  flowers of sulphur combined, will afford
considerable relief.   Cold applications of any
kind, as of cloth wetted  in  cold  water,  or
spirit and water,  would answer the purpose.
Also the following ointment.  Take the yolk
of one  egg, tincture of opium or  laudanum
three tea spoonfuls, neatsfoot or other oil one 
8o
table spoonful, to  be mixed and  applied—
Let the tincture and the yolk of the egg be,
first  mixed together,  and afterwards the qij
may be added.   This ointment gives  relief
when much disposed to itch.  If they pro-
trude outwards,   press  them between the
thumb and finger and at the same time anoint
and put  them  up carefully.  ' Those subject
to this complaint ought to lie down upon their
backs for  a few minutes after every stool. I
have known this  precaution to do much to-
wards preventing their return when once re-
moved.   I am  told an ointment made of the
oak ball,  powdered and stewed in hogs lard,
is a valuable remedy, and there is no reason
to doubt its efficacy.*
           CHAPTER  XIV.

                DIARRHEA.

  This complaint is sometimes very trouble-
some and injurious to pregnant women.  If
attended with fever,  let blood  from the arm
from six to ten or fifteen ounces according to
  * Take one inch of a tallow  candle, round its cor-
ners and smear it well on all  sides  with mercurial
ointment.  Put this up the rectum on going to be^
und let it remain till morning. 
8f
 the strength of the patient.   Should there b~
 much sickness at the stomach, a puke is ad-
 visable.   For this purpose,  take from ten to
 twenty or thirty grains of ipecacuanha. * Af-
 ter the bleeding,  or puke, or both when ne-
 cessary, it may be advantageous to use a por-
 tion of rhubarb and calomel.   Rhubarb,  fif-
 teen or twenty grains ; calomel, from three
 to five grains.  This, last is necessary, where
 there is irregularity in  the secretion of  the
 bile.
   When  the  necessary evacuations  are pro-
 cured, take  gum opium, twelve grains ; pow-
 dered rhubarb, forty-eight grains ;  ipecacu-
 anha, twelve grains ; syrrup, as  much as is
 sufficient  to  make  them  into pills.   The
 whole to form twenty-four pills, one of which
 may be given every six or eight hours.   In
 the mean time, the starch glyster  with tinc-
 ture of opium, or a glyster made with boiled
 flour, or of mutton broth with the same tinc-
 ture,  may be thrown up every three or four
 hours if necessary.  Sometimes blistering the
 wrists and ankles is found beneficial after the
 feveriih  sypmtoms are  subdued.   Bathing
the feet frequently in hot water,  might a: e
be tried. 
                   88

           CHAPTER  XV.

               STRANGURY.

  A frequent  inclination to void the urine,
Which is discharged in small quantities with
painful sensations at every evacuatioh.   ThU
complaint is calhd  Strangury.   The  long
retention of the  urine so often practised by
the ladies from delicacy,  frequently brings it
on.  But the pressure of the enlarged womb
upon the bladder, is the cause of it in the
last months of pregnancy.   If there be fever,
let blood from the arm.   Give frequent glys-
ters of warm milk and water.  Manna half
an ounce, and sweet oil one ounce, may be
given as a gentle purge.   Frequent  doses of
purified salt petre may be taken in  mallow!
tea.  Or spirits of  nitre forty drops, may he
taken in a  drink of  barley  water, every two
hours.   Two  grains of opium may  some-
times be taken,  and warm wet  cloths  may
be applied to the belly and  groins, to  be re-
newed as often as they begin to grow cool.
   I fa total suppression takes place, send for
a physician who can introduce an instrument
 for the purpose  of  drawing off the water.*
 It may not be amiss to add here, that some-
 times an incontinence of urine attends in the

      * This instrument is called a Catheter.    - I 
89
latter stages of pregnancy.   For relief in this
case, use occasionally, gentle purges,  avoid
sudden exertion, and  spend  more  of  your
time in bed.   But whenever  this complaint
occurs it is one  very sure indication that the-
child is rightly presented for the birth.
            CHAPTER  XVI.

               FLUOR  ALBUS.

   For a  description and the cure  of this
complaint see  chapter XXIII.  part  I.   It
seldom does  any injury, and is  commonly
followed by an  easy  delivery.   Where  it
becomes very profuse, and where  it violently
attacks those subject to miscarriage, recourse
may be had to  the proper remedies, and es-
pecially to the injection agreeable to the above
reference.   If attended  with  heat and fever,
moderate  blood-letting  and  gentle   purges
should be occasionally repeated.


            CHAPTER XVII.
     VARICOUS SWELLINGS OF  THE LEGS,
   Sometimes a strange distention of the viens
•f the legs takes place in the  last months  ot, 
9©
gestation.  To those who may  never havei,
seen such a case,  it might give considerably
alarm ; but it is not followed by  any inwne-;
diate danger; a disagreeable numbness comrj
monly attends it, and the distorted veins el-l
evate the skin, producing great unevenness.i
The proper remedies here are small frequent
felood-letting and gentle purging.
           CHAPTER XVIII,

                  CRAMP

   Is another  complaint which occurs chiefly
during  the last months.  For the cure keep
the bowels gently open.  If  it attend a  full
habit, bleed.  If it should come on  in the
night, jump  out of the bed and stand upon
the feet  till it goes off.   Sometimes to grasp
a cane or bed post or a roll of  sulphur  in the
band, affords relief.
            CHAPTER XIX.

      INQUIETUDE OR WANT OF SLEEP.

   A peculiar kind of restlessness sometimes
takes  place, which is attended with pain i% 
. Ahe region of the womb.  This pain is most
Revere at night, and resembles labour pains.
'"It frequently prevails  against a strong incli-
ts nation to sleep.   When in this situation the
Patient frequently feels the want of cool air.
jj"But after all her perplexity she will find her-
self refreshed by the morning.
    For the cure m  this case also, small bleed-
  ngs and gentle laxatives.  Or take  a drink
  rf cold water on lying down.   Also one end
  )f a wetted towel  might be  wrapped round
  3ne hand, and the other end be  let  to hang
  Dut of the bed.   This last is a simple and
  feasant remedy.
m                        •

etc i
t.             CHAPTER  XX.
art'
               FEAR OF DEATH. '
ur
fflt A distressing fear of the event of parturi-
  ion, sometimes takes possession of pregnant
  vomen,  as the dreaded time approaches.—
  Such should  be taught reliance on the pro-
  ection of Providence.  If however this dread
  ye  attended   with increased  heat, a white
t.  tcurf on the tongue,  quick pulse,  and espe-
  ;ially if  there be  a fixed  pain in the belly,
Bdihere is certainly a fever present, which ought
;.«'  no mean6  to be neglected.  It requiref 
92
blood-letting, and frequently a repetition <g
it with gentle purges.  Thirty or forty diifl
of the spirits of nitre may then be given u
some kind of drink.   Every kind of exerciie
must for  the time be avoided, and a light
diet only should  be  taken.   If these thinp
should be neglected through inattention, or
want of the necessary means, the dread of
death may be realized, and then her friends
may condemn themselves in vain,  for havii|
treated a serious  complaint with levity.  ■
             CHAPTER  XXI.

         DROPSICAL SWELLINGS, Ifc.

   Dropsical swellings of the  lower extremi'
ties often occur, and sometimes extend up to
the sides of the lower belly.  In some inst^
ces, the external parts of generation  are dis-
tended  to such a degree as to be very  painful,
and to make it difficult for the patent .to  waft.
This swelling peculiar to a state of pregflfc
cy, has been sometimes mistaken for conv
mon dropsy, and  has led to  the use of im-
proper medicines, and even to the operatioi
of tapping, bringing about the death of moth-
er and child, to the disgrace of  the  science
*f medicine.  In this case also, small bleed- 
9S
 rhgs and gentle purges, repeated as occasion
JmaV require, are the most safe and  proper
* remedies.

            CHAPTER XXII.
        DISTEN7I0N  OF THE ABDOMEN.

(.   The belly  is sometimes so  stretched as te>
,l crack the skin, afterwards forming scars oi
. a peculiar kind.   For ease and safety in such
 a case,  let the skin be anointed  with mutton
 suet beat up with a strong decoction of red
 1 roses.  When the. swelling  hangs  so low, as
 to be troublesome and painful, relief may be
 had by passing a broad bandage under it, to
 be supported by a soft  and  springy strap oi
 some kind, passed over the shoulders.   This
 aid would be particularly advantageous, to
^ such as  are  under the  necessity of walking
c; about.   Sometimes a rupture of the navel is
' the consequence of this  great distention  ; but
f this will be readily removed after the birth ol
L  the child, by the aid of simple pressure cnlv.
            CHAPTER  XXIIL
                  MOLES, ifC.
<    By whatever cause the womb is suflicientb
i  distended, all the symptoms attending prcg- 
•94
nancy in its natural  state,  may be excited>-
This distention is sometimes the consequence
of dropsy of a particular kind,  as  of small
vessicles of water hung together in the fortt
of clusters ;  sometimes it follows imperfect
conception,  in which  case  a  monster or
shapeless  mass is produced ;  and sometimes
it is the consequence  of moles  so  called,—
These are nothing more than a collection of
the thicker parts of the blood,  and happtt
sometimes to women subject to immoderate
menses ;  but  chiefly take place after a mi»
carriage.  The monsters have their cake and
cord, but moles have neither.
           CHAPTER XXIV.

                 ABORTION.

  The instructions given chap. VIII. part
II. are particularly intended to guard against
abortion.   In addition  to those remarks, I
must here add, that this event is but seldom
the effect of any  kind of moderate exertion.
And, although it may have been ascribed to
a great variety of accidents, yet in most cases,
it is the consequence of some disease of the
mother or child.   It will therefore be pru-
dent,  in all cases where there is a repethw 
§5
of miscarriage, to obtain  the advice of some
judicious physician.   For if any particular
disease or constitutional defect on the part of
the parent be the cause, all common attempts
for her relief will probably fail.
  The symptoms which indicate the approach
of this misfortune are various.  " But there
is generally pain in the back,  belly and infe-
rior extremities, that is, the thighs, legs, &c."
with a sense  of weight and weakness  in the
region of the  womb,  frequent inclination to
void the  urine, with a continual painful urging
to go to  stool.   But the most certain sign of
an abortion,  is a discharge of blood,  and this
is the most dangerous and alarming appear-
ance.  Various methods have been adopted
for moderating and staying it, see chap. XXI.
part I.
   But perhaps the most  effectual of  any is
the applisation of a cloth wetted with vinegar
and water, which should  be applied over the
parts,  and so firmly pressed with the hand,
as instantly to retard,  or  stop the stream of
blood.   Where  there are  irregular pains
without  much fever, small doses of opium
frequently  repeated, may be of service.  If
fever be  present, then instead of the opium,
small doses of ipecacuanha would be prefer-
able.   When violent floodings take place in
the advanced stages of pregnancy, so that it 
96
   may be difficult to determine,  whether the
   case is an abortion or premature labour, it has
   been advised to proceed immediately  to de-
   liver the  woman.   But it  scarcely ever is
   necessary to afford assistance by hand.  If
   however it  should seem not safe, to depend
   on the usual remedies,  it might be proper to
   break the membranes,  and discharge the wa-
   ters.  But  even  this  should be attempted
   with the greatest caution.   For says Doctor
   Denman, " In abortions, dreadful and  alarm.
   ing as they are sometimes, it Is" great comfort
   to know, that they are almost universally void
   of danger either from  the hemorrage, or on
   any other  account."    A  case  may occur
   however, where it becomes necessary  to de-
   liver the woman by art, in  order to save her
   from perishing by mere loss of blood.  When
   this is suspected procure the aid of  the most
   skillful physician  or midwife,   See part III.
   chap. XXI.  XXII, &c. &c.
     $^r~* To prevent miscarriage  and  at the
   same time to secure an easy and safe delive-
   ry,  every pregnant lady  who can bear it, ii
,   hereby most earnestly requested, to makei
   very frequent use of laxative medicines thro*
   the  whole course, and particularly througk
   the  last months of pregnancy.—Castor oil-
   manna—sweet oil—decoction of elder roots. 
97
or the like—any of these will  answer, but
perhaps the oils ought to be preferred in al*
most evety ca&.
EN& OJ THE BEGOND PAJtT< 
-g«°w^—nt—iiiimiiiim—i— w n ■—guy

       $att   dittb*


        Hints for the Midwife.
              CHAPTER  J,

               introduction.

   WHEN it is granted that there are some
 Women skilled in the art of Midwifery, the
 known liberality of the ladies will  indulge
 me  in a declaration that most of those whe
 make pretensions to  this important profe**
 sion are exceedingly ignorant  and self-cc%
 ceited.   A  great proportion of  them have
 been introduced into the practice  by being
 caught as they commonly call  it, with some
^one  or more women.  Their known igno-
 rance forbade them to be officious, and nature
 unassisted, or rather uninterrupted, perform-
 ed her own  office properly.   The  success in
 each case unjustly attributed to the attending
 woman, encouraging  others to employ her,
 she is presendy considered  a deep proficient 
99
ih the art.   Her vanity keeps an equal pace
with the fame of her skill, and in a little time
she affects considerable  knowledge of  most
diseases,  is dubbed a mighty doctress, and
not unfrequently  has the address to impose
her  fanciful prescriptions upon a whole ex-
tensive neighborhood.
   I have  no wish that all such should be for-
saken  by  no means ;  expediency and their
popularity forbid.   But it is right to demand
of them a submission to their  own proper
station, for as often as they exceed their due
bounds they do violence to the laws of God
and the cause of humanitv.   Within the lim-
its of a certain sphere, they might be useful
and respectable.   If they would extend their
usefulness, let them first learn how little
knowledge they possess, that they may exert
themselves in making more extensive attain-
ments.*
   There  is no doubt that all wish their ser-
vices  to be  beneficial or that  many are re-
luctantly drawn inro the practice.  But how-
ever good or humane their intention, instan-
ces of irretmv ible  mischief huvr occurred
  • I have no intention of calling- in question the ca
pucitv of the ladies for understanding this or anr oth-
er aft cr  science. It is mv candid opinion that, fe
male genius with equal cultivation would excel  that
«f the makts. 
10©
 from their  ignorance and ill-timed officious*
' ness.  To the candid and humane,  the foh
 lowing hints will therefore be acceptable.. ,
             CHAPTER  II.

          NECESSARY DEFINITIONS.

   A3 I shall be under the necessity of using
 names of parts not commonly  understood,1!
 shall state them with  their definitions  as far
 as necessary for my present design.
   I. The abdomen, is the name given to the
 belly.  It is the soft covering of the bowels
 extending from  the breast clown  to the fol»
 tawing bone, which is called,
   2. The pubis,  this bone stands  forward^
• forming an arch between the hips and is call*
 ed by some the  bearing bone.   It has a p*
 culiar kind  of joint  in  the  middle, which
 sometimes opens in cases of difficult labeling
 and when this happens  it is  commonly folr
 lowed by a collection of matter, distressing
 to the last degree,  very  difficult to cure and
 sometimes fatal to the patient.
   3. The Sacrum  is that part  of  the bones
 which is fixed-between the  hips backwards,
 and  is opposite to the pubis.   The  sacrum
 extends itself downwards and forwards form* 
101
1 ing a curve and makes it necessary to regu-
1 late the passage of the child in a correspond-
 ing direction.
   4. The large passage or cavity made  by
 these two bones together with the othr bones
 of the hips is called the pelvis.  If this cavity
 is much less than common, or out of shape,
 so as to prevent the passage of the child, the
 pelvis is said  to be distorted.  This distor-
; tion may be effected several ways.  The com-
 mon distance between the sactum and pubis
 is rather more than four inches ; but it is
 sometimes found to bo no more than one.—
 The lower part of  the sacrum which ! ends
> forwards and inwards forming  a curve  as
 above,  in young women  admits  of  a little
 motion backwards so as to make the passage
; of the  child more easy.   But in some instan-
; ces, especially in those women  who do  not
 marry till  they  become  old maids, it  is  so
; strong as not to admit of any motion at all.—
 In addition to this it sometimes  benas so far
 inwards as very much to obstruct the pas-
 sage.
    5. The mons veneris, is the fatty substance
 which  covers the pubis  and  extends down-
 wards and  sideways towards the two groins.
    6. The Labia, the two thick soft pieces of
 skin which pass on either side, still  down-
 wards frond the mons veneris,
                    f 8 
102
       7» The pudendum, external parts of gen«j
     ration, of  these the  labia are the principal
     parts.
?      8. The perinaeum, the part which begins
     at the lower angle of the labia and extendi
     backwards to the anus or fundament.  This
     part is subject to be torn in child-bearing.
       9. The  vaginai  the passage from the pu-
     dendum  to the womb.
       10. The uterus the name of the womb.
       11. At  the upper end of the vagina is an
     opening into the womb called the os uteri of
     mouth of the womb.
       12. The placenta, the afterbirth, called also
     the-  cake, and with the membranes including
     the  child waters, &c.  is sometimes called th«
     aecundi/ies*
       13. The umbilical cord, the navel string*
       14. The foetus,  the child  while in  the
     Womb.  To  these names I will add  in this
     place the five following  terms  expressive of
     certain changes which take place in the act of
     child-bearing.*
     .-—»-----—.----------------   i______________________i
      *I am informed that some of my fair readers area
     good deal exasperated with me for exposing "female
     vieainess."  I am extremely sorry for their want of
     information and judgment  Is not such knowledge u
     I ha>-e made public necessary for female safety? Cer-
     tainly it is.  How then in the name of common sense
     couid.it ever be made sufficiently known without sue*
     exposure, if they will have it by thgt.nafie ?Str  >.' 
lm
   IS.  Parturition, the act of bringing forth
a child.  It is another name for labour.
   16.  Dilatation, the act of  stretching and
opening at the same  time.  This is applied
to the  os uteri and to the pudendum.
   IV.  Distension, the act of stretching  of
making more open;
   18.  Expell, the act of turning out j this is
performed  by the uterus when it contracts^
which  it endeavors to do by certain periodi-
cal exertions called pains*
   19.  Presentation,  the act of presenting.—•
This term is applied to  the position of the
child,  and particularly to the part of the child
which  is  first sensible to the touch, at the
mouth of the womb,  when labour is coming
on.


             CHAPTER ill.

   XAT'URAL POSITION, PRESENTATION, &*C.

   It was  formerly believed that the child id
the natural position in the uterus was sitting
with its faqs towards the abdomen, and that
towards the time oi parturition, by the weight

indeed thatfemale delicacy should demand a sacrifice
of thousands of the best ot women, and tens of thou-
sands of tender innocents, to keep it in countenance. 1
Truth is umnctbte and time wiuucfold its powati 
104
of its head, it revolved  itself and turned its
head downward, ready  to  pass through the
pelvis.  This change  was called presenting I
to the birth.  But more accurate observation! I
have proved this  opinion to  be false.   No
such revolution  is  necessary.  And unles|
some circumstance has  occurred  to change
the position of the child, it is always prope*
for the presentation   If therefore the presen-
tation be a n. tural one,   the head is dowr*
ward resting  upon the pubis.  One side of
the  head is  towards the abdomen  and the
pther towards the sacrum, or in s me degree
obhqu 1 varying from  this position.   The
bulk of the  body is commonly on the right
6ide and $he  limbs  are  turned towards the
left.

             CHAPTER  IV.
        DEFINITION OF LABOUR, &C.

  The common time  for complete gestajiioi
Is forty weeks, at the  expiration of  whidj,
the process of labour  commences.       "l
  This process is not the effect of any partic-
ular exe tion of the child.  Nor of any-uni-
ted efforts of the  mother and child.   But it
is a  peculiar power of the worn!) itself, by
which at the ti ne appointed by the  God «
Mature*  it endeavours  to expel its contents* 
loS
   Labours are either  natural, difficult pr&
teruatural or complex.
   1.  Every labour should be called natural
if the head of the child present \ if the labour
be compleated within twenty-four hours, and
if no artificial aid be required.
   2.  If the  labour  be  prolonged beyond
twentv-four hours, it may be called difficult*
   3.  If any  other part except the head pre-
sent,  the labour may be said to be preternat-
ural.
   4.  All other  cases  requiring aidj may be
■said to be complex.
             CHAPTER  V.

       SYMPTOMS OF PRESENT LABOUR.

  The  first symptom of present labour is
anxiety, arising from a dread  of danger or
doubt of safety.  This  anxiety will  be in-
creased, if the patient should have heard of
accidents or deaths in any late similar case*
It is the duty of the  midwife  to  soothe  and
comfort her when in this situation, by suita-
ble  language,  and a diligent  and proper at-
tention  to every complaint.  But in the mean
time, she should by no means be persuaded
to offer  assistance before it is necessary. 
tm
   2.  At the commencement of labour, we-
men commonly have one or more chills,  or
fits of shivering,  with or without a sense of
cold.   But  should there be one strong and
distinct chill or shivering fit, it may be a dan.
gerous symptom.
   3.  There will be some difficulty in voiding
the urine.   It should therefore be evacuated
frequendy,  otherwise  it may ultimately be-
come necessary  to introduce a catheter.
   4,  There  will  sometimes  be  a frequent
painful  disposition  to go  to stool.  This
ought to  be considered  a  favourable symjv
torn.   A glyster or two, prepared  of miHc
and water or thin gruel, may serve to cor-
rect the pain.  Or  if no such disposition be
present,  the glysters may- serve  to evacuate
the bowels artificially.
   5.  The  mucous discharge, which before
was without colour, after the commencement
of  labour will be tinged u ith blood.  Thii
appearance is commonly  called the shew.
   6.  If together  with'the above symptomi
the usual pains be present,  the presumption
is very strongly in favour of approaching par*
turition, 
i07
              £ H A P T E R VI.     !•

•?   .toMMON APPEARANCE OF TRUE  PAINS.

    1. The  true pains usually  begin in tha
 loins  or lower part of the  back, pass round
 into the abdomen, and end at the  pubis,  or
i upper part of the thighs.   Sometimes how-
 ever they  take the opposite direction, that is,
 beginning at the thighs or pubis, and ending
 in the loins.   Someii nes too, they are confi-
 ned to one particular  spot,  as the back, abdo-
 men, thighs, and even to the  knees,  necis or
 feet;  and in some instances, odier parts are
 affected, as the stomach, head, &c.
    2. The true labour pain is periodical,  with
; intervals of twenty, fifteen, ten or five min-
 utes, and moderate pains frequently repeated
 are safer than  more severe ones at greater in-
! tcrvals.
    S. An experienced midwife, may general-
ly judges of the nature of present pains from
the tone of the patient's voice.   The  first
change effected by the pains, consists in»a di-
lation of the pans.   Forcible and quick dis-
tension,  gives a sensation like that produced
by the infliction of a wound,  and the tone of
Voice will be in a similar  manner interrupted
and shrill.   These  are vulgarly called  cut-
ting, grinding, or rending pains,   When the 
108
 internal parts are sufficiently opened, the child
 begins to descend, and then the patient is by
 her feelings obliged to make an effort to  ex-
 pel, and the expression will be made withal
 continued and grave tone of voice, or she will
 hold  her  breath and be silent.  These an
 called bearing pains.
   It is a common thing to say, that women
 have fruitless  or unprofitable pain.   This^
 an unfair and  discouraging  statement.  No
 person in  labour ever had a pain depending
 on her labour, which was in vain.
   4. In the beginning the pains are usuaw
 plight in  their degree, and  have long infer'
 vals, but as the labour advances, they becoffi,
 more violent,  and the  intervals are shorti*.
 Sometimes the  pains  are alternately, one
 Stronger the  next weaker, or  one  stronger
 and two weaker.  But every variety has its
 own  peculiar advantages, being wisely adapt-
 ed to the state  of the  patient.   NotWijj
 therefore can be  more  preposterous, than aiw
 Jcind of artificial attempt to add to the strea^fl
 of {he pains, or to hasten their return.  IV i.
 wrong even to direct the patient to help
 self.   The supposed skill of midwives in
points, has done more mischief to society, '
 tfe most skillful practice ever did good* 
109
            CHAPTER VII.

 IjpW FALSE PAINS  MAY BE DETECTED Ah'B
                REMOVED.

  A case may occur, where it may be ne-
cessary to determine whether  present pains
be true or  false ; because if false pains  be
encouraged, or permitted to continue, they
may at length occasion premature  labour.
  First then, some known cause  commonly
goes before and  brings  on  false pain3;  as
fatigue of any kind, especially too  longstand-
ing on the feet, sudden  and violent motion
of the body, great costivcness, a diarrhea, a
general  feverish disposition,  some violent
agitation of the mind or the like.
  2. But the most  certain way for detecting-
false pains, is by an  actual examination.  This
operation is commonly called taking a pain.
The position  in  which  women  are pi•<ced,
when  it is thought  necessary to  examine
them, varies in different countries,  and indeed
almost  every  midwife has her own opinion.
But most regular men,  direct the woman to
repose on a couch or bed, upon her left side,
with her knees bent and  drawn  up towards
the abdomen.   And this is certainly the most
convenient  and decent method.  The exami-
nation should  be performed with  the utmost
                     G 
110
care, decency and  tenderness.   If there be
perceptible pressure on the os uteri, or if it be
perceived to dilate  during the continuance of
a pain, the woman may  be considered as
really ia  labour.   But  if  neither pressure
nor dilatation can be felt, the conclusion may
be drawn that the pains are false.
   3.  If it be determined, that the pains are
false,  it will be proper to attempt  to remove
them.  When occasioned by fatigue of  any
kind, the patient should rest in bed.   If she
be of a feverish disposition, she should loose
some  blood.   Generally it will be proper to
give a dose or  two of manna with sweet oid,
or of castor oil or the like.  M ild and open-
ing glysters should be  injected every three
or four hours,  till  the bowels  are emptied.
After these evacuations, which should be re-
peated according to the exigency of the ca§gj
she should have half a grain of opium with
one grain of ipecacuanha, every three hours
till she is composed.
  4.  Let it be observed however, that an ex-
amination should never be made in too great
haste.  And if it be probable, that  the  pa-
tient  is really in labour,  an examination for
determining the state  of the  presentation,
ought not to be made  until the membranes
are broken, or till the os uteri is  fully dilated'
But more of this in another place. 
Ill
           CHAPTER  VIII.

     PROGRESS OF A NATURAL LABOUR*

  There may be said to be  three stages in
the process of natural labour.
  The first includes all  the circumstances
and changes which take place from the com-
mencement of the pains, to the complete di-
latation of the os uteri,  the breaking  of  the
membranes and the discharge of the waters.
  The  second includes those which  occur,
from the time of the opening of the os uteri,
to the expulsion of the child.
  And the  third includes  all the circum-
stances which relate to the separation and ex-
clusion of the placenta ; but to treat of each
of these stages more particularly  and in or-
der.
   1. The os uteri is not always found in the
same central position, nor does it always di-
late in the same length of  time.
  The first pirt of the dilatation is generally
made very slowly, but when the membranes
containing the waters begin to insinuate them-
selves, they  act like a wedge, and the opera-
tion proceeds much more rapidly.
   It cannot well be told with certainty how
long time will be required in any  case, for
the complete  dilatation of the os uteri, yet 
112
some conjecture may  be made.   If for ex-
ample, after the pains  have continued three
hours, the as uteri should be  dilated to the
size of one  inch,  then two hours will be re-
quired for dilating it to two inches, and three
more hours will  be required for a complete
dilatation ; making in  all eight hours.  This
calculation supposes the  labour to go on re-
gularly and with equal strength.   But the ot
uteri  sometimes  remains  for  hours in  the
same state,  and yet when it begins to dilate,
the complete dilatation is soon  perfected)
Again, in some cases the dilatation proceeds;
on regularly for a while, and then is suspend*
ed for many hours,  and afterwards returns
with great vigour.
  With first children,  this stage is common.
ly tedious and very painful.   Some consid}
erable judgment  is therefore necessary on
the part of the midwife, for supporting the,
patience and confidence of the suffering wo-
man.   As the labour proceeds, the pains be-
come more frequent and forcible.  And if
the dilatation  should take place with difficul-
ty, there will sometimes  be a sickness of the
stomach and vomiting.   This is a favourable
circumstance, and  it commonly has a tendenr
cy to relax the system.
  At length after a greater or lesser number
qi hours, as the case may be,  the dilatation 
llo
is effected.  But let it be carefully observed,
that  no artificial aid is to be offered during
this part of the process.  It may  indeed be
well enough to pretend to assist, with the
intention to compose the mind of the patient,
and inspire her with confidence.   But be as-
sured,  that all manual interposition,  will re-
tard the progress of the dilatation.
  Let the patient and bye-stander  be impor-
tunate.  Pain on the one  hand,  and igno-
rance  on the other may excuse them.  But
the midwife must be firm in the discharge of
her duty.
   Care  must be taken, not  to  break  the
membranes should an examination be deem-
ed necessary.  When the  os uteri  is fully
dilated, they are usually broken by the force
of the pains.   If this should not be the case,
they will be protruded outwards, in the form
of a bag,  and  then are  of no further use.
If the labour  has  not been  disturbed, the
child is commonly  born speedily  after the"
natural  rupture  of  the membranes;   and
therefore if  the  birth be delayed  after  this
event  takes place,  it  will be a very proper
time, to make a careful examination of the
state of things.
   Here I must be permitted to remark, that
touching the parts  too frequently is highly
pernicious.  The juices furnished  by nature 
114
for moistening, softening and by these means
preparing the parts for  distention,  must be
improperly exhausted by repeated application
of the hand.  If the passage  be thus left
dry it  will  be much disposed to irritation,
and the whole process may be deranged.  In
every  difficult case which has  come und«*
my observation,  I have  been able to trace
all the existirg evils  back,"* to the common
error of  too early taking in hand, as the op*
eration is commonly called.   Your poma-
tums, oils, lard, and ointments, are poor sub-
stitutes for natural fluids which are  wiped
away.   Indeed they may do injury, by clog-
ging the mouths of the little vessels through
which  those fluids are secreted.  By escap-
ing any such injury,  it happens pretty com-
monly that women  taken at surprise, have
better  times than  when  aided  by the  good.
midwife  of the neighbourhood.
   If there  be no  irregularity, nature is al-
ways competent to the task appointed  her of
God,  and the only circumstances which can
make it necessary to call in a midwife at nil,
are the possibility of such  irregidarity and
the convenience  of having  her de^.t lity in
management  of  the  placenta,  dressing  the
child, &c. 
115
            CHAPTER  IX.

    SECOND STAGE OP NATURAL  LABOUR.

  The second stage of labour  includes all
the circuinstances attending the descent of
the child through the pelvis, the  dilatation of
the external parts, and the final  expulsion of
the child.   In general it will follow that  the
further the labour  is advanced before  the
discharge of the waters, the more speedily
and  safely this second stage will be accom-
plished.
   As the head of the child passes through the
p  his, it undergoes various changes of posi-
tion, by which it is adapted to the form of each
part of the passage ; and  that more  or less
readi'v according to the  size of  the head,
strenth of the pains &c.   And whether these
changes are produced quickly, or in a  tedious
manner, whether in one or many hours, it can
by no means be proper to interfere.  For the
powers of the constitution will produce their
proper effct, with les*;  injury and more  pro-
priety than the umst dexterous  midwife.
   When the head begins  to pr«-ss upon the
extern:)', parts;  at  first  every pain me.y be
suffered to have its fall and natural effect.
But when a part of the head is fully exposed,
and the  fore part of the perinaeum is on the 
116
stretch, it is  necessary to use some precau-
tion to prevent its being torn ; and the mote
expeditious the labour, the more  is this caw
tion necessary.
   Some have thought, that if the external
parts be very rigid, they should be frequent
ly  anointed with  some kind of ointment.
Nothing  can equal the natural juices.  But
if from any cause the parts become heated
and dry,  flannels wrung out of warm water
should be  applied for some time, and after-
wards some very mild ointment might not be
amiss.  Women with first children are most
subject to inconvenience  and difficulty in
these respects.
   To  prevent any injury  from  lesion  the
external parts, the only safe and effectual
plan is  to retard for  a certain time the pas-
sage of the head through them.   Thereforej
instead of encouraging  the patient  at th»
time, to  use  her  utmost exertion to hasten
the  birth, she should  be  convinced of its
impropriety,, and be  dissuaded from usicg
anv  volutary  exertion.  If  she  cannot he
regulated  according to your wishes,  her ef-
forts must be counteracted by some equiva-
lent external resistance.   This may  be per-
formed by placing  the  fiager and thumb of
the right hand upon the  head of the child,
during the time of  a pain;  or by  placing the 
117
balls of one or both thumbs, on the thin edg»
of the perineum.  With  first children,  if
there be great exertion, and much danger of
a laceration, the right hand may  be used as
before, and the palm of the left hand wound
round with a soft cloth, may be applied over
the whole perinaeum, where it must be firm-
ly continued during the violence of the pain.
It i3 proper to proceed in this way, till the
parts are sufficiently dilated.  Then the head
may  be permitted to slide through them  in
the slowest and gentlest manner, paying the
strictest attention till it is perfectly cleared  of
the perinaeum.  If there  should  be any de-
lay or difficulty, when the perinaeum slides
over  the face, the  fore finger of the right
hand, may  be passed under its edge, by which
it may be cleared of the mouth and chin, be-
fore  the support given by the left hand be
withdrawn.
   The assistance should be applied in a pro-
per direction,  and with  uniformity.  The
danger of  injury to the external parts will  be
encreased by irregular or  partial pressure.
   The head  being expelled, it is commonly
deemed necessary to extract the body of the
child  without  delay.  But  experience has
now taught, that there is no danger, and that
it is far safer for the mother and child,  to
wait for the return of the  pains.   And when
                    G2 
118
the shoulders of the child begin to advance,'
and the external parts are again brought to
the stretch, the same support should be given
to the perinaeum as before.  The child should
then  be conducted in a proper direction, so
as to keep its weight from resting too heavily
on the perinaeum.   Tzvo or three pains  are
sometimes  necessary for the expulsion of the
shoulders after the head is born.
   The child should be placed  in such a situ-
ation, that, the external air may have free ac«
cess to its mouth, but let its head be covered.
Having taken the proper care of the mother,
it will  be necessary to  proceed to the third
and last part of the operation.

                    ■♦■
              CHAPTER X.
THIRD STAGE OF NATURAL  LABOUR, THE MAN-
         AGEMENT OF PLACENTA, iSTC.
   There is a  proper time  for dividing the
funis  or  umbilical  cord.   Before the child
breathes  and  cries, a motion  of the arteries
of the cord may  be felt  beating like  the
pulse.  But after  it has breathed and cried,
this pulsation or motion ceases, and the string
becomes quite relaxed and  soft.   These cir-
cumstances ought  to  take  place  before the
umbilical cord is divided.   Ten, fifteen, and
sometimes  twenty  minutes are required for 
119
the complete relaxation of the navel string*
%het\ let it be tied in two places, and divide
between them.
   Soon after the birth of the child, the mid-
wife should apply her hand upon the abdomen
of the mother to  determine  whether there
be another child, and whether the womb con-
tracts in a manner favorable to the separation
and  removal of the cake.
   Most  women  are  extremely uneasy till
the  placenta  is removed,  and  suppose  the
sooner  it is accomplished  the  better;  but
this uneasiness is  unnecessary, and all hurry
is improper.
   After  the  birth of the  child let the  first
attention be paid to the mother.   Tranquili-
ty should be restored to her mind, and the
hurried  circulation  of the  blood  should be
calmed.  She should be recovered from her
fatigue,  and  her natural  state regained as
soon as  possible.  With this design  let her
be kept quiet, affording her at the same time
some suitable refreshment.
   In  the course  of  ten,   fifteen or twenty
minutes, the pains will return,  for  the  pur-
pose of expelling the placenta;  and  it wiU
generally be expelled without  any kind of
artificial aid, which should  never be employ-
ed where it can be avoided.  But it  it de-
scend too slowly, the midwife may take hold 
120
 of the cord and by pulling in a gentle man*
 ner and  in  a proper direction,  may afford*
 some assistance ;  and  this should be done
 only in time of a pain.
   After  the  cake is brought  down into the
 vagina, whether by the natural pains, or with
 the artificial aid as above, it must be suffered
 to remain there till excluded  by the pains.
 This  may prevent a dangerous flooding.  If
 an hour be requisite for the exclusion, after
 it enters the vagina, no assistance ought to be
 offered, but after that time, it may again be
 gently pulled  in the time of the  pains.  No
 objections should be raised to this plan from
 any supposed advantage to be derived to the'
 child  from laying the  cake upon its belly,
 upon  hot embers,  in hot wine, or the like.
 All  this is perfect folly.
   Let it then be a settled point, that hurry is
 improper either in dividing the string, or re-
 moving  the cake.   Haste  in  the first may
 destroy the child, in the last must injure the
 mother in  a greater or lesser degree.   If
 the ill effects  be not immediately perceived,;
 she will  at  length  be sensible of the injury,
 when her health gradually declines.
   The conclusion to be drawn from the fore-
 going is, that parturition is a natural process
of the constitution, which generally needs no
assistance.   And when it is natural it should1 
121
always be  suffered to have its own course
without interruption.
            CHAPTER  XI.

   INTRODUCTION TO DIFFICULT LABOURS.

  In  consequence of their natural construc-
tion,  the  women must  be subject to great
pain and difficulty in parturition;  yet by  the
peculiar form of the mother, and the original
construction of the head of the child, ample
provision is made for overcoming all the dif-
ficulties to which they are subject.  But by
the  customs of society,  and various other
causes,  women  are rendered subject to dis-
eases  and  accidents which encrease  their
natural  inconveniences,  and  produce  new
causes of danger.  Therefore, there will be
occasions which will require assistance.
  The  first distinction of labour, requiring
the  assistance  of art, may be called diffcult
and every  labour in which  the head  ol  the
child  presents, but  which is delayed  longer
than twenty-four h«mrs, ought to be classed
under this head.
  Difficult or tedious labours may hero four
kinds. 
122
  I.  Those  which  are  rendered  difficult
from a too weak or an irregular action of the
womb.
  II. Those which are occasioned by a cer-
tain rigidity,  or firmness of the parts, in coni
sequence of  which the  dilatation is tediouJ
and difficult.
  III. 'Those in which a quick and easy pa$
sage of the head of the child is prevented, t>|
some distortion of the pelvis, or too large $
size of the head.
   IV.  Those  which are  rendered  difficult
from diseases of the soft parts.
            CHAPTER XII.

     FIRST KIND OF DIFFICULT LABOURS.

   1. The  action of the womb is sometimes
too weak in consequence of great distention.
In a case of this sort tb^ safest, and fre-
quently the only remedy*, ts to allow the pa-
tient sufficient time.   W the mean time,  she
may be suffered to walk, or stand, pursue any
'amusement,  or  choose that  position which
she may prefer.   Sometimes however  fre-
quent glysters of  warm milk and water, or
thin gfuel might  be  injected.  Or  if  the
pains should be feeble, and come on in a vc- 
123
ry slow manner, and if the labour be far ad-
vanced, it will be proper to give a glyster of
gruel madfe more  irritating by the addition
of an ounce of common  table salt,  or a like
quantity of purging salt; which ever may be
most convenient.
   2. The action of the womb may be feeble
and tediods in consequence of being partial
or incomplete.   In a case of this  kind, the
patient Mill  complain that the child lies very
high in the stomach, or she will have cramp-
like  pains in various parts of the abdomen,
which seem quite ineffectual.  If these pa'-ns
be  great, and different  from  common  a-
bour pains,  they  are commonly the  effect
of a feverish disposition ;  and if so, the pa-
tient  may loose small quantities of blood.
She  may take thirty or forty drops  of spirits
of nitre, in a cup of some kind of cooling tea,
every two or three hours.  Her bowels must
be kept open  with glysters, or gentle  doses
of manna, castor  oil or purging salt; and
sometimes  it will be  found useful to anoint
the whole abdomen with warm oil.   If little
or no fever be present, she might walk about
the room, in the intervals between the  pains.
If she should have suffered much and a long
time, after the blood letting and a glyster or
two, she should take forty-five or fifty drops
of the tincture  of opium, or one grain  of 
                      134
j,  »pmm mixed with one and a half grains of
   ipecacuanha, to be repeated,  if necessary, at
   the end of six hours.  The poofter is pre-
   ferable to the tincture of opium m this case.
     3.  Sometimes the pains are not sufficiently^
   strong to break  the membranes  containing
   the waters.  If the presumption be, that the
   membranes are too rigid, or if sufficient time
   may have been allowed, it  may become ne-
   cessary to break them artificially.   But as
   was  observed under the  head of Natural
   Labours, this must be done with the greatest,,
   caution.  It should be first known, that  the
   »s uteri is fully  dilated,  and care  must be
   taken, not  to be deceived in this point, be-
   cause the os uteri is sometimes  so thinly and
   uniformly spread over the head  of the child._,
   before it  is in  any degree dilated, as very,]
   much to resemble the membranes.         i.
      If it  be  determined to  break the  mem*.
   branes,  no instrument is necessary but the
   finger, or at most the finger nail prepared for ,
   the purpose, by being cut arid turned up.
     4.  The shortness of the funis or umbilical
   cord may be the  cause of difficult labour, re-
   sembling that which is the  effect of a feeble ,
   action of the womb, it may therefore be ex-
   plained  in this place.  The umbilical cord ;
   may be short originally, or may be rendered
   so by  being wound round the neck,  body or 
125
limbs of the child.  If the child  should be
drawn back*upon the declensi^fi  of a  pain,
the shortneH of the umbilical tord may be
always  suspected.   By allowing sufficient
time, this  i%convenience will commonly be
overcome.   If however the child should not
be born after waiting long enough, it may be
necessary to change the position  of the pa-
tient, and instead of reposing on  a  bed or
couch, as advised in the instructions for tak-
ing a pain,  she may be placed upon the lap
of one of the assistants.  It will be frequent-
ly found advantageous to prefer this position
in lingering cases, especially when the parts
seem fully prepared for dilatation.
   When the head  of the child  is expelled,
the funis may be  brought forwards over the
head, or backwards over the shoulders.  But
if neither can be done,  it may be necessary
to wait for the  effects of more time.   It is
not so dangerous as some   suppose, for the
child to remain sometime  in this position,
but the air should  hive free access  to its
mouth.   But  when it can no longer be con-
sidered safe, the funis must be divided with
the usual precaution of tying, &c.
   5.  If the child be  dead and swelled, the
labour will commonly be exceeding difficult,
and  put on appearances similar to those of
the foregoing cases.   It may be found neces- 
126
 sary in an instance of this sort, to pass a tow-
 el  or  ha^clrafcchief round  the neck  of the
 child,  and th»i by  taking hold of both ends,
 considerable  aid may be  afforded.   But if
 this method should not succeed^ one or both
 arms  should  be brought clown and included
 in  the  handkerchief,  by which means stiU
 greater force  may  be  applied.   In all cases
 however, where it can be done with safety,
 it will be more  safe and humane to wait trie
 effects pi natural efforts, than to use much
 force.
   6.  Consumption  and other diseases with
 general  debility, commonly cause great ap-
 prehension  about the  issue  of parturition.
 But if there is no untoward circumstance in
 the way, it will be  found, that there is a pe-
 culiar  balance obtaining between the strength
 of  the patient, and the disposition  of the
 parts concerned  for dilatation; give  them
 time and they will be delivered.
   7. When labour is common, there is gen-
 erally a sense of heat, quickness of the pulse,
 thirst,  flushed cheeks,  in one word a general
 feverish disposition.  These appearances may
 be considered natural efforts, for carrying on
 the depending  operations  of  the  system.
 But the fever sometimes runs too high, and
 exhausts those powers  of  the system,  which
«ught to have been otherwise applied.  When 
iif
this is the case, nothing can be more errone-
ous, than the  common  and almost universal
plan of  giving wine, spirit, or other cordials;
This kind of treatment is calculated to in-
crease  the ^ever,  and  destroy the  pains.
Instead  of spirit,  wine, or opium, have re-
course to cooling drinks, and moderate blood
letting ;  to be repeated according to circum-
stances.   To these may be  added frequent
mild glysters, and a gentle purge  or two.
The room should be kept cooland well air-
ed, and the patient as much as possible com-
posed.
   8. Fat and inactive women very frequent-
ly have slow  and  lingering labours, they
seem subject to debility of the indirect kind.
In every case of  this  sort  it must  be very
improper to make use of spirits, &c. to hast-
en the pains,
   9.  Patients under the impression of fear,
will in almost every instance be subject  to a
tedious labour, and as the time is prolonged,
their fears will naturally increase, so that ul-
timately, they may be brought into danger
by their  own cowardly imagination.   The
midwife  should therefore use  discreet mea-
sures to inspire more favorable sentiments.
   10. I  will conclude this chapter with a
general observation on the subject of  letting
blood in time of  labour.   It cannot be  pro- 
                   isa
perly admissible in every case, even with :h*
most robust women.   But if there be feverf
or if the pains be very strong, and the exer^
tions of the woman seem vehement; in tithed
of these cases it is necessary toJoose blood?
            CHAPTER XIII.          ,.,

    SECOND  KIND OF DIFFICULT LABOURS^

   Most women with their first children, suf*
fer more or less from the difficult distention
of the parts concerned in parturition.   But
the rigidity which is the cause,  commonly
lessens with every child, in proportion to the
number which  she has.   Let sufficient time.
be allowed her, and the constitution will find
sufficient  resources within itself,  for her de-
livery.  Sometimes blood letting is necessary
in this case.
   If the  woman  be far advanced in age at
the time of her having  her first child, this
rigidity of the  parts will be the greater, and
of course the labour may be the more  diffi-
cult.   Women of this  description,  might
generally avoid much  inconvenience, by oc-
casional  blood  letting  touards the close of.
pregnancy, by making  frequent use of gentle
laxatives, as manna,  sweet oil, castor toil atfdL 
129
tke like,  and by sitting over the  steams of
warm water,  every night  at bed time.*  It
may be observed  however that it very fre-
quently happens,  that women at  forty-five,
fare as well as  they could have done with a
first child at twenty-five.  None  therefore
ought  to  be  discouraged.  The natural ef-
forts of  the  constitution  in  these cases are
astonishing.
   A  difficulty of distention is  frequently
brought  on  by  a  premature  rupture of the
membranes  containing  the  waters.   When
this circumstance  takes place,  whether the
rupture be natural or artificial it sometimes
happens, that many hours or even  days  may
pass,  before  the  accession  of  labour.  In
this case, it would be best for the patient, to
continue  most of her time lying in bed or on
a couch.
 i The os uteri is  sometimes  removed from
its central position.   This may put on ap-
pearances similar to those of common rigid-
ity.   But no attempt should ever be made
to  change it  by  art.  Nothing  should be
done,  but direct  the patient to lie much of
her time on the side, towards which the os
uteri is turned.  Or  if the  os uteri be pro-
jected backwards,  which  is always the case,

* S*e die note at the close of the second part, page 7B>. 
150
when it cannot be reached in the beginning
or early part of labour, then the patient should
lie much of her time upon her back.
  The os uteri may be so rigid, as to require
from twenty-four to forty hours  for its dila-
tation, and yet no disorder be present.  But
it is sometimes made rigid  by an inflammf# ■
tion of  the part.  This state of  it may  be
known  by  its heat and dryness.  And if
the pains have long continued, without effect,
and the principal difficulty be the resistance
made by the os uteri, an inflammation may at*
ways be suspected.
   To remove such inflammation let some
blood be drawn, give every two hours forty
drops of the  spirits of nitre in a cup  of
some cooling tea,  to  which may be  added
one fifth of a grain of tartarized antimony,
and mild glysters should be injected.  In-
stead of giving any thing to raise the pains,
keep the patient quiet in bed.  Indeed a case
might  occur,  in which the  violence  of the
pains would force the os uteri down with the
head of the child, unless zhe were carefully
kept in a lying posture.
  The rigidity of the external parts, is fre-1
quently the cause of difficult labour ;  but  no
artificial aid is allowed, bat that advised un- I
der the head of natural  labours. CHAP. IX. 
131
           CHAPTER  XIV.

    THIRD  KIND OF DIFFICULT LABOURS.

   If the pelvis  be too small for the size of
the child's  head, it will obviously require the
more time for bringing  about the necessary
changes  for  its passage.  The  same conse-
quence wiil follow from a moderate degree
of distortion, or narrowness of the pelvis.
But as it is possible for  the head to be com-
pressed into one third part of its dimensions,
it  can of  course pass through  a passage,
which* would seem  to be much  too small.
If however,  the distortion be very great, or
the head be of such a degree of strength, as
to prevent  a passage entirely ; then the wo-
men must  be delivered by the aid of instru-
ments ;   otherwise she must perish together
with the child.   But instruments ought to be
introduced with caution, and in no case be-
fore time, with  o.her circumstances prove
them to be necessary.   And then  a surgeon
should be employed.
   If the  head  of the child should be un-
commonly  large, similar difficulties will fol-
low.  But this may be also overcome by the
natural  efforts, if sufficient time be allowed.
In  some  cases the head is  so  enlarged by
disease,  that it may be necessary to open it 
132
with an instrument.   But as the head when
distended with water, sometimes bursts from
the pressure of  the  pains,  this operation
ought not to be too hastily performed.
   If the face of the child be turned toward* -
the pubis, the labour  will commonly be te-
dious.  But generally no  artificial  aid is
wanting; more  time  must be allowed for
the descent of the child, and  more  care will
be required, when it passes through the ex-
ternal parts.  The case would be similar, if
the face  should present.
   A difficult labour, similar to that in conse-
quence  of a narrow pelvis,  will take plac*
when one or both arms present together with
the head.   Where it  can be done, the arms
should be put back  and carefully detained.
" In some cases of this kind, the head, an
arm, and a foot may be  all  felt at  the same
time.   When this happens, it is best to grasp
and bring down the foot, and deliver in that
 manner."'
   When a child is born, with one  or both
 arms presenting together with the head, the
 arm or arms will be much" bruised, and will
 demand attention.   They  should be bathed
 in vinegar and water,  or spirit and water,
 and soft poultices of some  kind should be
 applied. 
13J
            CHAPTER  XV.

    FOURTH KIND OF DIFFICULT LABOURS.

   Every  precaution  ought to be  taken to
prevent too great a distention of the blaader ;
for if the urine  should collect in large quan-
tities,  it will not only be  a hindrance to the
labour, but the  pain may become so great as
to do much injury.   If all precaution fail, a
catheter must be  used to draw off  the water
where it can be  done.
   Should there be a large stone in the bladder,
or an adhesion of the vagina, so as to prevent
the passage of the child, a surgeon ought to
\ie immediately  called in.
   If a large unnatural substance should grow
out of the os uteri, and obstruct the passage,
it may be necessary to lessen the head of the
child, by letting  out its contents.
■   Scars in the vagina from past injury, will
generally yield  to the  natural efforts of the
constitution.
   Sometimes the womb itself is  ruptured.
If this truly  alarming  circumstance should
take place, it may be readily known.   The
patient will  perceive distinctly a  sense  of
something giving way internally, with a  sud-
den excruciating  pain  in some part  of the
abdomen.   An  instant vomiting  of  what'
                    H 
134
 ever the stomach may contain will follotf,
 which will commonly  be a fluid of a brown
 colour.  An abatement or total cessation of
 the pains will take place, and there will be a •
 discharge of blood from the vagina.  In ad-
 dition to these symptoms, the limbs of the
 child may be  felt, by applying the hand to
 the  abdomen.   The  patient commonly dies
 though not always immediately.  A case has
 occurred, where the  child was turned after
 the  rupture  of the womb, and safely deliv-
 ered to the preservation of both  mother and
 child.  This  ought therefore  always to be
 tried.
   The cases of difficult labour admit of grea|j
 variety,  and much practice is  necessary fo»
 preparing any one to treat every case to the •
 best advantage.   Regard  should be had to
 the  cause of the  difficulty, which should be
 ascertained if possible, because a knowledge of
 this  would afford aid in determining the  pro-.
 per mode of procedure. Here I must be per*
 mitted to repeat my assertion, that the great-
 er number of difficult labours,  are  not  such
 from unavoidable necessity, but are rendered
.difficult,  from some improper managemtnt in
 the  beginning, or through the course of la-
 bour.  The  midwife  may sometimes err,
 the patient may be intractable, and the im»
patience,  ?!nd  unseasonable anxiety  of her 
135
friends, may lead them to demand improper
treatment.

            CHAPTER XVI.
             INSTRUMENTS, iS'c.
   Several instruments have  been invented
for aiding in difficult labours,  as the forceps,
vectis, filet, &?<:. but  as  they ought not be
used except in cases of great necessity,  and
then by those only, who are well acquainted
with instrumental delivery ;  I shall not at-
tempt at  a description of them.   Such mid-
wives however, as are desirous of being ac-
quainted  with this part of the art,  are refer-
red to the  late work of Dr. Thomas Den-
man, where they may  find a very distinct and
intelligent account of their  figure, and the
manner of  applying  them in practice,  Sec.
From this excellent treatise, a very great pro-
portion of these hints  are extracted, some in
the  language of Dr.  Denman ;  others with
considerable variation, as I found it most con-
venient to my design.
           C H A PTE R  XVII.
         PRETERNATURAL  LABOURS.

   Preternatural labours may be divided into
two orders. 
136
   I. When the breech or lower extremities
present.
   II. When the shoulders or upper extremi*
ties present.
   Natural and difficult labours are consider-
ed, as having reference chiefly to the mother.
   But preternatural  labours are considered,
as having reference  to the position of the
child.
   It therefore is obvious, that a preternatural
labour may happen  to  a  woman in ptrfect
health, who  has every possible regularity in
her  formation,  and'  who  may  have passed
through all the common changes of parturb
tion, in the most favourable manner.
   Different opinions have been entertained
concerning the  causes  of preternatural pre-
sentation, but  none  of them is  sufficiently
clear and certain, to be of any advantage in
directing  the conduct by which they may be
prevented.
   Various symptoms too have been as stated
as indicating   such  a  presentation.   But it
cannot be certainly known, until the part pre-
senting can be felt and distinguished by the
touch.   The head  may  be  known by  its
roundness and firmness.   The breech  by the
cleft between the buttocks and by the parts of
generation.   A hand by the thumb and length 
13?
of the fingers.  'And afoot by the heel and
its want of a thumb.
           CHAPTER XVIII.

 FIRST ORDER OF PRETERNATURAL LABOURS;

  In the first order  of preternatural labours
may be  included,  the presentation of  the
breech ; of a hip ; of the knees; and of one
or both legs.
  When a labour  is  so far advanced, that
the os uteri is fully dilated, if no part of the
child can be felt, it will be prudent to watch
carefully for the rupture of the membranes ;
because it  may be that the child ought to be
immediately turned ; and if it be done quick-
ly after the" waters  are evacuated it may be
effected with ease, but  if delayed a very little
time, the uterus will contract, after which it
is done  with  considerable  difficulty.   So
soon  as  the membranes are broken, it will
be  proper  to introduce the hand,  and make
the necessary examination.  Should the head
or breech present,  the hand may  be with-
drawn, and the labour  suffered to proceed
without interruption,  as a natural presenta-
tion.   But  when the breech presents, great
attention is required in conducting the body
                    H 2 
                    138

 in such a manner, as to secure a safe passarife'
 for  the head.  For if the face be tow ardV
 the  pubis, it  must be managed so as gradu-
 ally to  turn it,  till one ear shall be towards
 the  pubis, the other towards the sacrem.
   If it be found,  that the  child  will  pass
 readily enough  with its  arms turned up,
 there will be no occasion to bring them down,
 but  if the head remain fixed, after using the
 force which is thought safe  and prudent to
 be exerted, the arms should be brought down.
 Care should be used, not to break or dislocate
 die  bones of the child, or injure the ester*
 nal, parts of the mother.
   If there be difficulty  after  the arms are
 brought down, the finger might be passed
 into the mouth of the child,  and its lower
jaw  be turned upon its breast, taking care not
 to pull  by it.   By  this change of the posi-
 tion of  the head, the passage may be more
 \eadily  effected.   Should  necessity require;
 it, the body of the child  may be moved in
 different directions ;  that is from side to side,
 up and  down, using it as a lever for  the ex-
traction of the head ; but it must  be done
with all care and tenderness.
   But it  may happen  that after giving full
scope and due time,  to the natural efforts of
the- mother, they prove ineffectual for the ex-
pulsion  of the child.  Assistance  must be 
139
then given  her.   As the breech is supposed.
to present,  a finger  may be  locked in the
groin, and  such force used as may be deem-
ed sufficient to extract it without injury.  If
•his should not do, a ribband or piece of tape
may be passed over one or both thighs, with
which-considerable force may be used with
greater safety to the mother and child.
   In all cases of this kind it is necessary to
have particular regard to the umbilical cord.
It should nevvr be on the  stretch or it will
be highly injurious to the child.
            CHAPTER XIX,

 SECOND ORDER OF PRETERNATURAL LABOURS,

   If the  shoulder,  or one or both arms pre-
sent, there is a necessity of turning the child
and delivering by the feet.  This second or-
d  r of preternatural labours,  admits of  four
variations.
   1. The  first is, where the os uteri being
fully dilated, and th# membranes unbroken,
a superior extremity jis felt  through them :
Or where such  preternatural presentation is
discovered immediately upon the rupture of
the membranes and the discharge of the wa-
ters, before there is any return of the pains. 
140
 or any contraction of  the  uterus round the
 body of tiv child.   In this case the mange-
 ihent is simple and easy.  The patient is to
 be placed in the same situation as in a natural
 labour ; upon her left side,  with her knees
 drawn up  across the bed, and as near to.the
 edge of  it as possible.   Every practitioner
 however ought  to choose that position, in
 which he  or she  can probably perform with
 the greatest  dexterity.  The patient  being
 placed, if the external parts be not sufficient-
 ly dilated, the fingers of the right hand must
 be reduced into the form of a sugar loaf, by
 placing them together around the thumb, and
 with the hand in this form, the dilation must
 be sufficiently  effected.   But this operation
 should  be  performed  jrery slowly,  so as to
 resemble the nata'ral dilation as much as pos-
 sible.   When the hand can readily pass thro'
 the external parts, it must be conducted slow-
 ly to the os uteri.   If the membranes be not
 broken, they  must  be grasped  firmly so as
 to rupture them ;  or they may be perforated
 with  the finger.  Then let the hand be car-
 ried cautiously along the sides,  thighs and
 legs of the child, -till it Comes  to the feet, and
 if possible, by a firm  grasp and  waving mo-
 tion,  let both  feet be brought down together.
 Waiting then for a return of the  pains, they
may be brought a little lower,  and so on,  till 
141
thfey pass the external parts.   By observing
the toes- it may be told whether the back of
the child be towards the pubis, which is the
proper position.  The assistance to be after*
wards afforded may be regulated accordingly*
The feet may be wrapped in a cloth, so as to
be held firmly and used as may be afterwards
found most convenient ;  as in chap. XVIII*
Section third.
   2. The second variation of this order, may*
include those cases,  in which at the  time ot*
the ruptuife of the membranes,  there is very
little dilatation of the os uteri, and some de-
gree of contraction of the os uterus.
   As there is  danger of doing mischief by
every artificial dilatation of  the os uteri,  it
will be best to wait,  till it dilates in the natu-
ral wav.   It may not be  necessary to wait
however till the dilatation is quite complete,
but  only till it will admit'the  hand  readily.
Then with some additional difficulty,  it may
be conducted  as before.  In the mean time i£
the dilatation is delayed  from an inflammato-
ry affection of the parts, the treatment must
be similar to that advLed in chap. XIII. sec-
tion 5.
   3. The third variation may include those
cases  in .which,  together with the presenta-
tion of an arm or shoulder, there is the worst
possible situation of  the child in all other re« 
142
 spects ; as a close contraction of the Uterus
 round the body of the child ; the membranes
 having been long broken and the waters dis-
 charged ;  and in addition to the whole, very -
 strong pains.  In treating this case I will be
 particular.   It is ijjflproper to be  in a hurry,
 as though whatever could  be done must be|
 executed  in  haste. ,:'Such conduct would
 greatly alarm the patient, and make the mat-
 ter worse.   Let a very  accurate examination
 be made,  in the most deliberate manner.  A
 correct  judgment should  be formed of the
 presentation.  It should also be determined,
 to which side the feet  lie,  and  this last may ,
 be known by the situation of the palm of the"
 hand, which always naturally turns towards
 the feet.                                  i
   H iving made the necessary  examination,
 the contraction of  the womb must next be
 moderated.  And this must be done, wheth-
 er the contraction be continued, or alternate '
 as in natural pains,  or  irregular resembling
 cramp.   For  this purpose, if  she  be much '
 heated, let blood be drawn and  the Weeding
 repeated  according to circumstances.   Give
 one, two, or more mild glysters,  and use such
 language and conduct as may tend to soothe
 the patient.  When she  seems to be in some
 degree composed, give her two or three grains
 ofopium.  In jhe course of twenty  or thirty
___________i  ».ife--________________________■ 
14.5
minutes, she will be easy or sleepy, and then
will  be the time to proceed to the operation
of turning.
   I. should always  be remembered,  that so
much force mu-it be used, as  may be neces-
sary   to  overcome the  contraction of  the
womb, which constantly prevails.  But when
there is alternate  contraction and partial re-
laxation, the  hand must stop during the con-
traction, and  it must be spread out smoothly
to prevent a rupture of the womb.  In other
respects  plfcceed as  in the second variation
of this order.
   Sometimes the shoulder of the  child is so»
jammed at the upper  part of the pelvis,  that
the hand is prevented from passing.   In that
case, the fore „.. finger  and thumb must be
used in the form of a crutch under the armpit
of the child,  to  push  the shoulder towards
the head and towards the upper part of the
uterus.   However great the difficulty, com-
posure  and perseverance  are necessary.   If
the first, or any numbt r of efforts fail, they
still  mav be preparing the way for future suc-
cess.  Sometimes in consequence of the  par-
ticular kind of contraction of the uterus, it
may be so lengthened out, as  to make it diffi-
cult  to  reach the feet.   In  such a case on
finding the knees, the legs and feet may be.
brought down together ;  and here again care 
144
 rnust be taken, that an arm be not mistaken
 for  a foot.   The  feet when  found may be
 brought down  slowly, and for the  greater
 safety a ribbon  may  be fixed  over the wrist
an a noose, before  the hand  is  introduced,
 and when  the feet are brought low enough,
 the noose may be slipped with the fingers of,
 the  left hand over the feet, which will thus
 be secured.   If the body of the child be fixed
 across the upper part of the pelvis, great aid
 will be found to arise from holding  the two
 ends of the noose in the right hand, while
 with the finger and thumb of the left,  in the
 form of a  crutch in the armpit of the child,
 its body may be raised till it is  disengaged,
 and there  is  room  for  the entrance of the
 hips into the pelvis.  The remainder of the
 operation as before.
   4. The  fourth variation implies the fore-
 going difficulties, but in addition may take in
 the case of a  distortion of the pelvis ; and
 here the greatest difficulty attends the extrac-
 tion of the head.  Having therefore proceed-
 ed through the whole operation as described
 in the other variations, at length the whole of
 the child is born except the head.   While in
 this  situation, the  child  is in great  danger
 from the compression of  the funis.   But if
 there he a vigorous  pulsation in the funis
 ihere is no danger, and hurry will be improp* 
145
«r. Should the pulsation however which was
at first lively and strong, gradually decline,
and then altogether cease, the head must be
immediately extracted, or the child will ine-
vitably be lost.  If there be reason to expect
the preservation  of  the child, the force ap-
plied must be moderate and cautious, it must
be exerted in a  proper direction with regard
to the pelvis, it must be uniform  and com-
manded,  and if there be any pains, it must
accompany them.  If there  be  no  prospect
of saving the child  still more time may be
employed.   After using as  much force  as
may be consistent with the  mother's safety,
it will be proper to rest awhile, that the head
may be compressed  and adapted  to the pel-
vis.   And thus, by acting and resting alter-
nately, with efficacy and resolution, the de-
livery may at length be completed.   But if
the hold which  may be  had  cf the body do
not suit,  a silk handkerchief or ribbon ma^
be passed  round its neck, and by this  aid
the necessary force may readily be applied.—
 By pursuing this plan with firmness, resting
at proper intervals,  it must indeed be  a very
difficult case if it be not at length overcome.
   In  all cases where the head is extracted
with difficulty, it should be remembered that
by top violent force the head may  be separat-
ed from the body.  With proper moderation 
146
 and eare this accident will seldom happen—
 When  it does occur, the head  must be les-
 sened.   This  may be  safely  and readily
 enough performed, if an  assistant confine the
 head against the upper part of the pelvis, by
 applying the hand upon the abdomen, with a
 firm and  equal pressure till the opening is
 made, and  till some  proper instrument be
 fastened upon it ; this being done,  with ihe
 usual precautions the head may be safely ex-
 tracted.


            CHAPTER XX.

            COMPLEX  LABOURS.

   Complex labours admit of four orders.
   I. Labours attended with flooding.
   II. Labours  attended  with convulsions.
   III. Labours with two or more children,
   IV. Labours where the umbilical cord de-
 scends before any part of the  child.
   The first  order admits  four variations.
   1. Those which happen  in early pregnan-
cy, commonly called abortions.
   2. Those which occur in advanced preg-
nancy, or at the full periods of gestation.
   3. Those which happen between the birth
of the child, and the expulsion  of the  pla-
centa. 
                   147

  4. Those  which follow the expulsion of
the placenta.


            CHAPTER  XXL

        I.   FLOODINGS  IN ABORTION.

  If the foetus be expelled at any time before
the end of the sixth month, it may be called
an abortion.   But an expulsion in  any of the
last three months, may be considered a labour
premature or irregular.
  Cases of abortion neither require  nor ad-
mit of any manual assistance ; for the proper
treatment in this case see  chap. XXIV. part
II.                                    v
  But when a woman  is miscarrying with a
considerable and apparently dangerous flood-
ing, is so far advanced in pregnancy that it
may be difficult  to determine, whether the
case be an abortion or  a premature  labour ;
the circumstances  being  such at  the same
time as to render it unsafe to  depend on the
common remedies, it may become necessary
to hasten her delivery.   For this  purpose
the membranes may be broken and the wa-
ters discharged.   By this evacuation, the ute-
rus will be made to contract, and the flooding
will be stayed until the foetus can be expelled
by the natural efforts of the constitution. 
148
  It is worthy  of observation, that in some
instances, the foetus at an earlier stage of preg-
nancy, is found hanging in the os uteri, where
it might remain if neglected, and continue to
be the cause of a long and dangerous flood-
ing.   In lingering cases,  this ought at  least
to be suspected, and if discovered, the foetus
should be moved a little in  different direc-
tions, so as to hasten its expulsion :  Remem-
bering at the same time, that it must be done
in the gentlest manner possible.
           CHAPTER  XXII.

    PREMATURE LABOURS WITH FLOODING.

  In premature labours great and dangerous
?ioodings may be induced, either by the pla-
centa being attached over the os uteri, or by
a separation of a part or the whole of the pla-
centa,  so as to leave the open blood vessels
in a state of distention.
  The first may be discovered  by a fleshy
substance without any part of the membranes,
which presents on a common examination:
And the second may be known, by being able
to  distinguish  the membranes without  any
such  fleshy substance.   Although there i«
danger in either case, yet the  first is most to 
149
be dreaded.  The danger however is to be
determined, not by the supposed quantity of
blood lost, but by the effect produced on the
patient, one person can  loose  much more
than another.
   Danger is  indicated  by  weakness   and
quickness of the pulse, or by the pulse be-
coming and continuing  imperceptible ; by
coldness and paleness of the body,  and by  a
ghastly countenance ;  by  restlessness  and
continual  faintings ; by  short and  difficult
breathing, and by convulsions.   Sometimes
the patient is taken with a sudden and violent
fit of vomiting,  this is commonly beneficial.
Floodings with pain, are less dangerous than
those in which  die  patient seems to be at
ease.
   Having therefore used  every precaution,
and observed carefully the state of the patient,
so as neither to be too hasty  nor too late in
affording  assistance,  and  with  the greatest
deliberation having determined that she ought
to be  delivered by art, in order to preserve
her life, let her be placed as before directed,
then let the parts be dilated with great cau-
tion, so as readily to admit the hand.  If
tb : placenta be attached over the os uteri it  is
of no  consequence whether it be separated,
so as  to  corae  to its edge and  go up on the
Ou'>id • of the  membranes, which  may be 
150
ruptured at pleasure ;  or whether a perfora-
tion be made through  the  substance of the
placenta.   In either case, with regard to the
position of the child, its feet should be found,
and with  a  slow  waving  motion brought
down as advised in chap. XIX.
   If the placenta be not attached over the os
uteri, but  the flooding is the consequence of
a partial separation, and the case be urgent,
let the  membranes  be  ruptured,  observing
the kind of presentation ; and where circum-
stances seem favourable, the remaining part
of the  operation may be left to the constitu-
tion.   But if  the  symptoms be urgent and
the danger great every part of the proceeding
must be the more expeditious.
           CHAPTER XXIII.

FLOODING AFTER THE  BIRTH BEFORE THE EX-
         PULSION OF THE  PLACENTA,

  Whenever it can  be safely done, the pla-
centa ought to be  excluded  in  the natural
way,  see part III. chap. X.   But if there be
dangerous flooding, it  must be immediately
extracted.*  Pressure on the abdomen, gen-

  * It is too commonly the esse that the friends of the
patient together with the midlife, elated with joy it 
151
tie pulling of the funis,  a change of her posi-
tion, &c. &:. are first to be employed, but if
these fail, the hand must be introduced.   If
however the flooding  should have  already
proceeded  so far  as to induce fainting and
the like, the patient must be somewhat revi-
ved before the operation.
  Whenever it is determined to proceed, the
patient  being placed in a convenient position,
the funis is  to be hell in the  one hand, with
a moderate  degree of  tightness,  while  the
other is to be guided by the funis through the
vagina, os uteri, &c. into the uterus.   What-
ever dilatation is to be artificially made, must
be effected carefully ; and when the placenta
is examined, so  as to  determine  its degree
of attachment,  the procedure must be regu-
lated accordingly.  Sometimes  the irritation
excited by the introduction of the hand, brings
about the separation without any farther aid.
But if the attachment be complete, grasp the
placenta between all the fingers.   If no part
is separated by this attempt, the edge must
be found and  carefully raised.   Then with
the blunt end of the fieigers, continue the sep-
the happy deliverance of the child, demand an imme-
diate extraction of the cake. Hundreds have been de-
stroyed by this barbarous custom. The  natural ef-
forts ought always to be permitted to expel this als*
ts well as the child. 
152
aration in a slow and cautious manner. When
the separation is thought to be sufficiently
effected for the purpose, grasp it again and
gently bear it off low arcis  the adhering edge
till it is quite separated.   Then wait till the
womb begins to contract, which may be rous-
ed into  action,  if seemingly  inactive, by
throwing  the fingers back gently against its
side.   Then bring the placenta down into the
vagina, where let it stay  at  least one hour,
unless sooner expelled by the natural efforts
of the system.  These directions with some
variations, can be adapted to almost any case
that may occur.
           CHAPTER  XXIV.

FLOODING  AFTER THE EXPULSION OF THE PLA-
                  CENTA.

  The cautions advised above, will generally
prevent any dangerous loss of blood.   But if
by any means the uterus has been inverted, it
will probably be the cause of an alarming and
long continued flooding.   By external exam-
ination with the hand applied on the abdomen,
and by actual examination by the vagina, it
ought to be ascertained  whether the womb
be inverted, and if it be, it thould be speedi* 
15J
ly,  but cautiously  replaced,  afterward.; the
usual remedies would be successful, but nev-
er before.   If the uterus should be inverted
while the placenta or a part of it adheres,
this should first be separated,  and then the
uterus  may  be  carefully and gently replaced.
           CHAPTER  XXV.

      II.   LABOURS  WITH CONVULSION.

  Where the patient is  afflicted  with slight
delirium, swimming and violent pain of the
head, blindness, pain or cramp at the stom-
ach, chills  with  every  return of the pains,
great and excessive  vomitings, &c.  there is
danger of convulsions.
  Convulsions which attend parturition differ
in some respects from all others.  The most
obvious symptoms of this kind of convulsions,
are a contraction of the muscles, distortion of
the eyes, twitchings, foaming of  the mouth,
&c.  as  in  epilepsy, but there will also be a
snoring like that attendant on apoplexy, and
she will make a hissing noise as if she were
drawing her spittle  through her teeth.  By
observing  the cautions and advice given in
part II. convulsions may  generally  be pre-
vented.  But if they should take place the
                     I 2 
154
patient  should be  bled largely,  if  possible
from the jugular or neck veins, if this cannot
be done, blood letting front the arm  must be
repealed as often as may be necessary. From
two to five pints may be drawn in the course
of a few hours, and  when properly and suf-
ficiently employed, blood letting seldom fails.
   After bleeding, the warm bath,  or where
that cannot be employed, clothes wrung out
of warm water may  be  applied all over the
abdomen with similar effects.  But it may be
remembered that the patient ought not to be
delivered by art,  in consequence of the con-
vulsions, without first having  regard to all
the precautions given in the cases heretofore
explained.
           CHAPTER  XXVI.

.///.  LABOURS WITH TWO OR MORE CHILDREN.

   There  are  no  certain marks by which it
can be foretold that  a  woman  carries twins.
Neither an unusual size, nor uncommon sen-
sation about the  uterus, nor  any particular
dischargeof the waters,  nor the slowness of
the progress of labour, afibrds any information
worth attention.   But after the  birth of the
first child, it may be determined by applying 
155
the hand to the abdomen.   It must be a very
good rule to  keep patients who have borne
one child ignorant of there being another as
long as it can be done.   But in most instan-
ces after the birth of the first child,  the  se-
cond will follow in a few minute^ with great
rapidity.  The whole  progress w ill-general-
ly be the same as if there were but the  one
child.   But if the first one must be  turned,
it will require care not to break the mem-
branes  of the second,  if they be yet whole.
If the  first be excluded safely, there cannot
often be  any difficulty- in the exclusion of the
second.   If the first be delivered by art, the
presumption is,  the second will require sim-
ilar management.  Should the pains be  sus-
pended after the birth of the first, the second
should  be suffered  to remain at least  four
hours before artificial aid be introduced. But
if convulsions or floodings  take place, no
more  time must be delayed, than the state of
the case would warrant.
   In  twin cases,  the  two  cakes are usually
 united,  so as to form  one mass, though  they
 are  sometimes  distinct.  But whether sepa-
 rate or united, no attempt should be made to
 extract the placenta of the first till both  chil-
 dren are bom.   When  the  second  child is
 extracted by art, it is frequently the c^:e, that
 the placenta  must also  be  extracted by  art, 
155
and if one  must  be  so extracted the other"
ought not to be left behind,  because a flood-
ing might be the consequence.
            CHAPTER XXVII.

 IV.  LABOURS WHERE THERE IS A DESCENT Of
    THE UMBILICAL CORD BEFORE THE CHILD.

    If the umbilical cord should happen to de-
 scend before any part of the child, it cannot
 endanger the mother, but it necessarily places
 the child in jeopardy.   If it can be returned
 and  kept back, it ought to be done.  If this
 cannot be effected, it should be placed to one
 side, so as to avoid  compression.   For on a
 continuance of its circulation depends the life
 of the child.  Or if it be deemed more safe
 and prudent, the os uteri  being fully dilated,
 the child may be turned.  But  by the state
-of the umbilical cord it must first be deter-
 mined, whether the  child be living or dead ;
 for if it be dead, the labour ought  to be suf-
 fered to proceed.  So  also if the funis de-
 scend before the os uteri is dilated, the pre-
 sumption is that whatever aid could be af-
 forded would be fruitless, therefore the  la-
 bour  ought  not to be interrupted. 
157
          CHAPTER XXVIII.

   MANAGEMENT OF  WOMEN IN CHILDBED,

  After  delivery  give the patient suitable
refreshment and leave her to repose.  There
should be as little change as possible from her
former habits and customs,  either in diet or
in any other respect.  Let her drink be cool,
and her food adapted to the state of her case.
If she be very faint, a little  wine might be
allowed,  but in common cases spirits of every
kind are  pernicious.
  Pains sometimes occur for the purpose of
excluding the clotted blood, which may be
lodged in the uterus.   These are salutary ot
course, and ought not to be entirely stopped,
if it could be done.  But they will be more
effectual and moderate,  if one or more stools
be procured pretty soon after delivery, by in-
jecting a  glyster or two.  Also a cloth wrung
out of warm water, may be applied to the ab-
domen.   After the proper  evacuations,  if
the warm cloth does not afford relief,  small
doses of opium may be given.
  For a  soreness of the  abdomen,  a warm
flannel sprinkled with  spirits of  some  kind
may be applied.  It should be large  enough
to cover  the affected parts, and should be oc-
casionally removed.   Pain  in the  bowels- 
158
should be removed by a gentle purge.   And
in those cases, where the labour has beendif.
ficult and the patient tolerably robust, as also
in cases of a common  kind when the lochial
discharge is in any degree  deficient, it would
be prudent to give a pretty brisk purge, va-
ried according to the strength of the patient.
Jalap and calomel might be used to advantage
with this intention.
   Strict regard should be  had to cleanliness,
both as it  regards the person and cloathing
of  the patient.   And her mind  should be
kept  as cheerful as possible.  Without these
precautions, and  sometimes notwithstanding
all possible care,  the following dangerous fe-
ver may take place.
            CHAPTER  XXIX.

      PUERPERAL, OR CHILDrBED FEVER.

  The puerperal fever  comes on  gradually,
beginning from twenty hours to thirty days,
and sometimes as many weeks after delivery.
Weak and  delicate  women, and especially
those accustomed to genteel life, are most
subject to it.  It begins with a chill, and the
symptoms attending  it,  are,  nausea,  pain in
the head, loss of strength,  and restlessness.  ^ 
159
The skin is sometimes  dry, at ether times
partially  cr unusually moist.  The tongue
is dry, and sometimes covered  with a black
crust.  The pulse varies being sometimes
weak and small, and then again full and tense.
Wandering pains  are felt in the abdomen,
and sometimes they attack the sides, resem-
bling  pleurisy.   In some cases they extend
to the shoulder blade, to the short ribs, liver
and spleen, then descend to the bladder and
lower intestines.   The pain becomes so acute
in  some instances, that  the patient cannot
bear  the  weight of the  bed clothes.  The
face has a sorrowful appearance, and every
word and  action will more or  less express
her sufferings both of body and mind. Some-
times the belly swells as in pregnancy. Pains
are felt in the back  and  buttock?  the  legs
swell, and at  length the  breathing becomes
difficult.  So great will be the loss of strength
that she will be unable to turn in bed. Vom-
iting and diarrhea, and sometimes a stubborn
costivenens takes place.   The lochia  are
sometimes suppressed, at other times they
continue throughout the disease, and  when
the inflammation  is confined  to the uterus
this must be a favourable circumstance. The
urine is scanty,  is frequendy evacuated, and
is turbid.  Spot3  appear  on the joints.   It
continues from three to five days, and somej 
times in the country to ten, fifteen and twen-
ty days.   Although the appearances vary in
different patients, yet by  this catalogue of
symptoms, the puerperal fever may be known.
And if it should occur, a physician should be
immediately called  in.   But if none can be
obtained, on the first attack the patient should
be bled, according to  her strength and the
violence of  the attack.   Then a mild vomit
of fifteen grains of ipecacuanha, with  one
quarter or one half grain of tartarized anti-
mony should be  given.   And after a gentle
evacuation downwards an opiate at night.—-
Glysters,  fomentations,  and  an  opening
draught of senna, manna and cream of tartar
combined, may be  daily  repeated.   If the
disease be prolonged for several  days, it is
the more necessary that a physician  should
be called in, because bleeding in the common
way  might do harm.   But where the propri*
ety of  bleeding is doubtful, an emetic might
generally  be given with safety.  If there  be
frequent or involuntary  stools caution is ne-
cessary not  to administer any  thing which
may  do injury.  In such case, glysters of
chicken water, or flour and water boiled to a
proper consistence,  or flaxseed tea  ought to
be often repeated.   It requires judgment to
determine the  propriety of correcting this di-
arrhea.  If however  it  becomes  necessary 
161
through the debility of the patient to check itr
an infusion of columbo  root, or flowers of
camomile may be  used, as  also the starch
glyster with the addition  of fifty drops of the
tincture of opium.   Should a hiccuping come
on, take spirits  of nitre one quarter  of an
ounce, clean  water one half pint, and white
sugar at discretion.   Of this mixture give-
two  spoonfuls every  two or  three hours.—
She  should breathe pure  air.  Strict  regard
should be had to cleanliness.   Her rest must
be secured,  and silence  should  be carefully
preserved.   It is thought,  not without good
reason, that this fever may be communicated
by contagion. This circumstance will make
it necessary for the midwife to be cautious in
every  respect, so as not to  convey it from
one  to another.
           CHAPTER  XXX.

      DISEASES  OF LESS IMPORTANCE.

  1. Swelled legs.   A  very distressing
and painful swelling of the  legs sometimes
follows parturition.  In some cases it affects
one leg only, and  in others  it  seizes  upon
both.  Apply to  the swelled limb night and
morning an ointment made  of  an ounce of 
162
olive oil, and an ounce of camphor.  If there
be debility an infusion of columbo or camo-
mile might be used till the strength of the
patient be recovered.   If there be fever treat
it as at chap.  XXIX.
   2.  Swelled brearts.  Are relieved by
an ointment of olive oil and camphor as above,
or the ley poultice of a moderate strength,
or mercurial ointment, and finally the lancet.
   3.  Sore nipples.   Are to be relieved by
an application of Turlington's balsam, balsam
peru,  lead water, or by drawing the breast
three or four weeks before and after delivery.
If blood should be discharged from the breast
instead of milk, give  the  Jesuits  bark  and
wash the breast with  port wine.
  Sometimes a solution of borax is very ben-
eficial as an application to sore  nipples,  it
ought to be tried.                   *"
END OF THE THIRD  PART. 
■ ill—L-  —S—■■B^^——     L~ua
      $att  jFourtjh.
An  essay, on the  management and common
           diseases  of children.
            CHAPTER  I.

              INTRODUCTION.

  IN the first part of this work, a heavy task
is imposed on the mother  ; so heavy indeed
that I could not have expected her perform-
ance of it,  if my eye had not been turned
upon the great and continual aid, which 6he
ought to receive from her husband.   Let no
man think to excuse himself from this inter-
esting duty.  Whatever may be his occupa-
tion ; however important his calling  in life,
he  is bound by  self love, by parental affec-
tion, and by  that patriotic interest  which
every good man feels in the rising generation,
to devote a  considerable part of his attention
to  the government,  and instruction  of  his
children.
   " He is bound by self love."   It  is an ex-
cellent'institution, that children bear their
father'* name.  Not only as it assists in. the 
                   164
distribution and descent of property, but as
it  becomes a powerful motive in  favor of
education.  If posterity be  infamous, they
brand  disgrace  on the name they bear; if
respectable, they reflect honor upon their re-
spective families.
   " He   is  bound  by parental  affection."
The great tenderness felt by both parents for
their infant offspring is no doubt intended to
urge them to take measures  for the welfare
of  the  darling babe.   Experience might
teach us,  that a man of correct taste, could
not maintain a  warm  regard for a perverse
and disagreeable  child.  To love  a son or
daughter  merely as being ours, though des«
titute of all merit, must surely require very
strong animal attachment.   But the proper
steps being taken to form him worthy of es-
teem, parents find themselves daily rewarded
in  their  success.   As the  child  becomes
more amiable, their attachment which at first
is  altogether instinctive and considerably sel-
fish, gradually changes its form from the ani-
mal to the rational  kind.  Hence  they are
at  length prepared to practice self denial and
encounter every difficulty to  secure  to their
child a tranquil life.
   " He is bound by the interest he  feels in
the rising generation."   If a man  deserves
She. honorable appellation of a  lover cf hh 
                    165

^country,  his patriotism will  first  appear in
i his attachment to his family,  and  in  tile at-
tention he pays to the education of his chil-
ijdren.  Let him  make the greatest preten-
 sions to public spirit! and utter the loudest
..declamations for  the  public good ! If he be
.,' deficient in  his  parental duties, his love of
I country is mere  ostentation.   He is at best
x an office hunter.
   -The prosperity of a nation may be deter-
, mined by  its population,  which, if it be the
"greatest   possible,  necessarily implies the
 highest degree of civilization.  Hence the
\ manners  of a nation  have a powerful influ-
 ence  on  its prosperity.  The national cha-
* racter must ultimately be resolved into that
I of families and individuals.  Every true pa-
 triot must therefore  feel himself bound to
% add to the public stock  of respectability and
K happiness,  as well his  own  best example,
; as the additional number of  good citizens to
'* be raised up under his government and pro-
" lection,  in the capacity  of  the father of a
■ family.
!    There  is  another  consideration  of  still
 greater* importance  with those  who  have
 faith in divine revelation.  Believing all men
■ to  be accountable to the Great God who
 will judge the world in righteousness.   Con-
 templating every soul of man born into the 
tCu
world, as a candidate for immortal bliss or
endless woe.   Knowing that present and fi>
ture happiness depends  on the formation of
those tempers of mind which were in Christ
Jesus.  The christain will feel himself com.
pelled  by the  fear  of God, by the love of
truth,  and by the consolations of the gospel,
to be instant  in his  exertions to prepare his
children  through divine  assistance  for  the
kingdom of heaven.
             CHAPTER II,

    AGREEMENT OF PARENTS NECESSARY.

   Doctor Withe rspoon in his letters on edu*
cation says  " Husband and wife ought to be
entirely one upon this subject; not only agreed
as to the end, but as to the means to be used,
and the plan to be followed, in order to attain
it.  If their opinions happen to differ in any
particular, they ought to examine the matter
privately by themselves and settle it,  so that
not the least opposition may appear to the
children or servants."  Such unanimity will
be of great importance in  the  government
of a family.   " It will enforce every rule by
a double authority,  and recommend  it by a
double  example."   Without  this consent, 
                    167

 dieir  labours must be more than lost, not
* only failing to cio good, but necessarily pro-
t during much evil.
i  " These observations are by no means in-
. tended against  those  unhappy couples, who
 b being essentially different in principles and
 ; character, live  in a state of continual  war.
j It is of  little advantage to speak either to or
 k of such persons ;  but even differences incom-
 parable  smaller,  are  of very  bad  conse-
 quence.   When  one  for  example  thinks a
 child may be carried out, and the other thinks
 it is wrong ; when one thinks a way of speak-
 ing is dangerous, and  the other is positive
 there  is nothing in it ;  the things themselves
 may be of little moment, but the  want of
 jconcurrence in the parents,  or  the want of
 mutual esteem and deference easily observed
 even by very young children, is of the great-
 est importance."
             CHAPTER  III.

   ABSOLUTE AUTHORITY OF PARENTS OVER
         THEIR CHILDREN NECESSARY.

   In Part I. chap. II.  I have laid it down
' as a fundamental proposition, u that the rea-
 son and experience of parents should be em- 
168
ployed  in the government  of their childrm
through the whole course of  their infancy,"
Most children manifest a disposition to exert
their will in opposition to that of their pa-
rents before they are twelve months old; and
the  more they  are indulged, the  more per-
verse they grow, till at length their insolence
and petulence become intolerable.  As soon
as  possible therefore an entire and absolute
authority should  be established  over them.
" I would have it early, says  the doctor, that
it  may be absolute, and absolute that it may
not be  severe.   If parents  should be  too
long in beginning  to  exert  their authority,
they will find  the task very  difficult.  Chil-
dren habituated to indulgence for a few of
their first years, are exceedingly impatient of
restraint, and  if they  happen to be of stiff
or  obstinate tempers, can hardly  be brought
to  an  entire, at least  to  a quiet and placid
submission.   Whereas if  they are taken in
lime,  there  is hardly  any temper but what
may be made  to yield, and by early habit
the subjection becomes quite easy to them-
selves.
   The authority ought also  to be absolute,
that it may not be severe.   " The more com-
plete and uniform a parent's authority is, the
offences will be  more rare; punishment will
be  less needed,  and the more gentle kind of 
                    169

 correction will be abundantly sufficient; we
 see every where  about us examples of this,
 A parent that has once obtained, and knows
 how to preserve authority, will do more by a
 look of displeasure, than another by the most
 passionate words and even blows.   It holds
 universally in families and schools, and even
 in the greatest bodies of men, the army ^nd
 navy, that those who keep the strictest disci-
 pline,  give  the fewest  strokes.   I have fre-
 quently remarked, that parents,  even of the
 softest tempers, and who are famed for the
 greatest indulgence to their children, do, not-
 withstanding  correct them more frequently,
 and even more severely, though to very little
 purpose,  than those who keep  up their au-
 thority.  The reason is plain.   Children by
 foolish indulgence, become often  so froward
 and petulent in their tempers, that they pro-
 voke  their easy parents past  all  endurance ;
 so that they are obliged, if not  to strike, at
 least to scold  them, in a manner as little to
 their own credit, as children's profit."
  " There is  not a more disgusting sight
 than the impotent rage  of a parent who has
 no authority.   Among  the lower ranks of
 people, who are under no restraint from de-
cency, you may sometimes see a father or
mother running out into the street after a child
who is fled from them, with looks  of furv 
170
and words of execration, and they are often
stupid enough to imagine that neighbours or
passengers will  approve  them  in their con«
duct, though in fact  it fills every beholder
with horror.   There is a degree of the same
fault to be seen  in  persons of better  rank,
though expressing itself somewhat differently.
Ill words and altercations will often fall out be-
tween parents and children before company, a
sure sign that there is a defect of government
at home, or in private.  The parent stung with
shame at the misbehaviour or indiscretion of
the child, desires to persuade the observers
that it is not  his fault,  and thereby convinces
every person of  reflection that it is."
             CHAPTER  IV.

IMB BEST AND  MILDEST WAY  TO ESTABLISH
         THE NECESSARY AUTHORITY.

   " I  would recommend to every parent to
begin  the establishment of authority much
more early than is commonly supposed to be
possible:  that is to say, from  about the age
of eight or nine months; you will perhaps
smile at this, but I do assure you from expe-
rience, that by setting about it with prudence,
deliberation, and attention,  it  may be  in a 
in
manner completed by the age of twelve or
fourteen  months.  Do- not  imagine that I
mean to bid you use the rod at that age ; on
the coiurary, I mean to prevent the use of it
in a gr. at measure, and to point out a  way
by which children of sweet and easy tempers
may i c brought to such a habit of compliance,
as never to need correction at all; and what-
ever their tempers m.iy be, so much less of
this is sufficient, than upon any other suppo-
sition.   Th.s is one of my favorite schemes,
let me  try to explain and recommend it."
   " Habits  in  general may be  very  early
formed in children ;  an association of ideas
is, as  it were the parent  of habit.  If  then
you can  accustom your children  to perceive
that) our will must always prevail over theirs
when  they are  opposed,  the thing is done,
and they will submit to it without difficulty or.
regret."
   " To bring this about, as  soon  as they be-
gin to show their inclination by desire or
aversion, let single instances be chosen now
and then (not  too frequently) to contradict
them.   F  r example,  if  a child show a de-
sire to have any thing in his hand with which
he is delighted, let the parent take it from
him and when  he does so,  let no considera-
tion whatever  make him restore  it at that
time.  Then at a considerable intev-al.   per- 
172
 haps a whole day is little enough, especially
 at first,  let the same thing be repeated.  In
 the mean time it must be carefully observed,
 that no attempt should be made to contradict
 the child in the intervals.   Not the least ap*
 pearance of opposition, if  possible, should be
 found between the will of the parent and that
 of the child, except  in those chosen cases,
 when the parent must always prevail.
   " I think  it necessary that those attempts
 should always be made and repeated at pro-
 per intervals by the same person.  It is also
 better it  should  be by the  father, than the
 mother  or  any  female attendant, because
 they  will necessarily  be  obliged in many
 cases to  do things displeasing to the child, as
 in  dressing, washing,  &c. which spoil the
 operation.   Neither is it necessary that they
 should interpose, for  when once a full au-
 thority is established  in  one  prson  it can
 easily be communicated to others, as far as it
 is proper.  Remember, however, that mother
 or nurse  should never presume  to condple
 with the child, or shew any signs of displea-
 sure at his being crossed ;  but on the contra-
 ry, give  every mark of approbation,  and of
 their  own  submission  to tin same person.
   "This  experimeVit   fr-qucntly  repeated,
will in a little time so p^rfecdy h.Situate the
child  to yield to the pa vent,  whenever he, in- 
17J
tl terposes, that he will make no opposition.
  I can assure you from experience, having lit—
'  erally  practiced this  method myself,  that I
J  never  had a child of twelve months  old but
1  who would suffer me to take any thing from
  him or her, without  the least mark of anger
:  or dissatisfaction ; while they would not suf-
  fer any other  to do so, without  the bitterest
  complaints.   You  will  easily perceive  how
  this is to  be  extended gradually,  from one
  thing to another, from contradicting to com-
  manding, &x."
    This theory of Dr. Witherspoon is pleas-
  ing and interesting.   It  is also practical  as
:  I well know from my own experience.  But
  its importance in establishing  an  early and;
  absolute authority over children, will further
  appear from  the following  considerations,
  taken from the same excellent letters.
    " There is  a great diversity in the temper
  and disposition of children ;  and no less  in
  the penetration, precedence and resolution of
  parents.  From  these circumstances, diffi-
  culties arise,  which encrease very fast as the
  work is delayed.  Some children have natu-
  rally very  stiff and  obstinate tempers,  and
  some have a certain pride,  or if you please,
  greatness of mind, which makes them think
  it a mean thing to yield.  This disposition is
  often greatly strengthened in those of high
                    K2 
birth, by the ideas of their own dignity and
importance instilled into them from their
mothers milk.   I have  known a boy of six
years of age,  who made it a point of honor
not to cry  when he was beat even by his pa-
rents.   Other  children  have  so strong pas-
sions, or so great sensibility,  that if they re-
ceive correction, they will cry immoderately,
and either be,  or seem to be affected to such
a degree,  as to endanger their health or life.
Neither is  it uncommon for the  parents in
such a case to  give up the point, and if they
do not  ask pardon,  they give very genuine
marks of  repentance  and sorrow   for what
they have done.   I have said this  is not ui>
common, but I may rather ask, whether you
know any parents at all,  who have so much
prudence and firmness, as not to be discour-
aged in the one case or to relent in the other?
But it must always  be remembered that the
correction  is wholly lost  which does not pro-
duce absolute submission.  Perhaps I may
say that it is mere than lost,  because it  will
irritate instead  of reforming  them, and will
instruct or perfect them  in the art  of over-
coming their parents, which they will not fail
to manifest on a  future  opportunity.   It is
surprising to think,  how early children will
discover the weak side of their parents^ and
what ingenuity they will shew  in  obtaining 
11 J
 their favor or avoiding  their displeasure.   L
 think I have observed a chiid in treaty or ex-
 postulation with a parent, discover more con-
 summate policy at seven years of age, than
 the parent himself, even when attempting to
 cajole  him  with artful evasions and specious
 promises.   On all these accounts, it must be
 a vast  advantage, that a habit of submission
 should be brought on so early, that even me-
 mory itself  shall not be able to reach  back to
 its beginning.   Unless this is done, there are
 many cases  in which, after the best manage-
 ment,  die authority will be  imperfect; and
 some in  which any thing that deserves that
 name will be  impossible.  There are some
 families, not contemptible either in station or
 character, in which the parents are  literally
 obedient to  their children* are forced to do
 things against their will, and chidden if they
■discover the  least  backwardness to comply*
 If you know none such, I am sure I do*"
             CHAPTER  V.

THE BEST MEANS OF PRESERVING AUTHORITY.

   The Doctor's  reflections on  this subject
are so correct,  they correspond so accurately
with  my  own  observation and experience^ 
176
that I  cannot deny  myself the pleasure of
continuing the quotation, although  it has al-
ready  filled  up three  chapters.  This I do
the more readily having conviction  that the
works from   which  these  observations are
taken  are not in general use in any of the
southern states.
   " Whatever authority  you exercise  over
either children or servants, or as a magistrate
over other citizens, it ought to be dictated by
conscience, and directed by a sense of duty.
Passion or resentment ought to have as little
place as possible ;  or rather to speak  properly,
though few can boast of having arrived at
full  perfection, it  ought to have  no place at
all.  Reproof or  correction given in a rage,
is always considered by him to whom it is
administered,  as  the effect of weakness in
you, and therefore the demerit of the offence
will be either wholly  denied or soon forgot-
ten.   I have heard  some parents often say,
that they cannot correct their children unless
they are angry;  to which I have usually an-
swered,  then you ought not to  correct them
at all.   Every one would be sensible, that for
a magistrate to discover an intemperate rage
in pronouncing sentence  against a  criminal,
would be highly  indecent.   Ought not pa-
rents to punish their children  in the same
dispassionate manner ? Ought they not to b_e 
177
at least equally concerned to  discharge their
duty in the best manner  as  well in the one
case as in the other ?
  He who would preserve his authority over
his children,  should be particularly watchful
of his own conduct.  You may  as  well pre-
tend to force people to love what is not amia- #
ble,  as  to reverence what is  not respectable.
A decency of conduct therefore, and dignity
of deportment, is  highly serviceable for the
purpose we have now in view.  Least this,
however,  should be mistaken, I must put in
a caution, that I do not mean to recommend
keeping children at too great a distance, by an
uniform  sternness and severity of carriage.
This, I think,  is not necessary, even  when
they are  voung;  and to  children  of some
tempers, it may be very hurtful when they
are old.   But by dignity of carriage, I mean
parents always  shewing  themselves to be cool
and reasonable  in their own conduct; prudent:
ana cautious  in their Conversation with re-
gard to the  rest of mankind : not fretful or
impatient, or passionately fond of their own
peculiarities ;  and though gentle and  affec-
tionate to their children, yet avoiding levity
in their presence.  I would have them cheer-
ful vet  serene.  Their familiarity should  be
evidently  an  act  of condescension.   That
which  begets esteem will not faj|l to producr 
178
subjection.   Every  expression  of affecticn
and kindness  to children is  proper when it
is  safe, that is to say, when their behavourij
such as to deserve it.  There is no opposi-
tion at  all between parental tenderness' ;,nd
parental authority.   They are the best sup-
ports  to each other.   It is not only lawiul
but will be of service that parents should dis-
cover the greatest fondness for their children
in infancy, and make them perceive distinct-
ly with how  much pleasure they gratify all
their  innocent inclinations.  This  howevtr
must  always be done when they  are quiet,
gentle, and  submissive  in their carriage.—
Some have  found fault with  giving tktm,
for doing well, little rewards of sweet meats
and play things,  as tending to  make  them
mercenary,  &c. this is refining too much.—
The great point is, that they be rewarded for
doing good,  and not  for doing evil.   When
they are cross  and froward, I would never
buy  peace,  but force it.   Nothing can be
more weak  and  foolish or more destructive
of authority, than  when childr-eft  are noisy
and in an ill  humour,  to give them or pro-
mise  them  something to  appease  them.—
When the Roman  emperors began to give
pensions and subsidies to the northern nations
to keep them quiet,  a man might have fore
ieen without the  spirit of prophecy, who' 
179
would be master in a little time.  The case
is exactly the same with children ; they will
soon avail themselves of this easiness in their
parents, t on maud favours instead of begging
them, and  be  insolent when they should be
thankful.
  u The same conduct ought to be uniformly
preserved as children advance in understand-
ing.   Let parents try to convince them how
much they have their real interest at heart.—
Sometimes children will make a request, and
receive a hasty or  forward denial ; yet upon
reflection, the  thing appears not to be un-
reasonable,  and finally it is  granted, and
whether it be right or wrong, sometimes by
the force of  importunity, it is extorted.   If
parents expect either gratitude or submission
for favours so  ungraciously bestowed, they
will find themselves egregiously mistaken.—
It is their duty to  prosecute,  and it ought to
be their comfort to see the happiness of their
children ; and  therefore they ought to lay it
down as a rule, never  to give  a sudden or
hasty refusal; but when any thing is propo-
sed to them, consider deliberately and fully
whether  it  is proper ; and after that,  either
grant it cheerfully or deny it firmly. 
180
             CHAPTER VI.

PROPRIETY OF INCULCATING RELIGIOUS SENTti
                   ME NT.
                                         II
  " The only foundation for a useful educa-
tion in a republic is to be  laid in religion.-i
Without  this there  can  be  no  virtue, and
without virtue theie  can be no liberty, and.
liberty is the object and life of all republic^
governments."                           '
  These reflections taken from Dr. RusrrV
essay on the  mode of education proper in a
republic, are  completely correspondent with
my first  fundamental  proposition,  Part I,
chap. 2,/ And this excellent writer still pro-
ceeds to support my theory.   " Such  (says
he) is my veneration for every  religion that
reveals the attributes of the deity, or a future
state of rewards and punishments, that I had
rather see the opinions of  Confucius or Ma-
homet inculcated  upon  our youth, than see
them grow up wholly devoid of a system of
religious principles.  But the religion I mean
to recommend,  is  that  of the  New-Testa-
ment."
  " It is foreign to my purpose" to hint at the
arguments which establish the  truth  of the
Christian revelation.  My only business is to
declare, that all its doctrines and precepts are 
181
 calculated to promote the happiness of soci-
 ety, and the safety and well being of  civil
 government.   A christian cannot fail of be-
 ing  a republican.   The history of the crea-
 tion of man, and of the relation of our spe-
'i* cies to each other by birth, which is recorded
r in the old Testament, is the best refutation
* that can be given to the divine right of kings,
c and the  strongest argument that can be used
o. in favor of the original and natural equality
 of all mankind.   A christian I  say again,
:,;. cannot fail of being a republican, for every
:!' precept of the gospel inculcates those degrees
,:: of humility, self denial, arid brotherly kind-
 ft ness, which are directly opposed to the pride
rof monarchy and the pageantry of a court.
£ A christain cannot fail of  being useful to the
a republic, for his religion teacheth him,  that
n no  man  liveth  to  himself.   And  lasdy,  a
,i> christian cannot fail of being wholly inof-
.,, tensive, for his  religion teacheth him in all
», things to do  to others what he would wish,
w in like circumstances, they should do to him/'
,{,   " I am aware that I dissent from  one of
.j those paradoxical opinions with which mod-
 ern times abound, that it is  improper to fill
 the minds of youth with religious prejudices
j of any kind,  and that they should be  left to
.. choose their own principles, after they have
  u rived  at an age in which they are capable 
I8i
pf judging for themselves.  Could we pic>
serve the  mind  in  childhood and youfei
perfect blank, this plan  of education  would
have  more to recommend  it,  but this,^
know to be  impossible.   The human mini
runs as naturally  into principles,  as it doa
after facts -f it submits with difficulty to those
restraints or  partial discoveries  which an
imposed upon it in the infancy  of reason.
Hence the impatience of children  to  be in-
formed upon  all subjects that relate  to the
invisible world.   But  I beg leave to ask,
why  should we  pursue  a different plan .of
education with respect to religion, from that
which we pursue  in teaching the arts and sci-
ences ?   Do we  leave  our youth to acquire
systems of geography,  philosophy  or poli-
tics, till they have arrived at an age in which
they are capable of judging  for themselves!
We do not.   I claim no more then for reli-
gion, than for the other sciences,  and  I add
further, that if our youth  are disposed, after
they are of age,  to  think for themselves, a
knowledge of one system will  be the btst
means of conducting them in a free enquiry
into other systems of religion, just as an ac-
quaintance with one system of philosophy^
the best introduction to the study  of  allitbe
other systems in the world."           >i 
183
   When we still add to the above forcible
 reflections, the well known  fact that those
 children  who  are brought up  without reli-
 gious sentiment, readily  become extremely
 licentious and fall into every kind of dissipa-
 tion, the candid  reader must grant that pa-
 rents ought  by all means  to bring up their
* children  in the fear of God.
,             CHAPTER  VII.

J 'HOW RELIGIOUS SENTIMENT  MAY BE  EXCITED
    IN THE MINDS OF CHILDREN  MOST  SUCCESS"
>:    FULLY.
s;
<:    There are  two  methods of exciting reli-
i gious sentiment in the minds of children.
»    One is direct and will include all particular
I: instruction given for that express purpose.
i.    The other is indirect having reference to
it: the influence of example.
it .   1. What kind oi instruction should be di-
i  rectly employed,  has been a  matter of con-
to troversy.  I  shall  wave all  disputation and
i  offer a few reflections which to me seem to be
•^ correct. >
H     The  first  thing necessary to be taught is
  the simple existence of a God.  The curiosi-
  ty of children will prepare the way for secur- 
18*
ing this  fundamental  point.   But before f
proceed further, let me remove an objection  i;
   It is  alledged  by some  that children re-
ceive any kind of information more readily  j
than that pertaining to religion.   If we at-  J
tempt to teach an  infant,  the deep myste*'«»  I,
of those scholastic systems,  which cannot bt,
understood even  by  those  who teach then^
it is no wonder the little pupil should express
uneasiness,  or even disgust.  The defectj|
in the mode of* tuition,  not in the chdd.;—
The case would  be very different if simpki
facts only  were  properly presented  lo his,  -
mind.    The curiority of  children is eye*  <
awake,  they are all athirst for knowledge*-  .
They quickly discover the relation of cause
and effect, and eagerly enquire " Who made
it ? Whence came it ?  &c. &c." and not pcffj
ceiving the  necessity of granting a  FiRSTt|
cause, on  hearing the existence of many
things ascribed to the creating power of God,
they ask with equal  simplicity,  who made
him ?  Let them be encouraged in their- erf
quiries, and you  may, very quickly   teach
them this great truth, "  That God is."
   But it will be a matter of small moment
to teach a child the existence of Deity, unless
he be also taught more or less of  the divine
character.    And  even  this may be  done 
185
jnure readily than could be  expected by  any
 who never made the trial.
   What may be the essential character of an
'^omnipotent,  omnipresent,  and eternal Being,
 taken  in the abstract,  we cannot,  need  not
'^know.   We are not endowed with powers
*to contemplate it.   We are chiefly interested
\"in the communicable and moral perfections of
'God; his Holiness, justice, goodness,  truth,
:i and mercy.
'.:   Ii; should  be remembered however,  that
' the  incomprehensible Wisdom and awful Pow-
 er of God, should be employed to excite  that
'/sense oi profound veneration which must  pre-
cede all other genuine religious sentiment.
'   Now I believe that God made man ex-
-pressly that he might manifest himself to
''him, and that man might be hapyy in the en-
J joyment of the  manifestation.   We are  told
(tin scripture that   " God  made man  in his
'Own image," by which I would understand,
it a certain power of perceiving the  beauty of
'Holiness—-justice, goodness, truth,  &c. while
the  perception is  attended with certain emo-
tions,  highly pleasurable and  improving to
Kthe  person favoured with  it.  Perhaps  in a
,; state of original rectitude,  man was blessed
»with this glorious perception continually,  and
of course the consequent emotions were con-
tinually and  perfectly enjoyed by him.   But 
186
since the admission of iniquity into the\vorM(
mankind are barely susceptible of this hap(»
condition,  and to attain to it, must submit I*
very particular  discipline.   There are ho#>
ever strings in the  human heart which wh«ji
properly struck  will  accord to these divine
perfections.                            ->*-,
   We are conscious  of certain  pleasured!*!
emotions on beholding stupenduous greatneUs
or superlative excellence.   We  have other
agreeable  sensations  in performing acts of
goodness,  truth, or mercy,  or in seeing theft
performed by others.  To be more partictf
lar, if  we behold  a  man of superior dignity
we feel respect, or  reverence.  The sensatic*
is  sublime and pleasing.  An act of justkfc
meets  our approbation, and while we con-
template  it with  pleasure,  a  resolution is
formed in our minds, on every similar occa-
sion  to imitate it.   So  likewise  acts of be-
nevolence, truth, &;c. excite in us similar and
correspondent emotions which afford pleas-
ure and form the  mind for similar  acts.  It
is by a certain affinity of this kind thata prop-
er view of the divine character excites in us
the " Divine affections  of Reverence, Grati-
tude, Love, Obedience, and Resignation."
   The character of Deity  is unfolded to our
 view by various means.   u The heavens de-
 clare the glory of  God and the earth is fillet! 
187
 with hi3 wonderful works."   Objects great
 and small every where  present  themselves,
' challenging us as rational creatures, to trace
 out the perfections of the great author of all.
 Each discovery brings new delight,  whilst it
 makes  better the  heart  " of him who hath
 pleasure therein."  This employment consti-
 tutes the most rational and sublime happiness,
 and this  I venture to affirm is the great end
 for which man was created.
    Having taught our children the existence
 of a Great First Cause ; we cannot begin too
 early to turn  their attention to such displays
 of the divine character as they may be able
 to comprehend.   And we should remember
 that every attempt in which we fail to excite
 some one or more of the proper  affections is
 labour lost.  Therefore  when we shew them
 the heavens, the sun,  moon  and stars which
 God hath »rdained, we should make such
 remarks as may inspire them with Reverence.
    Whenever we mav perceive they are par-
 ticularly gratified  with some  article of food,
 we should make  mention of the  great Good-
 ness of him who is the giver of all our com-
 forts.   This method would excite their Grat-
 itude.   As  their  minds  expand we  should
 call their attention to the kind interposition of
 providence  in giving them parents,  friends,
 houses,  fields, fruit trees, beasts of burthen, 
188
and the like.  Instruction  given in this way
will  be effectual and lasting.   And thus th.
whole course of natural history might be em-
ployed  to extend  their knowledge of things,
and to point out to them the harmonies which
are displayed throughout  the works of crea-
tion, forming an infinite variety of melodious
voices singing the  Wisdom, Power and Good-
ness of God.  Their gratitude will insensih^
be mingled  with Love, and they will.be del
lighted with our instructions while they learn
to contemplate their Creator  as their great
and  loving  Father.  Their  obedience* to us
when made habitual, and their confidence it
our friendship  and  protection,  may be em-
ployed to teach them divine Obedience and
Trust.   At length from a general admiration
and esteem  of the divine communicable per-
fections, they  will be  prepared with joy to
" behold the glory of God in the face of Je-
sus  Christ  in  whom dwells the fulnesss of
the Godhead bodily,"  and by the contempla-
tion  of the  character of God as there more
clearly and interestingly revealed, be changed
into the same image from glory to glory.—
Let sceptics smile  or approve, I am happy to
declare that  such a manifestation of Deity is
worth an empire.                      ' •
  Before I  leave this part of the  subject let
me  observe, that,  although children should 
tSe
never be confined long to  any kind of reli-
gious instruction, unless they express a man-
ifest willingness for it, yet parents should
daily read in their hearing a portion of scrip-
ture, chosen where it  is most easily under-
stood.   And after they are old enough they
should be made to read a chapter or two eve-
ry day themselves.  But they ought not to
be compelled to pore over it till they feel dis-
gust at the book and all those who bind them
in such heavy chains.
   2. It remains  that  something be said of
the second or indirect mode of exciting reli-
gious sentiment.
   The plan I  recommend, requires judg-
ment,  reflection,  and  great attention  in our
whole conduct.  Nothing  should be admit-
ted in the intervals that may  counteract it.
There should be no  opposition between our
precepts and examples.
   As we would inculcate upon them Rever"
e.ice to God, gravity should continually ap-
pear ii our deportment.   No foolish levity
should be indulged.   No irreverent expres-
sion should ever escape from our lips.
   As we wish to inspire them with Gratitude,
with never failing  regularity we  should ex-
press our thanks to God at every meal, and
with the return of morning and evening as-
L  2 
190
sembie our children and servants for family
worship.
  As we desire they should imitate the Dei.
ty in Benevolence,  we  should treat all men
with gentleness and kindness.  We  should |
never be guilty of u that common but detes-
table custom, of receiving persons with cour-
tesy and all the marks  of  real friendship in .
our houses, and  the moment they are gone,
falling upon their character with unmerciful
severity."   We  should never  abuse a ser-
vant or any of our domestics, but at all times
shew'respect to their merit and endeavour ts
make them happy.   We should not suffer a
horse  or ox  to  be  unnecessarily  tortured.
We should not even approve the death of an
harmless insect.
   As we would have them distinguished for
love of virtue,  we should always pay  the
greatest attention to the man of real worth,
without regard to  the extent of his  posses-
sions.   We should never seem to be gratified
with a visit from the wealthy, making every
possible exertion  to   accommodate  them,
when at the same  time, we  would scarcely
treat a man  in  poorer circumstances with"
common civility.
   As we would wish them  to  have a  true
knowledge  of God  as manifested through
Christ Jesus,  we  should  strive to  be  like 
1*1
this Divine Teacher ; meek, humble, patient.
long suffering, benevolent, &c &c.
           CHAPTER  VIII.

   COMMON COUNTRY SCHOOLS ' INJURIOUS.

 > By  the  greatest  attention parents form
their children to virtue and religion.  But it
is a lamentable truth that too many entirely
neglect this important duty.  Most children
grow up like the  u  wild asses' colt."  This
being the ease it follows, that a school made
up of twenty or thirty children taken promis-
cuously from the whole neighbourhood, is an
assemblage of  vice sufficient to  ruin  the
whole.   Each one is contaminated with the
vices of all the rest,  and so our children bad
enough at best,  become twenty times worse.
   The person who is placed at their head is
commonly some  ignorant  and lazy fellow,
who is as  little  anxious as  he is qualified to
preserve their morals.   It  is true the man
can read and write, and by dint of  severe
-correction, and at the expence of a thousand
helpless  tears,  his scholars  receive a sketch
of his mighty acquirements.  Corrupted by
their school-fellows, debased by their teach-
rr's  ill  manners  and discipline, their little 
192
stock of literature is purchased at an expend
which the most liberal tour of science could
not compensate.
   Parents,   particularly  mothers,  should
teach  their children these  first rudiments of
literature.   Where  this  is  impracticable,
they should employ  some proper person to
teach them  under their own inspection. Per-
haps a female teacher might be preferred for
several of the first years.
   In neighbourhoods where the circumstan-
ces of the people make common schools ne«
cessary, the greatest  care should be taken to
employ the  best men to teach them.  It Is
unpardonable to prefer a worthless  creature
before a man of talent and worth for the sake
of saving  three or four dollars per year.
   I  shall conclude this chapter with  an ear-
nest request  of all  parents to educate their
daughters specially.   This will be doing the
greatest benefit to  the rising generation,^,
Nothing  could be  more important.   If it
could be at once universal it would reform na-
tions.   See  Part I.  Introduction.*
  * Since the  publication of this work, from some
cause, the spirit of female education is diffusing it-
self through the state of Virginia,  to an extent far
surpassing  any thing heretofore known.  It is sin-
cerely to be hoped, so laudable a design will never
more be abandoned or neglected. 
193
            CHAPTER IX

INTRODUCTORY REMARKS ON THE MODE OP PRE-
    SERVING THE  HEALTH OF CHILDREN.

  The  principal  things to be regarded for
the preservation of the health of children are,
cleanliness,  liberty, free air, regular cloath-
ing and proper food.
   1. When I  recommend cleanliness, I do
not mean that  they should always appear in a
dress fit for seeing company ; or,  that they
should never be suffered to foul their hands
and feet.  All that can be requisite is, that
they should be clean dressed once,  or if con-
venient, twice a week.  That they  should
lie upon clean  and dry  beds.*   This is an
important precaution,  as they would receive
less injury by being exposed a whole  day to
very inclement weather, if kept   in constant
action,  than from  lying a few hours on a wet
or damp sheet.  And lastly,  that  their skin
be frequently washed with cool water.   Per-
haps it might be a very convenient and prop-
er method, to  change the linnen of very dirty
children every night, giving them a clean
and dry shirt to  sleep in, and in the  morn-
  • There are some people who do not expose their
beds to the sun as often as they ought; this should
be done twice a week. 
194
ing  putting on again  the clothes  in  whjti
they  may be  suffered to  roll  about in M
din.*                                      J
   2.  By recommending liberty, I intend #
speak against  the improper custom of keep-
ing children  too  much confined in the ariro
of their nurse, and of shutting  them  up W
any one particular apartment.   They should
be indulged in running  about  the house or
yard at will.   Care should be taken however,
that they do not climb upon dangerous places.
In this respect, the greatest  latitude maybe
given them,  and yet  with a very little atten-
tion,  the thing might be  so conducted, as id
a gradual and unperceived manner, to lay the
foundation for their future regularity and in-
dustry ; but  they should never be left in the

  * There are some  who through ignorance of itSjjjf
effects, or through the most inexcusable indolencet
suiter  little ponds of water and filth to stand in their
yards  or under their  houses for months together.—
Such will probably pay very  dearl)  for their want tf
cleanliness.  I have seen some which might ultimate-
ly produce the most malignant diseases
  Not intending by any means to  insult  the feeling?
of the ladies, it is presumed the better informed Will
thank me for  stating the impropriety and scandal of
permitting loathsome insects so to infest houses and
beds, Uvat people of taste and decency cannot rest ft
them   It is hoped that all American women will shun
such a disgrace by  paying proper  attention to th*
neatness for which many,  very many of them already
deserve the highest credit. 
195
Care of  a heedless or vicious nurse ; for ia
such hands, not  only their lives are in dan-
ger, but they learn habits which may be per-
nicious to their morals and happiness through
life.  This last precaution well deserves  the
attention of the rich.  They  too often give
up the management of their  children to  ig-
norant and immoral slaves, whose interest it
is to contaminate the minds of their little mas-
ters, that through them they  may  in future
obtain favours and indulgencies.
  3. Sufficient liberty being granted them,
they will of course breathe in a pure and free
air during the day.  But  I must  here make
a remark on the danger of putting children to
sleep in a close  room, from  which every
breath of air is excluded.  Many promising
children have  perished in  convulsions, by
this act of mistaken kindness.
  4.  As to the  cloathing of children, it is
important that every part of it be  made loose
and easy.  Confinement in this respect must
endanger their health by obstructing the reg-
ular motions of the system, and may at length
deform them very much.  Their dress should
be  moderately warm, and should be- varied
with the weather and  seasons.  It will be
found on observation, that in most  instances
violent fever and croup happen to those chil-
dren  who are most healthy,  and who of 
196
course are pemitted to run about in cold and
windy weather without any change of cloathii
ing.   A very moderate degree of care on
the part of the mother might prevent much
mischief in this respect.
   5.  In the  article  of  food, children may
generally be  permitted to indulge their own
appetite.  If healthy,  they  will eat more or
less  for every hour in the day.   It is mucHi
better for their health to gratify them as often
as they request it, than  to confine them to
any  set meals adapted to  the  demand* of
grown people.                         i
   While they are young,  milk is the best,
and  ought to  be a principal article of their
food.   " Milk (says Dr. Darwin) is the nat-
ural  food for children, and must curdle in
their stomachs before digestion ; and as this
curdling of the milk destroys a part of the
acid juices of the stomach, there is no rea-
son  for discontinuing its use, although it \b
occasionally thrown out  in.  a curdled state.
A child of a week old, which had been taken
from the breast of its dying mother, and ty
some uncommon error, had been suffered to
take  no food  but vfater gruel, became sick
and  griped  in twenty-four hours,  was  con-
vulsed on the second day, and  died on the
third.  When young children  are brought
up without a breast, for the first two montta 
197
 they should have no food but new milk."   It
 should be weakened .with a little v ater, and
 some loaf or clean brown sugar,  might also
 be added.   But " the addition of any kind of
 bread  or flour is  liable to ferment and pro-
 duce  much aridity; as appears by the con-
 sequent  diarrhoea with   green  stools and
 gripes.   And they  should  never be fed  as
 they lie upon  their hacks, as in that position
 they are necessiated to swallow all that is put
 into their mouths ; but when they are fed as
 they  are sitting up,  or raised  pretty much,
 when  they have had enough,  they can per-
 mit the rest to run out of their mouths. This
 circumstance  is of great importance to the
 health of those children  who are reared by
: the spoon,  since if too  much  food is given
 them, indigestion, gripes and diarrhoea, are
 the consequences ; and if too little, they be-
 come emaciated ; and of the exact quantity,,
 their own palates judge the best."
   Most  mothers  from their natural tender-
 ness for their infant children, are led to feed
 them more or less of every article of  which
 they eat themselves.  In some instances it
 may not happen to do any mischief.  But it
 is always dangerous to oppose the obvious
 appointments  of the God of nature.   If we
 would be guided by  the intimations given us
 of his will, we should never feed our children 
198
with solid food*  till they were supplied with
teeth for masticating it.   I think no vegita«
ble should be given them till they are at least
five months old.
             CHAPTER  X.

SOME REMARKS, INTRODUCTORY  TO THE Cvsk
  OF THE COMMON DISEASES INCIDENT TO CHItr
  DREN.                               ' ;l'

  It is common for parents to be wholly de-
pendent on physicians,  for the relief of <km
children whenever they are sick.  In difficA
and tlangerous cases, it certainly  it besMd
procure the  most judicious advice.   But as
no one can be so deeply interested in the
health and happiness of their children as thf
parents themselves,  it  follows, if they have
the necessary information, that they must be
the proper persons to prescribe to their com-
plaints.  The truth of this may perhaps here-
after appear.  If parents  could  know the
symptoms which  usher in a violent attack of
fever,  by  being continually with their-chil-
dren, they might  always be apprized of their
first  disposition to disease.    This circum-
stance would be very important since a dis-
ease of whatever  kind, is most easily rem*- 
199
ved in its forming state.   Nay more, a very
simple system of medical knowledge would
answer this intention.  Such an one, as any
person of common understanding might exe-
cute.   But a fixed disease is ever difficult of
management,  and may not only perplex but
baffle the most skilful  physician.   Besides
there are diseases which  require immediate
assistance.   The croup  for  example,  fre-
quently carries off the patie&t so speedily, as
not even to admit of calling in a physician
from the distance of one mile.
   To prepare the heads of families  for this
important trust, would indeed be a great per-
formance.   It may  not be accomplished in
half a century.  But every attempt,  hoover
feeble, if well directed to.this great  end, de-
mands  the attention and gratitude of the
public.    t

            CHAPTER  XI.
SOME HINTS TO ENABLE PARENTS TO DETER-
   MINE  WHETHER THEIR  CHILDREN  ARE PAR-
   TICULARLY  SUBJECT TO DISEASE,  AND IF
   DISORDERED, TO JUDGE  OF THE  VIOLENCE OF
   THE ATTACK.

   Parents should be particularly attentive to
observe their children  minutely in all their
actions and habits, &c. 
200
   1.  They should observe the commoner
tent of their appetite, so that any consider*.
ble excess or deficiency in their eating -may
not pass  unnoticed.   This will be of Use,
since  a considerable change  in one of these
respects,  almost always takes place befow*
spell  of sickness.                      ■">'
   2.  Attention should be paid to their stock
Unimportant  as this might at first appear to
the inconsiderate> yet a  costive habit gene-
rally  precedes an attack of fever.         *ui
   3.  The degree  of exercise and  the ag'rhtjp
with  which it is performed deserve particu-
lar observation.   For all fevers are ushered
in  with a degree of slothfulness,  a sense* of
weariness, and in  children with a more than
usualdisposition to sleepiness.          -»>
   4.  By  noticing  whether  any of the foit«
going circumstances  take place after having
been exposed to unusual weather, or to greaJ*
er than ordinary fatigue :  Or  if the place or
season be sickly, by having  regard to these
circumstances, there will be the less danger
of being taken at surprize.
   5.  As  it is generally  the case  that some
complaints of lesser magnitude go  before and
give  warning of the impending danger; such
as costivcness, a sense of wearhiess, dullness
of the faculties, preternatural  appetite or de-
fect of it, a  puin in the  limbs, &c   There-' 
201
 fore when these marks of forming  disease
 present themselves,  a puke  or purge ought
 to be timely administered according to cir-
 cumstances.  This might frequently prevent
 great mischief.  Indeed in many instances,
 timply  bathing the feet in hot water,  and ta-
 king a plentiful draught of warm tea of some
 kind on going to bed,  might prevent an at-
 tack of fever, especially if the patient be not
 in a costive habit.   This last circumstance
 may be considered in most  instances as re-
s quiring  the  exhibition of a purge of some
. kind.   As also great sickness of the stomach
: might point out the propriety of a puke.
    6. But it will also be important for parents
: to be able to judge of the violence of thfedis-
 ease in case of an attack. They should tftere-
 fore frequendy observe the strength of their
. children's  pulse when  in health, its kind of
; motion,  the force with which it seems to pro-
\ pel the blood along, its apparent size, its tight-
 ness as to its extension lengthwise of the arm,
i its fulness, &c.   A  knowledge of these cir-
 cumstances attending the pulse,  will be very
 important in particular cases, especially where
 bleeding may be necessary.  For this opera-
 tion  cannot  be  proper unless the pulse be
 either strong and full, or tight, at least judi-
 cious advice should be had in cases with oth-
 er states of the pulse. 
202
   7. They should also  have regard to the
 manner  of breathing  in a  healthy child, til
 the state of his skin,  the appearance of hi
 eyes, the complexion of his teeth,  the coldljr
 and  degree of moisture of  his tongue, the
 proper figure and appearance of his mouth
 and  throat.  For  as the violence and danger
 of a disease are always in proportion to the
 irregularity presented in these circumstanfjl
 and  appearances,  it must be importantio o£
 tain  a correct knowledge of them all.
   8. Let us apply these remarks in a case or
 two.  It may be observed  that  children are
 subject to  some of the most violent diseases.
 If a child after exposure lo cold,  be taken
 sudienly at night when warm in bed, if the
 pulse be strong, full and tight, if it beatfbr-
 eibly in the neck,  if the face  be flushed  whli
 blood, while there is great heat and thirst, if
 he breathe irregularly, with  a stoppage''!
 every breath, if he have a cough, andpartid
 ularly if he express an increase of pain on
 pressing his side  with the hand, a pleuriitj
 should be suspected, and he should be imnie-
 diately bled; and this  operation  should be
 repeated again and again, as often as the vi&
lence of the symptoms require it.   A large
 bleeding at the first is  better than smaller
ones  repeated.  It should be so large as at
any rate to change the  manner of his breath- 
203
ing and lessen the pain.   The blood should
be drawn from a  large orifice.   After a co-
pious  bleeding,  let  three  grains  of tartar
emetic and twenty grains of  salt petrt* be
dissolved in one gill of water, and give a
tea-spoonful of this solution in barley water,
or flax-seed  tea,  or  any other  mild drink a
little warmed, every one two or three hours.
It will moderate  the cough and remove the
fever.   If it  nauseate  too much, the dose
should be lessened. As this calculation would
suit  a  child  of four or  five years  old, the
quantity of tartar shauld be varied according
to circumstances.   In the mean  time his
bowels  should  be evacuated  with  a little
manna, cream of tartar, castor  oil,  or^wjme
other mild purge.  Glysters might also W of
qervice.
  9. Again, if the child complain of pain in
die head, attended w?th redness of the eyes
and face.  If the admission  of the light to
his eyes seem to excite uneasiness or pain, if
he  startle at eveiy noise, be  very watchful
sometimes  making  violent struggles,  and
have a  full and tight, or hard pulse, inflam-
mation of the brain should  be  suspected.—
In this case the  child should  be copiously
  * The salt petre if rejected by the patient, might be
left out of the solution. 
                    204

•bled, purged  with jalap and  calomel, aqj
 glystered.  His4iead should be considerab^
 raised, cloths  wet with cold water and vine-
 gar should be applied to his head, and aftet
 bleeding and purging for four or five days, a
 blister should  be  applied to his head (shaved
 for the purpose) or to his two temples* ■)
   10. I have introduced the above cases il
 this place, because  more or  less of thof
 symptoms indicating danger to the lungs anS
 brain, frequently occur in measles, whtiajV
 cough, and other diseases of children-; and
 because it is important that these parts of the
 system so  essential to life, should be proper-
 ly guarded whatever  may  be the supposll
 conjWaint.  Whether it may be owing to tk
 gremer proportionate size of the head, andttf
 more delicate contexture of the lung* in chiV i
 dren, or to whatever cause it may be refer-
 red, it is a fact, that  in all fevers there is a
 greater determination  of  the  blood to the
 brain and  lungs  in children's  cases than in
 those of adults.


            CHAPTER XII.

                 RED  GUM.

  I  now proceed to consider some of the par-
ticular diseases t© which children are expto- 
205
aed.  And  the  first  to  be noticed is com-
monly called Red Gum; it has its name from
its appearance, being a red  eruption on anV
part of the body or face of very  young chil-
dren ; it is  is not dangerous, and generally
goes off in a fe w days.   Dr. Darwin supposes
it  may be the effect of heat,' and the friction
of flannel.

 u         CHAPTER  XIII.
                JAW FALL.
   Another  disease of young children is the
Jaw  Fall;  the  name  is sufficiently expres-
sive of its nature.  I  think it seldom occurs
in this country.   And whenever it doesJwp-
pen, it is said  to be incurable.  It rmjrbe
prevented however, by purging the child soon
after its birth with the following  preparation.
Take magnesia  twenty grains,  rhubarb  five
grains, grind them carefully  together.  Of
this powder give  from  three  to  five grains
every four or six hours, till the evacuations
are sufficiently copious.   Some think this an
excellent remedy and recommend it in all ca-
•>ts of new born children.   Perhaps it would
seldom  be  improper where the natural  dis-
charges are  deficient.  It may fee given  in a
little  breast milk or  fennel seed tea with or
without sugar.
                    M 
206
            CHAPTER  XIV.

        SORE OR  RUPTURED  NAVEL,

  If the  child be distressed with a sore na-
vel, mix together ten grains of  the sugar<of
lead and forty grains of wheat flour.  Spsifc-
kle the sore with this powder twice or thp
times a day, after having each time cleansed
it carefully and  tenderly with milk and wa-
ter.   Cotton or lint scorched very brown wi|
commonly dry up the sore speedily afterthe
redness is removed by using the above po*
der, or by  the application of the bread and
milk poultice.  Borax dissolved in water is
sometimes proper.
  JBr a ruptured navel apply a plaister made
ofme  diachylon salve and common resin \
say diachylon five parts,  resin one part to&4
melted  together.    This   application t actt
merely by confining the istestine  to its prop-
er place till nature may have time to perforin
the cure.                            •
            CHAPTER  XV.

                  THRUSH.

  This is  a very common complaint among
young children.   Its  first approach may be 
207
' known by sleepiness, and might generally be
 prevented by  a few doses of the powder re-
 commended in chap. XIII.   When this dis-
 ease takes place, the tongue becomes in some
 degree swelled.   Its colour and that of the
 throat is purplish.  Sloughs or rather ulcers
 appear, first on the throat and edges of the
 tongue, and at length over the whole mouth.
 These sloughs or ulcers are of a whitish co-
Dour, sometimes they are quite distinct and
 in some instances run together.  The time of
 its duration is uncertain.
   For  the  cure  let the  mouth be carefully
 and gently washed  several times in the day
 with the following  solution.   To half a^ill
 of water well sweetened with  molass^Kor
 honey,  add fifteen grains of borax.  tWien
^dissolved it is ready for use.   Or  if this
 should not be  convenient, take sage tea half
 a gill sweetened as before, add to it from five
 to ten grains of the best almond soup, to be
 used in the same manner as the former.
            CHAPTER  XVI.

           MILK IN THE BREASTS..

  It is very common  for milk to collect in
young childrens breasts, and their nurses in- 
208
tending them a kindness,  cruelly squeese it
out by dint of force.  This should never.be
dohe, because it sometimes induces a  hard
and dangerous  swelling.  The milk may be
scattered by bathing the breasts with a  little
spirit,  or by applying an ointment  made^tf
oil and camphire.
            CHAPTER  XVII.

                BELLY-ACHE.

   This complaint is  commonly the const-
qu^ce either of  the mother's eating too
mjH  rich food, or of feeding the child too
soon on vegetable diet.  Women giving such
should prefer a vegetable diet. Milk also is an^
excellent article for them at such times. Chil-
dren  should  be weaned at  ten  or twelve
months old; or at any event on the return of
menstruation.  The remedies proper for the
belly-ache are peppermint water,  tincture of
opium or paregoric elixir,  or the powder re-
commended in chap. XIII. but spirits should
never be  used.   If  tincture of opium be
chosen for  the purpose, not more than one
fourth part of a  drop ought  to  be given for
the first dose, but it may afterwards be re-
peated  and  gradually  enlarged.   I hare 
209
known a child of two weeks old to be con-
vulsed from taking one.drop at once.
  I will conclude this chapter  with observ-
ing  that no disease  can  be communicated
from the  mother to the child through the
channel of her milk.
           CHAPTER  XVIII.

                 TEETHING.

   Children seldom  begin to cut their teeth
till they  are three months old, and some not
till they are much- older.  The  symptoms
are,   a  vomiting,  lax, fever,  startinjBtfits,
swelled and  sore ears, and swelling^? the
glands or kernels of the throat  and groins.
The remedies are cold air, tincture of opium
and finally  cutting the gums.  They should
be cut  lengthwise  in the direction  of the
gums, and  quite through to the bone; but if
it be thought more convenient they may be
cut across.


           CHAPTER  XIX.
         ERUPTIONS ON THE SKIN.
  Where considerable eruptions break  out
upon  the skin qf children in other respects
                   M 2 
210
quite healthy, and of a full habit, their nurs«
should live  upon a vegetable  diet, and the
child should be  purged; for  this  purpose
nothing perhaps is  better than  calomel.  A
child of three months old, might take from
half a grain to a g.ain ; of six months old)
from one to two grains;  of nine monthalfc,
to a year, from one to three grains.
   If the  eruptions happen to a  weakly and
delicate child, let the nurse eat more gener-
ous food, &c.
            CHAPTER  XX.

   Mmrts on the tongue;  Toncuetied;  .
               costiveness,

   Warts on the tongue may be clipped with
a  very sharp  pair  of scissors.   Where the
tongue is  tied, the fnenura  or string under
the tongue may be divided with  the  same
instrument; and  it is always best to do it
while the child is young.
   Costiveness may  be corrected with the
powder recommended in chap. XIIL or with
castor oil, manna, or the like. 
                     211

(             CHAPTER XXI.
I;
^   PALLING DOWN OF THE LOWER INTESTINE.

'4   Children who cry much, or are long under
* the influence of a diarrhoea, are subject to the
* falling down of  the  sUaight  gut.   We are
1 told  of  various   means  for preventing  it.
  The following is perhaps as good as any.
8   If the  gut  be   considerably protruded,
l? swelled and inflamed,  let it be well bathed
  with  warm milk and water, and then let  a
  large and soft poultice of bread and milk be
  applied, to be exchanged for a fresh one every
  three or four hours till the infl-immation is
  removed.   Should the  swelling and inflam-
s mation be so obstinate as  not to yield tqghis
  method, let the  part be 'well scarified so as
  to evacuate the  blood freely.   Then apply
* the poultice as before and give the patient a
' dose  of  the tincture  of opium.   The scari-
{' fications, poultices, &c. should be  repeated
(  till the gut can be readily replaced.  Then
e  having washed  it  with a decoction of oak
  bark let  it be returned and kept up by the
i  aid of a bandage or truss; and this should
<  be done after every stool if the descent of
  die intestine should make it necessary.   In
  the mean time a  costive habit must be care-
 fully  prevented by the use of small doses of
  castor oil or some other gende purge. 
212
            CHAPTER  XXII-

                   IVOR MS.

   The most learned physicians are of opia-
ion that there is no such a disease as a tvorifr
fever, and that the disease erroneously knoipi
by that name is  an  internal dropsy of tk
brain.
   The symptoms pointing out  the presence
of worms are various and are the followiag:
Grinding of the teeth,  starting in sleep, dry
cough bringing up a frothy spittle, sighing
and suffocating manner of  breathing, pajn.in
the side, hiccup, heart-burn, vomiting, lax,
sudden urgings  to go to  stool, costiveness,
slimy stools, night sweats, sour breath, flush-
ing of one cheek,  itching of  the  nose, an
excessive appetite,  lying much on the belly,
swelling of the partition of the nose and of
the upper lip, the actual voiding of more or
less worms, a wasting away of  the limbs and
of the  whole  body,  jaundice, headache,
deadly snoring in sleep, convulsions, &c. &c.
   Our first care  should  be to prevent die
dangerous  effects  of  worms, and  there are
various  articles  of food which will answer
this  intention.   u Nature" says Dr.  Rush
in his  medical enquiries " has wisely guard-
ed children  against the  morbid tffects, of 
213
 worms by implanting in them an early appe-
 tite  for common salt, ripe fruits and saccha-
 rine substances, all of which  appear  to  be
 among the most speedy and effectual poisons
 for worms.   Ever since I observed the ef-
 fects of sugar and other swet substances up-
 on worms, I have recommended the liberal
 use of all of them in the diet of children
 with the happiest effects."
    The medicines  proper  for the removal of
 worms are.
    1. Common salt;  this may be given in
 doses of thirty grains upon an empty stomach
 in the morning, and is an excellent remedy.
    2. Sugar or  molasses in  large quantities,
 so that they  may  pass  out  of the stomach
 without  undergoing  any  material cntnge
* from digestion.   In  smaller quantities they
 will destroy worms in the stomach only.
    3. The expressed juice of onions and gar-
 lic are said to be considerably  efficacious
 against the excess of worms.
    4. Gun-powder ; a tea spoonful to be giv-
 en in the  morning upon an empty stomach.
 Perhaps three fourths  of the same quantity
 of salt petre would answer just as well.
    5. Carolina  pink root; if this  article be
 properly  used  it is a very certain remedy.
  About  half  an ounce  may be gently stewed
 in half  a nini of wat-rtill its strength is pro- 
                     214
  perly extracted.   Then let the decoction ht
  strained and well sweetened with sugar or
  molasses,  and  give one  fourth  of it everV
  two or three hours  to a  child four or  five
  years c^l.   I  have generally thought it best
  to add  to each dose about one eighth of an
  ounce  of manna.   The  importance  of  this
  addition will appear when it is remembejfl|
  that, the pink root is poisonous and if giyea
  in too large  quantities kills the child to whom-
  it is given.
    6. Aloes, four to six grains, rhubarb eight
  to fifteen grains, Jesuits  bark,  bears-foot,
  worm-seed, these  are all said  to be good
  xvorm medicines.                          \
    7. Calomel; this is an excellent and safe
  remedy whether given by itself or combined
  with jalap.   It is  most effectual howev§;
  when given in large doses, from four to:eigfet
  grains  might be given to a child of foutfr
,  six  years old.
    9. " But  of all the  medicines that I have
  administered,"  says Dr. Rush,  u I knowof
  none  more safe and certain than the simple
  preparations of iron, whether they be gwtti
  in the form of steel-flings, or of rust of iron.
  If ever they  fail of success,  it  is because
  they are- given in too  small doses.   I gene-
  rally prescribe from five to thirty grains every
  morning,  to children  between  one  and ten 
                   215
years old ; and I have been taught by an old
sea captain, who was cured of a tape worm
by this medicine to give from two drams to
half an ounce of it every morning, for three
or four days not only with safety  but with
success."
 t.           CHAPTER XXIII.

       INTERNAL DROPSY OF THE BRAIN. .

.   This  disorder  is  sometimes the conse-
 quence  of a  stroke upon the head received
 by falling or otherwise.   It may also be ex-
 cited by different kinds of fever.
   In  every  case where   there are pains of
 the limbs and head, sickness at the stomach,
 dilatation of one or both pupils of the eyes,
 and sleepiness, this  disease should be sus-
 pected.
   Dr. Rush in treating of this complaint in
his enquiries gives the following description
of it as taken from the writings of Dr. Quin.
   u In general the patient is at first languid
•'  and inactive,  often drowsy  and peevish
"  but  at intervals cheerful  and apparently
44  free  from  complaint.   The  appetite is
a  weak, and in many cases a vomiting occurs 
216
t; once or twice in the  day, and the skin it
" observed to be  hot and dry towards the
" evening.    Soon  after  these  symptoil
" have appeared, the patient is affected wy$
" a sharp headache, chiefly in the fore part,
" and if not thee generally in  the crown of
" the head.   It  is  sometimes however con-
" fined to one side of the head, and in that
" case, when the posture of the body is erec^
" (as  in sitting,)  the  head often  inclines to
" the side affected."   The vomiting, is less
troublesome  when the pain  in the head is
most violent,  and  the contrary.  Thereare
also pains in the limbs or the bowels, but
more constantly  in the back of the neck and j
between the shoulder blades; and in these
cases the head is commonly less effected.
  u The patient dislikes the light at this pe-
" riod, cries much, sleep* little,  and when he
" does sleep he grinds  his teeth, picka hj»'
u nose, appears to be uneasy, and starts often,
M screaming as if he  were terrified."   The
bowels are  in most  cases bound, though
sometimes they are in a  lax state ; and the
pulse is not much irregular in this early stage
of the disorder.*
  * I take the liberty sometimes to abridge Dr. Quin's
history and state it in a language more plain and easj
for common readers. 
217
   " These  symptoms are  subject to great
 fluctuation,  but whatever may be the degree
 or order of  them, after seme days one of the
 eyes will be turned inwards as  if looking at
 the  nose, and the pupil of the turned eye
 will be more dilated  than the other ; and if
 both eyes be  turned  which sometimes hap-
 pens, both pupils will be larger  than they are
 observed to be in healthy people at the same
 time, and in the same degree of light.  Af-
 ter this the vomiting becomes more constant,
 and  the head-ache more excruciating ; every
 symptom of fever makes its  appearance;  the
 pulse is  frequent, the breathing  quick;  the
 fever returns  with more violence  at  night,
 and  the face is flushed ; usually  one  cheek
 more than the other.   There are temporary
 sweats and  sometimes bleeding at the nose,
 but  neither  affordj any relief.   The patient
 is sometimes violently delirious."
   u  After  proceeding on in  this  way  for
 fourteen days,  often a much shorter space of
 time, the disorder undergoes a change and
 passes into the second stage.  The pulse  be-
 comes slow and v unequal both in  time and
 strength, the pains seem to abate,  a deep
 sleepiness ensues,  the  pupils are more dilat-
 ed ;  the  patient lies  with one or both eyes
half  closed which are  found on examination
to be insensible to light; the  vomiting ceases,
                    N 
218
the patient  swallows with greediness what-
ever is offered to him, and the bowels remaiq
obstinately costive."
   ',l If not-relieved, the second stage is soon
succeeded by the  third, which speedily ter-
minates  in  death.  The  symptoms in this
stage are a  v eak  and quick but equal pulse,
difficult  breathing with deep  snoring, the
eyes suffused with blood ;  alternate flushing!
and deadly  paleness of the face ;  red spots
or blotches 0:1 the limbs,  difficulty of swal-
lowing,  and lastly  convulsions  close the
scene."
   I must here observe however, that neither,
the dilated or insensible pupil, nor the puking,'
the delirium or the  squinting  always attend
this disease.  Children of every age, but
more commonly those of  four  or five years
old, are subject to it.
   As-was hinted before, this is the complaint
which was  little understood  till  lately, and
was commonly called  a worm fever.  Am
as worms are  in  some  instances discharged
in this disorder, ignorant and injudicious per-
sons may readily  enough   be deceived.  In
every instar.ee therefore where the symptoms
are suspicious,  parents ought to be alarmed,
and it  possible, they should procure relief on
the first  attack. 
219
   1- The  remedies to be employed  in  the
first stage  of this too often fatal disease are
bleeding and purging.   These should be re-
peated as often as may be necessary to sub-
due the inflammation.  If there be pain in
the head,  cold water,  or vinegar and water,
or  even ice-water  might  be applied with
cloths wetted  for the purpose, which should
be frequently changed. Sometimes the symp-
toms abate after two or three bleedings,  but
return in the course of a few days.   In every
such instance the bleeding  must be repeated
and the more certainly so if die pulse  be full
and tight.
   2. In the  last stages of this complaint
bleeding is seldom proper.  The  principal
dependance is to be  placed on the use of
mercury.   The patient should be salivated.
   At any stage of  the disease after the in-
flammatory symptoms are subdued, blisters
are beneficial and  should be applied to the
head, neck, and temples.
           CHAPTER  XXIV.

              CROUP OR HIVES.

  In this disease Dr. Rush makes  two im-
portant distinctions.  The  first is  attended 
220
with  spasm  and a dry cough.  The second
is without spasm and the patient under itj
influence, is able to cough up a considerable
quantity of phlegm.
   1.  The spasmodic  croup  conies on sud-
denly and that  generally in  the night; has
frequent  and perfect intermissions of the
symptoms for h®urs and sometimes even for
days, is attended with a dry cough  as above,
and is at  last particularly relieved by the use
of  the  warm bath,  assafoetida, opium, &c.
To be particular ; the child will probably go
to bed in  good health, and in an hour or two
wake in a fright with his face much flushed,
or even of a purple colour, he will  be unable
to describe what  he feels,  will breathe  with
much labour, and with a peculiar convulsive
motion of his belly;  his breathing  will also
be  very quick,  attended  with a sound as if
he were threatened with a speedy suffocatidri;
the terror of the child  increases his' disob
der,  and he will cling to the nurse ; and-if
not f peedily relieved by coughing,  belching,
sneezing,  vomiting  or purging, the suffoca-
tion will'increase and  the child will die.  It
is remarkable  that the cough in this disease
very much resembles in sound the barking of
a young dog.
  There  are also during  the continuance of
the disorder,  frequent eruptions of  little red 
221
 blotches on the skin, which for the time seem
 to afford relief;  and this eruption will some-
 times  appear and disappear two or three
 times  in the course of the complaint.  For
 the cure in this first distinction of- the croup,
 the remedies are,
   1.  Bleeding.  ^When the   difficulty  of
 breathing is great, the face much flushed,  or
 when  the  patient  expresses much pain  in
 coughing,  this remedy is absolutely necessa-
 ry, and should be repeated  as often  as may
 be requisite for  subduing these symptoms.
   2.  Vomits.   From  five  to  six grains of
 ipecacuanha with two or three grains of calo-
 mel may be given  to a child  from two to
 four  years  old,  or half a  grain  of tartar
 emetic with three or four grains of ipecacu-
 anha ;  or  five grains of ipecacuanha with
 two or three grains of turpeth mineral; or a
 teaspoonful of antimonial wine ; or a spoon-
 ful of a strong decoction of seneka,  called
 also rattle-snake root.  Which  ever dose is
 used, it should be repeated till the intended
 effect is produced, but bleeding ought first to
 be performed.
   3. Purges.   Jalap and calomel, from five
 to ten grains of  the former with two or four
 of the latter may be given to a child of three
 to five years old.  Or calomel alone from
three to five or six grains ; or jalap eight to 
222
twelve  grains;   or castor oil,  but this k
scarcely active  enough  for so violent a dis-
ease.                                      (
   4.  Warm bath.   This may be used either
before or after bleeding,  but it will be most
effectual after the evacuations,  and ought to
be repeated daily for some time.
   5. Glysters.   Milk and water or chicken
broth or thin gruel may be used for this pur-
pose and in some instances where the spasm
remains after bleeding,  &c.  fifteen drops of
the tincture of opium may  be  occasionally
added to the injections.  Ten to fifteen grains
of tartar emetic dissolved in  half a pint of
thin gruel or chicken water is an excellent in-
jection.
   6.  Blisters will be found very serviceable
after the evacuations of bleeding and purg-
ing ;  these may be applied to the back part
of the neck or  to the side of the patient.
   7.  When blisters are properly admissible,
 opium, assafoetida, &c.  may  be used with
 safety.
   II.  The second distinctions of this disor-
der is  attended with symptoms very similar
to those  of the first, but  may be known by
 its coming on  gradually and that commonly
 in the day  time ; by  its continuing and fre-
 quently increasing for  several  days wiiheut
Xny remarkable remission cr even abatement 
223
of the symptoms ; by the discharge of phlegm
from the wind pipe by coughing, as also  by
the  appearance  of slime in the  stools ; and
lastly by its  refusing  to  yield to the warm
bath, opium,  Sec.
  Thr remedies proper in this kind of croup
areas before, hut with some variation.
  1.  Bleeding when the breathing is difficult,
the face flushed, the pulse light, &x.
  2. Vomits, as under th- fr.-st distinction.
 ' 3. Purges.   But in  this case calomel only
should  be  used ;  the principal  dependance
should  be  placed  upos  this  medicine.  A
large dose should be given as soon as the dis-
order discovers itself ; six or eight grains to
a child four years  old.   Afterwards  smaller
doses should  be given every  day so long as
any of the symptoms continue.   From two to
four grains might answer this intention.
  It is important that relief should be afford-
ed on the first attack of this violent disease.
If neglected  it will be  fatal in almost every
instance.

            CHAPTER XXV.

CHOLERA MORBUS ;  OR PURGING AND VOMITING.

  This  disorder  makes  its  appearance  in
warm climates as early.in the season as April 
224
 and May, but in colder climates not till the
 middle of June or first of July.
   The danger attending it is in proportionto
 the. heat of the weather.  Children are sub*
 ieet to it from one or two weeks till two years
 old.
   It sometimes begins with a diarrhea, which
 will continue  for several days without anv
 other disorder ;  but most commonly  violent
 vomiting and purging and high Jever  attend.
 The matter discharged from the stomach and
 bowels is yellow or  green, and the stools are
 sometimes slimsy and mixed with blood with-
 out  any appearance of  bile ; sometimes too
 the stools are thin as water ; worms are fre-
 quently voided  whether die evacuations be
 bilious  or not : the  patient stems to suffer
 much  pain ; draws up  his feet and is never
 easy in ©ne posture ; his pulse is weak and
 quick ; his head very warm while his hands
 and feet are cold ;  the fever remits and re«
 turn3 with greater violence every evening;
 his head is sometimes so much affected  that
 he not only becomes delirious,  but will rave
 and try to scratch or  bite  his parents or nurse;
 his belly and sometimes his face and limbs
 swell ; he has great thirst in  every stage;
his eyes appear languid  and hollow  and he
sleeps with them half closed ; so great is the
insensibility of his  eyes that flies  light upon 
225
 them while* open and do not excite the least
 motion in the eye-lids.
   Sometimes the vomiting continues without
 the purging, but more commonly the purging
 remains without  the  vomiting through  the
 whole course of the disorder.
   The stools are sometimes large, emitting
 a very disagreeable smell ;  at other  times
1 there are  scanty  stools without  smell, and
 like the food or drink taken in by the child.
   This disorder  is sometimes fatal in a few
'days and in some cases even  in twenty-four
 hours.  Much  depends  on  the  state of the
■ weather, one cool day  frequently abates its
i'violence.   The time of  its  duration varies
nexceedingly, from a  few days to six weeks
 or two months.   When it is of long standing
rand tending to  death,  there is commonly
sigreat wasting of the patient's flesh, his bones
ilwill sometimes come through the  skin.  To-
wards the close of the disease there appear
n purple spots  on the skin with h-ccup, convul-
sions, ghastly countenance and sore mouth.
iWhen these last appearances come on,  the
 case has generally become incurable.
u  The following remarks may help to guard
gagainst mistakes in this disease.
i   1. It is sometimes thought to be the effect
ii of teething ; but as it comes on at a particu-
lar season of tire year  this mistake mav be
                     N 2 
2£6
avoided.  It is  true  however that it is renl
dered more violent when it  happens to seia
upon children in the time of teething.
  2. It is sometimes attributed to  worms;
but although worms are frequently voided in
this fever they are never the cause of it.
  3. It has been considered the effect of eat-
ing summer  fruits  ; but  where children can
get ripe fruits at pleasure,  it seldom occurs,
and indeed ripe fruits taken moderately have
a considerable  tendency to prevent it.  On
the whole it may be  considered  a species of
bulbous fever, and may be  cured as follows;
   1.  Give.a puke  to evacuate the bile  from
the stomach ; this may be done bv the aid of
a dose of ipecacuanha or tartar emetic, and it
should  be repeated as often as there is vom-
iting of bile, in every stage of the  disorder.
   2.  The bowels should then be purged with
manna, castor oil, or  magnesia.   Rhubarb is
not a proper remedy till the fever is subdued
in some  considerable degree.  If  however
the puking  and purging have c intiuued til;
there is good reason to belit-ve  that the  of-
fending matter  has been thrown off  by the
natural efforts,  the pukes  and purges must
be  omitted,  and instead of them,
   3. A few drops  of the tincture of opium
may be given in a chalk julep.  Say, prepared
chalk or crabs claws eight grains  to twenty j 
227
tincture of opium half a drop to three or four;
cinnamon water or  peppermint tea at discre-
tion ; syrrup as much as may be sufficient to
make it pleasant; to be given every  three,
four or  six hours.  Sometimes  a few drops
of spirits of hartshorn will be  a  useful addi-
tion to the above julep.
  4. Small blisters  might be applied to the
region of the stomach, or to the wrists and
ankles.
  5. Mint  and mallows teas,  or blackberry
briar root infused in cold water ; a dccoca.;r.
of shavings of hartshorn ; or a solution ci
gum arabic ; or  the  pith  of  sassafras wood
steeped in warm water with the addition of a
little mint or cinnamon ;  either of these ar-
ticles may  be prepared and used as a drink
to compose the stomach or oov/ris.
  6. Glysters  made of tlix-seed tea, or of
mutton broth, or of starch dissolved in water ;
either of these with the addition  of  a  few
drops of tincture  of opium may be frequently
injected.
   7.  Plaisters of Venice treacle  where it can
be had,  or flannel;; wetted  with  a strong in-
fusion of bitter herbs in warm spirits or Ma-
deira wine, might be applied to the stomach ;
or what might be  still  more convenient,  a
cloth folded so  as to be two  or  three inches 
228
square might be wetted with the tincture of
opium and applied as before.
   8.  As soon  as  the  violent symptoms are
subdued give bark in the form ©f a decoction
or in substance, to  which  may be  added a
little nutmeg ;  or if bark be offensive to the
patient, use port wine or claret in itsstead.f
At this stage it will be proper to indulge the
child in any particular article of strong food
he may happen to' crave,  as salted or  dried
fish,  salt meat, butter  or rich gravies, and
even the strongest cheese.
   9. Another  remedy when there is great
pain, is the warm bath, and it would be stiH
more effectual if  wine  were used instead of
water.   It is  also probable that a cold bath
a few times repeated  would be an  excellent
remedy.
   10. In  the recovering stage of the disease
it will be  found  very  beneficial  to carry the
child out to breathe a  fresh country air.
   In places v. here this  complaint prevails,
the following precautions will probably pre-
vent it.
   1. The drily use of the cold bath.
   2. The dress  of children should be care-

   * Peruvian Bark quilted between two pieces ofln-
 dia cotton,  and made up in the form of a waistcoat,
 may be worn as an excellent remed>  in the last stage*
 of (he disease. 
zzy
fully accommodated to the state and changer
of the weather.
  3.  Salted meat should be daily but mode-
rately used through the sickly season.
  4.  Good sound wine may be  given them
in portions adapted to  their age ; from a tea-
spoonful to half a wine glass full at the dis-
cretion of their parents.
  5.  Particular regard should  be had to
cleanliness both with respect to their skin and
cloathing.
  6.  Lastly, persons  living in sickly towns
ought to be specially  attentive  to all these
precautions ; and where It can be done  they
should  remave their children to the country,
before the sickly season.
           CHAPTER  XXVI.

       DYSSENTERY,  OR  BLOODY  FLUX.

  This disease is  defined by Dr. Cullen, a
contagious fever attended with frequent slimy
or bloody stools,  while  at the same time the
usual  contents of the  intestines are for the
most part retained ; and with a violent gri-
ping and a painful and frequent  urging to go
to stool.   If  there  be  a frequent  desire of
going to  stool especially after eating or drink- 
23U
ing,  it is  considered a  certain  mark of tliii
disease.   It occurs in the same seasoas that
intermittent fevers do, and  like them, it fol-
lows long dry, long moist and  h»t weather.
Sometimes  it comes on with cold shiveriogs
and other marks  of fever, and in some in-
stances the fever attending is  very violent
and inflammatory.   Sometimes  though not
so frequently a diarrhoea is the first symp-
tom.   There is commonly a loss of appetite,
frequent  sickness,  nausea,  and  vomiting
which are  considerably  proportioned to the
violence of the disease.   In every case where
there is violent fever the danger is  consider-
able.
   In the cure of this disease regard must be
had to the degree  of  fever present, for if
there be great thirst, acute pains and a tight
though small pulse,  the patient should be,
   1.  Bled ; and if the pains and other vio-
lent symptoms continue,  the  blood-letting
must be  repeated  every  twelve  or twenty-
four hours till they  do yield.
   2. Pukes are sometimes proper, but they
should be  used when there is great sickness^
at the stomach only, and if the  marks of fe-
ver as above  be present, a puke should not
be administered till after one or more bleed-
ings.
   3. Purges  should be frequently repeated, 
231
but they must be of the most gentle sort, as
cream of tartar, purging salts, manna, castor
oil, Sec. one of these should be used every
day  while the disease continues.   Let it be
remembered that jalap and  rhubarb are not
proper in  this complaint.
  4.  Glysters  of flax-seed  tea  or mutton
broth with a little tincture of opium should
be injected two, three or four times, for eve-
ry twenty-four hours.  If there be great heat
and  pain  in the bowels  cold water might be
injected in the form of a glyster  ; and indeed
it could do  no injury if  there  were no very
inflammatory symptoms.
   J.  Opium.   A dose of the tincture, or a
pill of the solid opium should be given every
night ;  and  after sufficient evacuations it
might be used every six or eight hours if ne-
cessary.*
   6.  Cooling drinks.  Whey,  flax-seed tea,
camomile  tea  not too strong,  mallows tea,
mullen tea,  and barley water, are  all  proper
for this  purpose. And if there be much fever
cold water is a very proper drink.
   7.  A decoction of gum arabic or shavings
of hartshorn with spices  ; mutton suet boiled
in milk  ;  a decoction of black-berry roots, or
a gruel  made of a little flour prepared accor-
  * Opium is seldom safely,, used until the patient has
keen sufficiently bled and purged. 
                    232                     I
ding to Dr. Buchan,  viz.  Take a few hand'
fuls of fine flour, tie it  up in a linnen cloth,
and boil it in a pot for six hours till  it be-  ,
comes as hard as starch ;  afterwards grate it  ,
and make it into gruel.   Either of these will
be  very  useful  when  the patient is much  ,j
spent.
   8.  Blisters may be applied  to  the wrists
and ankles, but not commonly until after the
fifth day.
   9.  In the close of the disease,  port wine,
madeira or sherry  wines are proper.
   10. Where the  fever intermits, and espe-
cially where it assumes the shape of the third
day fever and ague, the bark is a very proper
remedy, to be given chiefly in the fore  part
of the day.*
   11. To prevent the contagion from spreadi-
 ng the  patient should be kept very clean.—
 His room should be well aired and properly
 cleansed,  and  vinegar should be  frequently,;
 poured  upon a hot brick, stone, or piece of
 iron.
   12. To prevent  this disease, have regard
 to the instructions given in chap. XXV.  part"
 IV.  for preventing cholera morbus.

   * Or apply the bark-waistcoat, as advised in a note
 under the forejoinsf disease. 
233
           CHAPTER XXVII.

            MESENTERIC FEVER.

   There  is another  disease which has  its
principal  seat in the  intestinal glands, and
may therefore be properly enough admissible
in this place.   It is  a fever excited by ob-
structions in the mesentery, from which cir-
cumstance it  has its name.   Children are
subject to it from infancy up to the age of
three or four,  ana even six or eight years.
   This fever remits, and sometimes has ir-
regular intermissions, is  attended with los6
of appetite, swelled  belly and pain in the
bowels,  and  has often been  mistaken  for
worms.   If therefore the usual remedies for
worms should fail, the child will sooner or
later be affected with very great indigestion ;
costiveness or purging ;  irregular appetite ;
flushed cheeks or total loss of colour ;  im-
paired strength and spirits ; remitting fever ;
a hard  swelled belly ; and emaciated limbs.
These symptoms  will therefore sufficiently
specify the disease.
  It  frequently follows  measles and other
eruptive fevers.  Children that are confined
to coarse and  unwholesome food, are badly
cloathed,  not kept sufficiently  clean, or neg-
lected s© as not to receive sufficient exercise, 
234
 are most  subject to  its attack.   Hence the
 negro children of the southern states fre.
 quently perish with this fever.
    After this information, it is hoped, that if
 the humane f elings of slave-holders will not
 compel them to do justice to their blacks, a
 sense of interest will direct  them to use the
 necessary  pains for the preservation of their
 property.
  ^  When any symptoms of  this  destructive
 disease present themselve^, enquiry should
 be made into the manner of feeding, cloath-
 ing and cleaning the  child.   Every error in
 these articles must be corrected.
    It the patient have not too long  laboured
 under  its  influence, frequent purging with
 calomel will of itself perform a cure.
   In more advanced stages of this complaint,
 it would be best to call in the aid of a  phy-
 sician.   But where this is impracticable pro-
 ceed to give the following bolus three times a
 week.  Take calomel  two grains, ipecacuan-
 ha from half a grain to one grain,  nutmeg or
ginger powdered six grains, to be mixed up
 in honey or syrrup for one  dos? for a child
from two to four years old.  Fifteen  or twen-
ty drops of antimonial wine may be given the
intervening nights where the calomal is not
used.
  Having  continued these remedies till the 
235
fever is removed,  ■  • hardness of the  belly
subsided, &c.  di-n the ; '.r.-ngdi of die patient
should'be restored by the use of bark, steel,
cold bath,  bitter? of  columbo  and orange
pv .1, or camomile fl-wns, &~- gentle  exer-
cise, friction,  light nourishing food, kr. hz.
All greasy  or fat articles should be avoided,
as also those preparations of pastry which are
of a clammy nature.
          BHAPTER XXVIII,

              HOOPING COUGH.

  This disease commonly falls upon a whole
neighbourhood about the same time, and is
therefore  said to be epidemic.   It is mani-
festly contagious, and like several other con-
tagions, it affects persons but  once in the
course of their lives.  Children therefore are
most commonly the subjects  of it.   Some-
times however it occurs in persons consider-
ably advanced in life.   Grown  persons and
those who are elderly, in proportion to  their
age, are less liable to be affected than chil-
dren and youths growing up.
  This complaint at first puts on the appear-
ance of a common cold, and  Dr.  Cullen
makes mention of instances which never  as 
23<3
sumed any  other shape than that of a cold,
although they were obviously the  effects of
this contagion.   But this is  not commonly
the case.  Generally  in  the course of the
second week, or  at  farthest in the third,  i
the convulsive motion  which gives the name
to this disease,  manifestly  shews itself,  and
is commonly called a  whoop.  This whoop,
together with the circumstance of the general
spread of the  disorder, sufficiently  distin-
guish it.
   " The chin cough,"  says Dr.  Darwin,
" consists in an inflammation ©f the membrane
which lines the air vessels of the lungs.  The
whole of the lungs are probably not infected i
at the same time, but  the contagious inflam-
mation continues gradually to creep on the  \
membrane."   This opinion seems to account  |
very  well for its long  continuance, which is
from  one month to three,  and sometimes
much longer.  "This complaint is not usually
classed among febrile  disorders, but a fever
may generally be perceived to attend it du->
ring some part of the day,  especially in weak
patients.  And  a general  inflammation of
the lungs frequently  supervenes,  and de-
stroys great numbers of children, except the
lancet, or four or six leeches be  immediately
and repeatedly used.
   When  the child has permanent difficulty of 
237
breathing which continues between the cough-
ing fits ; unless blood be taken from him, he
dies in two, three, or four days, of the inflam-
mation of the lungs.*   During this  perma-
nent difficulty of breathing the hooping cough
abates or quite ceases.   Many have been de-
ceived  by  this  circumstance unfortunately
supposing the child to  be better.   But after
once or twice,  bleeding the cough returns,
which is then a good symptom, as the child
possessing  the power  to cough is relieved,
and once more breathes with ease."
  The remedies in this disease are :
  1. Gentle vomits of tartar emetic ;  this ar-
ticle should be given in small doses frequent-
ly repeated till  it produces the intended ef-
fect.
  2. Mild purges repeated, so as to keep the
bowels gently loose and open.
  3. Blisters to be  frequently repeated,»they
may be applied to one or both sides of the
breast.
  4. Warm bath.  This  is an excellent re-
medy where the cough  is violent and the
child much exhausted.  The  bath  should be
a little above blood heat.
  5. In every instance where  there  is diffi-
  * This is a very important point, and should bf
particularly observed. 
238
culty of breathing  between the fits of cough-
ing, the only  safe remedy is copious bleed.
ing.   If this be neglected or  omitted,  the
child  may die.
  6. Young  children  should lie with their
heads and  shoulders raised, and should be
constantly watched day and night to prevent
them from strangling in the cough.   A little
bow of whale bone or  of elastic wood should
be used to extract the phlegm out of  the 1
mouths of infants.    The  application of a
handkerchief to their mouths when in the act
of coughing might suffocate them.
  7.  After the disease has continued some
weeks, and especially if the patient be much
reduced, the following dose calculated for a
child three or four years old may be useful.
Say, calomel  one sixth part of a grain, opium
one sixth of  a grain, rhubarb two grains, to
be combined  and repeated twice a day.  But
opium will be very pernicious  as  long as
blood-letting  is proper.
  8. Towards the close of the complaint all
feeble patients should be daily carried out on
horseback.   This is a most excellent remedy. 
239
           8HAPTER  XXIX.
                 MEASLES.
   Ibis disease is epidemic.  It depends on
a specific contagion,  and occurs  most fre-
quently in children.  No age however is ex-
empted from it if the person have not been
subjected to it  before.  It  commonly first
appears i« the month of January, and ceases
after the  middle of summer; but by  various
accidents  it may be produced at other times
of th: year.
   Tnc symptoms as given by Dr. Cullen are
nearly as follows.  " The disease  always be-
gins with a cold chill which is soon followed
by  the usual symptoms  of  fever; as thirst,
heat, loss of appetite,  anxiety, sickness and
vomiting ;  and these are more or less  con-
siderable  in diff-rent  cases.  In  many in-
stances the fever for the first two days is in-
considerable ;  but  sometimes  it  is  violent
from the beginning, and always becomes vio-
lent before the eruption appears.
   This fever is always attended with hoarse-
ness, with a frequent hoarse dry cough, and
often with some difficulty of breathing.  The
eyelids  are swelled, the eyes inflamed and
watery.  There is a discharge from the nose,
with frequent sneezing.  In most instances
the patient is drowsy in the beginning. 
240
  The eruption commonly appears upon the
fourth day ; first on the face, and successive-
ly on the lower parts of the body.   Is shews
itself first in small red points, which collect
together in  clusters  on the face,  and where
they are easily perceived to be a little elevat-
ed by the sense of touch ; but they can scarce-
ly be felt on other parts of  the body.  The
redness of the  face continues and sometimes
increases for  two days.  On the third day
the  vivid redness is changed to a brownish
red, and in a day or two more, the eruption
entirely  disappears,  and is  followed by a
branny scale.   During the whole time of the
eruption the face  appears full, but not much
swelled.
   Sometimes the fever disappears as soon as
the  eruption takes  place, but this is seldojn
the case ; more commonly it continues, oris
increased after the eruption, and in some in-
stances  even  after the branny scales appear.
As long as the  fever exists in any considera-
ble degree, the cough continues, and that gen»
erally with  an  increase of  the  difficulty of
breathing.  Sometimes an  inflammation  of
the lungs takes place.  This is a very serisus
circumstance when it occurs, and ought to be
specially observed.
   All the  above symptoms admit  of very
great variation,  and in some cases there wifl 
241
be in addition to them, soreness of the throat
spitting of  blood mixed  with  the phlegm
coughed up, gripes, diarrhoea,  and bloody
stools^  / suppose that fourteen  days inter-
vene between the time of receiving the infec-
tion and the appearance of the disease.
  It may  be well to observe  that the erup-
tion does  not invariably appear on the third
or fourth day, but varies even to the eighth.
Neither does the eruption disappear invaria-
bly on a  certain day,  nor in  an unchanging
manner;  nor is  it  always followed by the
branny scales.
  The fever attending the measles is in most
instances of the inflammatory kind; but by
improper  management, or neglect, as well as
by the predisposing circumstances attending
the patient, it may  assume a different form.
The remedies to be  employed in this disor-
der.are,
  1. Blood-letting.  This is  always neces-
sary when there is a full pulse attended with
great pain and violent cough ; and that too
in every stage of the disease, whether before
or after the  eruption  takes place ;  or even
after the eruption has entirely  disappeared.
  2. Vomits.  A dose of ipecacuanha, will
generally remove the sickness at the stomach.
  3. Soothing drinks,  such as barley-water;
balm  tea;  flax-seed tea; cider  and water
                    O 
made very weak ; vinegar and water,  apple
water; dried cherry-water, &c. These moist-
en the throat and afford much relief.
  4.  Blisters.  After  sufficient  evacuation,
by bleeding or otherwise, blisters may be ap-
plied to the neck and  sides.   They prevent
injury to the lungs.
  5.  Opiates.  If the pulse  be  soft and the
patient  labour  under  the distressing symp-
toms of diarrhoea and cqugh,  opium may
be used not only  at night, but  at  any time
during the day.  This remedy however, will
seldom  be proper earlier  than  the fifth or
sixth day.
  In most  instances  if the  patient be kept
cool, and  take opening and cooling drinks,
&•.   If he be bled when the  symptoms are
violent, as also about  the time  the measles
disappear or when the branny scale presents
itself; and if his bewels be  opened on the
third and  fourth clay  of the eruption,  with
cream of tartar,  flowers of sulphur, manna
or the like ; little else  will be wanting espe-
cially in childrens cases.
  Y3* Here let it be  particularly observed,
that in  every instance where the eruption
seems to take place with difficulty, and where
the pulse  is full and tight with  other marks
of  great  fever, all  spirituous  liquors and
other heating medicines  are highly perni- 
»  cious.   In such   cases  sufficient  bleeding
  would be much more proper.
    It may be useful also to observe that there
  is a fever which sometimes takes place  dur-
  ing tlv* prevalence of the measles, very much
  resembling that disease, even assuming the
  appearance of  an eruption.   But persons are
  Still liable to take the true measles after hay-
  ing been  subjected  to this  disease.  It is
  sometimes attended with symptoms of the
  croup, See chap. xxiv.   Distinction 2d.  In
  that case the treatment must be the same as
  if  croup were the orig'mal disorder; in  all
  other respects the  remedies useful in meas-
  les might be employed in this kind of fever.
     Patients when recovering from the measles
  are frequendy subject to  diarrhoea.  This,
  uncomfortable symptom may be removed by
  moderate doses of opium frequently repeat-
  ed.   The drinks  recommended above, arti-
  cle 3d will also be of use.
     Sore eyes  sometimes follow the measles:
  Th-se are to be cured by blistering the tem-
  ples, and back of the neck,  and washing the
  eyes with a weak solution of white vitriol.
     A  cough and  fever frequently attend lor
  some   time  after the eruption disappears-
  These are to be relieved by a vegetable diet,
  warmth, and gently riding out in the  iresh
  and open air. 
344
   py When the measles  are expected, it
will oe found beneficial to prepare for them,
by living chiefly on milk, and vegetable diet,
and  by   avoiding  every kind of  spirituous
liquors.
           CHAPTER  XXX.

           PUTnrot sorE'ThroaT.

   This is a fever  from contagion.   It gene-
rally appears in autumn, from September to
December.   Children and women are more
subject to it than men, and  persons  with
black eyes  are  more subject  to  its attacks
than  others.  More  boys recover  from it
than girls.   I generally follows moist, wet
and hazy weather.
   The principal symptoms attending it are
great weakness; slight  eruption;  weak and
quick pulse ; ulcers in  the throat; delirium
^especially at night; diarrhoea ;  inflamed and
watery eyes; and  a  flat and  ratling voice.
The ulcers and sloughs  in the throat are of a
whitish ash color,  and  the breath of tin; pa-
tient is very offensive to the smell.   The re-
 medies are,
   1.  Blood-letting for the first three days. 
z*a
  2* Pukes.   Say  ipecac, ten  grains  and
calomel four grains, to be taken together as a
dose for a child of  eight or ten years old.
  3. Bark, wine and cordial aliment.   The
bark should be given in substance.*  But if
that be  impracticable, a  decoction may be
substituted.   Port wine should  be  prefered.
If wine cannot be  had, a decoction of Vir-
ginia  Snakerootf  (commonly called   black
anakerooi)  is a tolerable substitute., Chick-
en broth is the best diet, and should be used
as early as possible in the disease.
   4. Blisters  should be applied to the neck
 and throat.  But blisters  drawn in this dis-
 ease should never  be  dressed with colewart
 leaves ; some kind of mild ointment spread
 on  a  bit  of  fine linen should  be  prefered.
 For this purpose melt  together oil five parts,
 and bees-wax one  part.
   5. The mouth and throat should be wash-
 ed with barley water or very thin  gruel, to
 which should  be  added a little vinegar and
 honey,  and if convenient a  portion of the
 tincture of myrrh.  Sixty or eighty drops of
 die tincture   of myrrh  might  be added to
 half an ounce  of the gruel,  &c. or  if the
 myrrh  cannot be  had, as much calomel as
   * The bark waistcoat may be worn ihroughout the
 whole course of the disease, and for sometime after-
 ward*, even till fully recovered. 
246
may  be sufficient to turn it of a whitish co«
lor, will be a good substitute.
   JCT" I  have found great benefit from fre-
quently washing the mouth and throat well
with the following mixture.   Take salt petre
half an ounce  and borax one quarter of an
ounce ; the whole to be dissolved in one pint
of water and sweetened with honey.    I have
used  it successfully  in  a number of cases
without any other topical application.
  6.  The steams of vinegar and myrrh re-
ceived into the throat by the  help of  a fun-
nel are sometimes beneficial.   The following
will often answer a very good purpose after
blood-letting:
  T.  Wash the  throat with a decoction  of
equal parts  of  the  bark of persimmon tree,
sumac root, and briar root.  Let it be,,  made
pretty strong, and add to one quart, as  much
alum  as is  equal in bulk to a middle sized
chesnut.
  8.  Touch the ulcers twice a day,  with a
soft moss dipped in a tincture of equal parts
of burnt alum  and  blue stone, (blue vitriol)
dissolved in rum or  brandy.   Put in as much
as will dissolve* 
24r
           6 H A PTE R  XXXI.
              SCARLET FEVER.

  This fever like the foregoing, depends1 on
a specific contagion.  It comes on with chil-
liness, sickness at the stomach and vomiting.
These symptoms are specially  characteristic
of the disease.  There are in some cases a
swelling of the throat, and difficulty of speak-
ing, swallowing and breathing.   Sometimes
there  is a  squeaking voice and ulcers in the
throat, which are in some instances deep and
covered with white, brown or black sloughs.
A thick mucus is discharged from the nose,
sometimes from  the  beginning,  but  more
commonly coming on  about the fifth day.
An eruption appears on the skin, sometimes
preceding, sometimes following the swelling
And ulcers of the throat.   In  some, the
eruption  is confined to the outside of the
throat and breast;  in  others wholly to the
limbs.  In some,  it appears on the second
and  third  day, and never afterwards.  In
some, it appears with  the sore throat, and
perhaps in others  without it.  The bowels
are generally regular but  some have  diarr-
hoea.
  This fever is moderately inflammatory and
differs from  the malignant  or putrid  sore
throat in the following particulars. 
248
  1. It is not always attended  with a sore
throat.
  &. The eruption in this fever is of a deep-
er red color, aud is more smooth, resembling
the  back of a boiled lobster.
  3« The skin is also more hot and dry.
  4. The skin peals off in the close of this
fever.
  5. It is not so dangerous as the putrid sore
throat.
  6. It commonly goes off with a  swelling
of the hands and feet.
  7. And lastly it frequently appears in sum-
mer and dry weather.
  Again  this  fever may  be  distinguished
from a common inflammation of the almonds,
&c.  called  quinsey, by the  following  re-
marks.
  1. The appearance  of ulcers  in common
quinsey, is confined to  the almonds,  &c.
  2. A strong full and tense pulse attend an
inflammatory quinsey,  always admitting  the
use of the lancet.
  3. A common quinsey is not attended with
external redness.
  The remedies for the scarlet fever are,
  1. Puking.  Ipecacuanha and calomel com-
bined as in the foregoing disease, chap. xxix.
This preparation is to  be prefered before alb
others, it is a certain cure if given on or before 
                    249

 the first day.  The dose should be repeated
 according to the violence of the disease.
   2. Small  doses of  calomel.   If the pa-
 dent should  be  very  weak small doses of
 opium  should be  added to the calomel, to
 prevent its purgative effects.
   3. Blisters should be applied behind the
 ears -n [ on the throat.
   4. The throat  to he washed as in chap.
 xxx. except  that  in the first stages of this
 disease, the best gargle perhaps  is a solution
 of salt petre  with  the addition of borax, but
 it must not be quite so strong  as advised for
 the  putrid sore throat.  Calomel is a proper
|#ticle to be applied to the ulcers in the throat,
 see  article 4th,  under the h*_ad   of puU-rd
 sore throat.
   5. Snuff may be used  about the fifth day
 to excite a running at the nose.
   6. Towards the close of  the disease, wine
 and Water or  wine whey may be used to such
 extent  only  as to keep up a very gentle per-
 spiration.
 ■'"7. Whenever the  swelling of  the extre-
 mities  takes  place, a few  doses of calomel
 mav be repeated.
   It is worthy of observation, that this dis-
 ease can  be communicated  before it can be
 known to be present in any case.   It is there.: 
250
fore unnecessary to remove children out of
the fam ly where it makes its appearance.  -
   Some are of opinion that the scarlet fever
might be prevented by using occasional dose*
of rhubarb.  This remedy  is  worthy of a
trial.
           CHAPTER XXXII.
                                    -    I-
       INFLAMMATION OF THE  EYES.

  3ore eyes are of two kinds.
  1. That which  effects the coats of the ball
of the eye, &c.
  2. That which affects the eye-lids only.   ;
  The causes inducing inflammation are,
 . 1. External violence, wounds, particles of'
du^t, sand, etc. or the hairs of the eye-lilts
inverted.                               "M
  2. Too much light or strong  light too long
continued, sitting up at night  before a  fire,
riding  in scow,  particularly  when  it  falls '■
early or late in the season, writing or reading
too much at night, and  too long accurately
inspecting very minute objects.
  S. Frequent intoxication.
  4. Sharp matter,  such as tobacco, &c. re- -
ceived into the eye. 
                    15J51

   $. Sympathy.  Sore  eyes are  frequently
 taken by looking  at others in that condition,
 and is the effect of an active imagination.
   6. General  fever  sometimes induces this
 disease.
 ja  The remedies are as follows :
   1. Bleeding.   When there is general fe-
 ver,  copious bleeding from the arm will be
 necessary.   If no general fever  be present,
 cupping the temples and scarifying the inside
 of'the eye-lids.
   2. Purges.   These may be more or less
 , violent according to the violence  of the dis-
 ease.
   3. Blisters.    These  should   be applied
 to the neck,  behind the ears, and  to the tem-
 i Ples-
 *  4. Certain washes.  These must be mild
[ pr sharp according to  the stage  of the dis-
 ease.  In most instances when an inflamma-
 tion of the eyes first appear, cold  water, milk
 «nd water or mild lead water will be proper.
 fThe lead water should be made  into a poul-
 tice and applied to the eye affected, first cov-
 ering it with a bit of cambric or muslin.
   5. In the last  stages of this  disease  the
 eyes  may  be washed with the following so-
 lution,  white vitriol and sugar  of lead of
 each forty grains, spring water one gill.   If
 this be not convenient,  weak spirit and wa- 
252
*er,* Madeira wine and water, salt and w»,
ter or a decoction of oak bark and leaves not
ioo strong.
   In curing this disease, the patient should
not be exposed to the light;  and all spiritu-
ous liquors must be carefully  avoided.
   When  they are particles  of dust  or the
like in the eye, it may sometimes be washed
out  with  clean water.   If an inverted  hair
be the cause, it must be  plucked out.
   If  the disease  should  be of long  standing
and  be  obstinate,  setons  and issues will be
proper.
          CHAPTER  XXXIII.

                  BURNS.

  If fever be excited by  a burn the patient
should be bled, and purged with  gentle laxa'
tive medicines.  But  the greatest  depen-
dance should be  placed upon applications to
be made to the part affected.  Tar, lead wa-
ter, rum and water, holding the part affected
near to  the fire,  or in  cold water ; the part
should be immersed and  kept covered with
the water, for one or more hours.   Oil is an
  * Say water five spoonsful, brandy or rum one
|popnful. 
253
 improper application.   A strong solution of
 soap and water is a  good application.  An
 ointment made of James-t<,wn weed,  (stra-
 iffkHtumj is  said to be an excellent remedy,
 after the inflammation is subdued.  Cold and
 salted dough made  of Indian corn meal is a
 good application,  especially where the  skin is
 ttnbroken.
  • Spirit  of  turpentine diluted with rum or
 lyandy of such strength as just to be tolerably
 well borne, is the West and  safest application
 to a burn.   This or tar  ought always to be
 applied where  the injury done by the fire is
 Considerable.
i

           CHAPTER XXXIV.

           BLEEDING AT THE NOSE.

   I. This may be the effect  of too strong a
 circulation of the blood towards the  head, and
 in that case die patient should,
   1. Let blood   as  often, as may  be neces-
 sary.
   2. Cold application should be mada to h:s
 head,  and should frequently be repented.  I
 have known  the application of a cloth wetted
 with cold water made to the groin, to afford
 instant relief. 
254
  II. Debility sometimes may be the predis;
posing cause.  When this is the case, laud*
num, blisters, and common salt are the prop-
er remedies.
.  The preventative remedies are  gentle ex-
ercise with a milk and vegetable diet.
          CHAPTER  XXXV.

        SCALD  HEAD  AN1» TETTERS.

  For the cure  of scald  head and  tetter
worms, the first thing necessary  is to cleanse
the part affected, by carefully washing it with
milk and water.
  2. Apply  mild poultices, changing them
every four hours for two or  three days.—
Then apply a solution of ten grains of coi o-
sive sublimate dissolved in one pint of spring
water.  Some  recommend  a tar ointment,
others a stiff plaister of pitch so as ultimately
to extirpate the hairs, as  the  best remedies
for scalded bead.   Oihers recommend a de-
coction of tobacco ; strong solution  of soap
and water, &c.  Sec. 
                    J.5Z

           CHAPTER  XXXVI.

       WHITE  SWELLING OF THE JOINTS.

    O.i the HVst attack of this disease, " apply
 eight or mo-e  leeches and afterwards small
 blisuirs to die joint ; gentle frictions  of the
 part; two or three vomits a week, with en-
 ^re rest of the limb ; and in the end sea-
* bathing," or a bath of salt and water.
    Electricity ought to be used in  every case
 where it can be done.   This remedy will
 • frequendy succeed when the appearances are
 unfavourable.
    Early  application  should  be  made  to an
 able physician.  Too often by an unaccounta-
 ble kind of neglect the fives of very promising
  children are lost.
; '      .     CHAPTER XXXVII..

                    MUMPS.

     This disease is often epidemic, and mani
  festlv contagious.  It comes on with the usual
  symptoms of fever, and is soon after attended
  with a considerable swelling of the throat and
'  meek.   The swelling at first seems to be fixed
  in a moveable lump at the corner of the lower 
256
jaw, but it soon spreads  itself over  a great
part of the neck.  Sometimes it is confined
to one side of the neck, but more commonly
both sides are affected.
   The swelling continues to increase till the
fourth day.   From that time it declines, and
in a few days more passes off entirely.
   As the swelling of  the  throat goes off,  it
affects the testicles in the  male  sex, or the
breasts in the female.
   The fever attending thi» disease  is com-  <
monly slight and goes off  with the swelling  *
of the neck.  Sometimes however, when the
swelling of the testicles does not succeed to
that of the neck, or when  one  or the other
has been suddenly checked by cold or other-
wise, the fever  becomes very considerable.
Fever under these circumstances is  some-
times attended  with delirium, and has in,
some cases proved fatal.
   As this disease  commonly runs its course,
without   either   dangerous or  troublesome
symptoms,  so it seldom requires any reme-
dies.       %
   A cooling regimen, and care to avoid cold,
are all that will  be commonly necessary.
   But when upon the disappearance of the
swelling of the  testicles in males, or of the
breasts  in females, the fever becomes  con- „
siderable, 
25T
 •  Then
   1. Let blood according to circumstanctSj
 and repeat it daily till the fever abates.
   2. Give one ob moregentle purges.  Even
 calomel and jalap would not be amiss.
   3. Warm'steam  should be applied to the
 breast  or testicl s   It is  a very convenient
 method to take a newly opened gourd of suit-
 able size.   Put into it a few mullen leaves—
f Scald the  inside of the gourd and its  con-
c tents—Pour off the water, and let the testi-
cles or  breasts,  as  the case may  be, hang
 down  into the  gourd.   Continue  to repeat
 the  application three  or four times a day so
 long as it is necessary.  At each  application
 the  pat affected should  be made to  sweat
 freely.
   "1 his mode of sxveating is useful whenever
 tithtr the breast §r testicle  is affected  with
}painful szvelling from  whatever cause.
          CHAPTER  XXXVIII.

             COMMON QUINSEY.

  This disease  is  an inflammation  of the
soft  membrance  of the inside ot the throat.
It chiefly ;.!fects  those parts commonly called 
258
the almonds ; but frequently spreads itself 60
as to affect every part of the throat;
   It first shews itself by some swelling and
redness of the parts.  As Mhe parts swell it
becomes more  painful and difficult to  swal-
low—the pain  sometimes  shooting into the
ear.  There will be a  troublesome clammi-
ness of the mouth and throat, with a frequent
but difficult discharge of phlegm.  And there
isTommoniy considerable fever.
   This  disease is  never contagious.  It is
commonly occasioned by cold externally ap-
plied,  particularly about  the neck.  Young
and robust people are  most  liable to it's at-
tack.   Persons once  affected  with it are
therefore the  more easily affected a second
time.   It occurs most commonly in spring
and autumn, when there are  the most fre-
quent changes of weather.
   For the cure of this disease,
   1. Bleed, as far as the general fever may
 make  it necessary—Leeches applied to the
 throat and leistering the same, may be found
Useful in some cases.
   2. A full dose of tartar emetic given as a
 puke, must be useful in a great  majority of
 instances.
    3.  Warm steam frequently inhaled into
 the throat by the help of the spout of a tea-
 pot, or funnel,  or  other  instrument.  For 
;,                    259
j*this purpose hot water, to which is added u
j little vinegar,  may be used.
t   4. (ro-gles.  Sage tea and honev.  A de-
>  coction of roses and honey.   A  decoction
  such as is  recommended under the article of
  jutrid sire throat.   Any  of these may  be
  used at discretion.
    5.  Frequent  purges  repeated from the
  first to the fifdr day if  necessary.   Glaubers
  salts answers this intention very well.
  >  G. Sweating medicines  are generally use-
  ful.  After  one or two bleedings and pur-
\  gings—u;ke, tartar eiir^t. three grains, spring
  witter two gills,  laudauum thive tea spoons-
  full— )f this preparation one table spoonfuU
  may be given every second or third hour.
I 5, 7.  If  the  swelling progress  obstinately-,
• .notwithstanding all these re medic.-.— hi n  re-
! jpeat the use of warm  steam  till  the tumor
'  breaks ; or if it should not break of itself,  it
  should be opened with a lancet or other prop-
  er instrument.
    Njr.  When it is reduced to a certainty,
  that the  quinsey cannot be scattered,  warm
  l-oultices  may  be applied externally. 
2C0
           CHAPTER  XXXIX.        -*j

  CATARRH, COMMONLY CALLED A BAD COLD.

   This disease commonly begins with some
 difficulty of breathing through the  nose,  and
 with a sense of fullness stepping up that pas-
 sag".  There is commonly some dull pain
 and a sense of weight felt in the forehead, as
 also some stiffness and soreness in the motion
 of the  eyes.
   After a short time, a thin watery and  hot
 fluid  flows from the eyes and nose, more
 particularly from the latter ;  and this' fluid
 sometimes is so acrid as to excoriate the cu-
 ticle, or outer coat of the skin, over which it
 passes.
 ^ There  is also pretty commonly a peculiar
 kind of indolence and weakness felt over the
 whole body.   Some cold  shiverings are felt,
 or at least the patient is more than ordinarily
 sensible to the coldness of the air.
  The pulse becomes frequent, especially to-
wards evening.
 ' Before  many'days a troublesome cough—
a hoarseness—a sense of roughness and sore-
ness in the  air  pipes—and  a difficulty of
breathing take place.
  The cough is at first dry, occasioning pains
about trie  chest, and more especially in  the 
261
 breast.  Sometimes  pains resembling rheu-
Imatism are felt in several parts of the body,
 particularly about the head and neck.  There
f will  however be  a  considerable increase  of
 thirst.
    In young people  the case remains but a
 few days  in  the  above condition before  the
 cough becomes more effectual, and the phlegm
 coughed up is ticker and more white.  The
 mucus from the nose is also thicker and less
I corroding to  the skin.   The appetite returns,
F and  the patient gradually recovers ordinary
f health.
•    But  when the violence of the  disease  is
 considerable, or when there is danger of con-
 sumption from heriditary predisposition, it is
 certainly most safe,  and often it is absolutely
  necessary, to have recourse to suitable rem-
 edies.
    For the cure,
    1. Where there is considerable fever the
  patient should  be  bled—And  this  remedy
  should be daily repeated as often as the vio-
  lence of the symptoms  make it necessary.
    2.  A full dose of tartar emetic or ipecacu-
  anha.
i    3.  The patient should live on a light diet,
j  abstain  from  all laborious exercise, and in
  violent cases even  from  walking about the

                     P 2 
362
house,  and there should be no fresh applica-
tion of  cold.
   4.  Gentle purges frequently repeated will
much assist the cure.
   5.  Warm diluting drinks should be free-
ly taken, especially at  night—such as flax-
seed tea,  mallows tea,  or  even weak  hyson
tea.  If one tenth or one twentieth part of a
grain of tartar emetic  were added to a free
drink, at intervals of two  or three hours, it
would be the more effectual.
   6. Occasional doses  of salt petre from five
to ten grains at  a time, well diluted in one
of the above drinks.
   7. After five  or six days blisters may be
repeated according to existing circum6tanceR.
   8. Heat applied to the skin  before going
to bed at night.   After proper evacuation the
patient  may sit or stand  near a  good fire,
 turning side for side until very v/aTm.  This
will be  found a good general stimulant.
   9. After the fever and  pains subside,  the
. patient should  gradually return to his usual
habits.
   It may not be*  improper to observe here,
 that, an affection  like  the common catarrh,
 or bad cold, sometimes  spreads itself in  a
 speedy manner over a  very extensive tract of
 country ; nay  sometimes not even confining
 itself to one continent.   This complaint is 
253
  commonly  called  an  Influenza, and  in  u*
 : progress attagks old and young almost with-
  out distinction.
    In this affection the treatment  proper  in
  common cold is likewise proper.
    For the use of those who hare no  better
  Bource of  information, I will also  add the
  following observations.
    When a  violent catarrh or  influenza seizes
  upon old people, particularly those of a fleshy
I habit of body,  of those who have been in ha-
  bits  of drinking ardent spirits  freely, it is
  very apt to affect  their lungs with bastard
  pleurisy, (peripreumonia notha.J   In such
  cases large blood-letting would  certainly be
  very pernicious.  Rather treat  them as fol-
  lows, viz.
    1. Let them be kept warm and take freely
  warm diluting drinks.
    2. One  or  more doses of  ipecacuanha or
  tartar emetic, may be necessary.
    3. Tne  violence of  die fever should be
  moderated by using gentle  laxative  medi-
  cines.
    A.  Blisters  may be freely used.
     5.  After a  few days hore-hound tea may
  be taken pretty largely.                  *
    6.  Warm steam  may be frequently moaled
  into' the lungs—-specially if the cough be.
   -onrc? dry. 
264
   7.  If sweating can be procured  by usiny
warm teas only,  it  is very  well ; but nu
strong medicine  should be  given  for that
purpose till after the fifth or sixth day, when
small doses of  the  rattle-snake*root might
be used with advantage.
   8.  Warmth, and composure of  mind are
indispensable.
  9.  Elixir paregoric  is a  valuable remedy
in the last stages of this complaint, in the ca-
ses now under consideration.  Thirty to six-
ty drops the dose, to be repeated every eighth
hour.
  Note.  Blood-letting may be necessary in
some cases, but  it should be done under the
direction of much experience and judgment
only.
            CHAPTER XL.

 SOME REMARKS ON THE MEDICINES  PRESCRI-
     BED IN THE  COURSE OF THIS WORK.

   1. Allum, is used in floodings and in long
continued fluxes.  It is given to grown per-
sons in doses of five to twenty grains every
four, eight, or twelve hours, according to the
exigency of the  case.  In women's cases it
may commonly be  mixed with kino, which
see. 
                      *65

     2. Aloes Succoterine,  is a purgative medi-
   cine, very stimulating to the rectum or low-
   er intestine, and  if too frequently used,  in-
   duces piles.   It  is  however a very good ar-
   ticle in cases of suppressed menses, worms,
   fcfc.  The dose  for grown persons may be
   from six to sixty grains.   For a child of two
   years old, from two to  six grains.
     3. Assa Foetida,  is used in hysteric cases.
   In  hysteric  suffocation,  a plaister made of
   assafoetida one  quarter  of an ounce,  and
   camphor  ten to fifteen grains, may be applied
■   to the stomach,  and will be found a useful
   remedy.
    4. Bark.  Of this article  there  are  two
   kinds, viz. the red and pale.  It  is a useful
   remedy in feeble habits,  and strengthens  the
   stomach and bowels.  It is employed in  the
   cure of fever and ague ;   but it  is sometimes
   unsuccessful unless  the  patient be first bled
   one or more times.   Its dose for a man may
   be from thirty to sixty grains, to be repeated
   every one, two or three  hours.   A dose  for
   a child of two years old,  from five  to  ten
   grains.
    5.  Borax, is used to  relieve children in
   thrush,  it  is also proper for making gargar-
   isms in cases of sore throat,  whether in scar-
   let  fever or putrid sore  throat.  In cases of
   thrush it may be prepared as follows : Take 
266
borax sixty grains, honey one ounce, and it is
better to add as much water as mny serve to
dilute it sufficiendy.   It is said to be useful
as a medicine to be taken inwardly  in cases
of fluor albus.  The dose from five grains to
sixty.   If taken in this disease, a few grains
of nutmeg or cinnamon should be added to
each dose,  otherwise it may produce  vom-
iting.
   6. Calomel, is an excellent medicine.   It
may be used as a purge either alone or com-
bined with jalap. * If it be intended to operate
speedily, it  should be combined.  If hot it
is most effectual by itself.   Sometimes when
given too often, or in too large doses, it pro-
duces a salivation.   The dose for a man is
from five to twenty grains, for a child of two
years old from two  to four grains ; if  given
for worms  it might be combi^d with a little
aloes or jalap.   In  ail billious fevers  it is a
very useful remedy, and after sufficient evac-
uation by  bleeding,  &c.  it may be given in
small doses, frequendy repeated,  with very
great advantage.
   7. Camphor, is  a very powerful  stimu-
ian* and is  sometimes useful in  fever after
sufficient depletion.  It  produces sweating
and may be given in doses from two to twen-
ty grains.   It is sometimes useful, combined
with salt petre.   When dissolved in spirit, it 
267
is sometimes useful as an external application
for the relief of pain, inflammation, numb-
ness,  palsev, &c.
  8.  Carolina  Pink  Root.*    Perhaps  the
dose of this article as advised in chap, xxn.
part iv. may be too strong.  It will be safest
to make  trial as follows.   Take cne quarter,
of an ounce, stew it gently in one pint of wa-
ter down to three gills.   Give half a  gill ot
this decoction to a child six years old, morn-
ing and evening, and observe its effects.  If
it procures unusual drowsiness, the dose may
be considered too strong, and ought therefore
to be lessened  or entirely omitted.
   9. Castor Oil,  is a'  mild  and pleasant
 purge ; its dose for a man is from one to two
 table-spoonsfull, for a child of two or three
 years old  from one to two tea-spoonsfull-T
 .  10. Camomile Flowers, make  a tea which
 is useful in weakly cases, as of  indigestion,
 sickness at the stomach from weakness, be.
   11. Columbo, is said to be almost a speci-
 fic in cholera morbus, nausea, vomiting, pur-
 ging, diarrhoea,  dissentery, bilhous  levers,
 indigestion, want of appetite,  and most dis-

   • Add to each potion of pink-root  a  sufficient
 quantity of senna to make it ^t gently as a purge-
   + Frequent doses of  castor-oil during the tart/two
 mJSFS pregnancy will certainly conduce to «i>
 •asy and tafe delivery. 
268
 orders of the stomach and bowels where ne
 inflammation exists.  But on  the principles
 of Dr. Rush's  theory, in  every species of
 cholic, blood letting ought to be  die  first
 remedy, and afterwards perhaps gentle evac-
 uants.  Then if debility prevail, the colum-
 bo with orange  peel,  &c.  would be proper.
 From ten to thirty grains every three or four
 hours the common dose ; but it may be ex-
 tended even to one sixth of an ounce.
   12. Cream of Tartar,  is  a very  mild
 purge, and  may be  given  from one to two
 ounces.  If dissolved in a large quantity of
 warm water, and takpn in a gradual manner,
 it evacuates the intestines in a mild and effec-
 tual way.   Combined with jalap, it is con-
 siderably effectual  in exciting the action of
 the absorbents ; by these means I once cured
 an ascites,  that is a dropsy of the belly, of
long standing.
  13.  Cinnamon. .  An  excellent  aromatic,
and considerably strengthening to  the  bow-
els, and is recommended in cases of flooding^
whites, &c.
  14. Ether, if applied externally relieves
pains, and if giveninternally it removes fla-
tulency, asthma, hiccup, &c.  If applied to
an inflammation and is suffered to evaporate,
it will cool and relieve it wonderfully.  If ap-
plied to chronic rheumatism in a state of con- 
zuy
 !  linement  so as to prevent its evaporation, as
   with a cloth wetted with it and covered with
 ■_  the palm  of the hand, it will relieve the pain
   on opposite principles.
 '    15.  Elixir  Vitriol, is a valuable remedy
   in weakness of the stomach, indigestion, &c.
   but being considerably stimulant,  it must be
   improper when the pulse is  tense, and in all
   cases of inflammation.   Its dose from ten to
   thirty drops, in a cup of some kind of liquid.
   If this article  be dropped on linnen or cotton
   cloaths, it destroys them.
     16. Flies, called also Cantharides, are used
 '  for the purpose of drawing  blisters.  Per-
   haps the best mode of applying them is in the
   form of  a quilt.   If prepared  in this form,
   one quilt  will serve three or four times, when
   applied on  plaisters,  the  skin  should be
   guarded  by  applying a thin bit of muslin be-
   tween it and the flesh.  The application of
   cantharides  sometimes excites a strangury.
   See chap. xv. part n.  When this circum-
   stance takes place, the patient should drink
   plentifully of some diluting draught.  A tea
   made of mullen would answer a good purpose
;   in this case.   He  should also take a dose of
   opium, and repeat it in eight hours if neces-
   sary.   Blisters are  seldom proper  till the
[  violence  of a  fever  is reduced by bleeding
   and purging,  They should not  be dressed 
270
with colewort leaves.  Some kind  of mild
ointment- should be preferred.
  17. Ipecacuanha  is an excellent puke,  and
is the mildest and safest of any  yet known.
Its  dose for grown persons  is from  five to
thirty grains, and for  a  child  of two years
old from one to five grains.   It may be taken
in a cup of  tea or  in the form of bolus,  and
while it operates the patient may drink freely
of weak camomile tea.
  18.  Iron  is one  of the most  powerful
strengtheners.   In  weak lax, and pale habits,
such as cachexy,  green sickness, it is the  best
medicine as yet  known.   But it is often in-
judiciously employed so as to do irreparable
damage.  If there be tension, rigidity  and
spasmodic stricture existing in the system,  it
is highly pernicious.   Let it  therefore be
observed that  if the use of this article  excite
pain in the head, with other feverisb symp-
toms, it should  not be continued.   It may
be given in the  form of  simple filings,  rust
of iron,  or  the salt of steel.   If the rust or
filings be used, the dose may be  from five to
ten grains ;  if salt of steel be  chosen, from
one to three grains may  be the dose.  It is
generally the best method to administer it in
small doses,  frequently  repeated.   Cases
may occur  in which  this article  is really ne-
cessary  and in which, notwithstanding  its 
                     271

  propriety, it may  cause considerable sick-
 ' ness and pertubations.  In such  instances a
f moderate dose of opium may be given after
  each dose,  or the patient may be directed to
  take it on gcang to  bed at  night, and again
  half an hour before rising up in the morning ;
  and at other times of the day let hirn or her
  walk  moderately  immediately  after taking
  the dose.
     19.  falap is an  excellent purge,  if it be
  -ground together with cream of tartar it  will
''  operate  in  smaller  doses than when taken
i  singly ; and  it  will  furthermore act more
  gently and without griping.   Ground togeth-
  er with hard sugar, it becomes a good  and
  safe medicine for children.   Combined with
  calomel, it  is a most powerful p'urge.   Its
  dose for a man is from twenty to forty grains,
  for a  child two or three years old, from  five
  to eight or ten grains.   In cases of  billious
  fever, after bleeding, when  that evacuation
  is required, ten grains of jalap with  five
  grains of calomel might be taken ever) three
  or  four hours 'till a sufficient effect is produ-
  ced.
     20. Kino is an astringent gum and is useful
  in diseases of laxity,  such as diarrhoea, fluor
  albus, &c,  it may be given  in the following
  form.  Take kino two parts and allum three
  parts, grind them together ;  of this mixture 
272
the dose may be from  five to fifteen grains,'
every three or four  hours.   In  cases  where
the ahum is improper or disagreeable, from
five to fifteen grains of the kino alone, it may
be dissolved in water  or  a solution of gum
arabic,  to which  may  also be added a few
drops of laudanum.
   21.  Magnesia  is  a very mild article, it
corrects aridity in the stomach and in  the
first passages.  Hence its effects in relieving
heart burR,  as also giddiness, vomiting,•and
pain in the stomach, when they are the con-
sequences of an acid matter collected in the
stomach.   It also relieves gripes in children
when  brought on by the  same cause.  Its
dose for an infant may  be from two to five
grains,  to be given in a tea of  fennel seed,
and repeated.  The addition of a small por-
tion of rhubarb  or manna  gives  it a little
more activity as a purge.
   22.  Manna is one  of the mildest purga-
tives, and may be given with great safety to
children and pregnant women.   It is proper
in  pleurisy,  all  inflammatory fevers,  and
such other cases as may require mild purges.
Its dose is from half an ounce to two ounces ;
and it is best perhaps  to dissolve it in a de-
coction of cassia, which is an inferior kind of
cinnamon.  If a little tartar emetic or some
other active article be added, the manna wiK 
  aperate much more effectually.  Say manna
 (half an ounce, tartar emetic half a grain, to
 i be repeated eveiy two or three hours.   This
 } would,be an excellent preparation as a purge
  in child-bed fever.
    23. Gum Myrrh is a stimulating medicine
  and is admissible in those cases only where
 , iron is proper, as in chlorosis, &c.   Its dose
  may he from  five grains to thirty ; a tincture
  may be  made of this gum as  follows : Take
  gum myrrh three ounces, proof spirit or good
 r wine,  one  pint and a half, digest  them ten
  days  with  a  gentle  heat.  The  tincture so
  prepared is a useful addition to  cleansing
  gargarisms, such  as are proper in  putrid
  sore throat, &c.
    24.  Nutmeg is warm and agreeable to the
  taste,  is good for  the  stomach, corrects  a
  laxative  habit, relieves indigestion, &c.  its
  dose is from six grains to thirty, if roasted
  in substance, it is said to be more astringent
,  and is an excellent remedy in chronic  diarr-
  hoes and dissenteries.
    25.  Orange-peel is employed as a stomachic
  medicine, it promotes appetite, gives strength
  and vigor  to  the  bowels, and is  therefore
  proper  in  cases of indigestion,  flatulency
  when  the consequence of debility, &c.  It is
  rendered more effectual by joining  it with
  eolumbo, the  yellow outside  rind should l>e 
U.i*
preferred ; infusions  with water are  better
than any preparation with ardent spirit.   In
all cases where bitters are required, the use
of spirit must be injurious.  Wine,  if good,'
might be useful.
  26. Ol?ve Oil, called also Sweet Oi, is em-
ployed as  an external application, it is  im-
proper  however in cases of burns, especially
if the skin peel off.■.- But  I intend in a par-
ticular manner to recommend a frequent use
of it internally, to such women as are wont
to have  hard labours.  They should begin its
use several days before the  time of delivery.
One or  two ounces should be beaten up with
one or  more yolks of eggs till it will readily
mix with water, then add  half a pint or a
pint of water sweetened  with manna or syr-
rup.  With this she should keep her bowels
constantly  lax.   Where  there  is  sufficient
strength, blood letting should also be em-
ployed.
  27. Opium  is  a powerful cordial, it eases •
pain, but  at  the  same  time  very much in-
creases  the circulation, and is  therefore very
injurious in inflammatory fevers, especially
if the brain, lungs, liver, stomach or bowels,
&c. be the seat of the disease, at least con-
siderable evacuations should be  procured be-
fore it is ever employed in such  cases.   It is
never proper if there be tensity in the pulse. 
278
   In eases ot external tumor and consequent
 pain, it is frequently admissible, and when
 debility prevails with a soft and languid pulse,
 it is an  excellent remedy.   Its dose when
 taken in  substance may be from  one to three
 grains, in a  bquid  form,  as laudanum or
 tincture of opium,  which are two different
 names for the same thing,  the dose may be
 from  twenty-five to fcixty  drops.    But it
 thould be remembered that this  article gene-
  rally induces costiveness.
    28-  Precipitate of Mercury is either red or
  white.   U applied  in dry  powder to a foul
 • ulcer, they cleanse  it. When combined with
"'mild ointment  or  hogs-lard,  they  form a
 'drying ointment, useful  in eruptions on the
  skih,  sore nipples,  &c.  Take lard, or rather
  sweet  oil hardened sufficiently by   melting
  bees-wax together with  it, half an  ounce ;
  precipitate forty to sixty grains, mix them in
  a cold state,  and the ointment is prepared.
  .   29. Rhubarb is  a mild purge, and may be
  Kiven in doses from twenty to sixty grams,
  but as it is considerably astringent,  it should
  not be employed  where  a  costive habit w to
   be avoided.   In  chronic diarrhoeas, it may
   be given in small  doses of five or six grams,
   combined with opium, two or three:JJ»

   day. u^£rs^£S£Rn
   matory cases, ana  is inercvw»w 
276
dyssentery ; but  in  cases of debility, it is
frequently  useful; combined  with manna it
wilUevacuate the  intestines without exhaust-•
ing the strength of the patient in any consid-,
erable degree.
  SO. Russian Castor is  useful  in hysteric
cases, see  part i. chap. xxm.  But  it may
also be  used in  form of  a tincture.   Take
castor one  ounce, proof spirit two pounds,
digest ten  days, and it is ready for use ;  the
dose may be from twenty to sixty drops.  It
is sometimes taken to advantage in conjuncr
tion with  laudanum, say laudanum twenty-
five  drops, tincture  of castor  twenty-five
drops,  the whole  for one dose in hysteric
suffocation, as, also in painful menstruatioii:
where blood letting is not needed.
  SI. Sal Ammoniac, of this one ounce may
be dissolved' in one quart of water or of spirit
and water combined.   This solution is use-
ful as an external application in cases of in-
flamed, breasts, &c.
  32. Spirits  of Nitre or Nitrie  Ether, is
used in fever, and  is  an  excellent medicine
for quenching thirst,  expelling flatulences,
preventing nausea and vomiting, and mod-
erately strengthening the stomach ; it is dia-
phoretic and  cooling.  The dose may vary
from twenty to forty drops. 
   33. Spirits  of Sal Ammoniac, and  Spirit*
tof Hartshorn are similar in their nature and
| effects, but the first is perhaps the best. The
| dose may be from fifteen drops to sixty ;  it
 is useful in faintings and other hysteric af-
 fections ; if given in wine whey it generally
 procures a very pleasant sweat.
   3-1. Salt Petre, called also Nitre, is a use- ,
 fal remedy in inflammatory fever.  The dose
 may vary from three grains to forty, every
 two hours.   It is most effectual if given im-
 mediately after its solution.   Some caution
 however'is necessary in using this article, as
  it sometimes occasions a  nausea or pain  in
 the stomach.   In such cases it requires plen-
 tiful dilution,  and sometimes  the addition ot
  a little camphor.   Nitre is an excellent in-
  gredient in girgarisms and mouth waters.
    35. Salt of Tartar, called also Fixed Al-
  kali,  is used for making  the  saline mixture.
  Take salt of  tartar twenty grains,  lime juice
  or vinegar as much as may saturate it, or till
  it ceases to effervesce ;  pure water one and
|  a half ounces, and syrrup two ounces.  The
\ whole  mav be taken in  the  course of-four
3 hours, to "be repeated as ^nasm
  thought necessary.   It may be given also^in
,  a  simple solution, with- pure water , nvtins
»  shane the dose may be from ten to thirty or
   Se^^in..   But it should always be  sum. 
276
ciently diluted.  Every three cr four gian.t
require one ounce of w ater.  The saline mix-
ture given in a state  of effervescence fre-
quently corrects vomiting.  The simple so-
lution of tartar relieves heart burn, &c.
   35.  Senna  is a purge of considerable ac-
tivity,  and is commonly taken in form of an
infusion.  Pour one pint of boiling water on
one quarter of an ounce of senna, let it stand
several hours  in a moderate degree ot heat.
One gill may  be taken every two hours as a
dose for a grown  person ;  and one or two
spoonsful for a child two  years old.  It is
rendered more pleasant and mild in its ope-
ration, if one ounce of manna- be added.—■
The addition  of a  small  portion  of ginger
will help to prevent its griping.
   S7.  Flowers  of Sulphur  is a  gentle and
pleasant purge.   It is also effectual in cuii;.^
affections of the skin, as the itch, &c.  com-
bined with the cream of tartar, is  useful in
piles.   It is also a very good purge to be em-
ployed on the  third and fourth day of the
 measles.
   38. Tartar Emetic,  called also  Tarlarized
 Antimony,  may be so varied in its dose as to
 produce sweating, puking, or purging.  It is
 a medicine both safe and convenient, and has
 but little taste.   The dose  as a puke is from
 one  grain to live,  and may be dissolved in 
t warm water.  When used in children's eases
ifone grain may be dissolved in one  ounce  of
 wat-r, '.vhich may be swcietud with sugar ;■
 at aspo r.uul or  two may be given every half
 hour  liil 1-h; patient vomits, if that be the in-
 tention.   W'm.j given to procure  sweating,
 the dose m:*y vary from one eighth  to oi.e
 b.Ifof a grain,   it may  be repeated  every
 two or three hours ;  and in inflammatory fe-
 vers, ten or  more grains of nitre should be
[i added  to  each dose.   This is an  excellent
 remedy to be employed in inflammatory ca-
, ses after sufficient blood-letting.   Ii  it  be
 given in small doses, well diluted  every half
 hour, it will act as a  purge and the more cer-
 tainly so, if some  mild purgative  be added,
 as manna, purging salts, 8tc.   This  last  is
 an excellent remedy in dw beginning of  fe-
 ver ; and if sufficididy employed,  frequently
 wilt remove the  disease.  As the  tartar is
 hearlv without taste,  it is very easily  impo-
t sed on obstinate- children,  by  mixing it with
  cold  water  and  giving it when they ask  for
 dri,nk. 
280
            CHAPTER  ZLI

        A NOTE  ON  FEVER-

THE  NATURE OF FEVER IS  BRIEFLY STATED,
  AND SOME DIRECTIONS ARE GIVEN FOR  THE
  CURE.

  A  man in habits  of labor* will  rise early
in the morning, and  commence his business :
he will toil all day, and barely be sensible of
fatigue at night.
  This  ability to continue his  labors  very
much depends  on the degree of regularity
with which he proceeds.   For if he perform
more than his  usual portion of work, his
strength  will rail in a much shorter  time.
  The energies which constitute his strength,
and his ability to continue his labors for any
longer or shorter duration, depend,  first on
the state and  probably on the operations of
the brain;  and secondly,, on exercise and
habit.  H iwever much a man may be accus-
tomed to labor, if he be unwell, ltis strength
fails  him.   However vigorous  his lualth
without  habitual labor, he will soon be over-
come by fatigue.  However much fatigued,
rest  restores his strength.  And  the  more
accustomed to labour, lh; less  rest  will be
sufficient to maintain his strength. 
281
  The energies upon which bodily motion
as in labor, running, walking, or the like,
depends, are generated in the  system, per-
haps in the brain and nerves, and are depos-
ited  in the muscles.   The muscles thus fur-
nished with a  capability of motion,  are by
exercise  and habit brought  under  the  in-
fluence   or command of the  will.*   But
whenever there is  a deficiency of such ener-
gy  in the proportion of such deficiency  the
will ceases to  maintain its influence or com-
mand.   A man very much weakened by fever
has  very little strength.             '
   The heart and  arteries are endued with a
 similar ene/gy ; that is, with a capability o\
 being put into  motion.   But these   are not
 unde"be command  of the will, neither can
 the  will have much influence in increasing or
 lessening their motion.                    ,
   By physicians  this energy or capability of
 motion^n the  heart and arteries,  is called

 f"thf motion of the heart and arterie^s
 roused and maintained by other remote pow-
 ers, which act upon their excitability-   Such
 are the blood itself, the nourishment d.dy u
 ken in, the excrements, the passions, the ej

   * These energies when under the command rf the
  will, are called  length. ^^ 
282
forts of mind, the  noise and  bustle of bust-
ness, bodily labour or exercise, warmth, &c.
   Any of  these or other powers,  which are
naturally, habitually, or accidentally applied
to any part  or parts of the system,  and
which on application are capable of producing
an increase of motion  in the heart and arte-
ries, are called stbnulmts.
   The motion thus  produced is  called ex-
citement.
   The excitement of the heart and arteries
must be continual, for the continual preserva-
tion of life ;  of course there must be a contin-
ual prtduction of excitability.
   The excitability of the blood-vessels, and
the voluntary power of  the muscles, must be
the sam- principle differently employed.  For
if there be  an extraordinary  increase of ex-
citement for any considerable  length of time,
it w}ll be found,  that, there  will  be a pro-
portionate dimunition of voluntary strength*
Fever always weakens the patten*.
   Then of course voluntary muscular motion,
as also the excitement of the blood-vessels,
must invariably expend a quantity of excita-
bility commensurate  to itself.  That is, in
any given time, say for one day by way of
example  ; then, as in  the case of voluntary
motion,  the more violently a man labors in
the morning, the less he will be able to labof 
                    2B3

:n the evening—and  the contrary : so also
the more violent the excitement in the morn-
ing, the  same  stimulants being applied,  the
less will  be the excitement in the evening—
and  the  contrary.  And again,  as the man
who labors regularly according to his ordina-
ry-custom, can continue to labor with uniform
strength  through the day, so ordinary excite-
ment may likewise be .«*i'.form throughout the
day.
   Consequently if the quantity of excitement
of the whole mass of blood vessels be exactly
proportioned to the quantity  of excitability
constantly  generated or furnished, then  the
excitement will be equable, or  natural, or
healthful.
   If there  be an application  of more than or-
dinary stimulants, and if such application be
suddenly made, then there will be an increase
of excitement ;  and if the  increase be suffi-
cient to induce a sense of languor., and  gene-
ral distress, it is fever directly produced.*
   If the  quantity of stimulants acting  upon
the blood  vessels, be less than natural,  the
quantity  of excitement will also be less than
natural,  and of course there will be an accu-

  * Fever in this state maybe almost universally cured
by bleeding and purging only.  Sometimes by puking
and purging  only ; and soiaetim#s by wuier  one ot
the three remedi»* 
584
 mutation of excitability.  For excitability is
 considered to be uniformly generated,  if the
 energies of the  brain remain the same.
   If such  increase  of excitability become
 considerable, it  must therefore  follow th;t
 the ordinary quantity of stimulants,  or even
 less than the ordinary quantity, would  be ca-
 pable of producing an increase of excitement.
 This is fever indirect^ produced.
   It would seem that excitability can be gen-
 erated and conveyed* to the muscles or blood-
 vessels,  whilst they themselves are not in  a
 condition capable of motion.  Cold when ap-
 plied to the blood-vessels is said lo produce
 sedative effects.   That is, cold when applied,
 in the degree of its quantity lessens excite-
 ment, increases excitability and prepares the
 blood-vessels for the  indirect production of
fever.
   This  is really  matter of fact, and  I  am
 therefore inclined to believe that, the princi-
 ple of excitability can be  conveyed to the
 blood-vessels whilst they are  too much stif-
 fened by their  want of warmth to admit of
 their ordinary easy motion.  Such is the case
 With the fingers,  limbs, and even  lips of a
 man long  exposed to very severely cold
 weather.
   If every branch of the blood-vessels, that
 is, if the blood-vessels of  the  head, of the 
i:yj
lungs,  of the liver,  of the intestines, &c. and
of the limbs, if all these  branches of blood-
vessels are of a strength justly proportioned,
then a fever,  whether directly or indirectly
produced,  will not  readily do material dam-
we • but the increased excitement will grad-
ually  wear  down the  accumulated stock oi
excitability, and  the ordinary healthful state
of the  system will be restored.
   But if one or more of these branches of the
blood-vessefcbe by any means more weaken-
ed or become more excitable than the others,
then in such a case, a fever may very spee-
dily  do  much  mischief.  For instance ; a
 finrer bruised  by  a  blow, swells, inflames
 and becomes painful.  Here the strode weak-
 ens the injured  vessel.  The faithful  ves-
 sels leading to the  finger thus injured, propell
 th- blood Into it  with a force  too grea. for
  is weakened state.  The  weak vessels arc
  f course  stretch,d:  the  stretching is u*
 .welling, as  also the cause oft^>
    Now suppose a case  in whica bv  the ap
 niication of cold,  th.-re  is  great increase ot
 tire^ode of: exc tabifuv 5 suppose  also, thax
    , Cease the  blood-vessels of the lungs are
 xn this case  n     rendcred more  excitable
 T^r  whkb  c  Ste the other parts
 ^  Z««   And suppose  again  morr-
  ^\"Xmanwhoviinthisunfortunat. 
                   286
condition,  without upprehen: ;on of danger,
lays'himself" down in a warm bed :  as he be-
comes quite warm, the ordinary  stimulants
of the night begin  to  act with their whole
force on ar. pccumulattdstrck of excitability,
A fever necessarily follows.   By  the force
of the excitement, that  is, by  the force uf
the fever, the blood is dr'veh  into the ves-
sels of the lungs •, these vessels being weak-
ened, are quickly brought to dV Mretch ; or
being  highly   excitable,  q: vly  act with
much more than ortiinar) fo!«;e.   In either
case, their extreme branches must be affected
with a greater or lesser degree of stretching,
that is, pain.  This is infammutcry f ver ;
and this species of it,  is commonly called an
infanimation of the lungs.
   It is found that the decomposition, that is,
the rotting of vegetable and animal matters,
produces  a kind of gas  or vapor, which,
when mingled  with the atmosphere and ap-
plied to the lungs and  skin, is violently stim-
ulant.
   If this  kind  of poisonous pes be speedily
generated and suddenly-  applied, the blood-
vessels are quickly  roused to a state of vio-
lent excitement, in  some instances, so as to
exhaust the whole stocky of excitability in a
few days or even hours.  This is maligr.crt
fever* 
2aT
   If the same kind of gas  be more  slowly
generated and of  course  more gradually ap-
plied  to the syvtem,  a scute  of  fever is  pro-
duced which has  been called the jail fever,
slow fever, camp fever,  & -.
   The awful prostration of strength  which
attends these states of fever, is the result of
exhausted excitability.
   The brain itself, or whatever may be the
sourae from which the principle oi excitabili-
ty is   derived, seems  to  be so  completely
prostrated, that twenty,thirty,  and even six-
ty days are sometimes necessary for  its re-
covery.
   In  most instances of,fever extticed by the
application of preternatural stimulants,  there
will  be  a greater than ordinary quantity of
bile secreted : or  else the action of the blood-
vessels of the liver will be the first of the sys-
tem which are subjected to prostration.  Tiiis
I infrr from the facts, first,  that these fevers
are so marked with unusual discharges of
bile,  that  there   can be no doubt about its
extraordinary secretion ;  or secondly, that  a
yellowness of  the skin,  &c. attends,  which
leads to thf conclusion that the liver lv.is in  a
 greater or less degree,  feiled to  perform its
 office.  Som-times however, the spleen first
 of all is subjected to a state of complete ex^
 haustion.   This is proven to me by two cases 
iiSS
 of  dissection which have fialcn  under  my
 own immediate inspection.  This is billions
fever.
   1 have been ready to believe that, the cold-
 ness of the  nights, which is  almost-always
 found to be greatest in the neighbourhood of
 lakes, ponds and rivers, is the principal cause
 in bringing about that state of fever which is
 called intermittent.*  Cold/is sedative.  Its
 nightly  return necessarily brings  about a pe-
 riodical application  of its sedative powers.
 The accumulation of excitability thus period-
 ically  produced, prepares for a periodical
 state of fever.  The marsh miasma gradual-
 ly applied, continues to bear upon the system,
 tending to  wear  down the  general stock of
 excitability, so as to weaken the  system and
 co-operate  with the indirect  efforts of cold
 nights to  prepare for the commencement of
 fever;  and at length the chill  completely
 formed, becomes the stationary point, like a
 winter  solstice, between the prevalence of
 excita' ilitv and excitement.   Perhaps agree-
 ably to the opinion of Dr. Darwin, in  some
 instances a torpor of some one of the viscera
 may contribute to produce a  similar state of
 things.   According to the season, this state
 of fever will partake  more or  less  of the
 symptoms of billions fever.
•Fever and ague as it is vulgarly called. 
289
  If cold be long or frequently applied to the
blood-vessels of the limbs, these vessels are
at length thrown into a state of habitual fever.
This state of fever is commonly  called rheu-
matism.  The chronic nature of this fever is  N
the result of a law of animal organization.
Thus by habitual use one hand  is  made  to
grow to  a larger size than the other.  Thus
the face of the drunkard is made to assume
a perpetual blush, as if nature would declare
her own shame whether the poor sot is capa-
ble of feeling it or not.
   The same law is involved in  the chronic
shape which  intermittent fever  neglected
most commonly assumes.
   Fever is neithsr more nor less than an  ir-
regular motion of the blood-vessels.   In oth-
er words,  Fever is morbid excitement.
   It is general.   In this state it is  common-
 ly  least injurious, especially if indirectly pro-
 duced, and if there be no pre-existing  locat
 debility.   So  also in cases  of  direct fever,
 where  the stimulant exciting  it is not long
 applied.   This is the state of things in an  or-
 dinary fit  of intoxication.    The immorality
 and  other tendencies of drunkenness are  not
 here considered.                          f
   It is local. Such is a fit of inflammation ot
 the bowels.   In this case  the excitement ot
 the blood-vessels of  the extremet.es is below 
290
par, whilst  that of the intestines  threatens
destruction.
  In all cases of fever with local determina-
tion, there is danger of a destruction of such
branch or branches of  blood-vessels, as labor
under the attack of the fever.
  This destruction  takes place  in the form
of suppuration, gangrene, or schyrrus.  And
in either of these forms, it is properly called
a lesion of the part.
  Where  there is fever  without lesion, it
: hould be called by the simple name of dis-
ease ;  but  when  lesion has actually  taken
place, it would then be properly called a dis-
order.
  Fever therefore in  all cases  where it ter-
minates  fatally,  has  either  exhausted  the
stock of excitability,  or produced incurable
lesion.
   All disease  then is fever,  in some one of
its  states.   And, Fever is a unit.
   Phrenitis, or inflammation of the brain,
is fever  with a local determination to the
head,  in consequence of pre-existing debility
of  the blood-vessels of the head.
   Pleuritis or pleurisy, is fever with  local
determination to the  pleura, or  membrance
lining the chest.
    Peripneumonia,  or inflammation of the 
ZyJ 1
lungs, is fever with local determination to the
vessels of the lungs.
  Gastritis, or inflammation of the stomach,
is fever with determination to the vessels  of
that organ.
  Entcntis, or inflammation  of the bowels,
is fever determined towards the bowels, &c.
  When the excitement is general and  vio-
lent, either the pulse will be strong and full,
or it will communicate  to the  fingers a sense
of tightness like a stretched  cord, or it will
be  nearly  or quite  imperceptible.   In the
mean time there will be great uneasiness felt
in the limbs, languor or heaviness,  wander-
ing pains or drowsiness.  These appearances
commonly shew  themselves  before there is
great local determination.
   During  this state of things it will be proper
to  bleed and purge  according  to the degree
of  violence of the case ; and if this treatment
be  timely employed, and sufficiently repeat-
ed and "extended, one, two or three days
would commonly be sufficient for performing
the cure.
    Cases of violent local affection, are atten-
 ded with pain of the part affected, and  are
 commonly ushered  in by   the  symptoms
 which also attend general  fever.  The pulse
 will be obstinately corded ; although it may
 be small it will he tight ; in  some instances, 
ZV2
however,  the  tightness will gradually disap-
pear, and the  artery will feel to the touch as
if it  had  received much  additional length.
In the mean time it can be  relied about from
side  to side of the space where it  is usually
felt in the arm.  This seldom happens unless
in cases  where blood-letting has been neg-
lected.  In this state  of  fever with light
pulse and pain,  every time the fever rise?,
blood should  be drawn from the arm in such
quantities  as  may be sufficient to remove the
tightness of the pulse, and at least  to mode-
rale  the pair.   Purges should be daily re-
peated according to circumstances, and a  por-
tion  of salt petre, cream of tartar, and tartar
emetic, should  be  frequendy  administered.
Take salt petre half an ounce, cream of  tar-
tar half an ounce, and  tartar emetic five or
six grains ; dissolve the whole in one pint of
spring water, and give one table-spoonful ev-
ery  third hour.
   When  the pulse has  become relaxed in the
way hinted at above, there  is commonly an
engorgement of the blood-vessels of the lungs.
In that case small and  repeated blood-letting
will prepare the way for copious blood-letting
as in ordinary cr.ses.
   When blood-letting is often repeated,there
 w ill follow an increase of excitability, which
 will very  much distress the patient, and re- 
293
    tard the cure, unless it be worn down by the
    application of blisters.   These should be fre-
    quently applied after the fifth  day, and the
    extent of them should be greater  or less,  at;
    the disease may be more or less violent.
       This kind of treatment is proper in all ca-
    ses of inflammatory fever,  except that the
    cooling mixture does  not  at all  times sit well
    on the stomach.
       In  applying blisters  some regard  should
    be had to the seat of the pain.   They  should
    be applied as near to the part affected as may
;    be convenient.
       In jail fever, slow fever,  &c. the  state of
    the bowels should be regulated ;  afterwards
    strict  regard must be had to the s$a*te of ex-
    citement ; when below par, it should be rais-
    ed by administering suitable stimulants, such
    as a tea of camomile flowers, snake-root, &c.
    frequent small blisters, warm teas of garden
    herbs, &c.  These remedies will generally be
|    most  sukable through  the night, and for
    some hours  in the morning.  When  the fe-
    ver rises,  which is commonly towards noon,
    a warm solution of cream of tartar, repeated
    to as great extent as the stomach and bowels
    will conveniently bear,  will be  found useful.
    Nitric  ether, or sweet spirit of nitre, is a
    very valuable remedy in this state of fever.
    It a^ts as a  gentle stimulant, the effects of
                       R  2 
294
which are chiefly confined to  the  stomach:
Twenty drops  may be  given every second
hour.
   In fever and ague,  if the fever run  high,
put it down by  blood-letting.  Give the sys-
tem a shock with a dose of tartar  emetic  a
few hours before the  time of  the  fit of  the
ague :  clear  the bowels with one or more
doses of calomel and jalap.  During the in-
termission give warm  drinks ; during  the
heat of the fever give cool  drinks ; repeat
the bleeding  and  purging till the patient is
sufficiently reduced ;  draw blisters after the
evacuations.   Blisters in all cases and  states
of fever should be drawn  in the time of the
intermission or remission only.  If all these
fail, give the bark.  If the patient be thirsty
and generally feverish, always use the cream
of tartar freely, together with the bark.   It
is a mistake to  suppose the bark must be long
retained in the bowels in order to secure its
good effects.    Give it as freely as the patient
can conveniently bear it,  and let  it pass off
with the cream of tartar.
   Whatever be the name or  state  of  fever,
the  only  rational  intention in the cure is to
restore a regular state of excitement.
   No man can be  a  proper judge of the er-
rors of excitement, who  does not well un-
derstand the pulse. 
295
  All specific remedies, eommonly so called,
are  monuments of quackery.   The  physician
indeed, is the  man, who can  ascertain the
state of excitement in any given  case, and
then apply an appropriate remedy.  Families
should be  careful how they subject lives to
the h,i2urd of  being destroyed by well meant
ignorance.
R S 
Explanation of some words for  the help of
            common readers.

Abortion,  An untimely birth, a miscarriage.
Corroding, Eating away.
Costiveness, Being bound in the body.
Debilitate, To weaken, to make faint.
Depletion, The act of emptying.
Diaphoretic,  That which causes  sweating.
Diarrhoea, A lax or looseness of the bowels
Dilute, To make thin, as with water.
Dilution,  The act of making thin.
Distorted, Out of shape.
Effervesce, To b®il or work like beer.
Effervescence, The act of boiling like beer.
Emaciated, Made lean.
Equivalent, Equal in value.
Exhausted, Drawn out, spent.
Gestation, The act of carrying a child in the
              womb.
 Hemorrhagy, A  flux of blood  which is un-
              natural.
 Hymen,  The virginal membrane.
 Imperforated, Not pierced through, without
               a hole.
 Indigestion,  A disease in which the food lies
               heavy and unchanged on the
               stomach. 
297
Incontinence, Inability to restrain or withhold.
Indication, A mark  or  sign by which to be
              known.
Insinuate, To introduce gently.
Interposition,  Putting in by way of interrup-
              tion.
Irretrievable,  Not to be  repaired.
Laceration, The act of tearing.
Manual, Performed  by  the hand.
Membrane, A thin covering of flesh.
Menstruate, To discharge the  menses.
Menstruation, The  act of discharging  the
               menses.
 Mucus,  A slime.
 Mucous,  Slimy.
 Nausea,  Squeamishness,   sickness   at  the
               stomach.
 Parturition,  The act of bringing forth.
 Periodical, Occuring at stated times.
 Premature, Too hasty.
 Pressure,  The  act of  bearing  upon,  01
               squeezing.
 Saturation, The act of Ming till no more car
               be received.
 Suffocation,  The act of choaking.
 Suppression, The act of stopping.
 Suspend, To stop for a time. 
 
INDEX.
PART I.
Chap,	, 1.	Introduction.	5
	2.	Fundamental proposition. -	7
	3.	Importance of exercise, &c.	8
	4.	Importance of virtuous affec	
		tions.	15
	5.	Love.	17
	6.	Grief. - -	23
	7.	Anger.	26
	8.	Fear. -	28
	9.	J°y-	31
	10.	Envy.	32
	11.	Malice.	33
	12.	Scriptures recommended.	33
	13.	Temperance in eating.	35
	15.	Menses., §<#fc Wtention of	37
	16.		41
	17.	Painful	42
	18.	Obstructed	43
	19.	Obstructed menses continued 45	
	20.	do. do. do.	47
	21.	Immoderate menses	4ft
 
»                    600
Cha». 22. Whites        -       Pcge a\
       23.  Hysterics      -       -      53
       24.  Cessation of menses         57

              PART II.

Chap.  1. Introduction      -    -     59
        2. Proper conduct of wife, &c.  61
        3. Wife ought not to appear in
            the husband's place     -    67
        4. Sure  way of happiness in the
            married state     -     ?    f;9
        5. One word in favor of econo-
            my     -    -      -      71
        6. Signs of ^conception    -     .73
        7. Pains in a state of pregnancy
           necessary      -           f6
        8. Exercise, diet,  &c. in pregnan-
            cy                        77
        9. Sickness of the stomach, &c.  80
       10. Heart-burn     -      -      83
       11. Ccstiveness       -      -  84
       12. Tooth-ache    -            84
       13. Piles  3&  -        .      85
       14. Diarrhoe*!                  86
       15. Strangury                  88
       16. Fluor Albus       . -        89
       17. Varicous-swellings of the legs 89
       18. Cramp       -      -      90
       1°>, Inquietude or want of sleep  90 
 Chap. 2u. Fear of death     -     page9\
       21. Dropsical swellings, &c.     92
       22. Distention of the abdomen   93
       23. Moles, &c.      -     -     93
       24. Abortion      -       -     9s

               PART III.

'Chap.   1. Introduction        -        98
         2. Necessary definitions    •   100
         3. Position,  presentation, &c.  103
         4. Definition of labor    -    104
         5. Symptoms of present labor  105
         6. Common appearance of true
             pains       -       -     1°7
         7. How false pains detected, &c. 109
         8. Progress  of a natural labor   111
         9. Second stage of   do.       H5
        10. Management of placenta    118
        11. Introduction to  difficult  la-
             bors       -        -      I21
        12. First distinction of do.      122
        13. Second distinction of do.    128
        14. Third distinction of do.    131
        15. Fourth distinction of do.    133
        1;-. Instruments, &c.     -      135
        17. Perternatural labors         1^5
        18. First orderof do.     -    1;5,
        1.9. Second order  of do.        139
        20. Complex  labors     -       1*( 
802
Chap. 21.  Floodings  in abortion  pagelW
       22.  Premature labors with flood-
            ing     -     -       -     148
       23.  Flooding after  the birth be-
           fore the expulsion of the cake 150
       24.  Flooding after the expulsion
           of the cake     -    «     152
       25.  Labors with  convulsion     153
       26.  Labors  with  two or  more
            children       -       -    154
       27.  Labors  where there is a de-
            scent of the umbilical cord
            before the child     -     156
       28.  Management of women  in
            child-bed        -     -     157
       £9.  Child-bed fever      -    158
       30.  Swelled legs, swelled breasts,
            sore nipples, &c.      -     161

               PART IV.

 Chap.  1. Introduction      -        165
         2. AgreejB"^| of parents neces-
            sary %^J-       -       166
         3. Abswlute authority of parents
            ovei" their children necessary 167
         4. The best  and  mildest way to
            establish the  necessary, au-
            thority    -  '  -    -     17Q 
303
 S. The best means of preserving
    authority      -       page 17 j
 6. Propriety of inculcating reli-
    gious sentiments     -     180
 7. How religious sentiment may
    be  excited in the minds of
    children most  successfully  183
 8.  Common country schools in-
    jurious    -              191
 9.  Introductory remarks on the
    mode of preserving the health
    of children, &c.      -      193
10.  Some  remarks, introductory
    to the cure of the  common
    diseases incident to children 198
11.  Some hints to  enable parents
    to  determine  whether their
    children are particularly sub-
    ject to disease, and if diseas-
    ed to judge of the violence of
    the attack     -     -       199
12.  Red gum      -      -     204
13. Jaw-fall /*"%    -    "   3°5
14. Sore or ^  JH-ednavel     206
15. Thrush      dp  -     206
16. Milk in the breads     -    207
17. Belly-ache     -    -     208
18. Teething     -    -     -  209
19. Eruptions on the skin      209. 
304
Chap. 20. Warts on the tongue, tongue-
           tied, costiveness       page 210
      21. Falling down of the lower in-
           testine       -       "     211
      22. Worms     -              212
       23.  Internal dropsy of the brain 215
       24.  Croup or Hives       -    219
       25.  Cholera morbus, or purging
           and vomiting     -       223
       26.  Dyssentery, or bloody flux  229
       27.  Mesenteric fever     -      233
       28.  Hooping cough      -     235
       29.  Measles      -        -    239
       30.  Putrid sore throat    -     244
       31.  Scarlet fever     -      -    247
       32.  Inflammation of  the eyes^   250
       33.  Burns       -       -     252
       34.  Bleeding at the nose        253
       35.  Scald head and tetters      254
       36.  White swelling of the joints 255
       37. Mumps     -      -     255
       38. Quinsey     -     -    -  257*
       59. CatarrlitfrACommon cold   260
       40. Some Yem#ks on  the  medi-
            cWesJprescribed in the course
            of This  work         -    264
        41. Note on fever.  The nature
            of fever is briefly stated, and
            some directions are given for
            the cure      -     -    280 
 
(f
«■». "^JV :.,
V^V'J^*
v  y. 
Me-dU Hist,
   idX
  Kl °

  iSO*,*- 
t '.fiM*
k&-r-*>