THE 
ART 
O F 
PREVENTING DISEASES, 
AND RESTORING 
HEALTH, 
FOUNDED ON RATIONAL PRINCIPLES, 
AND ADAPTED TO 
PERSONS OF EVERY CAPACITY. 
By GEORGE WALLIS, M. D. S. M. S- 
EDITOR OF THE LAST EDITION OF MOTFIERBY’S MEDICAL 
DICTIONARY, AND SYDENHAM’S r 
NOTES, &C. &C, ' 
From Fa& and Reafon we our Practice 
The firmed Bafis, and the founded Law, 
Whence Nature’s powers in fulled Vigour rife, 
And dread Difeafe with all his Phalanx flies. 
NEW-TO RK: 
Printed by SAMUEL CAMPBELL, 
N°* 37, Hanover.Square, 
]tf,DCC,XCIV, EXPLANATORY PREFACE. 
TN the perufal of feveral works on the prevention and cure of 
I difeafe, I have feldom met with any that, according to my 
conceptions, have been formed with fufficient perfpicuity ; tor 
though fimolicity of ftile may be efl'entiallv neceffary, confider- 
jng the clafs of people to whom fuch labours are add re fled ; 
Hill I fee no caufe, why the very principles and reafoning by 
Tvhich they ought to he dire<5ted in their purfuit Ihould either be 
totally omitted, or treated in fo flight a manner, as not to afford 
any material advantages—the principles I mean are, the Natujre 
of Constitutions, and the immediate Causes of Dis- 
ease ; for whether we wifli to prevent or cure, thefe two points 
mull ever be kept in view. To prove this, let us inquire, by 
what are we directed in our attempts to avoid difeafe ? 
From the knowledge of the remote caufes, being well ac- 
quainted with the effeft which they are calculated to produce in 
the machine, and preventing their accefiion ; but in all cafes this 
cannot be done ; in many, prevention of that circumftance is 
impofflble—how then mull we a£t ? By fo regulating the pow- 
ers of the conftitution, that it may be placed in inch a Ante 
as to be rendered incapable of feeling the efFett of the remote 
caufe. 
And how can this be accomp’ifned without beinp thoroughly 
acquainted witli the nature of the conftitution itlelf; Indeed, it 
feems not only neceffary in this refpeft, but alio to render the 
difeafe, when the caufe has produced its confequences, as mild 
as poftible. Various proofs of the validity of this doftiine will 
arile upon flight confuleration. In inoculating for the fmall-pox, 
we find very often great variability in the difeafe ; and this can- 
not, it is clear, be owing to the matter by which the complaint 
is occafioned, having any variability of action ; for the fame 
matter taken from the very fame pock will produce in different 
habits a difeafe of very different natures, with refpeft to miid- 
nefs or malignancy—it is therefore obvious the variation mull 
arile from fome deviations in the feparate habits, which require VI 
EXPLANATORY PREFACE. 
different modes of preparation ;—and, probably, it is owing to 
want of accuracy in this point that forne children after being in- 
oculated die, and feveral fall into other maladies. 
With refpeft to the other principle to which we mud advert 
with regard to the cure ; we fhould confine ourfelves to the im- 
mediate cause or causes, which, acting in the habitjpioduce 
thofe fymptotns, an enumeration of which is called difeafe ; lor 
all other caufes in this poin! of view are of no avail. Matters 
it by what means the difeafe-has been occafioned, fince the ac- 
tion of that caufe is pad ? the effeft at this time aiding as a 
•caufe, ckims on]yr attention, for that conquered, the difeafe va- 
jnilhes. To explain, let us take the Dropfy,-—its caufes have 
been faid to be, 41 an hereditary difpofition—drinking flrong li- 
“ quors, want of exercife, excefhve evacuations—l'udden dop- 
“ page of thofe which are cu lomary and necefiary—large quan- 
titles of cold, weak, watery liquors drank when the bod) has 
C( been over-heated by violent exercife—a low damp marfhy fi- 
44 tuation—long ufe of poor watery diet, or vifeous aliment that 
44 is. hard of tligeftron. It is often the effedt of other as 
4< jaundice, feirrhus of the liver, violent ague of long continu- 
44 ance, loofenefs, dyfentery, an empyema, or cor.fumption of 
*' the lungs—in ftiort, whatever obftrudts perfpiration, or pre- 
44 vents the blood from being duly prepared, may occafion a 
“ dropfy.” Thefe may produce this malady, 1 do not deny, 
but that not one of them is the immediate caufe againd which 
our remedies are folely to be levelled to perforn a cure, nor any 
number of them, except fuch of which dropfy is only a fymp- 
tom. It is to the effect brought on by thefe caufes that weare to 
attend, which I lake to be general relaxation of the folich—a thin 
watery hlood--and a weakened action of the abforients, (23.*) by 
which more water is thrown into the cellular fyflem and differ- 
ent cavities by the exhaient, than can be taken up by the ab- 
forbent veflels. 
From the enumeration of the former, not any thing can be 
collected refpefling the cure—-but from the immediate caufes 
every thing, as they plainly point out the indications, viz. to 
invigorate the lolids, and increafe the affion of the abforbent 
fydem, that the water may be taken from the places wherein it 
is depofited, and thrown out of the machine. 
It was the dcfefl in thefe particulars that furnifiicd one prin- 
cipal reafon for prefenting this work to the public, in order to 
fupply other information ablolutely necefiary, and more elTen- 
tially beneficial. I have therefore been obliged to divide the 
• Where tlie figures are put without the No. thefe refer to the Psge-.-wiiere with tho No. or 
futseeding it, to the Picicnjuiens in the nii'eiclit forms—-and flits throughout the wi.i h explanatory preface. 
work into diftinCt heads—the firfl: of which comprehends the 
anatomy of thofe parts in which refide the a Clive powers of 
the conftitution chiefly, with intent to make my reader ac- 
quainted with the nature of them, their ufes, connections, and 
dependencies ; that he might have fome idea of the materials 
upon which he was to aft ; as well as be taught what he might 
expect from them ; for to attempt to teach a man the mode of 
proceeding in any art, without informing him of the nature ot 
the fubjeCt to which he is to direct his attention, would be like 
throwing a rough diamond to a glafs-gvinder, he might deftroy, 
but never poltih. Suppofe a man feized with a pain in his 
bowels, attended with trifling evacuations, he fees cordials are 
good in fome of thele cafes, and flight opiates—he takes them, 
they give him relief for fome time—they return more violent- 
ly, he has recouife to the fame remedies, ’till an inflammation 
comes on—confidering the intervals of eafe he has obtained, he 
has no conception bow this can arife—let him be informed cf 
the (IruClure and nature of the bowel*, he will foon underhand 
that they are fubjeCt to irritating caufes, liable to inflammatory 
aflfeCfions ; and readily conceive why thofe irritating caufes 
muff be removed before cordials and opiates ftiould be taken ; 
which he could never do without fuch knowledge of the parts* 
Indeed, I believe for want of this many have fallen facri- 
fices. 
The parts being fliewn in their Ample flate, I have next 
fpoken of them collectively, (hewing the nature of different 
constitutions, which are formed by the combinations of 
thefe. 1 conceive this knowledge effential neceffary towards 
the preventing of difeafe, palliating fuch as are incurable, and 
conquering thofe which lie within the reach of our powers ; 
for there are a variety which require particular attention, in 
order that full effe£ts may be given to our regimen, and medi- 
cal treatment ; for, without the one is properly adapted to the 
other, we fhall not only be foiled in our attempts to cure ; but 
the very means ufed for prefervation from, will be inftrumental 
in bringing on difeafe, which too frequently proves mortal. 
This we need not here farther elucidate, as what we have faid 
in the former part of the preface, and in the introduction, ren- 
der it unneceffary. 
Thus far the parts of the machine to be a&ed upon have 
been confidered. It remains now to fpeak of thofe which are 
the agents, the non-naturals, fo term’d, and medicinal 
substances—the firlt of which have called forth my atten- 
tion, iu order to £hew the great influence they have on, and 
how by being properly managed, they contribute to keep the EXPLANATORY FREfAct. 
body in a Hate of health ; for it is almoft folely on them that 
we muff depend for this purpofe—for good air—proper ali- 
ment, moderate in quantity—fuitable exercife and reft-—with 
due fubordination of mental affections, form the bell plan for 
our bodily fecurity—we have therefore endeavoured to fhcvv 
how they a61 under different circumftances, and how neceffary 
it is to lay down rules with refpe6t to them ; which, by obfer- 
ving, (apply the mofl pleafing confequences—freedom from 
pam, vigour of mind, and a placid old age ; and, by negle6fing, 
the contrary extremes—befides, we have confidered fome of 
them with refpeA to their powers as medical fubftances, and 
fhevvn how they a6f, as by thefe means wc might afford an op- 
portunity of properly combining the two, that they might af- 
fi ft in ft lengthening, and not, by producing contrary effects, 
counteract each other. 
As for medicines, . there, perhaps, my reader may confuler 
me too fyftematical, as 1 have preferved the terms of the 
fchools, and reafoned too abftra611y, perhaps, according to his 
comprehenfion* However, when it is known that 1 have given 
the derivation of every term, and explained the powers of each 
c’.afs, as commonly conceived, in a manner to render them in 
this place caiily intelligible; for the terms themfelves, once un- 
derftood, are infinitely more exprefiive, and involve more ideas 
than any other which might be thought more familiar, I (ball, 
I hope, fland excufed, as well as for dwelling upon the powers 
which medicines exert ; for it appeared not only neceffary to 
(peak of the good that was likely to accrue from this action, 
but alfo of the mifehief which they might create, injudicicufiy 
applied ; therefore I was to exhibit them in different views, 
that it might be known where their -exhibition was fafe, where 
uncertain, or perhaps detrimental—becaufe a medicine may be 
proper refpe£ting a complaint to be relieved, but its mode of 
adtion injurious to the conflnotion—for inftance, eoflivenefs is 
to be. removed, if it fliould be attended with heat and pain in 
the bowels, (hewing that in them there is a great irritation, 
and that the blood muff circulate too freely, the flimulant pur- 
gatives, are improper, (*.73—if there fliould he coldnefs in 
them, and the blood circulates uncommonly flow and languid 
the cooling, (171.) fliould not be ufed—and if habitual cofiive- 
nefs be an error of the habit, the ailringtnt kind, (172.) fliould 
be avoided. 
i ihould be taxed by feme of my female readers with inhu- 
manity, if the rifing race of infants were forgotten, with whom 
many have faid little is to be done. Take them from the indul- 
gence of loud parents j the vanity, ignorance, negle&, and fel- EPLANATORY PREFACE. 
AAmefs of conceited nurfes, I believe very little would be necel- 
farp ; fave where they, like adults, were liable to be a 
with accidental complaints, and then properly nuried, they vr-.--.Ail 
be more readily cured* To the formor I can only reply ; my 
animadverflon muit yield to “ who can help it.’’ 1 lament the 
misfortune of the infant, and pity the feelings of the parent, 
whofe partiality lays the foundation for ten thoufand heart-aches 
*—and to the cuftoms of the latter, with all their train of poifons, 
I oppofe the plain directions given under the article Nuriing 
to the perufal of which I recommend all mothers, and ra- 
tional fuperintendants, and leave it to fpeak for itfelf ; it is un- 
complicated, founded upon facts deduced from obl'ervatioa and 
experience, and fupported by the voice of reafon* 
The parts of which we have here fpoken form what is necef- 
fary to be underllood before any one Aiould enter on the prac- 
tice of phyftc, as without thefe the adventurers fail upon the 
boiom of a dangerous fea, diveited of rudder and compafs. It 
mult be to clear to common obfervation, that I ihall confuler it 
admitted; and proceed to dole with the account of the pra<SH~ 
cal part—and here 1 have laboured to be as iimple, and ulual- 
ly concife, as the nature of fuch a work would admit. 
After ihewing the tendency of the difeaie in general, I have 
particularifed the deleription of each, that is, colic&ed the fymp- 
tom3 which have happened, forming its hiftory ; but as the whole 
of thefe do not always occur, yet liill would burthen, from their 
number, the memory of thofe who have flight knowledge, or 
are totally uninformed—out of thofe I have fele&ed the charac- 
terillic figns, by pointing out fuch fymptoms as are agreed al- 
ways to attend, laying down before the remote or immediate 
caufes : becaufe if it appears that the patient has been in the way 
of the former, it increafes the probability of his being attacked 
by the latter, which give origin to the difeafe. In this there 
leems to be a peculiar advantage, becaufe the immediate caufe or 
caufes being remembered, leads us fairly to account ior a num- 
ber of the iymptoms by which the patient may be opprefled* 
This needs no exemplification, on comparing one with the other, 
it will appear obvious. 
With refpeft to the medicinal fubftances, a catalogue is gi- 
ven of themclafled under different heads, with the common dofes 
annexed, and alfo a variety of formulae—in the firjlplace, lor the 
purpofe of fupplying a number of materials poflefled of iimilar 
powers, though in different degrees, under one head ; that the 
preferiber might have an opportunity of makrng his own elec- 
fion, and varying them a3 particular cireumftances might require ; 
befides empowering him to preferibe in the moil Ample manner--? EXPLANATORY PREFACE. 
X 
•in the fecond, to ihew the nature of medical compofition, Jiow and 
in what forms particular ingredients might be united ; and here 
I mull obl’erve, that the compound medicines I have ufed are 
chiefly thofe of the laft London difpenfatory; where they are 
not. they are particularly fpecified from whence taken. 
There are, alio, other advantages in this work, which will be 
to young Undents of no little confequence ; for here they will 
be relieved in their invelligation of the real meaning of techni- 
cal terms, as they are either explained in the body of the work 
•where they occur, and references made in the Index, or in the 
Index icfelf; and the various articles referred to different places 
will iitew them the different powers they poffefs, as well as the 
belt modes of compofition—for inftance—myrrh is referred to 
143. 164* 183. 193*—by thefe it will be (hewn, that it is a fti- 
inulant—expectorant—emenagogue and antifeptic, and the 
red of the numbers following the letter F. will refer the reader 
to hi different forms in which it is preferibed. 
S'ich, then, my plan, fuch my reafons on which I rifque its 
fupport. It is not for me to determine whether it is hap- 
pily conceived, or well executed. Some things have 1 borrow- 
ed, much altered, and many additions made, wherever I 
thought it n ight anfwer any good purpofes ; for my intent 
was— 
To give rational information to thofe, who, not being pro- 
perly educated, are obliged to praclife from neceffity ; de- 
claring, at the fame time, my with to flop the daring hand 
of inconfiderate rafhnefs, bold from ignorance, and carelefs front 
contempt of facial dury. 
To convince thofe who are led by humanity, or whom in- 
fiin&ive whim, too oft miftaken for that virtue, prompts to vi- 
fit the miferable roofs of fickly indigence, that fomething more 
is neceffary to conftitute the medical pilot—to convince them, 
that in family recipes, and borrowed noftrums, there is little 
fucceff, and lefs fecurity— -that if ftimulated by the defire of 
doing good, the materials to which they fliould be limited, lie 
ivithin a narrow compafs—warmth—decent cloathing, moderate 
living, induftry, and cleanlinefi. Thefe form the regimen of 
Confcientious elegance; and are, nine times out of ten, the poor 
man’s bell preicriptions—thefe are the powerful cordials—thefe 
the reftoratives of a good Samaritan—and with thefe every hof- 
pitable houfe-wife would be a phyfician fuperior to an Hippo- 
crates without them. TABLE of CONTENTS. 
SECTION L 
INTRODUCTION, - - Page 17 
Chap. I, On Bones, Cartilages, and other component Parts 
of the Machine, - ~ - 21 
Chap. II. Brain, and other more complex parts of the 
Machine 5 - - - 26 
SECTION II. 
iOn Confutations, - - "57 
SECTION IIE 
0« the Non-naturals, 65 ; with an Account of the Liquids 
which we in common ufe, 80 
SEC T I O N iV. 
Confutations more particularly fpecified, 85 
SECTION V. 
Necejfary Cautions r effecting Food, Exercfe, 104 
SECTION VI. 
Q/z Nurjing, - ~ - -.114 
SECT 1 O N VIE 
O/i Medicine, - - - - 128 
Chap. I. Medicines which a5l on the inert Solids by 
means of the vital Principle, - - 132 
Chap. II. Medicines which act upon the living Solids by 
means of the fame Principle, - - 143 
Chap. III. Medicines which alt upon the Fluids through 
the Syflemy . - - - 183 
Chap. IV. Medicines which manifejl Action chiefly, if 
not folely, in thefirfl Paffages reffecting thefluids, 189 
Chap. V. Medicines which produce their covfequcnces 
by external Application, or on fubjlances formed within table of contents* 
the Machine, though lodged without the Verge of Circu- 
lation, • - - - 195 
SECTION VIII. 
On Hifeafe in general, - - 202 
Chap. I. Febrile Hffeclions in general-, - 203 
On continued Fevers.—§ 1. Simple continued.—§ 2. 
Inflammatory.—§ 3. Nervous.—§ 4. and Putrid, 
from 203 to 229 
Forms of Medicine, 229 
§ 5. Mixed fever, 240 
inf lanced in the Puerperal, or Child-bed Fever, *43 
SECTION IX. 
F.einittcnt Fevers, - - - 25c 
Bilious, marflj remittent Fever, - 255 
S E C T I O N X. 
Intermittent Fever, - - - <2 cc; 
SECTION XI. 
llcftic, or chronic remittent, without Crifls, - 261 
SECTION XII. 
Eruptive levers, - - /ro/7; 264to 29S 
§ 1. Small-pox, 265.—§ 2. Inoculated Small-pox, 275 
—§ 3« Meazles, 280.—§ 4. Water-pox, 285— 
rw, or ibid.—§ 5. Scarlet Fever, 287—§ 6. 
Miliary Fever, 288.—§ 7. Fryfipelas, or ftrovs in* 
flanimator}' lever, 294.—| 8. Pemphigus., bullous* or 
veficulary Fever, 297. 
SECTION XIII. 
Chap. I. 0« Inflammation, - - 2g8 
Chap. II. Inf animation of the Head and Neck, 310 
§ 1 . Inflammation of the Brain, 310.—§ 2. 0/ //?<• E,zr, 
3r3*—§ 3- A>, 3H-—§ 4- 0/ //* Throat, 
3s 7 —§ 5* Malignant ulcerous Sere Throat, 322. 
Chap. III. Inflammation of the Breaf, - - 324, 
4 ' • PPurify, Inflammation of the Pleura, 324—§ 2. 
0/ l he Lungs, or Peripncumony, 32.7.—Of the Medi- 
ajlinum TABLE OF CONTENTS. 
ajlinum—of the Heart—the Membrane fur rounding 
the Heart—of the Diaphragm, 328.—Malignant 
Pcripneumony, 329.— 1. Vomica, 330.—2. Empy- 
ema, 330.—§ 3. Pulmonary Confumption, 331.— 
Tabes, 334.—Tabes dorfalis, or dorjel Confurnption, 
335.— § 4. Inflammation of the Stomach, or Gaflri» 
m, 335 -—§ 5- 0/the Inteflines, or Enteritis, 337. 
§ 6 Of the Liver, or Hepatitis, 339—§ 7. 0/" 
Spleen, or Splenitis, 341.—§ 8, Of the Kidneys, or 
Nephritis, 341.—§ 9 Of the Bladder, or Cy/litis 
343.—(y //>c Peritoneum, or Peritonitis—0/ the 
Omentum or Cowl, or Omentitis, 344.---O/' the Me- 
fentery, or Mejenteritis—Of the Mufcles of the lower 
-Belly, 345- 
SECTION XIV. 
0/ Difeafes where Pain is the charaSleriflic Symptoms. 345 
§ 1. Head-ach, or Cephalalgia, CephaUva, and Hemi- 
crania, 346.— § 2. Ear-acb, or Otalgia, 348.— 
§ 3. Tooth-ach, or Odontalgia, 349.---§ 4 Pains 
in the Side, or Pleurodyne, 350.—§ 5 Ttfz/z.r of the 
Stomach, or Gyflrodynia, 352.-—§ 6. Colic—Colic a, 
356.— $ 7. Nervous Colic, 339.—§ 8 0/ 
the Liver, or llepatalgia, 361.—§ 9. Pains of the 
Spleen, or Splenalfia, 363.—§ 10. Ttfz'zz z/z XVz/- 
zffj'r tfW Ureters, or Nephralgia—Gravel 364.— 
§ 11. Sro/zr z'/z the Bladder, 366.— 1. SupprCffion of 
Urine.—2. Stranguary, or Stranguria, 367.—3. 
JJyfury, or Dyfuria, 367. § 12. Rbeumatifm, Hip 
Gout, or Sciatica—Lumbago, 369—§ 13. Gozz/, o>* 
Arthritis, 373. 
SECTION XV. 
Morbid Evacuations, - 38© 
Cit-ap. I. Alvine Evacuations, - - -381 
$ 1. Cholera Morbus, or bilious vomiting and inteflinal 
Flux, 382.—§ 2. Dyfentery, or t'.nefmodal dy(en- 
teric inteflinal Flux, 385.—Hcpatirrhcea, 382. 389* 
Lientery, white and black I lux, 382—Diarrhoea, 
38b 389. TABLE OF CONTENTS. 
Chap. II. Hemorrhages, or fanguinary Evacuations, 
§ 1. Spitting of Blood, or Ramoptyfis, 391.— oughing 
up of Biood, 390, 391—§ 3. Bleeding at the Nofe, 
39°. 393.—§ 4. Vomiting of Blood, or Hasmatamejis, 
390.394..—§ 5. Bloody Urine, or Hematuria,'390. 
395.— § 6. Biles, or Hemorrhoids, 390. 397. 
Chap. III. the Serum, or lymphatic Part of the 
Fluids are evacuated in too copious Quantities, 399 
§ 1, Morbid Difcharge of Urine, or Diabetes, 399 
— § 2. Morbid Difchnrge of Sweat, or Epidrojis, 
401.—-Forms of Medicine, 403J 
SECTION XVI. 
Chap. I. Abiive Nervous Affections, - - 413 
§ 1. Tetanus, 414.-—§ 2, Convulfions, 417.-*—§ 3. Epi- 
lepfy, or falling Sicknefs, - - 418 
Chap. II Paflive nervous Affections, - 422 
§ 1. Apoplexy, or Apoplexia, 423.— and Le- 
thargy, 426.—Catalepfy, 426.— §2. Palfy, or Pa- 
ralyjis, 428. 
SECTION XVII. 
Madnejs—Infania, - - 432 
Melancholy, or gloomy Madnefs—Mania, dr furious 
Madnefs, 432. 
SECTION XVIII. 
Afebtions of the Lungs, - - 439 
§ 1. Common Cough, or Tuffs, 439.—§ 2 Hooping or 
convuljive Cough, 440.—§ 3. Ajlhma, 444.—§ 4; 
Suffocating Catarrh, 448,—§ 5. Spurious Peripneii- 
7/zowj, 449. 
SECTION XIX. 
Difeafes wherein the Humours of the Machine are parti- 
cularly concerned, - - 4-1 
§ 1. Jaundice, or Iblcrus, 451.—§ 2. or Hy- 
drops, 454.—Anajarca, or general Dropfy, 454, 455. 
—Dropfy of the Belly, or Afcites, 454, 455.—0/' /£<? 
C/Z>o/?, o/- Hydrothorax, 455, 456.—0/ the Pericar- 
dium., 457.—Of the Womb, or Hydrometron, 454. TABLE OF CONTENTS. 
457*—0/ the Head, or Hydrocephalus, 454. 461.-7 
§ 3 Tympany, or Tympanitis, 464.—§ 4. Nervous 
Confumption, or Atrophy, 465.—§ 5, Scurvy, or Scor- 
butus, 466.—$ 6. Scrophula, 470.—§ 7. Cancer, 475. 
—§ 8. or Gonorrhoea virulent a—Pox, or Lues 
venerea, 479. 
SECTION XX. 
Difeajes of the Skin, - - 48S 
$ 1; 488.—Tetter, or Herpes, 488.-— § 2, Scald- 
head, or Tinea, 490.—$ 3. Leprofy, 491. 
SECTION XXI. 
§ 1. Inflammation of the Womb, 496.-—§ 2. Menfess 
Menorrhagia, Zoo copious, 498.—§ 3. Whites, or 
Leucorrhcea, 500.--$ 4. Menfes fuppreffsd,painful, 
or retained-—Amenorrhoea, 502.—§ 5. Hy/leric DiJ- 
eafe, or Hyfleria, 505.—§ 6. Hypochondriac Dif- 
<?#/<?, or Hypochondriafis, 510.—$ 7. Hyjleria-hy- 
pochondriac Difeafe, 515.— § 8. Indigejlion, called., 
Dyfpepfia, 517.-—$ 9. Rickets, or Rachitis, 519— 
§ io. Dread of Water, or Hydrophobia, 524.-— 
Forms of Medicine, 527. INTRODUCTION. 
SECTION I. 
WHEN we rede£t on the precarioufnefs of man’s exigence 
in this life, the multiplicity of. dangers, with which he 
is furrounded, even from the fird moment of his being to his 
ultimate dage; and alfo that the fabric of his machine is l'o 
formed, that the means neceffary for its prefervation are fo ma- 
ny inftruments wearing out its powers and conducing to diffolu- 
tion ; and, at the fame time, confider, that he is fubjeft to an 
immenfe variety of difeafes, which often occafiion him to drag 
out a life of pain and mifery ; nay, frequently cut him off even, 
in the bloom and vigour of his age: it will not appear extraor- 
dinary that many men of the firft, and mod didinguilhed abili- 
ties, have devoted themfelves, not only to the ftudy of Medi- 
cine, in order to cure thofe maladies, by which man is conllant- 
ly attacked; but alfo prevent their origin, or the mifehiefs which 
are apt to i'ucceed. 
From the time of Gai.en, who has, upon this lad fubjeft, 
written mod elaborately, to the prefent day, we have had vari- 
ous publications, calculated to indru£t mankind in the Art of 
preferving Health, preventing Difeales, or Ihortening their Du- 
ration by the ufe of judicious applications : indeed, of late years, 
their particular documents have been diidioully conveyed in 
fuch a dyle, as to be readily intelligible to common underdand- 
ings ; fo that each man might become, in fome degree, his own 
Phylician. Such laudable undertakings merit the highed praife, 
and, if well conduced, premife the mod lalutary eonlequences* 
for there can be no doubt but the modes of preventing Difeafes, 
ihortening their Duration, and warding off their evil tendencies' 
by early aflidance, are not only the eahed, but fafed, and mod 
pleafant. 
What has been written on this fubjecl may to many, perhaps, 
appear fufficient: and foit probably might be, were all men’s con- 
ditutions fimilar; for the methods adviled by many of thofe 
authors, are felefled with great jud ment, and extremely well 
calculated to anfwer the ends propofed, under the circumdance 
above fpecified; but there feems to be a very great defect in all lN'UODUCT 10 N. 
the publications which have treated on thefe fubjedls—they give 
no information to their readers how the variations of conditu- 
tions are to be distinguished, or in what cafes the methods are 
properly to be altered; and without this the preferibing of re- 
medies can be considered little lefs than a fpecies of quackery, 
by whatever authority it may be fan&ioned. 
1 he univerfality or generality of any medicine furnifhes the 
idea of the mod flagrant abfurdity, fuitable only to the arrogance 
of every ignorant impoftor; and certainly appropriating reme- 
dies of the fame fpecific nature to one complaint in all consti- 
tutions, however diffimilar, is, ac lead, a branch of the fame 
tree; for it is a fa6t uncontrovertible, fupported by the founded 
experience—that what may be of great Service to one constitu- 
tion, may to another be highly detrimental, though labouring 
under the fame affetdion. 
lo elucidate this, I Shall adduce af very familiar example—to 
many of my readers', perhaps, experimentally comprehenfible ; 
I mean the mode of obviating the effects of Inebriation. 
Under this cucumflance we will fuppofe a man of drong da- 
mina—full habit of body—with good digedive powers, and a 
nervous fydem acting with firnanefs and regularity; and one, 
of a relaxed cor.ditution—not abounding with blood—a weak, 
delicate Stomach—and the nerves eafily irritated— 
The advice to alleviate the conditutional didurbances occafi- 
oned by this indiferetion—is lying in Kd, and promot ng per- 
Spiration by plentiful dilution, that is, drinking copioufly of 
weak tea—fmall broth—thin gruel—weak white wrine or vinegar 
whey—or fome fuch liquors warm, that the fuperabundance 
may be evacuated with which the patient has been loaded, and 
the body foaked, as it is termed., into its fober dandard. For 
the robud man the advice might be proper—for by the furcharge 
of the vafeular fydem, and the flimulus of the intoxicating 
liquids, his habit becomes nearly to aflume an inflammatory dif- 
polition, difeovered by pain and a fenfe of fulnefs of the head ; 
rednefs or his eyes; quick drong pulfe ; much heat, and great 
third—which are the general concomitants of fuch a debauch ; 
and thus he requires abdinence, evacuation, red, and dilution 
for his alleviation. But the fame mode, applied to the other, 
renders all his conditutional defedts worfe, he experiences the 
uneafy fenfations of languor, ficknefs, oppreSTed Spirits, and un- 
defcribable Sinkings—all increafed by fuch a regimen ; whofe 
good confequences are derived in the former cure from relaxa- 
tion and debilitating the fydem. The delicate conditutioned 
man requires fredi air, riding on horfeback, a glafs or two of 
generous wine, or fome cordial, fuch as will invigorate thepow- INTRODUCTION. 
19 
crs of hi® habit, promote vafcular action, drengfhen his domacH, 
increafe infenfible perfpiration, and thus conquer thofe unhappy 
feelings he labours under from increafed weaknefs and debility. 
Simple as is this fa£t, and of little confequence as it may be 
thought, the fame peculiarities occur in difeafes of the mold 
alarming nature ; and I am perfuaded that it is from ignorance 
or inattention in this point, that people are apt to increafe their 
maladies, nay often make that, which would, left to itfelf, have 
been mild, become dangerous by applications not adapted to 
the particular nature of the conflitution. For as curing dif- 
eafes depends on the knowledge of this particular, by which we 
can more certainly appropriate our remedies to the benefit of 
the afflifled, fo doubtlefs mud it be a more effential point in 
preferving from, preventing, and Ihovtening their duration, as in 
all our endeavours we mult attempt to keep the conflitution in, 
or bring it to a date of health, confident with the principle of 
its formation, and the nature of the particular parts of which it 
is formed—and how can this be accomplidied without the pecu- 
liarities of the conflitution are known to the perfon applying 
remedies, or fixing on any regimen? 
In order, therefore, to attain this point, as thefe (beets are 
addreffed to the un-informed, it appears unavoidable to give 
fome account of the human machine# with regard to the flruc- 
ture, dependencies and aftion of its parts, before we enter on the 
means to be ufed in particular cafes, that every man may be 
informed of the materials upon which his remedies and regimen 
are to operate; be able to difeover their particular date, and 
hence proceed with fome degree of regularity and certainty. 
Now the human machine confids of SOLIDS and FLUIDS, 
differently difpofed, for the purpofe of fupporting each other ; 
fo that as the parts are worn away or dedroyed by the necefiary 
actions of life, they may be again fupplied ; and this diminu- 
tion and acceffion preferves a condant routine, until the animal 
agreeable to the laws of nature, is dedroyed by its own exer- 
tions, the machine being rendered incapable of continuing its 
vital a£tions : thus, without any preternatural caufe, gradually 
defeends to the grave. 
But in order to promote the different purpofes allotted to the 
folids and duids for the well-being of the human body, they are 
varioufly divided. 
The SOLIDS into bones, cartilages or gridles, ligaments, 
mufcles with their tendons, nerves, veffels, glands, and mem- 
branes. 
The FLUIDS, into blood, nervous fluid; perfpirable matter 
flowing through thefkin infenfibly, or in form of fweat; faliva 20 
INTRODUCTION. 
feparated by the glands of the mouth and throat ; ear-wax ; mu« 
cus; gaftric and inteflinal juices, liquids fecreted into the fto- 
tnach and bowels ; c'yftic and hepatic biles, feparated by the li- 
ver, lodged in part in the gall bladder, in part emptied into the 
firft bowel called duodenum ; pancreatic juice, or that of the 
fweet bread ; urine, femen, liquor of the proflrate gland, and 
that fluid which moiftens the internal furface of all cavities ; 
the glary mucilaginous liquid of the joints called fynovia; tears, 
mucus of the noftrils; a white nutritious fluid feparated from 
the food in the inteftines, called chyle, lymph, fat, and mar- 
row. 
It will not be neceffary to give prolix accounts of the differ- 
ent component parts of the human machine ; but only fuch as 
may enable our readers fo far to underftand the anatomy, as tp 
fumifh ideas fufficient to affifl them in purfuing the future fub* 
je& with fome requifite degree of accuracy. OP $ONES, CARTILAGES, &c* 
CHAP. I. 
Of the BONES, CARTILAGES, and other component Parts of 
the Body. 
THE BONES are the hardeft, and mod folid parts of the 
human machine, calculated to fupport thofe which are foft 
and lefs firm, in all the:r motions and preflu res ; they are cover- 
ed with a membrane, or thin bladdery fubflance, called periofle- 
um, on account of its covering the bone, which is exquifitely 
fenfible, being plentifully fupplied with nerves and blood veffels. 
The outfides of bones are commonly more compact than the in- 
ner parts ; and are formed of plates, joined together by tranfverfe 
fibres ; their infrdes are fpongy and cellular, in which is con- 
tained marrow, within membranous bags, filling up the cells ; 
this marrow, being more or lefs dillributed over all the bones, 
and tranfuding through their plates and fibres, makes them 
tougher, and lefs brittle; the bones are fupplied both within 
and without, with blood veffels and nerves. 
CARTILAGES or GRISTLES, are folid, fmooth, white, 
elaflic fubflances, between the hardnefs of a bone and that of a 
ligament, (fee ligament below) covered with a membrane called 
perichondrium, becaule it covers a cartilage, which is akin to 
the periofleum of the bones; they ferve to make the bones, 
whofe extremities or ends they cover, move freely in the joints; 
they limit the growth of bones, as to their length, by hindering 
the bony fibres from fprouting out; and, therefore, when tha 
cartilages in the joints are eioded, an immobility is there form- 
ed, called anchylofis, or ftiff joint, by the elongation and coali- 
tion of the fibres of the bones that are articulated together ; 
fometimes they ferve as ligaments to join the bones together, 
and fometimes they do the office of bones to greater advantage 
than thefe would do; as the cartilages of the ribs, which, by 
their elaflicity chiefly contribute towards expiration; the carti- 
lages that make out brims of cavities, &c. 
LIGAMENTS are white, tough, flexible bodies, thicker and 
firmer than membranes, and not fo hard or folid as cartilages, 
without cavity; difficultly ltretched and with little elaflicity ; 
they ferve to connect parts together, and keep the part to which 
they are fixed in a proper fituation, as appears remarkably in 
the joints or articulations ; they are made up of fibrous layers or 
ftrata ; the largeff and ilrongelt of which run lengthwife. 
MUSCLE,—This is the name of the immediate organical in- 
flrument of motion in the animal body, whether voluntary or OF TONES, CARTILAGES, bV» 
involuntary ; it is called organical, becaufe mere elafticity is 
the immediate caufe of fome motions, as in expiration*. 
The general charafteriftic of a mufcle is, to confift of flefhy 
fibres which, when afting, contraft themfelves, and become 
fhorter; this contraftion, according to different circumftances of 
the mufclc, and the parts to which it is fattened, produces differ- 
ent effefts, and different motions. 
If one end of a mufcle is tied to a fixed part, and the other to 
a moveable one, when it afts, its fibres contracting will pull 
the moveable part’to that which is fixed. 
If both the parts, to which the extremities of a mufcle are at- 
tached, be moveable, by its aftion, they will be both drawn to- 
wards each other. 
If the mufcle be hollow, and contain a fluid, when it contrafts, 
it will prefs upon, and endeavour to expel its contents ; fuch a 
mufcle as the heart, and in fome meafure the flomach, and uri- 
nary bladder. 
If the fibres of a mufcle return upon themfelves, in the form 
of a ring, when they contraft, they will diminifh the area within 
that circumference, making the circle narrower. Such mufcles 
are employed to {hut cavities, and are called fphinfters, becaufe 
they have the power of clofing cavities and reftraining the exit of 
anything they contain. 
TENDONS.—Thefe arc continuations of flefhy, mufcular 
fibres; each tendon being divifible into as many fibres, or rather 
bundles of fibres, as the mufcle itfelf is to which it belongs; but 
the tendinous fibres are more compafted and frnaller, drier and 
harder, than the flefhy fibres ; they are not capable of contraftion, 
but ferve like ropes to pull, when the flefhy fibres aft, for the 
commodioufnefs and firmnefs of infertion, and for the direftion 
of motion. 
NERVES.—Thefe are foft white cords, proceeding either 
from the brain or fpinal marrow, and running to every minute 
part of the body, and are the immediate inftruments of fenfation, 
and indifpenfably necefTary for the continuance of mufcular mo- 
tion. 1 hey are fuppofed by many to contain a very 
fluid, but appear without any cavity difcernible even by the finefl 
microfcope. 
VESSELS in the machine mean the animal tubes or canals 
* The arteries have been fuppofed by fome to contract themfelves 
after diftenfioa by this elaflic power; though they may in fome degree, 
yet not totally, for they certainly, and I believe it is generally allowed, 
aft by ti e contiaftile power of their mufcular coat, as may be inftanced 
in blufnirig—and their fudden increafe of aftion from other local irritat- 
ing caufes, and forne nervous affeftions. OF BONES, CARTILAGES, &C. 
through which fluids or juices move ; the leaf! imaginable vefiel 
is made of the leall membrane, rolled up in the form of a hol- 
low cylinder, or parr of a cone. The veflels, as their coats mult 
be thicker, are compofed of thicker membranes, upon which 
fmaller veflels run. 
Thefe are divided into arteries, veins, absorbents, se- 
cretory veflels, and excretory duds. 
ARTERY.—This is the name of that kind of veflel which, 
arifing originally from the heart, contains a fluid whofe motion 
is direded from thence towards the extremities and furface of 
the body. The larger and eaflly vifibls arteries contain red 
blood, are of a conical figure—-flow, tapering from the heart for- 
wards, and ramifying varioufly ; in living animals they beat, 
or have what is called a pulfe, anfwerirtg to the motion of the 
heart ; their coats look whitilh, and are pretty thick and 
ftrong, 
VEINS.—Thefe contain a fluid whofe motion is from the 
extremities or furface of the body towards the heart; their coats 
are thinner and more tranfparent than thofe of the arteries, and, 
therefore, they appear of a bluilh, livid colour, the blood Alining 
through them. In many places they have valves within them, 
which open towards the heart, and Ihut the contrary way. 
ABSORBENT VESSELS.—So called,becaufe they abibrb or 
take up fluids, and are divided into Lymphatics and Lacteals, 
from the particular liquids they convey to other parts-—they are 
fimilar, only have different origins, and calculated for different 
purpofes, from whence they take their names, the former convev 
the lymph or aqueous fluids, the latter the milky juice, formed 
from the aliment in the inteftines called chyle; the lymphatics 
are the general abforbents, and carry the juices to what is called 
the receptaculum chyli, thoracic du£t, and left fubclavian vein; 
the la£teals to the receptaculum chyli, or receptacle of the chyle. 
The lymphatics and laftcals are very fine veflels ; the former 
of which arife from the furface of the body, and all cavities or 
cells of the cellular membrane ; the furface of the inteflines, of 
the urine and gall bladders, of the ventricles of the brain,, and of 
all other parts, and carry a pelucid liquor towards the recepta- 
culum chyli, and the thoracic dudl, in which, like the la<fteals, 
do they all terminate. 
SECRETORY VESSELS.—Thefe are all thofe tnbulior mi- 
nute tubes, in the different organs, which are adapted for the 
purpofes of fecretion, prefumed to feparate and ftrain off the dif- 
ferent humours from the general mafs of fluids. 
EXCRETORY VESSELS are thofe tubes or du&s which 
alfo belong to the different organs of fenfation ; whofe office is to 24 
<5? BONES, CARTILAGES, *&C. 
carry off the humours that are feparated, and either convey them 
to their appropriated receptacles, where fome of them are depo- 
fited, or discharge them out of the body, 
GLAND denotes in general an organical texture, of a circum- 
fctibed figure, framed fo as to feparate from the blood, a liquid, 
different from, and unlike the blood; of thefe are various kinds, 
fome more fimple, others more complex or compounded, and are 
called by the common people, kernel. 
MEMBRANE.—This is a web or rather a lamina, or Hough 
formed of a very thin fubltance, appearing like a bladder, whofe 
thicknefs bears a very fmall proportion to its breadth and length. 
Moil, if not all the membranes, we fee in the animal body, are 
compofed of, and refolvable into thinner ones. 
FIBRE is a fmall thread or filament, without a cavity, at leaft 
without one vifible ; whofe breadth and thicknefs bears a very 
fmall proportion to its length ; the leaft fibre of all is too minute 
to be perceived by our fenfes, however affifted. The fibres we 
can perceive, are no other than fo many bundles of frnaller ones 
tied together. 
Now thefe are the different folids of the human machine lim- 
ply confidered, and being differently difpofed and united, by 
means of the cellular membrane, of which we (ball foon fpeak, 
form the human body. This is divided into the living solids, 
called folida ‘viva, and into the inert solids, called Jolida in- 
ertia, which conftitute the hard parts, and help to complete the 
cellular fyflem. 
Thefe are again divided by phyfiologifis, or thofe w7ho treat of 
the human body and teach the ufes of its various parts, into 
three fyiiem*. The vascular system—the nervous sys- 
tem—and the cellular system. 
The FIRST of thefe lias the heart for its center; that is to 
lay, all the tubes or canals which are cciripi'ehended in this divi- 
fion, either carry fluids out from the heart, or return and convey 
them to it, and comprehend every fpeCies of artery, vein, Jinus, 
du£i, and abforhent vrjfcZ, and may be diftinguilhed into circula- 
tory vcJJ'els, excretory vejfels and abforbents ; veffels, through 
which the blood circulates, by which particular lluids are fepa- 
rated from it, by which thefe lalt are carried from the place 
where feparated, and by which fluids are taken up, and carried 
into the machine. 
The CIRCULATORY VESSELS include ail the arteries, 
which fpringing from the aorta or large artery of the heart, and 
that called pulmonary, fupplying the lungs, carry out the gene- 
ral mats of blood, and all the veins, which being vefie&ed back, OF BOOTES, CARTILAGES, £sfc. 
arid uniting at the two great finufes of the heart, return it, and 
thus maintain perpetual circulation. 
The Jecretory, excretory veffels, and abforbents, we have before 
explained. 
The SECON'D or NERVOUS SYSTEM, has the brain as its 
bafis, from whence iffue different portions called medulla oblon- 
gata, fpinalis, and nerves. Some affirm that there are two fets 
of nerves—the one adapted principally for the purpofe of per- 
ception and fenfation, bellowed on the feveral organs of i'enfe, 
internal and external ; while the other is blended with the muf- 
cular fibres, becaufe it is obfervable in certain difeafes, that the 
mufcular ftrength fhall be totally exhaufted, and jet the powers 
of perception and fenfation remain entire; and on the other hand 
that the mufdes fhall fometimes exert prodigious ftrength, while 
the fenfes are all locked up* hence the authority on which ia 
founded the diftindfion. 
But we mull obierve, that though all animal motion feems 
to be derived from the nervous fyftem, and although the heart, 
like every other mulcle, can adl no longer than the communica- 
tion through the nerves which are beiiowed on it, remains free ; 
yet there is a neceffity for diftinguilhing between the vafcular 
and nervous fyftems; becaufe it will appear, when w;e come to 
inquire into the nature of difeafes, that there may be evident 
diforder in the one, while little or none lhall appear in the other ; 
and this confideration will greatly influence us in the diredlions 
neceffary to be given for procuring relief. These form the iiv~ 
ing folids. 
The INERT SOLIDS, not only conftitute fuch parts of the 
body as have neither nerves nor veffels ; viz. the cuticle and 
its continuations ; the nails ; the hair ; great fliare of the fub- 
llance of bones ; cartilages ; ligaments ; tendons and their 
membranes : but thefe inert folids form the connedting medium, 
every where between the living folids, binding together every 
minute veflel and nervous filament ; and there are innumerable 
nerves and veffels in all parts of the body, except thole above 
mentioned, which no eye can trace ; yet, if we reafon from ana- 
logy, and fay, that the fmallell branches and filaments are like 
the vifible trunks and cords, then the tranfverfe fedtion of thefe 
muft be circular ; and confequently, when they come to be in- 
terwoven or laid together, they muft univerfally leave interme- 
diate pores, and minute cavities ; hence we may underftand, that 
though there may be fomc par,s of the body, which have nei- 
ther nerves nor veffels, i. e. no living f lids, yet there is no place 
in the whole fabric to w-hich the ceiiular i’yllem does not extend, 
and where there is not fome mixture of inert folids 5 befides u- 26 
OF THE BRAIN, &C. 
niting and binding together the different fpecies of veftels, whida 
either rife from or terminate at the heart ; and all the nervous 
cords or filaments, which fpring from the brain or fpinal marrow, 
however varioufly they may be combined, difpofed, or interwo- 
ven ; and this fibrous and laminated conne&ing fubftance is not 
endowed, like the living folids, with either ienfe of feeling or 
power of motion. 
That the CELLULAR SYSTEM extends itfelf univerfally 
throughout the whole frame, and has a general and free commu- 
nication, fcems fully proved by fome particular difeafes, fuch as 
itniverfal droply, called anafarca ; where water diffufes hfelf 
through the whole body ; or emphyfcma, where air occupies the 
fame fpace, palling from pore to pore, aud cell to cell ; for this 
membrane confifls of a number of little cells, hence its name, 
which in many parts communicate with each other. 
In the natural and healthy Hate, the cavities of the cellular 
fyftem, are either filled with a thin fine fluid called lymph, or 
with oil— hence it is diftinguifhed into two parts, the lymphatic 
and adipofe, according to the fubflances it contains. 
The pores, or minute cavities of the lymphatic part, are al- 
ways to be underflood as imerpofed between every nervous fibril; 
whereas the adipofe cells are not io univerfally extended, the fat 
or animal oil being always lodged in diflin£l bags or velides, elfe, 
was it fuffered to diffnfe itfelf as freel? through the cellular fy- 
flem at large, it would be equally diftrefiing and fatal with the 
fpreading of water in an univerfal dropfy, or of elaftic air in ais 
emphyfcma. 
CHAP. II. 
Of the BRAIN, and the other more complex Parts of the Machine* 
HAVING now (hewn the folid principles, and the fyflems 
of which the human body, aggregately confidered, con- 
ibis, we lhall take a view of fome parts which are formed out of 
thefe, with their fluids and ufes, and give fuch accounts as may 
be requiiite for the proper information of our readers, to enable 
them to difcover what parts are afteiledin particular difeafes, and 
diftinguiih their nature. We therefore begin with the Brain, 
which is a foft pulpy fubftance, furrounded by two membranes, one 
called dura, the other the pia mater—and has alfo a third called 
arachnoid, from its finenefs, fimilar to a fpider’s web—the chief OF THE BRAIN, &C. 
27 
peculiarities to be taken notice of for our purpofes are the SI- 
NUSES, which arc nothing more than large veins or receptacles 
for blood, and the VENTRICLES. Like other parts of the bo- 
dy it has a variety of arterial branches coming from the heart, 
which are diffufed through its fubltance, and on the membranes 
.—from this is derived the whole nerves of the hujnan machine, 
as the l'pinal marrow is no more than a continuation of tiie brain 
through the vertebrae of the back—and this is confidered the 
fource of all perception, fenfation, and fupport of mufcular mo- 
tion.—It is not confidered in itfelf very fenlible, but can tranf- 
mit moll acute fenfations to every part of the body by means of 
the nerves, when in a (late of health—and mod. violent ones when 
difeafed ; there is not the fmallefl portion of the living lolids but 
is materially connected with it—fo that it not only gives flrong 
impreflions to, but feels flrong impreffion from the fmallefl por- 
tions when affe&ed ; and it may be coniidercd the fountain of all 
nervous instability, by which all the parts dependent upon the 
nerves are put into motion, cr continued capable of perfeveriug 
in their adlion. 
And here, as we fhall often have occafion to fpeak of NER- 
VOUS INCITABILITY, and MUSCULAR IRRITABILI- 
TY, two powTers to which we allow the exigence of the machine, 
in a living date, and the a£tion of all its moving folids with re- 
fpedt to their continuance, are entirely owing, it will be proper 
to defevibe what vve mean by thefe two terms ; becaufe they cer- 
tainly do in l'ome degree exid independent of each other, not- 
withftanding their intimate union, aui in general conjunct adlion 
•—and alfo, as by this knowledge, we fhall in fome cafes be able 
to difeover, how from particular defeft in thefe two powers, le- 
parately attended to, difeafes put on different appearances—and 
are to be prevented, alleviated, or cured by our applications made 
to them dillin&ively as well as unitedly. 
By INCITABILITY we mean that power in the brain and 
nervous fydem, which may be put into aflion by mente-1 affec- 
tion, as well as local irritation? and which produces thofe appear- 
ances we cal] fympathetic. 
By IRRITABILITY we mean that power which may be 
put into a&ion by material dimulus locally exerted—yet is obe- 
dient to the influence of the nerves in general—and cannot, in 
the living exid for any confiderable time without this 
union. 
To elucidate this, we fhall obferve that many will be thrown 
into convulfions by uneafinefs of mind—we alfo know that the 
fame complaint will be occalioned by fevere irritation on fome 
part or parts of the machine ; or that parts themfelves only will, OF THE BRAIN, l£c. 
from this fonrce, experience fuch effefts—as in cramps. Now 
as we are totally ignorant how the mind afts upon the brain, and 
nervous fyftem- —how thefe aft upon the mufcular fibres—nor 
can we conceive how immateriality, which we take the thinking 
faculty to be, can aft upon materiality, we can by no means make 
life of a term, which points out fpecifically the aftion of thefe 
caufes productive of morbid effefts 
In order then either to prevent,alleviate, or cure the complaint 
from thence arifing, we prescribe fuch things as may amute the 
mind, and keep it free from thofe painful reflections—and put 
the body i to fuch a ftatc as to render it lefs fufceptible of im- 
preffions from this fource. 
On the other hand, we advert to the part or parts affefted, and by 
our applications locally direfted endeavour to remove the irritative 
caufe in order to promote a cure and with intent to prevent 
a return, do fuch things as to render the part or parts incapable 
of being affefted by the caufe, or put under fuch circumltances 
as to render the acceffion of that caufe imprafticable—hence we 
think the diferimination between the two terms abfolutely necef- 
fary—as we lhall in advifing remedies always pay the ftrifteft 
attention to conftitutional peculiarities. 
The LUNGS are fituated in the cheft, and there divided into 
two large portions called lobes, the one on the right, and the 
other on the left fide, which are feparated from one another by 
a tranfverie membrane tailed rnediaftinum—-dividing the cheft 
into two equal feparate cavities, that have no communication with 
one another : but the left lobe of the lungs is confiderably lefs 
than the right, becaufe the heart with its membrane, called pe- 
ricardium, from irs furrounding the heart, with the great veffels 
that open into it, are contained in the left divifion.—The lungs, 
befides their external membrane, and cellular texture of which 
they are compofed, are a congeries of air veflels from the wind- 
pipe, which is a firm tube, made up of cartilaginous or griftly 
rings, joined together by mufcular fibres---thefe rings backwards 
are incomplete ; this ciefcends into the breaft almoft to the balls 
of the heart, and there divides into two great branches, the one 
right, and the other left; which again are divided and fubdivid- 
ed into leffer and leffer ramifications—and fo diftributed through 
all the fubftance of the lungs, terminating at length in fmall mem- 
branous, dilatable cells, or vefiejes—as well as thefe, there are 
veffels which carry blood, and juices derived from the blood 5 
and thefe two kind of canals are fo uniformly difperfed through 
the lungs, that in every phyfical point there are branches aft 
over, befides thefe they are fupplied with nerves and abforbents. 
Various are the ufes of this organ. OF THE BRAIN, &<?. 
29 
The mod important is that of refpirntion, by which a trajec- 
tion of blood is effe&ed through their i'ubAance, and circulation 
completed, in which life confiAs; by comminuting, condenfing, 
and rounding its particles, and thereby adapting them to flow 
through the canals of different fizes in the body ; creating red- 
nefs in its globules— betides it has feveral ufes which are of the 
greateA confequence to the animal, for by this means the abdo- 
minal vifcera are with a continuance alternately prefled upon, 
and freed from that cornpreflion ; by which means conco&ion in 
the ilomach and inteflines is promoted ; and the circulation 
through the fyftem of the vena portarum, or large vein of the 
liver, which otherwife would be too fluggifli, is urged on. The 
faeces and urine are expelled by its efforts ; fmelling is perform- 
ed by ir.fpiring, or fnuffing up air; the foetus is excluded by its 
afliilance; and fuftion, fo neceflary for the prefervation of the 
new-born animal, is performed, and without it there could be 
no fuch thing as voice or fpeech brought about. Beiides, the 
lungs are confidered as the recipient of animal heat, that is, the 
quantity of atmofpheric air which rufhes into the lungs at every 
infpiiation being loaded with thofe particles creating heat, they 
are feparated from the air and pafs into the blood, and by their 
evolution through the couife of circulation form an univerfal Ai- 
mulus to the vafcular fyflem—and at the fame time they perform 
the office of excretion, throwing out fuch matters which have 
become ufelefs, and would be hurtful if continued in the habit. 
In the middle of the cheft between the two lobes of the lungs, 
rather inclining in its pofition to the left fide, lies the HEART. 
It is a Arong hollow mnfcle, having two cavities, feparated by 
a feptum or divifion, which are called ventricles, out of which 
iifue the two large arteries of the human machine—-One called 
pulmonary artery, becaufe it ferves the lungs; the other aorta, 
or large artery of the body; near the mouths of thefe two ven- 
tricles are two other hollow mufcular fubAances, from their fimi- 
liiude to dogs ears, called auriculae, into which the vellels call- 
ed vena cava defeendens, and afeendens, and pulmonary veins 
open—the two former into the right, the latter into the left. 
It is alio enveloped wich a membrane from its fituation, furround- 
ing the heart, called pericardium, by which, and the large vef- 
fels, it is kept in a fixed pofition, within this membrane there 
is a fmall portion of a ferous fluid. 
As we have confidered the brain to be the fource of all incita- 
fnhty, fo do we the heart one at leaA, and that the principal 
fource ot irritability, whofe chief office is to promote the circu- 
lation of the blood, an account of which may not in this phace he 
jmproper. OF THE BRAIN, ISc. 
But before we enter on that fubje£l, we mull obferve, that all 
the arteries of the machine ramify from the aorta, as branches of 
a tree from its trunk, dividing themfelves into minute ramifica- 
tions, in which there are no valves, except at the origin; 
whilft the veins mull be looked upon as branches forming a 
large trunk, in which there are valves inferted, which open to the 
heart. Now in the former of thefe vefTels there is required no 
fuch contrivance, becaufe the blood, having a quick progrellive 
motion from the contra£lile power of the heart and arteries, has 
a fuflicient force impelling it from behind, which prevents its re- 
trocellion, whilft, on the other hand the flow motion of the 
blood in the veins and their weaker .contraftile power, unaflilled 
with a force adequate to that of the heart, have great need of 
fuch an invention to prevent its regurgitation, and fecure its re- 
turn to the heart. 
Now for a moment let us fuppqfe the heart full of blood, that 
is, the ventricles have ceafed to beat, and that it is put into mo- 
tion by fome caufe, what will be the refult with regard to the cir- 
culation ? The lefler circulation through the lungs will be per- 
formed in the following manner; the blood will be propelled into 
the pulmonary artery from the right ventricle, pafs through the 
lungs, and return to the left auricle by the pulmonary vein ; in 
the fame manner in the greater circulation it will alfo be forced 
into the aorta, diffufed through the reft of the machine, and re- 
turn to the right auricle by the vena cava, palling through thq 
different glands, in order for them to fecrete fuch fluids as they 
are deflined for; whilft, at the fame time, thecapillary or hair 
like tubes, where there is no fuch glandular contrivance, will 
pafs olf the matter of perfpiration, the auricles then being filled 
with blood will contra£l; ejed; their contents into each ven- 
tricle, and the fame routine be performed again as above de*> 
fcribed. 
The particular organs which we have now mentioned muft be 
looked upon as the three moft material ones for the fupport, and 
prefervation of life, and the fources and inftruments of incitabi- 
hty, and irritability, by which they perform their a&ions, and 
on which all the moving powers of the machine depend ; but 
into the account we muft alfo take the blood, which, with the 
lungs, we confider as the recipient and diffufer of that fluid, or 
thofe particles which animate nature, and fupply an univerfal 
ftimulus, which occafions the action of thefe fources and inftru- 
ments of vital motion. 
The BLOOD is a red homogeneous or apparently uniform 
fluid, as it circulates in the veflels, from whence all the other 
fluids of the human rnachine are fecreted, or feparated ; but OF THE BRAIN, &C. 
When out of thfc body, and left to itfelf, divifible into three dif. 
tinft fubftances-—ferum, gluten, and red globules, by a very fim- 
ple procefs ; though untouched, appearing only as two, called 
ferum and craffamentum, the latter floating in the former ; but 
the craflamentum is of different degrees of firmnefs in different 
fubje&s. 
'1 he SERUM in an healthy flate is altnoft colourlefs; at 
other times, it is yellowifh, or perhaps of a greerrifh hue, while 
the top of the craflamentum has different degrees of firmnefs, and 
puts on different appearances with refpeft to colour, according 
to the age, fex, and date of health of the fubjetl from whence 
it is taken. The ferum cf the blood, like the white of an egg, 
coagulates when highly re&ified fpirit of wine, called alchohol, 
or any of the mineral acids, are mixed with it; or when heated 
to about i6oth degree of Farenheit’s thermometer; but other- 
wife it continues in a liquid flate. 
The CRASS AMENTUM is compofed ©f a peculiar fub- 
ftance, which gives rednefs to the blood, and of, what phyfiolo- 
gifts term, coagulable lymph, from its coagulating fpontaneoufly.- 
This coagulable lymph may be feparated from the red part in 
two ways ; either by ftirring the blood which is frefh drawn, 
with a whifk, when the lymph coagulating in a fliort time, will 
adhere to the twigs, and appear like a firm membrane of awhit- 
ifh colour, compofed of fibres interwoven with each other ; or by 
placing a piece of craflamentum on a flrainer, and pouring on 
water repeatedly, until the red particles being wafhed away {hall 
3eave only the whitifh fubflance behind. 
With regard to the red globules, it is not perfe&ly agreed of 
what nature they are ; but it is aflerted that the red colour is 
owing to a mixture of fome portion of ferruginous or irony mat- 
ter ; in confirmation of which it may be obferved, that the blood 
always becomes florid after a courfe of medicines of that nature ; 
but whether it arifes chiefly from the addition of ferruginous 
matter, or owing to the increafed motion which thefe medicines' 
always produce, will admit of fome difpute, for it is always 
found that the blood grows more red, in proportion to the attion 
and the ftrength of the veflels, and thefe medicines are allowed 
to produce fuch effefts. 
The proportion of the red part is fmall in refpect to the o- 
ther conftituent parts, for one grain weight of this colouring’ 
matter, will tinge, in a perceptible degree, a thoufand of pure 
water. 
Now as the blood in its healthful flate is a tenacious fluid, 
capable of receiving a greater portion of heating particles in 
proportion to its tenacity, as it pafles through the lungs, fo ac- OF THE BRAIN, &C. 
cording to its ftronger or weaker tenacity, will it be capable 
of retaining more or lefs of thefe (Emulating particles, thus from 
this caufe, will it be more or lefs ftimulant, and aflift in produc- 
ing different deviations in the conftitution, befides it is from dif- 
ferent caufes liable to undergo many alterations ; hence alfo will 
other differences he formed, of which we (hall take notice in 
the fucceeding pages. 
Indeed we might give fome general practical ideas refpefting 
this point; but as many peculiarities arife from the date of 
ether organs in the machine, that are worthy of obfervation, and 
neceffarily combined with thofc already pointed out; we mult 
now beg leave to deferibe them alio with their ufes, but firft we 
fLall fay fomething on— 
The THORAX or BREAST. This is a large cavity, fome- 
what in the lhape of a cone, reaching from the lower part of the 
neck to the abdomen or lower belly, from which it is divided by 
the diaphragm, or midriff. The bones which form this cavity 
are twelve vertebrae of the back behind, twelve ribs on each 
fide, and the fternum or bread bone before. This cavity is con- 
fiderably fhorter before than behind, from the diaphragm flantmg 
downwards, and backwards. The ribs which guard the great elf 
part of the cavity of the thorax, are all articulated with their 
refpeflive vertebrae, in fuch a manner as to admit of a motion 
upwards and downwards ; they are all, except the lowcrmod or 
twelfth rib, connected and articulated with the fternum, or breaft. 
bone ; by the intervention of cartilages, or gridles, fo as to ad- 
mit of the fame motion upwards and downwards. 
From the ftru&ure of the ribs which are more or lefs arched, 
being convex outwardly, and concave inwardly towards the ca- 
vity of the thorax, it follows, that if the ribs are all moved up- 
wards, round their articulation with the vertebrae, their arched 
middle parts mull be pulhed outwards and laterally, and the 
fternum, to which they are joined, outwards and forwards ; and 
confequently, the cavity of the thorax will be widened and en- 
larged. 
But there is a fet of mufeles which perform this office, which 
arc called intercoftals, from their being fituated between the 
ribs, and are both internal and external ; they run obliquely 
from the edges of one rib to thofe of the ribs neareft each other, 
for the whole length of the ribs, and from the higheft rib to the 
lowed: the fibres of the external have a direction contrary to 
that of the internal, by which contrivance their joint action be- 
comes the more fteady, and the ribs being pulled in the diagon- 
al of thefe two direftions, endeavour to pull the ribs nearer one 
another ; drawing the inferior ribs nearer the fuperior, and thus ©T THE BRAIN, 
33 
the cavity of the thorax is widened, that the lungs may expand 
themfelves in infpiration. 
But there is another contrivance to promote this purpofe ; 
the DIAPHRAGM or MIDRIFF. This mufcle, which divides 
the breaft from the lower belly, arifes from the bread; bone be- 
fore, from all the ribs on eacli fide, from the feventh to the 
twelfth; and behind from the fall vertebrae of the thorax, and 
the firft one of the two loins. Its fibres run fleiliy from the cir- 
cumference to the center fome way. and then become tendinous ; 
the whole diaphragm Hants, its anterior origins being remarka- 
bly higher than its polterior ones ; it is not plain, but remarka- 
bly convex towards the thorax, and concave towards the abdo- 
men ; infomnch that its middle or center riles always higher in 
the thorax than its highell origin at the Hern urn ; when it a£ts, 
the flelhy fibres Ihortening, pulls the tendinous center towards 
their origin, that is, downwards, thereby rendering it plainer, 
and lefs convex, and fo lengthening the cavity of the thorax 
down ; hence the enlargement of the bread is promoted two 
ways, by the intercodal mufcles railing the ribs, and making it 
wider, and the a&ion of the diaphragm rendering it longer or 
deeper—and by thefe means the feveral ufes above fpecified 
from the action of refpiration, is promoted. See pafie 28. 
Immediately under the diaphragm lies the LIVER It is of 
an irregular fliape—its right part fills almolt all, what is called 
the right hypochondre, or fide under the ribs below the dia- 
phragm, in an adult body, when found, reaching commonly no 
lower than the Ibort ribs. In the fcetus it is bigger, in propor- 
tion to the reft of the body, in all its dimenlions—its middle 
part lies in the region over the ftomach, called epigaftrium ; 
and its left in the upper part of the left hypochondre, not reach- 
ing fo far down as the right; fome of its exterior parts are 
fmooth and convex, humouring the concavity of the diaphragm ; 
its under part is concave on the right fide, anfwering to the gut 
called the colon before, and the right kidney behind; its middle 
part, in which the gall bladder, called the vefica fellis is placed, 
lies over the gut, called duodenum, which touches the gall blad- 
der; its left part covers the ftomach—it is thick in the middle, 
and upper fubftance, towards its fides it grows flenderer, at 
length terminating in a thin edge ; by a furrow in the interior 
and concave part which receives the umbilical vein, or that of 
the navel in the fcetus, on its anterior part; and by another an- 
fwering to that backwards reaching to the pollerior limits of the 
liver, which receives the venous duft, both which canals are per- 
vious veflels in the foetus, but in the grown animal degenerate 
into ligaments, the liver is divided into two unequal parts call- OF THE BRAIH, &C. 
34 
ed lobes ; the right being much larger than the left ;th re Is be- 
lides,a fmall lobe in its pofterior concave part, commonly called 
the lobule of Spigelius ; there is likewile a tranfverfe foffa, or 
furrow, running alotlg the middle of its concave, and under part, 
in fomc tneafure fepdrating its anterior and larger from it3 pofte- 
rior and fmaller part; it is attached to the diaphragm, and its 
weight is in feme meafure fupported by ligaments from that 
mufcle, which are produdlions from the membrane which lines 
the inlide of the lower belly called peritonaeum, where it lines 
its concave furfaCe, hnd is united by other fuch productions, 
with the neighbouring parts : it is furnifhed with atteries from 
ramifications of the aorta, called cceliac, mammary, phrenic, re- 
nal, and capfular—but it is furnifhed with veins of two kinds—- 
totally differing from each other, which cannot truly be faid of 
any cither part of the body : to wit, the vena portarum, and its 
branches diftributed through the fubftance of the liver, which 
perform the office of arteries, carrying blood into it ; and the 
other veins, which carry blood out of it, emptying themfelves 
into the vena cava, like the reft, all over the body. 
As the reft of the arteries and veins may be compared to the 
trunk of a tree with its branches, fo may the vena portte and its 
different ramification, be compared to the root, trunk, and branch- 
es—for it is formed by a conflux of all the veins, which return 
the blood from the ftcmach, omentum, fpleen, pancreas, inteftines, 
and mefentery ; and anfvver to the cceliac, and mefenteric, both 
liiperior and inferior, arteries.—It is worthy to be obferved, that 
all this venous fyllem, which by its union conftitutes the vend 
portarum is unfurnifhed, unlike the other veins of the body, with 
valves ; fo that from its trunk it may be injected backwards to 
the minuteft origins of fmall veins, in all the parts juft now men- 
tioned. The trunk' of the vena portarum, thus formed, enters 
the liver between two eminences in the little lobe, called by the 
indents, portte—that is, rrdges forming a little channel or 
Itreignt between them : as foon as it is formed into a trunk 
it is found to have got llronger membranes or wails than other 
veins, and even tougher than the aorta or large artery of the bo- 
ciy itfelf. This new and extraordinary ftrength of the coats of 
1 he branches of the vena portarum, they carry w ith them through- 
out all the fubdance of the liver; and they are diftributed from 
trunks to branches, lmaller and fmaller, in the fame manner as 
arteries are in the other vifecra. 
Thus is blood brought into the liver by arteries, called hepatic, 
of the common fort ; and bolides by the vena portarum, fumiffi- 
t.l with Itrong coats, and performing the office of an artery, the 
tt.fty inliaape cu that kind in the whole body. The ultimate OF THE BRAIN, iff. 
35 
fmall capillary branches, both of the hepatic arteries, and vena 
portarum, terminate in minute venous twigs, which arifing all 
over the fubftance of the liver, and forming larger and larger 
branches by uniting together, at length open by feveral large 
mouths into the vena cava about the poderior, or gibbons part 
of the liver. 
The liver is fupplied with nerves from the intercoflal, and par 
vagum fo called ;—they are but fmall in proportion to its bulk, 
and therefore k is not liable to violent pains. 
The great ufe of the*liver is to leparate bile, for many good 
purpofes in the animal cgcanomy ; and as it is now and then 
wanted more at fome times, than at others, there is in the liver 
a receptacle for part of this fluid, called the O A.LU~BUAD.PE,R, 
which is a pretty large hollow vefiel, nearly the fhape of an ob- 
long pear—lituated in a fovea or furrow, in the anterior concave 
part of the right lobe of the liver, reaching from before back- 
wards attached to the liver in different places by a cellular tex- 
ture, covered over in its under part, by a portion of the mem- 
brane of the liver, which reaching beyond it keeps it fad in its 
fituation. Under this, all over its furface, is a celjuiar texture 
•—next to that, a thin mufcular coat, confiding of pretty confpi- 
cuous, longitudinal, oblique, and circular fibres ; under that a 
fecond cellular—then a nervous ; and innermoft of all a villous 
coat, fimilar to what is found in the domach and intedines. 
There are likewil'e, efpecially in its fmaller part or neck, pores, 
which yield a mucous juice, to defend it againd the acrimony of 
the bile : from the fame part is produced its duff, which dretch- 
ing towards the left is inferted into one called the hepatic du£it 
which ariies from the repeated union, and conflux of the biliary 
duffs all over the liver; the- union of thefe two duffs together 
forms the duff, called the dudus communis cholidochus, which 
penetrates into the duodenum, or fird of the fmall guts, juft be- 
low the domach. Thus we find the bile feparated by the pori 
biliarii of the liver, pafies into the hepatic duff, part of which, 
is condantly pouring into the duodenum, and part into the gall- 
bladder, whofe ufe is to receive the bile, there to retain it, until 
it be fqueezed back again by prefiure of the didended domach, 
and aftion of the diaphragm, through the duftus communis into 
the duodenum ;—by daying there, the bile is rendered thicker, 
fome of its aqueous parts being reforbed by the inhaling veflels 
of its villous coat, and therefore dronger, and of a more faturat- 
ed yellow ; it likewife becomes more (harp, bitter, and rancid, 
by the heat of the contiguous and circumjacent parts ; while the 
domach is empty the gall-bladder is at liberty to be didended 
and filled, and therefore becomes fuller after long fading ; and 36 
OF THE ERAIN, &V, 
the fuller it is, the lefs compreffion of the flomach is required t® 
fqueeze tlie b:le out of it—fo that the more we are prompted to 
eat, and (luff the flomach by violent hunger, the greater quanti- 
ty of bile will be poured into the duodenum, b' the iwelling of 
the flomach during digeftion, to promote fo much more effectu- 
ally the codtion of tiie aliments ; and the cyflic bile will be the 
{harper, and flronger, by having remained fo much the longer in 
the gall-bladder. 
So that we find the duodenum receives two forrs of bile flow- 
ing into it from the fame canal, viz. the hepatic frelh fccreted 
from the liver, which never has been in the gall-bladder, but 
goes flraight on into the inteflines, and the cyflic alfo. 
Both biles are of the fame natures and properties, differing 
only in degree, infomuch as many fpecies of animals have no 
gall-bladder, and therefore are only furnifhed with hepatic bile, 
as amongft quadrupeds, the elephant, horfe, afs, and deer ; amongfl 
Birds, the ojlrich, whofe digeftion is fo ftrong, the Jlorh, and the 
pigeon—not to mention fotne fifhes. 
The BILE is fomewhat vifeid ; coagulable by heat and alcho- 
hol; of a faturated yellow colour, inclining to green, extremely 
bitter; the fharpefl, and moff Simulating of all the circulating 
humours of the body, neither acid nor alkali when frefh, but 
ilrongly incl ning to, and quickly fufceptible of, putrefaftion ; 
and promoting that difpofition in any fubftances with which it is 
mixed, if they are capable of it; it mixes readily with water, it 
flames not in the fire, unlefs it be dried, and then it burns almofl 
all away ; it is a powerful penetrating foap in every refpedl ; it 
diffolves all gums and refins, being rubbed with them. 
By thefe properties, when poured upon the alimentary mafh 
an the duodenum, it muff effect, firjl, a more intimate diffolution 
and mixture of the heterogeneous parts together, as it is readily 
mifcible with water, and renders oil and oily fubftances fo ; Je- 
condly, though it is not a&ually an alkali, yet it nearly approach- 
es towards it ; and muff dimi uih the acefeent difpolition of the 
chyle, of which we fhall fpeak hereafter, and render it more fi- 
xnilar to animal nature, which is alealefeent: and lafily, by ils 
Simulating power, a4 it is the molt acrimonious of all the ani- 
mal fluids, it, no doubt, helps to excite the periftaltic motion cf 
the inteflines, and thereby promote conco£tion ; and, as like a- 
loes, it is a purgative, which it refembles not a little, it afnfts in 
the expulfidn of the feeces ; fo true is it what Lord Bacon fays, 
“ that the bile is the incentive and Jlimului of many functions of the 
loelyC 
The PANCREAS, or SWEET-BREAD, fo called, is a long, 
whitifh, tender, and friable glandular mafs, Ltuated behind the OF THE BRAIN, &C. 
37 
$omach and fpleen, under the liver. Beginning at the fpleen on 
the left fide, it ftretches tranfverfely acrofs the vertebrae, and 
with its other extremity, is connected with the duodenum. In 
the human adult, it is about feven or eight incites long, and one 
or more thick ; its end at the fpleen is fmalleft, and it protvs 
gradually broader, at it approaches to the duodenum, where it 
terminates : it hath arteries from the tceliac ; its veins run into 
the fplenic vein, which opens into Jie \era portarum ; its nerves 
come from the par vagnum, and as they are but final], it hath, 
like the liver, but fmall fenfation : its ltru&ure confifts of fmall 
round acini or glandular {hoots, connected together with much 
cellular texture ; from each of thefe, there is a fmall du£t lent 
out towards the middle ; all thefe dufts open into the principal 
du£t, which runs along its axis all its length, and opens into the 
duodenum, five or fix inches from the pylorus, or lower orifice 
of the ftomach, at the fame place with tiie biliary dudt. 
As the ftructure of the pancreas is the fame with the falivary 
glands, fo its juice perfe£tly refembles the faliva in every proper- 
ty—and therefore may be prefumed to have the lame ufe—to di- 
late, open, and diiTolve the alimentary mail), and render the chyle, 
to he made out of it, more fimilar to animal nature ; as it is con- 
fiderably larger than all the falivary glands put together, and fi- 
tuated in a warmer place, its juice mull far exceed the faliva in 
quantity. It is propelled into the inteftine by the common im- 
petus and courfe of circulation, affifted by the preffure of the 
adjacent parts upon it in breathing : It is poured into the gut at 
the fame place with the biliary duct, that it may be immediate- 
ly mixed with, in order to temper and dilate, the bile, which is 
both thicker and Jliarpcr than itfelf. 
Tiie OMENTUM, or CAWL, is a broad membrane, thin and 
tranfparent, tender, and cafily torn, arifing from the anterior and 
inferior border of the •ftomach, and falling down commonly as low 
as the navel, fometimes much lower ; then doubling backwards 
and upwards, is conne&ed with the inteftine called the colon, un- 
der the ftomach, thus forming an empty bag. Befides, its prin- 
cipal connexion with the ftomach and colon, it is likewife at- 
tached to the duodenum, to the fpleen, pancreas, and mefentery ; 
it lies immediately under the peritoneum forwards, being a pro- 
duction of its cellular part, and covers part of the ftomach, and 
the greateft: part of the anterior furface of the inteftines. 
It is every where a double membrane—but every portion of 
the thin membrane, by iifelf, may be divided mro two thinner 
membranes or {loughs, which are joined together by a thin cel- 
lular texture, in the cells of which fat is depofited : the fecretioa 
here is performed in the moft Ample manner, their being no o- ©F THE BRAIN, &C. 
ther apparatus befides arteries, veins, and pinguidinous ducts, 
leading to the cells, or veficles. The fat is diflributed in the o- 
mcntutn very unequally, being in fome places thin and tranfpa- 
rent, in others an inch thick in fat ; in corpulent perfons it con- 
tains a vail quantity of fat ; it hath its arteries from the cceliac; 
its veins terminate chiefly in the fplenic branch, and ail of them 
ultimately in the vena portarum. 
The ufes of the omentum are,jirjl, to interpofe between the 
peritoneum and the inteflines, and part of the ftomach—that all 
three parts may be preferved warm, moift, and flippery, and hin- 
dered from growing together : and fecondly, to furnifh oily mat- 
ter for the bile. 
The SPLEEN is fituated in the left hypochondre, that is, under 
the cartilages of the left (liort ribs; it is connected with the colon, 
ftomach, left kidney,and by its upper part with the diaphragm; its 
fituation is changed by the fuinefs or emptinefs of the ilomach ; 
it follows the motion of the diaphragm, and is afFe&ed by the 
inflation or fubiideuie of the colon. In general it is placed up- 
wards, and backwards from about the middle of the fnort ribs on 
the left tide ; in its natural and found date, it is about fix or fe- 
ven inches long, about three in breadth, and one in thicknefs, of 
an irregular and fomewhat oval figure, and of a dark livid colour ; 
it receives arteries from the coeliac, thefe entering its fubftance, 
are divided into innumerable branches, and by their evanefeent 
extremities terminate in minute veins, forming, by their union, 
the fplenic vein, which flows into the vena portarum. The vef- 
fels of the fpleen are very large in proportion to its bulk, and 
yet it hath no excretory canal but its vein ; its nerves are fmali 
and few. 
As the fubftance of the fpleen is entirely vafcular, with a ten- 
der cellular texture to fupport the veffels and keep them toge- 
ther ; its chief ufe has been confidered to confifl in dividing and 
attenuating the blood that runs into and flows through it ; and 
from its fituation, as it is much agitated, this alfo afiifts in the 
circulation and comminution of the blood through it, and 
thereby rendering it fit to temper the fluggifli mafs fent from 
the omentum and mefentery into the vena portarum, and expe- 
dite the fecretion of bile in the liver. 
As we confider the (ESOPHAGUS and STOMACH continu- 
ations of the fame tube, we lhall proceed to deferibe them toge- 
ther, and afterwards make fome obfervations on the inteflines. 
7 he (ESOPHAGUS, or GULLET, begins at, or is continued 
with the PHARYNX or THROAT, runs down along the pofte- 
rior part of the thorax, behind the wind-pipe, and molt common- 
ly fomewhat to its left, paflfes through the diaphragm, and a fhort CF THE BRAIN, £«jV. 
■way under it opens into the ftomach, into which it conveys the 
aliments ; it is made up of feveral membranes or coats : the ex- 
ternal one is cellular—next to that is the mufcular coat, confid- 
ing of two pretty ftrong plains of fibres, the exterior of which 
are nearly longitudinal, the anterior nearly circular. When the 
former act, they fhorten and widen the tube—thus fitting it to 
receive aliment ; when the latter exert themfelves, they render 
it narrower and longer, and propel the aliment onwards : this 
alternate adlion, begun at the origin of the canal, and continued 
downwards fucceffively through its different portions, one after 
another, determines the rout of the aliment into the ftomach. 
Its innermoft coat, called nervous, is tough and ftrong, fit to 
refill the hardnefs and roughnefs of what may be fwallowed ; it 
is lined with fnort villi, (landing up like velvet, fomewhat in the 
manner of thdfe of the ftomach and inteftines, of which we fhall 
prefently fpeak. There are likewife numerous fecretory dndls 
opening into it, which yield a mucous liquid, by which it is 
moiftened and lubricated, in order to facilitate the paffage of the 
aliment through its cavity. 
The STOMACH, or VENTRICLE, is fituated in the abdo- 
men, or lower belly, immediately under the liver, which covers a 
great part of it above, and laterally; it is placed tranfverfely, in the 
main, from right to left, but fomewhat obliquely, fo that its left 
or upper orifice, called cardia, which is continued to the oefopha- 
gus, lies more towards the vetebrte ; and the right or lower, 
called pylorus, which opens into the inteftine duodenum, more 
anterior. In figure it refembles a bag-pips ; its thickeft part be- 
ing its left extremity, at the implantation of the cefophagus, from 
which it tapers to the pylorus* The CART1LAGO ENS1FOR- 
MIS. or lower part of the bread bone, anfwers nearly to its mid- 
dle : the fpleen lies contiguous to its lower part, on the left, and 
the pancreas behind its bottom. 
The ftru£lurc of the ftomach is in general the fame as the 
cefophagus, of which it may be confide red a dilatation. Its 
molt external membrane is a continuation of the peritoneum ; 
its next is cellular, in which its great branches of blood velfeis 
and nerves run ; in it there are likewil'e conglobate glands and 
lymphatic vellels. Under this lies the mufcular coat—tlie exte- 
rior layer is a continuation of the longitudinal fibres of the oefo- 
phagua, w hich open and difperfe themfelves over the ftomach— 
and as the ftomach is by much the larger of the two, and of at! 
irregular figure, they mull of courie be thinner, and lefs nu- 
merous in fume places than others. They run molily along the 
length of the ftomach, and terminate at the pylorus; they feein 
to ihorten die ftomach, though but iu a feeble manner, and OF THE BHAIN, &C. 
40 
widen its middle. The other ftratum or layer, anfwering tc 
the circular fibres of the cefophagus, is by much the ftronger of 
the two; its fibres run in a general way round the ftomach, at 
right angles with its axis, though with confiderable and intricate 
deviations: they feemlike the analogous Ilratum in the oefo- 
p’nagus, to lengthen the tube they encircle, and contrad its ca- 
vity ; a remarkable plain of this fame Ilratum runs from the 
left orifice to the right by the fliorteft way, viz. along the up- 
per and lefter curvature of the ftomach ; and appears to coun- 
teract its other fibres, by drawing the two orifices towards each 
other. And it is obferved, -hat at the entry of the cefophagus 
into the ftomach, the circular fibres are remarkably thick and 
lirong, which therefore may ferve, in feme meafure, as a 
fphinder to it, to fir tits its cavity there ; but, upon the whole, 
the exad courfe of the mufcular fibres of die ftomach is fo ex- 
tremely difficult to be traced and deferibed, that hardly any two 
anatomifls, unlefs they copy from one another, agree in their 
account of them. It is fufficient to conceive them to be fo fra- 
med and diftributed, as to enable the ftomach to prefs upon its 
contents every way, and gradually to expel them—Next to, and 
immediately under the mufcular coat, is another cellular texture, 
more confpicuous than the exterior one, in which pretty large 
trunks of blood veffels and nerves run, after having penetrated 
through the mufcular coat. Under it lies that called nervous 
which is a firm, tough, white, and pretty thick 
conftituting the principal and moft peculiar coat of the Homach. 
The fixth in number is another cellular web, much thinner and 
more fubtile than the two former—made up of fhorter threads 
and laminae—The innermoft of all is the villous coat, fo called, 
hecaufe it hath villi, or pile like that of velvet, Handing out 
from it ; thefe villi are fmall membranous produdions, or 
iheaths containing rhinute tubuli, both of the arterial a. d venous 
kind, opening into the cavity of the ftomach. The arterial *u- 
buli pour into the ftomach a liquor much more fubtile than 
blood, to be mixed with the aliments for the purpofe of digefti- 
on—and when the ftomach is empty, this liquor growing (harper 
concurs with the faliva in exciting the fenfe of hunger, as has 
been faid ; the venous tubuli are abforbent, and reforb liquids 
from the ftomach ; the innermoft or villous coat being larger 
than the reft, forms wrinkles here and there, more or lets con- 
fpicuous, but at the pylorus there is a remarkable one ; where 
a duplicature of the coat formed by this wrinkle all round the 
pylorus, and projeding into the entry of the duodenum, ferves, 
together with the circular fibres of the mufcular coat, to con- of The brain, 
tract, and aimed flout. that orifice, and let only the thinner parts 
of the ali'mentary mails be expeiied out of the flomach into the 
inteftine very gradually, and in fmall quantities at once : over 
all the infide of the villous coat, there open excretory dufts of 
mucous glands, feated in the fee oil’d cellular membrane, which 
furnifh a lubricating liquor,fas in the cefophagus, ferving to de- 
fend the acutely fentient infide of the flomach from the acrimo- 
ny or otherwife hurtful qualities of what we may eat or drink. 
.The flomach is plentifully furnifhed with blood.,velTels ; its 
arteries .all come from the cceliac, and its veins all empty them- 
fejves into the .vena portarum : it is no )efs largely fuppljed with 
nerves, every branch of which ariie from the par vagnum. • 
Now the ufe of .this organ is for the dig.efi.icn of our food, in 
Older to promote the noi,mfh merit of the other parts of the body, 
as w,ell as itfelf—and this it is .fuppoftd to promote by heat, 
moifiure, agitation, and fermentation—all which, that it is capable 
of producing, it will be eafy to conceive,, when we confider its 
ftrutShire and lituation—for we find it is almoft covered with the 
liver, lies contiguous to the fpleen and pancreas—is pofTtHed of 
a mufcular coat—has large trunks of, blood veflels running thro’ 
its, fubftances-r-lies clofe under the diaphragm—and fluids pro- 
fuTcly excreted into its cavity, and perpetually prefling down tlife 
cefophagus—befides its lying over the aorta, or gieat artery of 
the machine—and thus, the texture of the aliment is broken, the 
juices they afford fet at liberty, mixed with the gafiric juices, cr 
thofe of. the lloroach, thrown into a fiate of fermentationand 
changed into materials proper for forming nutritious fluids, as far 
as the firft procefs extends—which are farther perfected when they 
pafs into the inteftines,.whole lirudture is fimilar to that the ftc- 
nuch—by being mixed with .bile, pancreatic, and inteflinal fluids ; 
converting them into a white liquor called chyle, which is abforbed 
by the labfeal vefiels, and there in their paffage through the lym- 
pluitic glands to the receptaculum chyli further mixed and di- 
luted with lymph -, from this receptaculum the chyle is carried 
into the vena cavr., thrown with the blood into the right auricle 
of the heart, thence into the right ventricle, which ejects it into 
the lungs, by the pulmonary artery, in which organ it is further 
elaborated, thrown from thence into the left auricle and vetricle, 
and then into the round of the greater circulation, where it meets 
with fretli attrition ; and thus, in a little time, converted into a 
perfectly nutritive fluid, which is applied to the particular paits 
for their i’upoort as war-ted. Bur the flomach, befides being the 
inffrument lor performing the firft procefs of dig eft ion, is pofTefT- 
ed of another material power, that of promoting fvmpathic af- 
fe&ions in the conflitution. Thefe are fuch affections as appear 42 
Of TfilE Bit AI If, 
in parts far diflant from thofe, where the action of any fubft 
caufing fueh diliant affeflions, are locally afling—as fweat induc- 
ed by antimonials taken upb’n the ftomach, and only afling im- 
mediately on that drgart—vomiting produced by a done llimu- 
lating the kidney, See.- but of this however we lhall fpeak more 
at laige, when we come to treat particularly <?n this fubjefl—■ 
and now proceed to deferibe the inteflines, and their ufes—which 
have been divided, and are fix in number, three fmall, and three 
large, viz. DUODENUM* fo called from being twelve finger 
breadths long ;—JEJUNUM, from being commonly found emp- 
ty ;—ILEUM, from being fupported in part by the bones Called 
ilia—thefe form the three firft, or fmall guts. 
The DUODENUM is wider than the others—as it receives 
all the malh expelled out of the ftomach ; which cannot be faid 
of the other guts, feme part thereof being reforbed by the way, 
but chiefly on account of its having, for a great part of its length, 
from its origin progreilively, no external tough covering from 
the mefentery to limit its fize ; it is likewife redder and more 
flefliy than the jejunum and ileum, its mufcular fibres being thick- 
er and flronger. About its middle it receives the duff: from the 
pancreas and liver, called pancreatic and biliary, which palling 
through its coat, obliquely open into it through one orifice ; it 
makes feveral curvatures—the molt confiderable is that by which 
it aicends almoll perpendicularly fome way, foon after the two 
duffs open into its cavity, whereby the alimentary mafh mull needs 
be fomewhat retarded in its paflage through it; and the bile and 
pancreatic juice the more thoroughly mixed therewith, and with 
one another ; in its beginning, its innermoft coat is even, with- 
out wrinkles or furrows, fueh as are called valvulse conniventes ; 
but in its progvefs, and towards its terminations, it gets many 
fueh ; which mail further retard the progrefs of its contents ; it 
is fupplied with arteries chiefly from the lame tuink that fupplies 
the ftomach, viz. the coeliac ; fome lafleals, though but few a;ife 
from it 
The JEJUNUM.—It is not eafy to fix exaflly the limits be- 
tween the duodenum, nor ileum, and this gut : one way of dif- 
tinguifhing the jejunum from the ileum, and perhaps the belt, is 
to call all that jejunum, whofe circumvolutions are above the 
umbilicus, or navel ; and whofe cavities are remarkably furnifh- 
ed with rugae or valvulse conniventes ; this will make it about 
a third Ihorter than the ileum ; it is narrower than the duode- 
num ; its mufcular fibres are thinner and weaker ; it has fome 
clufters of glands, called Peyer’s, from their difeoverer, and fends 
forth numerous lafleals. 
The ILEUM makes its windings chiefly below the umbilicus; OF THE BRAIN, &C. 
43 
the lateral foldings are fupported by the ofla ilia, above the thigh 
bones ; its ftru&ure is much the lame with that of the jejunum, 
except that in it the valvulce conniventes decreafe gradually, both 
in number and fize, till at length they difappear. It hath more 
of Peyer’s glands than the two former, efpecially about its ter- 
mination, and fends forth extremely numerous laCteal veffels, the 
jejunum and it furniftttng almoft the whole of thefe canals : it is 
confiderably longer than the jejunum, and is continued to the firft 
of the thick guts called colon. Both the jejunum and ileum are 
furniftied with blood veffels from the mefenterica fuperior. The e 
fmall guts are the inftruments immediately employed in making 
the chyle ; whofe coats are pretty much the fame with thofe of 
the ftomach. 
The thick cr large guts are alfo three in number—tbe Cy£- 
CUM, COLON, and RECTUM. 
The ileum, the laft of the fmall guts, terminating near the 
right kidney, opens into the colon ; at its juuCtion with the CiE- 
CUM : this is a fhort wide fac about three inches long; its diame- 
ter about thrice as large as that of the fmall inteftines; it is fiiu- 
ated under the right kidney, and hid by the laft convolution of 
the ileum, and has an appendix arifing laterally from its bottom, 
called appendicula vermiformis, and is about the fame length, 
but very {lender, its not exceeding a quarter 
of an inch ; its termination is fhut, and it flu&uates loofe. 
The COLON from its origin makes a large turn upwards 
far as the liver ; then proceeds tranfverfely to the left under the 
gall-bladder, which it touches under tbe bottom of the ftomach, 
towards the fpleen and left kidney, to which it is fattened ; from 
thence patting, it makes feveial turns, the whole of them pretty 
much in the figure of a capital S inverted, then terminates in the 
reCtum ; fo that it furrounds, in a manner, the whole abdomen, 
fometimes afeending, lometimes defeending ; hence it happens 
that one ftool is often fucceeded by a fecm.d : by this contrivance 
likewife the faeces are longer kept, and hindered horn being eve- 
ry now and then indecentlv voided. 
The RECTUM or STRAIGHT GUT, fo called becaufe its 
courfe, if the length of the body is regarded, is ftraighr, though 
it is bent backwards and forwards, humouring the direction of 
the os facium and 03 coccygis, bones fituated at the lower part 
of the back, begins where the laft curvatures of the colon end, 
and is terminated at the anus 
It is worthy to be obferved, that; there is a remarkable con- 
trivance at the junCtion of the ileum with the colon and caecum, 
by which the contents of the fmall inteftines are allowed a free 
paflage into the thick ones, but fmall regrefs or retropulUon from OF THE BRAIN, 
44 
the latter into the former is effectually hindered and flopped; 
this is called, valvuli Bauhini—Tulpii, or—Coli. Its effeft in. 
the animal (Economy is very falutary ; for as the contents of the 
inteflines begin to putrify, and become foetid in the caecum, by 
their being retarded there, both upon account of its capacioufnefs, 
And the almofl perpendicular afeent of the colon, which is conti- 
nued from it, if their repulfion into the ileum was not effectually 
hindered, the chyle in the fmall guts would he tainted with pu* 
tridity, and even eXcrementitious matter thrown up at the mouth 
in obftihate coftiv'enefs ; whereas not fo much as a faecal halitus, 
or the fubtileff effluvia, can get that way in a Hate of health, 
though ftools fhoulcl be wanting ten or twelve days together, as 
happens in a common way to many. 
J he caecum being muOh wider than the fmall inteflines, and 
at the fame time lower than the implantation of the ileUm, the 
contents muft, in feme theafure, ft&gnate there, efpeciallv as the 
colon from its origin mounts' in a'manner perpendicularly as fair 
as the liver in the right hvpochondre. By ftagnating in fo warm 
a place, their putridity inc: cafes there, and they‘acquire a fascal 
odour, which is not cbferved in the contents of the fmall guts \ 
they likewtfe become ief fluid, and more confftent, by the re- 
forption of the move' fiqtiid parts through the laCleals and other 
bibulous veins, Ail! continuing! - * ' ■ ' - ' 
Tl-e vermicular appendix of the caecum, by the numerous 
glandular outlets i.i its cavity, ferves, as well as a receptacle for 
the meconium in the foetus, to lubricate the contents and mem- 
branes of the caecum, into which it opens, as well as its own, in 
order to faci'itate the propuffion of the faecal matter, and prevent 
its adhefion to the coats of the caecum and its own, and where 
it muft llagnate longer than it had ftagnated hitherto any where 
in the inteftinal tra£f. This ufe likewife takes place in the born 
anima ; and befides in obftinate coflivenefs, by affording more 
room or ftowage for the congefted faeces, it renders that com- 
p'aint more eafy to be borne, and iefs detrimental than it other- 
wife might be. 
The caecum and colon, beftdes having a ftronger mufcu’ar coat 
than the fmall inteflines, are furnifhed with three ligament-liker 
running length-ways on their outlide, dividing their fur- 
face into tbiee portions, nearly equal. Though they appear like 
ligaments externally, they are made up in their inner ftrudfure 
of true mufcular fibres, and ftrengthen the longitudina’ fibres of* 
the mufcu'ar coat; as they are longer than the proper coats, they 
keep them drawn up into folds or wrinkles. 
T hrough thefe inteflines is propelled and urged on the remain- 
der of the alimentary mafii, after having undergone the a&ion oi OF THE BRAIN, 
45 
the final) guts : it confifts of the earthy part of the materials tak- 
en in for food—of the membranous, fibrous, cartilaginous, and 
bony carts, that could not be fufficientiy broken, and comminut- 
ed by the ftomach or inteftines fo as to be taken up by the lacte- 
al, and other abforbing veffels ; the recrements of the bile, and 
mucus furnifhed by Peyer’s glands, ail mixed together. 
The caufes of its propulfion are the fame as in the fmall guts, 
viz. the action of reipiration, and the peiiftaltic motion of the 
inteftines themfelves ; but its courie is (lower than in the fmall 
guts, upon the account of its thicker confiftence, the afcent and 
windings of the colon, the delay it meets with from furrows 
within the tube, and the great flop from hard faeces, pent up in 
the redum by the fphinfter ani, The putridity is increafcd as 
it goes on ; and as putrefadtion generates air, the colon is com- 
monly found diftended with flatulency. The whole is more and 
more gradually exhaufted and robbed of its moft fluid parts ; and 
as what putrid miafmata are abfoibed by the mefocolic veins, are 
determined finally into the vena portarum, to contribute towards 
the rancidity and putrefeent difpolition of the bile, fo that even 
here the faeces, which are upon the point of being expelled out 
of the body altogether, are tendered ufeful and made fubfervient 
to the perfection of what is left behind. 
The RECTUM begins in the pelvis where the laft curvatures 
of the colon end; its mufcularcoat is much ftronger than in the 
other inteftines ; the ligament-like bands, which in the cfficum 
and colon are collected into three portions, are fpread equally 
over its furface, that no part of it may be weaker than another, 
left it fhould give way in the effort of throwing out its contents. 
Into this inteltine the faecal matter, now confident and fhaped by 
the cylindrical cavity of the colon, efpecially in its laft curva- 
tures, where it is more uniform, and not fo much diftended by 
flatulency, is received and accumulated therein, until, by its in- 
creafed bulk, weight, and acrimony, it becomes troublefome, 
and would prove hurtful if long retained. Then it is expelled 
by the mufcular powers furnifhed for that purpofe—and ftrong 
powers there are. and admirably fitted to anfvver their end. 
The INTESTINES are not left to move at random in the ca- 
vity of the abdomen, but artfully tied down by* a membranous 
web, which prevents their circumvolutions from being entangled 
in each other—at the fame time allowing them a gentle but limit- 
ed motion. That part of it, which is connected with the fmall 
inteftines, is called mefentery ; the other part faftened to the 
colon, mefo-colon. The redtum has a particular membrane al- 
lotted to itfelf for fixing it. 
This membranous web, for the mefentery, and mefo-co’on 46 
OF THE BRAIN”, &£. 
are one continued membrane, is a double produ&ion of the peri-* 
toneum, arifing from the vertebra* of the loins; its two laminati 
are joined together by a cellular texture, in which the lacleals, 
blood veflels, &c. run, and the mefenteric glands are placed ; 
when this double membrane hath arrived at the inteftines, its 
laminte feparat'e and quite furround them, thus furniflving their 
external covering. 
Upon a flight furvey of the ufes produced by the mechanifm 
of this part of the human machine, vye cannot avoid being (truck 
with wonder at its apparent fimplicity, anfvvering fo many falu- 
tary purpofes. If we trace the materials thrown into the flo- 
mach for our fupport through the inteftinal tube, we muft more 
aud more admire the excellency of the divine workmanfhip ; for 
as foon as we take our food it is received into a place, in all 
points calculated to render it fit for yielding its nutritious con- 
tents, by mixing with the falivary and gaflric juices—having 
its texture broken by mufcular adlion, not only of its own coats 
but the organs of refpiration, and the quickly repeated (hocks of 
the largeft artery in the human machine, and from heat, increaf- 
ed from its fituation. foon thrown into the procefs of fermenta- 
tion—by all which it is rendered fluxile, and pafles, from the 
contrivance at the lower orifice of the flomach, (lowly into the 
head of the firft of the inteftines—more capacious than its infe- 
rior part; it is there mixed with the bile, increased in its quan- 
tity in proportion only as it is wanted, by the very means of 
thofe things which require it, and pancreatic juice, calculated tQ 
convert the vasious portions into a nutritious fluid, by mixing 
the parts uniformly together, at the fame time affording a ftimu- 
lus to promote the propulfive force of the inteftines, and conse- 
quently increafe the a£tion of thofe veflels implanted in the (ides 
of them to convey it through the mefenteric glands, where it re- 
ceives more liquid, thinner than itfelf, to increafe its fluxility 
into the receptacle appropriated for this purpofe,and from thence 
into the blood—the feculent, or thicker part, being at the fame 
time pu(hed forwaids into the larger bowels, from whence there 
can happen no regurgitation of any, even of its finer parts, tho* 
delayed tor l’ome time, in order that a portion of its alkalefcent 
or ftimulating materials may be carried through the vena porta- 
rum, into the liver, to increafe the acrimony of the bile ; and 
as here .he feces acquire a greater hardnefs, confequently (land 
in need of a greater force to propel them forwards for their exit, 
the bowels in this place are poflefled of greater ftrength, and 
require a ftronger (limulus to excite them to more powerful ac- 
tion, which the putrefeent ftate of the fasces, acquired by delay, 
affbids. OF THE BRAIN, ifc. 
47 
But befides the ufes, herein fpecified, appropriated to the 
ftomach and inteftines, there is another very confiderable one be- 
llowed on them, particularly the former, by which very material 
affections are diffufed to almoll every part of the machine, and 
from which all the fenfible parts of the body receive Very peculiar 
and extraordinary advantages—I mean that of conveying action 
to different parts, and feeling the effects from thefe fympathetic- 
ally and inftantaneoufty;—for in many cafes the ftomach not on- 
ly will experience perceptible effects locally of things received 
into its cavity, but communicate effeCt to different parts from 
that local aClion ; nay, will produce them fometimes without the 
animal being fenfible of any aCtion going forwaids in that organ ; 
and will itfelf be affeCted by fome caufes aClihg on other different 
parts, with the fame unconfcioufnefs of the locality of action, as 
well as fenfible perception cf fuch aCtion—lo clofe an union is 
there between this organ, and the inteftines, with various parts, 
the moft diftant as well as the more contiguous. 
Opium, the aClive preparations of antimony, bark, and a num- 
ber of thofe medicines called cordial and antifpafmodic, will dif- 
fufe their effeCts to the machine in general, and fome particular 
parts, from what they exercile on the ftomach, particularly itfelf. 
Hence will opium produce fleep—take oft pain—promote per- 
fpiration or fweat—(top evacuations—alleviate and conquer fome 
convulfive or fpafmodic affections.—Atitimonials take off cuticu- 
lar fpafms, productive of febrile affections, allay febrile heat— 
promote infettfible perfpiration and fweat.-—Bark increafe the tone 
and ftrength of the fyttems—flop fome evacuations—increafe o- 
thers—and give firmnefs to the mufcular fibres. 
Cordials invigorate the habit—increafe the circulatory powers 
of the conftitution—fubdue lownets—fainting—warm the habit 
—and produce difcharges from the fkin. 
Mufk, ai'afoetida, camphor—take off feveral convulfion affe&i- 
bns—and all thefe things are done by the ftomach, diffufively 
communicating effeCts to the various parts, whole office it is to 
perform their different operations, or to thofe where thefe mor- 
bid effeCts may be manifefted. 
And it will alfo be affeCted by the fenfations induced on differ- 
ent parts diftant from itfelf. Spafmodic affeCtions of the pore# 
of the fkin will produce ficknefs, naufea, vomiting—fo will a ftone 
in the kidney ; violent blows on the head, or conpeftions on the 
brain, will occafion fimilar effeCts—and a variety of others might 
be adduced tending to prove the fame points ; but enough lias 
been here advanced to prepare us for the fuller difcufiion, ami 
better underftanding of thefe coufequential particulars, when we 
come to fpcak more fully on them, as they occur repeatedly in or The Main, &V* 
the courfe of the fubfeqiierit fheets.—We miifl now avirt to this 
kidneys. 
The KIDNEYS are two pretty folid glandular bodies, fituat- 
ed in the posterior part of the cavity of the abdomen, on each 
fide of the vertebrae of the loins, between the lad falfe rib, and 
the ofia iliaca or hip bones. The right kidney lies under the great 
lobe of the liver, the left under the fpleen, and therefore is high- 
er ; they are commdnly about live inches long, about three broad, 
and one and a bale thick ; they are connected with the cplpn, 
duodenum, liver, and fpleen, by the produQipns of the peritone- 
um. They arc in fhape not unlike a large bean, their circum- 
ference being convex oil one fide, and concave on the other—the 
concave fide is turned towards, the vertebrae, or back bone. 
The kidneys are furrounded with a loofe cellular texture, in 
which there is much fat y this likewife invefls the arteries and 
veins of the kidneys. The proper coat or membrane of the kid- 
neys is double, being cornpofed of two laminae, or layers—-be- 
twixt which there is a very fine cellular texture ; the external 
laminae is very thin, and only furrounds the body of the kidney j 
the internal one penetrates everywhere by numerous elongations 
into the fubilanfce of the kidney* from which it cannot be fepa- 
rated without tearing. T he fubflance of the kidneys is fmooth, 
even, and uniform in adults—-in young children divided in a man- 
ner into feveral lobes and tubercles, or portions. 
They are fupplied with very large blood vefTels—-commonly 
called emulgents. The arteries arife from the great defeending 
artery of the heart; nearly at right angles, one large trunk for 
each kidney ; they run horizontally to the kidneys, and common- 
ly without divifion—and having fent oft branches to the external 
fur face of the kidney, the chief trunk enters into its body at its 
concave part, and is diflributed by an infinite number of fmail 
branches over all its fubflance. The veins running; along with 
the arteries open in a large trunk from each kidney into the ca- 
va defeendens, or large defeending vein, near that part of the aor- 
ta where the arteries arile. 
If the kidney is cut through its convex, towards its,concave 
part, into two equal portions, there appears a three-fold fubflance 
com poling it's body —-trie exterior part called cortical, round the 
whole circumference of the kidney, of a bright, vvhitifb, g ey 
colour a middle fubflance, called medullary, Undated, or [beak- 
ed, which terminates in the third, called papillary, as it ends in 
eleven or twelve papillae, or nipples, from the ends of which 
the urine drops through feveral fmail holes in the cavity of the 
kidney. 
The intimate flructure of the kidney is entirely vafcular—the OF THE BRAT N, &C. 
49 
ftriall arterial branches proceeding towards the papillae are reflect- 
ed back with ferpentine circumvolutions towards the fur face of 
the kidney, then are bent again towards the papillse ; and, at 
length, fend otfi ftraight urinary duffs perforating the papillae, 
and tending to the cavity of the kidney called pelvis, which is 
continued to the ureter, a veUel which runs into the bladder. 
The pelvis, which is truly the head of the ureter, is the refer- 
voir into winch the urine drops from all the urinary duffs cr tu- 
buli. It is formed by the confluence of three large urinary ca- 
nals, into which the fVriall urinary duffs open by holes laterally. 
This cavity, or pelvis, is ftraitened at length into the ureter, one 
to each kidney ; fo that the kidney may be imagined to be a vaf- 
cular congeries, confiding of arteries, uriniferous duffs, or thofe 
which convey urine, and veins, all running together over the 
fubilance of the kidney,; the urinary duds opening at length in- 
to the great Urinary refervoir, or pelvis, which terminates in the 
ureter. In the kidney there are no follicles feslween the lalt ar- 
terial branches, and the fir ft urinary duffs. 
By this apparatus is the urine feparated in the fubftance of 
the kidney and fent into the ureter : the vaft largenels of the emul- 
gent arteries, and their proximity or nearnefs to the heart fhew, 
that a great quantity of blood comes, in a fmall fpace of time, to 
the kidneys. Now the blood, which is newly come from the 
heart, mult contain a great quantity of water, as, befides our 
drink, and the flomachic and inteftinal juices, almolt all the 
lymph of the body is poured upon the chyle, in its receptacle in. 
the lower belly, and the duct in the thorax, immediately before 
it is mixed with the blood. 
This water is impregnated with the falts of the blood, and fotns 
animal oil, attenuated by the procefs of concoftion, or digeltion, 
and circulation, and rendered mifcible with water, and united 
with thefe falts, together with fubtle terreftrious or earthy parts, 
abraded from the infide of the animal tubes, conftitute the mat- 
ter of urine. The diameters of the urinary duffs are adapted to 
admit thefe, and exclude, in a found ftate, every thing groller, 
as globules of blood, mere oil unattenuated, milk or chyle, and 
ferum or lymph, that is concrefcible by fire, urine being not fo ; 
at the fame time they tranfmit every thing that is thinner, if it 
arrives at the kidneys ; fo that urine is the lixivium or ley, as 
it. were, of the blood ; by the feparation of which it is edulco- 
rated. Its falts and oils, which begin by repeated circulations 
to be more acrid than the tender veflels of the nerves and brain 
could bear, being wailied off, and thrown out by the urinary paf- 
fages. 
The URETERS, arifing from the pelvis of the kidneys, run or the brain, &c. 
down obliquely, and with a tfery fmall inflexion from the kid- 
neys to the lateral parts of the inner and anterior fide of the 03 
facrum, or lower part of the back, and paffing between the rec- 
tum and bladder, are inverted in the latter. Their ftrnclure is 
much a-kin to that of the inteflines, though the innermoft coat 
is fmooth and membranous, furnifhed with glands feparating a 
mucilaginous liquor to defend it againft the fharpnefs of the 
urine ; they open into the neck of the bladder on each fide, pene- 
trating obliquely through its coats. 
The BLADDER is a membranous and flefhy fac or bag, ca- 
pable of contraction and dilatation, fituated in the lower part of 
the abdomen or belly, immediately behind the joining of thofe 
bones, Called ofla pubis—and oppoiife to the beginning of the 
reCtum. Idle figure of it is neatly a fhort oval—it is broader on 
the fore and back, than on the lateral parts, rounder above than 
below, when contracted ; and broader above than below when 
diftended. It is conceived, as divided into the body, ntek, and 
bottom, into anterior and poflerior, and into two lateral parts, 
right and left. 
The upper part is termed its bottom—its neck is part of its 
lower portion, with refpeCt to its fituation in the body. The 
bladder is not within the cavity of the peritoneum, that mem- 
brane only covering a part of its bottom or upper part, and com- 
ing down no-farther anteriorly, but being reflected over the blad- 
der, defeends, covering it, as far down as the infertion of the 
ureters. 
The ftructure of this organ is nearly the fame with that of the 
ureters, viz. befides the peritoneum, which covers but part of it* 
there is firft an external cellular, under that a mufcular coat; 
then a fecond cellular, then a nervous coat, and the innermofl of 
all, a coat, in fome meafure, villous, furnifhed with glands which 
feparate a mucilaginous liquor, neceflary to defend it againfl the 
fharpnefs of the urine, which Magnates within it often, fot a ve- 
ry coufiderable time together. 
The fibres in the mufcular cost run in all manner of directions, 
the outermoft, and moft remarkable feries is longitudinal, run- 
ning from the neck upwards, ai.d hath been thought to deferve 
a particular name—detrufor urinte, expellerof urine—the others 
run obliquely, by different degrees of obliquity, and fome alto- 
gether tranfverle : the neck* or under part of the bladder, is £hut 
by a mufcular fphinCter, like that of the anus. 
The ufe of the bladder is to receive the urine which keeps 
conffantly flowing from the urinary duds and kidneys into the 
pt !vis and ureter—and to retain it ; that it may not indecently 
dribble, and difiu;b the functions of life. It fee ms to change OF THE ERAIN, &C. 
its nature no otherwife than by its being kept at reft in a warm 
place, thereby becoming more acrid and ftimulating. The urine 
is detained in the bladder by its i'phincter, till by its diftenlion,and 
the acrimony of the urine, either or both, we are made, uneafy 
and endeavour to expel it through the urethra—fee page 53, £4, 
&p.—out of the body, which is done in the fame manner as the 
faeces are thruil out—by the joint adlion of the diaphragm, and 
the mufcles of the abdomen, affifted by the proper mufcular coat 
of the bladder—and the pyramidial mufcles, in a particular man- 
ner, favour the evacuation of the bladder, as they lie nearly 
over it. 
The UTERUS, or WOMB, the habitation of the foetus, is fi- 
tuated between the urinary bladder, which is ])laced before it,- 
?nd the intettinum re£tum placed behind it. In a grown woman, 
not with child, it is about three finger breadths long, two iri 
breadth, where it is broadeft, and one in thicknefs; it is of the 
figure of a fiat fiaik, convex before and behind, with edges inclin- 
ing to fiiarp 5 its broadeft extremity, which is called its bottom, 
is uppermoft ; and its fmall part, called its cervix or neck, is 
downwards-—it is covered over with a produbtion of the perito- 
neum, two portions of which, one on each fide, fatten it to the 
Sides of the pelvis, and are called the ligamenta lata, or broad li- 
gaments. 
The womb, when impregnate'-, hath but a very fmall cavity, its 
walls being very thick ; the cavity is, in tome meafure, ot a tri- 
angular lhape, and it is lined with a very thin fmall membrane. 
The womb is made up of a compacted cellular lupttance, with 
a copious intermixture of blood veflels—there appears fmne thing 
like mufcular fibres amidft the cellular fubhance, efpecially ta 
women newly delivered, variputty diftributed in little circles. 
The fmalier and lower part of the womb, called its neck or cer- 
vix, abounds with callous rugae, or folds ; m the interltices or 
fpaces of which there are mucous hnufes, and here and there 
round vettcles full of a pellucid lymph, where it opens into the 
vagina, deferibed below ; it forms a round protuberance, not un- 
like the glans penis, called the os uteri, mouth of the womb, or 
03 tincse? becaufe fuppafed, like a tench’s mouth, divided by a 
rimae or chink ; on which protuberance there is plenty of a mu- 
cous, glutinous liquor, furniffied by numerous finufes there : this 
glutinous liquor ferves to fhut the os uteri in pregnancy. 
The VAGINA, or canal of the uterus, is about fix or feven 
Inches long ; it is ftretched from the mouth of the uterus to the 
pudendum, or external parts; it is of the fame texture with the 
■uterus ; cellular, with numerous blood veflels interwoven : its, 
Saner furfaee hath feveral rugae, or wrinkles j there are likewife OF THE BRAIN, &V, 
nei'vous papilise fpread over it, which render it more fenfible j 
its external orifice is furrounded with mufcular fibres, which 
conftriel it. 
Tile uterus, as hath been faid, is plentifully ftored with blood 
veffels; they aie fnrnifbed from the hypogaflrics, by which, like- 
wife, the ii ner and greater part of the vagina is fupplied ; its 
outer extremity is furnithed from the external haemorrhoidal. 
The worhb is adapted for the retention of the embryo, and its 
nourifhnent, till the time of birth ; and with the veffels of the 
vagina, for affording the monthly evacuation called menfes, or 
catamenia. 
But to the womb, for the purpofe of promoting the generation 
of the human fvecies, there are united two other 
on each fide, the one called tub® fallopian®, Fallopian tubes, 
from the difcoverer, Fallopius ; the other, ovaria, from their re- 
taining ffnall round fuhltances of the nature of eggs. ■ 
On each fide of the fundus uteri the former open by two fmall 
orifices, which in a dead fubjeft, -with difficulty admit a hog’4 
briille ; from this fmall opening each tube proceeds fomewhat 
‘tranfverfely -from the -fundus towards the lateral parts of the pel- 
vis, running between the duplicatures of the broad ligaments—• 
their diameters gradually augmenting to their extremities, where 
they are about a quarter of an inch wide ; they run not flraight 
from the womb, but wind in fuch a manner as to turn their 
wide, open extremities towards the ovaria ; thefe extremities are 
jagged or fcollopped ; their external membrane, or covering, ia 
from the peritoneum ; their proper coat is plentifully furniffied. 
with veffels ; there are fome obfeure, feemingly mufcular, fibres 
interfperfecl, fupperted by a fpongy cellular texture. 
The OVARIA are two whitiih, oval, flat bodies, fituated on 
the fides of the fundus uteri, to which they are joined by a kind 
of fF.ort ligament, and inclofed, together with the tub® Fallo- 
pian®, in the duplicature of the broad ligament—their fubftance 
is cellular and clofe, without fat—in it there are found, even in 
the ovaria of virgins, little 101111x1 veficles, called ova, or eggs— 
of an uncertain number, commonly ten or twelve, full of a trans- 
parent coagulable fluid. vThefe ova adhere clofely to the texture 
of the ovaria. • •. • ... 
The OVARIA and TUEiE Fallopian®, are fupplied with 
blood-veffels from the fpetmatics, which have nearly the fame 
origin in females as in males—viz. the arteries of the aorta, 
near the rife of the emulgents, and the veins from the vena cava, 
and emulgeut vein ; thefe inofculate with the veffels that go to 
the uterus. ; • ; 
Thefe alfo are fuppofed to perform particular functions in the OF THE BRAIN, t$C. 
53 
propagation and formation of our fpecies—for the ovaria are 
Squeezed by the edges of the tubes, dil’engage fome of the ova, or 
eggs, which are impregnated, generally one, now and then two, 
three, or four, which are forced into the tubes and carried into 
the cavity of the uterus, where they fix themfelves and are re- 
tained, and here the foetus is nourithed to the proper time for 
its birth, which happens almoft always in the fpace of nine 
months. 
We might now, according to what we firft propofed refped- 
ing the nature of our fubjed, finifh our anatomical account, as 
fufficient has been defcribed to give a tolerable idea of conftitu- 
tions in general; but as we alfo intend to ftiew the methods of 
preventing, or flopping the progrefs of particular complaints, lo- 
cal as well as'general-—we inuft, before we conclude, fpeak of 
the teftes, urethra, and penis, the male parts of generation—as 
they are fubjed to fome complaints which require early atten- 
tion, by which feveral difagreeable confequences may be prevent- 
ed. 
The TESTKS, or TESTICLES, with regard to their fitu- 
ation, are fufficiently known ; they are defended from cold, and 
other injuries, by feveral membranes or coats. 
The outer one is called the ferotum—which is made up of the 
epidermis, or fcarf-lkin ;—the Ikin, and immediately under the 
latter, a thick cellular texture, clofely adhering to it, but with- 
out mufcular fibres : next under this is what they call dartor, 
from its drawing up the lkin. This coat envelopes each tefiis 
fingly; and by the jundion of both together, where their fides 
are contiguous, make a partition or feptum between the two 
teftes: it is likewife wholly cellular, without mufcular fibres, 
and without fat. Under the dartos is the cremafter mufcle, i'o 
called fiom fufpending the tefticles ; there is one to each, and 
arile from the tendon of the obliquus defeendens, oblique descend- 
ing mufcle of the lower belly ; yet fome fibres from the obliqu- 
us afeendens, oblique afeending mufcle, the embracing the body 
of teftes all around, ferve to ri;fe it, and fquee-'.e ic in the aft of 
generation. It is probable, that by the adion of this mufcle, 
that the ferotum is gathered up into rugas by cold, as neither it, 
nor the dartos, are furnifhed with mufcular fibres. Under this 
mufcle is another coat of a loofe cellular texture, called vagina- 
lis, from forming, as it were, a kind of Iheath to the teftes, be- 
tween which and the inner moll coat of all is a loofe fpace, in 
fome meafure like that between the heart and pericardium, where 
a watery humour is contained -the laft and innermoft toat is 
called, from its whiteneL, the albuginea ; it is a thick, clofe, ftrong- 
membraue, immediately contiguous to the kernel of the teftes ; OT THE BRAIN, l$C. 
the fubftance of which kernelly part is of a white colour, and 
from reafon and analogy, it is concluded to be a continuation of 
the evanefcent branches of the a>tery called fpermatic, from its 
fupplying blood to the teftes, from whence the femen is fecreted, 
rolled up together. L is divided into more than twenty portions 
or cluflers, feparated from one another by as many partitions, 
which are productions of the albuginea. Each clufter, contain- 
ed between two partitions, terminates in one du£t ; which duffs, 
above twenty in number, meeting together, form a kind ot net- 
v/ork adhering to the albuginea ; every duel anaftomofing with 
thofe contiguous with it: from this duel arife ten or twelve o- 
ther dillinfl duffs, which being feparated, bent, or folded in a 
wonderful manner, make as many vafcular cones, and by their 
uniting conftitute the head or beginning of the'epididymis, or 
fmall tefticle. This Angle dufl, varioufly bent and folded into 
lerpentine windings, fuch as there is no inftance of in any other 
part of the body, its windings being fattened together by cellu- 
lar texture, makes a roundilh body on the upper and pofterior 
part of the tefticle, called epididymis, which, at length, termi- 
nates in a firm and tough cylindrical tube, called vas deferens. 
The PENIS confifts of two bodies called corpora fpongiofa, or 
cavernofa, fpongy or cavernous bodies—part of the urethra, the 
glans or nut at its extremity, and its integuments. The integu- 
ments are, firtt the fcarf-lkin, and true Ikin—which being folded 
back, and adhering round the root of the glans, forms what is 
called the pisepnee, in the infide of which there are fmall glandu- 
lar folliculi, which leparate an oily fubftance, ferving to make 
the praepuce flip over the glans, and hinder them from growing 
together : this fubftance forms white flakes, and grows rancid 
ar.d foetid by long flag alien. In hot countries, it is more apt 
to corrupt ar.d create inconveniences, than in temperate climates. 
This feems to have introduced circumcifion, which was early 
praftifed all over the Eali, and made a part of the Jewifti reli- 
gion. It is performed by cutting off the praepuce quite round, 
clofe by the root of the glans. 
Under this common integument, the penis hath a proper coat 
covering ail its body, from the glans exclufive backwards, and is. 
ot a tough tendinous texture. 
The i WO CORPORA SPONGiOSA arife from the os pu- 
bis on each fide, and are continued to the root of the glans : they 
are fo called, be. aufe they are porous like fponge, and capable 
of being enlarged by a fluid penetrating their fubftance, chiefly 
in the living, by blood—or in the dead fubje£t, by mercury or 
inflation of air. 
Ihe URETHRA is a continuation of the neck of the bladder, CF THE BRAIN, ifc. 
and runs ih a furrow between the two corpora fpongiofa to the 
extremity of the glans—it confifts of two thick, ipongy membranes, 
with a fpcn y texture between them—its beginning is covered 
by glans called PROSTATiE—at its emerficm from which, it 
becomes thicker and wider for the length of an inch, which thick 
part is called its bulb, from the refemblar.ee it bears to a bulbous 
root; its inner membranes are pierced with many holes, here 
and there, through which, from a glandular apparatus in the 
fpongy fnbftance of the urethra, a mucilaginous liquor is furnish- 
ed, ferving to defend it again!! the acrimony of the urine. Bc- 
fides thefe orifices, there are three other glands, two near the 
blilb of the urethra, one on each fide, about the fue of a pea ; 
each of which fends off a long duft which opens into the urethra, 
and a third lingle one, lei's than the other two, at its bend under 
the os pubis—which fends off two du£ts opening likewife into 
that canal. The firlt ttvo are often found, but l'ornetimes want- 
ing or very fmall ; the third is but feldom met with—the orifices 
are called by fome lacunae ; thefe glands—Cowper’s glands ; they 
both, probably, ferve for the fame purpofe. 
The GLANS is a continuation of the fpongy fubfiance of the 
Urethra, reflected over its extremity, and expanded in the form 
we fee : it is covered over wi h a thin epidermis or l'carf-fkin, 
under which there are numerous nervous papillae, rendering it 
extremely fenfible. 
The penis is plentifully fupplied w'ith blood v'effels from the 
iliacs, both external and internal—its nerves come from thofe of 
the loins and facrum. 
The life of the parts we have now deferibed are for the pro- 
pagation of our fpecies, and fome for the evacuation of urine. 
We fliall now' conclude what we mean to advert to on the ana- 
tomical part of the machine, which we have rendered very eafy 
to be conceived, and think will be highly ufeful in aflilting tire 
uninformed readers to have juft conceptions of what we mean 
by particular confiitutions in general,—what of general difeafes, 
and thofe called topical, or confined to fome particular part,—and 
make them perceive the reafon why fuch and fuch particular re- 
medies or regimen Ihould be employed in fuch and fuch particu- 
lar cafes, as come within the reach of every man’s power—whe- 
ther they aim at preventing the acceffton, or fhortening the pio- 
gr-efs when begun ; all which will be much better, and eafier uu- 
derflood, by the Iketch. concife as it is, which has been given. For, 
certainly, laying down rules and diteftions for a man how to 
proceed in nervous cafes, who has no idea of a nerve ; in inflam- 
mation, who knows not any thing of the vafcular fyftem ; injaun- 
dice, Jl one, gravel, who is totally ignorant ot the liver, f 1« n, OF THE BRAIN, &C. 
bladder, kidneys, is as bad as leading a man blindfold through a 
country to difcover its beauties, and give him a knowledge of its 
fituation, foil, produce, &c --And to talk to a man of difeover- 
ing the nature of his conflitution, and dire&ing him to proceed 
agreeable to its difpolkion, without telling firft of what it is com- 
pofed, and making hith fenlible of the natural aftion of its com- 
ponent parts, would be as vague and ufelefs as chopping logic to 
a rullic—it might confound, but could not inform : and it is for 
want of true knowledge in tliefe particulars, that men, in other 
refpe&s jfenfible, are fo often heard delivering a profufion of non- 
fenfe on medical fubjects. We therefore, in order to correct er- 
rors fo often detrimental in their confequences, have prefumed 
to alter the general plan of publications of this fort, by thus be- 
ginning anatomically—and (hall now proceed to fhew the differ- 
ent cordlitutions—what they are, and how they may be dii'co- 
vered. 
But, firft, we muft take notice of thofe parts which are called 
the moving powers, by w'hich all cbnftitutional a£tion is promot- 
ed, and life preferved ; and tliefe are—the brain and nerves—the 
heart, and va fcularfj/Jiem~~-the lungs and blood—and the mufcular 
fibres, 
Now in proportion to the different degrees of power which 
tliefe pofifefs in their natural flate, fo may conftitutions in gene- 
ral be propeily denominated. 
The hmin and nerves are cotifidered as the origin of incitability 
--that is, motion produced in them by mental affe&ions, and 
fympathy. 
I he heart, vafcular fyjlcm, and mufcular fibres, as the foun- 
tains of irritability—that is, motion produced by material ftimu- 
lus. 
The lungs and blood, the fource from whence all animal heat 
is derived—the univerfal ftimulant of the human machine. 
The mufties or mufcular fibres, as the inftruments of motion. 
The fiornach, intejlines, and other 1vifeent, as parts which may 
themfelves be a£ted upon, and produce a£tion of fome of the ge- 
neral moving powers, and each on parts diftant from them. 
But we muft obferve, that with refpe6t to the term, initability 
—it is by all authors equally applied to the nervous and vafcular 
fyftem, as well as mufcular fibres, which we have fhewmit ne- 
ceffary ro alter, and confine it to the two laft alone—becaufe, in- 
dependent of the nerves,, they cannot be put into motion without 
fome material ftimulus locally applied to them—vvhilft the nerves 
.may be brought into a&ion by affections purely mental'—the 
precife nature of whofe action we cannot deferibe, and know 
them not but by effects. Betides, though they are in the habit ON CONSTITUTIONS. 
57 
united clofely, they may exift independent of each other, and 
may be feparately affe&ed—(hewing thofe affections belonging 
to themfelves, without difturbing each other in many cafes. 
It was, therefore, unavoidable to feoarate the two-—that con- 
futations might be precifely and diftin&ively maiked, where the 
action of one or the other were mod prevalent, and hence great 
confufion prevented : add to this, it empowers us to account 
more rationally for fvmpathetic attentions, that is, where parts 
didant from others, (liew manifed (igns of attention, though the 
caufe producing them lies in fotne more didant part ; or where 
aife£tions are fuddenly produced in the habit, from fome exter- 
nal appearances out of the habit, no matter being at that time 
inherent that occasions theie affections from the locality of irrita- 
tion. But we mud allow alfo, that the nerves are capable of 
being put into motion by material dimulus. 
Hence then it is clear—that 
The nerves are capable of being brought into aCtion by mental 
affections, fympathy, and material dimulus, themfelves abftraCt- 
edly confidered. 
The vafcular fyftem, and mufcular fibres, under the fame con- 
sideration, only by mate ial dimulus. 
That in their combined date, they mutually aft on each other, 
in many cafes, or may be feparately affefted. 
Now as the moving powers vary in their different degrees, and 
different combinations refpefting thofe degrees, fo do we conclude 
conftitutions ought to be determined—and fo ought different re- 
gimen, and applications of medicine, be advifed—for preferving 
health, preventing, retarding the progrefs, and curing of difeafes. 
section rr. 
Vn CONSTITUTIONS. 
rTTIERE is no fubjeft on which we heal valetudinarians fo 
muth converge, as the particular nature of their conftitutions ; 
nor any on which they forrr fuch a variety of conjectures, rat the 
fame time to fpeak fo pofitively, as if they underdood what was 
meant by the term ; nay, even are angry if you difpute their want 
of the molt minute knowledge in this relped ; and, indeed, it is 
almoft held as an undoubted truth, that all men are the belt judg- 
es of their own conftitutions. 
Notwithftanding, I can by no means allow this to be a truth, 
yet 1 can very readily conceive how they make the miftake, and 
what it is that they build fuch a conceit—they mean, that all ON CONSTITUTIONS. 
men can tell what things befi agree with them, which commonly 
cur, and which they have obferved from repeated experiments; 
but this only comprehends the effeCt produced by different caufes* 
and may a Hi ft in giving information to fcientific men in inveffi- 
gating the precife nature of particular confutations ; but never 
can lead men, who have not made the medical art their ftudv, to 
fufficient difeoveries, for underffanding the fubjcCt properly ; a 
fubjeft which cannot be ferutinized too clofely, as perhaps the 
■whole good to be derived from judicious afiiftance upon that 
knowledge totally depends. We (hall, therefore, go a little deep- 
er into this matter, in order to lay a foundation for the applica- 
tion of thofe remedies, from whence every man may derive be- 
nefit, with fome degree of certainty, and after which all naturally 
thirft with the greateff avidity. But to make this bufinefs eafy, 
we lhail confine ourfelves to the terms of which people in gene- 
ral make ufe, and endeavour to fhew, what ought to be under- 
flood by them, applied to the varieties prefenting themfelves in 
different fhapes in the human machine. 
Mankind in general have furnifhed a great number of confti- 
tutions-—under the following appellations : 
1. Strong rebuff 
2. Weak, relaxed, delicate 
3. Nervous 
4. Irritable 
3. Torpid 
6. Collive 
7. Lax 
8. Bilious 
9. Plegm&tic 
io Scorbutic 
i 1. Gouty 
12. Rheumatic 
13. Scrophulous 
14. Flatulent 
ij. Plethoric, or full 
16. Hot 
17. Cold 
18. Confumptive. 
And thcie have been deduced from the different appearances of 
the conftitution—ihe various effects to which they were prone; 
the humours confidered as inherent; and to the affections of 
particular parts, which they conftantly, or on flight occafions, 
experience. But before any benefit can accrue in the application 
of remedies, or the manner pointed out by which mifehief may 
be avoided from the fame fource, we fhould be acquainted with 
the corporeal conftruCtion and nature of their powers, which 
conffitutes moll of thefe deviations ; and it is for want of this 
knowledge that felf created pbyficians, doffiors ofimagination, oc- 
cafion very often a multiplicity of evils to their credulous patients, 
and to themlelves, under many morbid circumftances—prescrib- 
ing boldly the fame applications to conftitutions diametrically 
oppofite to each other, and which req lire very different materials 
to conquer the fame complaint. For want of this knowledge, 
I have known coughs converted into pulmonary confumpiions, and ON CONSTITUTIONS. 
that not unfrequently ; gout into apoplexy ; colds, inducing flight 
febrile affeblions, into inflammatory fevers ; fort throats, eafily cu- 
rable at firft, made dangerous, and too often fatal-—and many o- 
t-her deleterious tranfitions occur from the fame fountain-—for 
it is a certain faft, there is not any man that does not fancy him- 
felf, in feveral cafes, a phyfician; and when, by his ignorance in 
advifing improper remedies, he has created mifehief, perhaps 
death, he confoles hunfelf, and the unhappy friends, by faying, 
he did it for tlie bed. 
To guard, therefore, againft the unfortunate confequences of 
thefe good aft ions, our duty calls upon us to fpecify the particu- 
lar nature of thefe conftitutions, that we may hereafter, when 
requifite, point out properly adapted remedies, that the patients 
may not fail in the attempt to alleviate, qr cure, or prevent par- 
ticular complaints. 
In STRONG, ROBUST CONSTITUTIONS, 
The mufcular {lamina are firm, and well compafted ; power- 
ful and agile in motion ; the pulfe flrong and full ; the nerves 
equable and forcible in their influence ; the circulation of the 
blood free, and the texture of that fluid poffeffed of great tena- 
city; the complexion healthful, and the whole habit in a Hate 
of ftrong aftivity. 
In WEAK, RELAXED, and DELICATE, 
The reverfe of thefe occur-—the mufcular (lamina are weak 
and loofc, imbecile in motion, and foon wearied ; the pulfe fmall 
and quick ; the nerves irregular and debilitated in their influence ; 
the circulation of the blood languid, its texture loofe ; the com- 
pleftion pale or fallow ; and the whole habit in a ftate of debi- 
lity. 
In the NERVOUS—the conftitution is like the latter in a 
great degree, but the nerves are eafily incttable from flight caufes, 
creating fpafmodic affections in different parts. People of this 
conllitution are generally timid—have great variability of fpirits, 
and much l'ubjeft to byfteric fits, cramps, and flying pains,— 
putting on the appearance of various complaints, according to 
the parts affefted ; the urine is commonly pale, fometimes made 
in fmall quantities, then becomes turbid—or in large quantities, 
then remains limpid. In thefe, therefore, the nervous fyftem is 
in fuch a ftate, fo as to be quickly incitable, and readily and fre- . 
quently thrown into morbid aftion. 
In the IRRITABLE, 
There is a ftrong propenfity in the vafcular fyftem, and muf- 
cular fibres, to be thrown into quick ftales of contraftion—the ON CONSTITUTIONS. 
conftitution being in an intermediate {late, between the robufl: 
and relaxed, and participating, in fome degree, of the nervous, 
Thefe are fubject to have the circulation of the blood readily 
increafed—-fluftiings in the face—-are irafcible, and eafily moved 
to anger—they are foon heated by any llimulant taken inter- 
nally. 
Oppofite to this conftitution is the 
TORPID In thefe the circulation of the blood is languid, 
feems rather to creep, or undulate, th&n circulate ; the extremi- 
ties are generally cold, and they feel, without any caufe very 
often, internal oppreffion ; dreading, and fearful of imaginary 
calamities—they are naturally -inadive, and indolent, unlefe 
roufed by fome pleafurable purfuit; irrefolute, mutable, and ve- 
ry often timid in the extreme, where any difficulties are to be 
furrhounted, and the habit is generally coflive..u-w ~ 
The PHLEGMATIC. 
In thefe the lungs, ftomach, and inteftines, are apt to be load- 
ed with too great a quantity of vifeid phlegm-—from the digef- 
tive organs being in too weak a (late, and wanting a due i'ecre- 
tion of bile--the habit coftive—in general cold—fubjed to chro- 
nic coughs, and expedoration of tough vifeid phlegm—the cir- 
culation of the blood fluggiffi—the breathing laborious—the muf- 
cular fibres and vafcular fyllem torpid—though corpulent, they 
very often are grefs, and frequently fubjed to cedematous, or paf- 
ty {welling of the legs. . .. • . • , 
The PLETHORIC. 
Thefe are fuch rvhofe conftitutions is apt to breed a great 
quantity of blood, and are chiefly of the irritable clafs, more in- 
clining to the robuft and athletic. In thefe the digeftive powers 
are good—the appetite fometimes voracious, fon: 'times mode- 
rate—frequently haemorrhages occur, and very often copious 
evacuations of different head-aches of the dull, heavy- 
kind, attended with frequent giddinefs—they are liable to be- 
come often drowfy and lleepy, and fond of that fpecies of indul- 
gence—and thefe generally arife from too great plenitude in the 
fanguinary fyftem. .... . ' . . : . 
The BILIOUS. 
Are fuch as have a very copious fecreticn of bile, which is apt 
to colled in its repofitOry the gall-bladder, nor be regularly ex-" 
creted, or pafs into the duodenum, or firft inteftine—by which 
means, ftagnating there too long, perhaps from its vifeidity, it 
acquires a degree of acrimony, which, when poured into the in- 
teftines, occalion bilious colic, cholera morbus, or a vomiting up ON CONSTITUTIONS. 
61 
and purging of bile—bilious loofcnefs. In thefe, the qomplec- 
tion has generally a fallowifh cart ; they complain frequently of 
bitterilh tafte in the mouth-—are commonly coftive, and have 
deep-coloured urine often, depofiting a yellow lediment; their 
appetite is very variable, and their digeftion, for the raoft part, 
weak. 
The COSTIVE. 
In thefe conftitutions, fome of them are naturally fo inclined— 
but if not, it depends on particular ftates of the inteftines, abdo- 
minal mufcles, and the different vifcera that pour forth their con- 
tents into the bowels ; in thefe cafes, the inteftines are either 
in a ftate of too great torpidity, or there is a deficiency of the 
internal fluid—pancreatic juice—or bile, which laft may be too 
inert—or the abdominal mufcles may be too relaxed—which 
occurs fometimes in women who have had feveral children. 
The contrary of which happens in 
The LAX ; 
for in them the inteftines may be in too irritable a ftate—(light- 
ly moved, or may be too flippery, from an increafed difcharge of 
the pancreatic and inteftinal glands—or the bile may be too 
acrimonious—or acrid humors may be too conftantly poured 
into the inteftines, and ftimulate them to too ftrong and quick 
repeated aftion. 
The FLATULENT 
Are fuch as have too great a quantity of wind, or air, in the 
nabit, in a loofe unfixed ftate—particularly in the ftomach and 
bowels, which is difcoverable very often by flying, wandering 
pains, increafed on warmth by its rarefa&ion—by diflenfion of 
the ftomach and iateftines—a rumbling noife in the bowels—e- 
miflions of wind upwards and downwards—and thefe may occur 
from a weak digeftion—allowing particular materials to emit their 
air, and the juicCs formed from them incapable of re-abforption 
*—from their not being properly elaborated in the firft paflfages : 
from being alia too tight laced, women often induce this com- 
plaint—and by the too common and frequent ufe of warm gly- 
llers—by a relaxed flate of the ftomach and inteftines—and by- 
feeding conftantly on flatulent food, and keeping long falls. 
The SCORBUTIC. 
Such are indifcrimatcly fo ftiied, who have the appearances of 
eruptions on the furface of the Ikin of different kinds—red puftu- 
lous pimples,nettle-rafli, or dry feurfy feales—-thefe truly indicate 
a prevalent acrimony in the habit of fome fort j but the true 62 
OF CONSTITUTIONS. 
fcotbutic conflitution is known by other marks—black, or livicF,. 
or yellow fpots, on the furface of the Ikin—tender gums--bleed- 
ing on th& {lighted touch—fallow completion—rank fetid fweats 
—loofe texture of the flefhy parts appearing puffy and flabby 
and this owes its origin to the texture of the blqod being in a 
broken or very loofe ifate—whilfl the former depends more up- 
on acrid humors in the habit—obftru&ed, or rather diminifhed, 
perfpiration—-weak digeilive powers, and feeding on unwhole- 
fome food, or eating and drinking too freely and luxurioufly.- — 
Thefe, therefore, are better divided into acrimonious and fcorbu- 
tic—the firft where the acrimony of the fluids is indefinite and 
cannot be ranged under any known fpecies. 
The GOUTY 
Are fuch as are troubled with flying pains, occupying chiefly 
the fmall joints of the hands and feet-—and having regular fits of 
that difeafe—being fubjedl frequently to indigeftion, and to be 
feized with pains of the joipt of the great toe—-or having pains 
of the ftomach and kidneys, alternating with thofe of the hands 
and the feet—fubjedl, from the fame caufe, to be teafed with pains 
in various parts before the fit of the gout has become regular, or 
has retroceded, or is mifplaced, owing often to debility of the 
adlive powers of the conflitution-—particularly the flomach and 
vafcular fyftem. 
The RHEUMATIC. 
Thefe are fuch conftitutions as are replete with rheumatic 
acrimony, which fixes itfelf in different parts of the machine, 
chiefly on the large joints, and runs along the courfeof the rauf- 
cles—or fixes itfelf alfo on the membranes of the mufcles, fonre- 
times affedting one, fometimes another—and flies conflantly from 
place to place, affuming different appearances according to the 
peculiarity of the habit in which it vendes—-becoming in fome 
aente and inflammatoiy, particularly in the robufl and athletic, 
who have flrong {lamina, and are readily irritable—-in others, 
painful and chronic-—in fuch whofe conftitutions are more debi- 
litated or torpid. 
The SCHROPHULOUS. 
Are fuch, in which that taint called fcrophula, or King’s evil 
is inherent, manifefting itfelf by glandular tumors, chiefly of an 
indolent kind, in the neck, for the moft part, but alfo in other 
places of the bodv, where the lymphatic glands are difperfed, 
particularly in the lungs and mefentery—-attacking the fair com- 
pleclioned and delicate moft commonly—(hewing itfelf alfo by 
an enlargement of the upper lip and alee nafi, or fides of the nor- 
flrils—and fwelling of the belly—a preternatural flight heat ge- ON CONSTITUTION Si 
rally attending the whole habit-—and febrile affections—and 
fometimes a fhort tickling cough. 
The HOT and COLD 
Depend upon the quantity of blood, in an healthful ftate and 
different degrees of vafcular aCtion—if the habit is full, and the 
vefiels are in a ftate of irritability, the conftitution will be of the 
former ilafs—if there is a paucity of that fluid, or no redundancy, 
and the vafcular fyflem is in torpid ftate, whereby circulation is 
not duly performed, it will be of the latter-—for where the blood 
is moll; fuperabundant, and irritability of the vafcular fyftem 
great in degree there will always be the m'oft heat, and vice ver- 
fa. 
The CONSUMPTIVE. 
Thefe are generally fuch whofe texture of folids are very de- 
licate— the vafcular fyftem irritable, and fome degree of acrimony 
in the humors—pale compleftioned—narrow chefted—long necki 
ed-—fubject to febrile heats, imitating heCtic—eafily thrown in- 
to pulmonic haemorrhages—-and frequently afFccled with flight 
tickling coughs-—their teeth clear, with an appearance like tranf- 
parency—their eyes often bright, fometimes towards evening 
languid—the ends of the fingers rather bulbous—and the nails 
curved inwards, particularly when they approach near a morbid 
flute. 
We have here attempted to point out what is to be underflood 
by the terms commonly made ufe of in applying them to par- 
ticular contlitutions ; but we find that fome have alluflon to, and 
involve general ideas—whilit others are only confined to finsle 
or particular ones, and of which no ufe can be made, whilft in 
fuch a vague, and unfettled flare—for in order to be-of fervice, 
either in our preventive or curative plan, we mull advert to 
thofe particulars which form conftitutions in general—for it is 
by the regulating of them we mull adminilter relief, when af- 
flidled with difeafes to which they are ptone—and prevent thofe 
whole feeds are dilTeminated through the habit from becoming 
aclive, and by that means conftituting complaints to which they 
are fpccifically aeiapted—we, therefore, form conftitutions into 
feparate divifions—fuch as are jimple and general— mixed and 
general--and fuch as are peculiar. 
SIMPLE, and GENERAL are, 
1. Strong and robuft. 
2. Nervous. 
3. Irritable. ON CONSTITUTIONS. 
4. Torpid. 
5. Weak, relaxed, and delicate. 
But thefe w>ay be combined—and form others, 
As STRONG—-ROBUST—and irritable, 
Torpid, 
Nervous, 
Though the Hr ft of thefe is what mofl commonly takes place. 
The WEAK, DELICATE, and RELAXED- -may alfo be 
fubjeft to the fame combinations— 
Nervous, 
Irritablej 
Torpid, 
Apt to take place in the order here fet down—with regard to the 
molt general mode. 
The MIXED and GENERAL—are 
1. Plethoric. 
2. Hot. 
3. Cold. 
4. Confumptive. 
5. Acrimonious. 
For thefe may be combined with any cf the former—but depend 
upon the quantity and quality of the blood—and the greater or 
lefs degree of the irritability, or instability of the vafculsr or 
the nervous fyftem. 
The PECULIAR are,- 
The t. Lax. 
2. Cortive. 
3. Bilious. 
4. Phlegmatic. 
5. Scorbutic. 
6. Gouty. 
7. Rheumatic. 
S. Scrophulous. 
And 9. Flatulent. 
Any of which may be combined with thofe which are nmple and 
mixed—as a court itution may be 
Strong, rcbuft, plethoric, hot, coftive, gouty—fo may the 
weak, relaxed, and delicate—though plethora is mod generally 
the concomitant of the former. 
It will be unneceliary 10 iortn any ether combinations in this 
place, as the reader will very readily conceive them himfelf; 
we lb all only, therefore, obferve, that there are feme which can 
never exilt in a combined itate, viz. ON CONSTITUTIONS. 
65 
The Jlrong and robujl, with the weal, relaxed, and delicate— 
the hot and cold—the irritable and torpid—the lax and cojiive. 
Now as there is certainly fuch a diverlity of conihtutions, 
many of them diametrically oppofite to each other ; and as there 
is alfo a variety of accidents and difeafes which will affeCt the 
different conftitutions in limilar modes, how can it happen that 
one and the fame application iball be proper to all? For it is ow- 
ing to the operations of the habit that difeafes are prevented—• 
made milder, or cured ; and it is to our applications, that thefe 
falutary operations are often brought about where nature is de- 
fective—and, confequently, obliged to our affiftance. We mud, 
therefore, ieleCt our remedies, and appropriate them to the par- 
ticular conditutio,ns ; and let our directions be formed, with re- 
fpeCt to diet and conduCt, confident with the fame conditutional 
points—and more efpecially where our attempts are levelled at 
the prevention of morbid attacks ; in completing of which we 
are to aim at keeping the condituticn in a date of health, ade- 
quate to the powers with which it was originally endowed ; fo 
that the common caufes of difeafes may not be enabled to pro- 
duce their effeCts ; which originate from different qualities and 
changes of the air; called conllitutions, climate, morbid effluvia, 
and intemperance or indiferetion ; under which lad we compre- 
hend all thofe aCtions which, in their regulations, depend upon 
our own power, or are deduced from neceffity. 
Or, that fuch difeafes, as are unavoidable, may be made to 
produce their influence on the machine in the mod mild and gen- 
tle date; fuch as, fmall pox, meades, and various fevers, and 
other complaints of the infectious or contagious clafs ; or thofe 
which arife from an hereditary caufe : in accomplidiing which 
purpofe, it will chiefly depend upon the proper ufe and applica- 
tion of what are called the NON-NATURALS ; which, before 
we can be enabled to give proper directions in thefe points, we 
mud examine, and diew the peculiar influences they are capable 
of producing in the habit. 
SECTION III. 
OF THE NON-NATURALS. 
celebrated HOFFMAN, to whofe labours the art of 
phyiic is much indebted for its improvement, fays, “ A 66 
OF THE NON-NATURALS. 
** phyfician aftifting in the curative operation of nature, fhould 
“ ufe the milder and fimple diretetic remedies, rather than thofe 
** which are vfery aCtive, and compounded of the pharmaceutic 
“ clafs. By disetetic is to be underflood, thofe materials which 
“ are taken from fuch things, as every body requires for the 
“ prefervation of health and life, and which are received in the 
“ fchools, Under the denomination of non-naturals ; for, inaf- 
‘‘ much, as from a wrong or inordinate ufe of thefe, the fir ft 
“ foundations and proximate origin of difeafes arife, and alfo 
“ have their violence increafed; ib nothing is better adapted to 
expel or fubdue morbid afFedions of various kinds, than a 
“ proper tffe of them, with a regular mode of living, for without 
“ that, nature tan do no good in healing, nor medicine produce 
** its defired effeft. Whence the truth of GALEN’s aliertion, 
That medicine has no efficacious remedy which can bring 
ii any permanent affiftance,- if the mode of living fhould refill it, 
“ or fhould not a£t in conformity, and become an ufeful auxili- 
** ary.” And he folemnly afferts, “ That by dietetic remedies, 
** (in which change of air and climate, proper exercife, well 
“ adapted meat and drink, alfo a prudent ufe of whey and mi- 
“ neral waters, with abftinence and eafe are to be included,) he 
** lias performed fuch things in conquering obflinate chronic 
“ difeafes, which chiefly had their long and fixed feat in the 
“ weakened fyflem of the nerves, as fpafmodic, convulfive, 
“ hypochondraic, and hyfleric affections, which others had in 
“ vain tried to accomplish by medicines elegantly compounded* 
** and judicioufly administered, and he himfelf had expected 
4t from medicines of great fame.” 
And certainly the doctrine is perfectly true—medicine can do 
very little in a variety of cafes, without a ftrid adherence to a 
well-adapted regimen—and in preventing the machine from be- 
ing afflicted with a diverfity of maladies, nothing. The failure 
of all the arcana, fpoken fo highly of by a number of the anci- 
ents, as to be called panaceas—nay, the hands of Gods—indeed* 
thofe fupported by names of no lefs confequence than FRIAR 
BACON, and LORD VERULAM, have proved how little de- 
pendence can be placed on the molt extolled noftrums—whilft 
Carnaro, and feveral others of more modern date, have experi- 
mentally and ineonteftably proved what may be done in thefe 
points by a proper regimen, feledted with judgment, and per- 
fevered in with refolution—not only curing different obflinate 
difeafes, which had reftflccl the force of the art of medicine, in 
the hands of the molt well-informed and fagacious practitioners, 
but infuring a continuance of health in a green old age. For 
Carnaro fays, “ At eighty-three 1 now enjoy a vigorous (late ON THE NON-NATURALS. 
67 
{* of body and mind— T mount my horfe from thelevel ground — 
“ I climb fteepafcents with eafe ; and have lately wrote a co- 
?* medy full of innocent mirth and raillery ; when 1 return home, 
“ either from private bufinefs or the Senate, I have eleven grand 
f‘ children, with whofe education, amulement, and fongs, I am 
V greatly delighted ; and I frequently fing with them, for my 
“ voice is clearer and ftronger now, than ever it was in my 
f* youth. In fhort, I am in all refpe£ts happy, and quite a flran- 
“ ger to the doleful, morofe, dying life, of lame, deaf, and 
“ blind old age—worn out with intemperance.” 
Great as are thefe advantages—how happy fhould it make us 
in our refle&ion, and how thankful to the benevolence of Pro- 
vidence ought we to be, that thefe, in a great meafure, lay with- 
in our reach ; for enviable as are the bleffings CORNARO en- 
joyed, he from a ftate of conftant torment, by a fteady 
adherence to, and uniform perfeverance in temperance, appro- 
portioning his regimen to the nature and exigencies of his con- 
jhtution only—which is extremely worthy of imitation, as its 
'confequences wil} amply reward for any mortifications we may 
have jo encounter in the beginning. In order to qualify our- 
felves for which, we muft proceed to enquire into thofe fources 
from whence he drewfuch confolation—and here we flball find, 
they all concentered in the proper ufe QF THE NON-NATU- 
RALS—fo called, bccaufe they affe£t man without entering in- 
to his compofition, or Conftituting his nature—.but yet are fo 
neceflary, that he cannot live without them—we fhould rather 
term them neceflaries—as they are things natural iq themfdves, and 
to man’s exiftence neceflary, arid unavoidable. However, as our 
bufinefs in this place is to give information on fnaterial things, 
we fhall refrain from verbal inveftigation, as of little moment— 
ahd confider them in the following order—fhewing their mani- 
feft qualities, and explaining their perceptible effects. They 
have been divided into fix heads, viz. 
1. Air. 
2. Aliment, 
3. Exercife and Reft. 
4. Wakefulnefs and Sleep. 
Repletion and Evacuation. 
6. Paffions, and AffeHions of the Mind. 
But before we enter on a full d.ifcuffion of thefe feparately, we 
muft obferve, that the fix might, with great propriety, be re- 
duced to four—-as exercife and reft produce pretty nearly fi- 
milar effedls on the couftitution, as wakefulnefs and fleep—hence 
might thefe not improperly be reduced to one head, allowing 68 
ON THE NON-NATURALS. 
fomething more to exercife, than wakefulnefs, becaufe of the muf- 
cular motion employed in the former. 
As for repletion and evacuation, they, we (hall find, more pro- 
perly belong to the clal's of difeafes, as thefe being too profufe 
or too fparing, conftitute mo'bid affe&ions of the habit How- 
ever, we fliall fpeak of each in their place, agreeable to their 
arrangement—and firfl of 
A 111.—And here we mean not to enter into philofophical or 
chemical fubtleties of the nature of this fluid, but confine our- 
felves to that of atmcfphere, whofe different Hates and changes 
produce perceptible effefls on the conflitution—and which all 
ages have confidered as one of the occafional caufes, and that ve- 
ry material, of health or difeafes, according to its good or bad 
properties, affefting the body by infpiration, as well as its cir- 
cumambiency. It is a fluid poffeffed of fpecific gravity, elafticity, 
and tranfparency, and compreffible—it furrounds the earth, and 
when agitated, or driven in currents, forms wind : it is extremely 
fubtile, penetrates, and mingles with every part of the body, and 
by its elaltic property, gives an inteftine motion to all the fluids- 
and a lively fpring to all the fibres, which promote circulation ; 
it is never abfolutely pure, but always mixed with heterogene- 
ous particles, and that air which we call pure, is fuch as is not 
overcharged with any fleams. ... , 
It has its varieties, and differs with refpedl 
t. To its weight or levity. . 
2. Heat or coldnefs, 
3. Drynefs or moiflure. 
And 4. Purity or impurity. 
Now thefe properties of the air feparately, or by their different 
combinations, produce many unpleafant effeds on the conftitu- 
tion—give rife to and aggravate many fymptoms in particular 
complaints—as well as are the origin of many difeafes them- 
lelves. ■. 
i. For if the air is too heavy, it produces inflammatory affec- 
tion* of the membranes in the cheff and lungs, called pleurify 
and peripneumony, head-ach and giddinefs, &c. by preffing up- 
on the furface of the body—obflru&ing the pores of the lkin, 
hence impeding perfpiration—accelerating the motion of the blood 
—occafioning it , to crowd on the internal parts, and there circu- 
late too rapidly—hence it is impelled too forcibly upon the lungs, 
and too copiously upon the brain—impeding, indeed, the natu- 
ral functions of thofe organs which lie remote from the furface 
of the machine. i ; . . ON THE MON-NATURALS* 
69 
2. If it has too much levity, its elallicity, is increafed, and hence 
produces, by vafcular diftenfion retarding the circulation of the 
blood, and by diminilhing the reflilance of the fluids contained 
in the pulmonary velfels, difcharges of blood from the lungs— 
hylleric,' and hypochondriacal affections—rheumalifm—gout, &c. 
3. Should the air he too hot, by rarefying the humors, and 
weakening the fibres, it incrcafes the circulation, and augments 
perfpiration, in which it is greatly aided by its additional Itimu- 
lus on the vafcular fyHem—whence acrimony is induced in the 
remaining fluids. ' ~ 
If too cold—local inflammations—as quinfeys, pleurilies, perip- 
neumonies, are brought on by over dillending the lungs from 
its gravity—increaling the tone of the velfels by conltringing their 
fibres—condenfing or thickening the humors—and lelfening per- 
fpiration. And lhould this Hate of the air fuddenly fucceed too 
long-continued heat—ardent, bilious, and other fevers are the 
conlequence—by producing its efleCts on the conflitution, wife re 
the blood is in too rarefied and acrimonious a Hate, and the hu- 
mors participating of that acrimony with which the fanguinary 
mafs is fo replete. 
4. Too dry an air fhrivels up the folids, incraflates or thick- 
ens the fluids, and difpofes to febrile affeCtions—whilfl: too great 
moijlure in that fluid, relaxes, and debilitates, leflens perfpiration, 
renders the blood too watery—and by thefe means becomes ex- 
tremely injurious, laying the foundation for coughs, aflhmas, 
dropfies, intermittent and nervous diforders. 
From the combination of fome of thefe different qualities of 
the air, different affeCtions found their origins.—Coldnefs and 
moifture are offenflve, wefi.nd, to the conflitution—but heat, moif- 
ture, and levity, are more pernicious, becaufe thefe, acting toge- 
ther, fupply the habit with a putrefcent tendency, from whence 
many of our moll dangerous complaints arife, as vomiting and 
purging of acrid bile, called cholera, bilious loofenefs, malignant 
fore-throats, and putrid fevers. 
; 5. The purity and impurity of the air depends upon the greater 
or fmaller quantity of heterogeneous particles ; thefe are parti- 
cles which belong not to the air in its natural Hate, which float 
in it—hence it has, befides the above evident qualities, others 
which efcape-detection by the fenfes, though from their deletri- 
ous or mifchievous efleCts, fufficiently manifefl—fuch are from 
infections of various kinds—as fmall pox, meafles, icarlet fever, 
&c. malignant effluvia, exhalations, &c. 
With regard, however, to thefalubrity of the air, we muft ob- 
ferve—that is moll falutary, which is pure, dry, and temperate, 
untainted with noxious damps, or putrid effluvia’, from any caufe ON THE NON-NATURALS. 
whatever : but the fnrcfl mark of good air in any plage, is from 
the longevity of its inhabitants. 
The evident matks ot a bad, or infalubrious air in any 
are dampnefles, or difcolouring of plailter or wainfeoat ;—moul- 
dinefs cf bread, wetnefs of fpenge, melting of fugar, rutting of 
brafs or iron, and rotting of furniture :—and nothing is more con- 
ducive to render air noxious, load it wit,i putrid fleams, and 
breed bad diftempers, than permitting common and crowded bu- 
rial places to be within tfre precinft, of populous cities ; or num- 
bers of poor people living in uncleanlinefs, collided together ir$ 
ima'll houfes, or narrow ftreets. 
Valetudinarians experience the moft agreeable fenfations when 
the wind is wefterly, though when at north, or north eaft, it is 
accounted bracing and healthful. Indeed fo powerful an 
has the influence of the winds, agreeable to the quarters in which 
they were fixed, been fuppofed to have, that it has been aliened, 
our difpofitions and tempers are greatly affe&ed by them;—long 
continued eafterly winds make people, who are naturally cheer- 
ful, very irritable and morofq. Nor does our tempers being 
affe£ted by the different flates of air, feem at all improbable* 
inafmuch as the body and mind are linked together in fuch clofe 
and intimate bonds of union, that they reciprocally aflcdl each 
other : for as corporeal affections will, we k;row, alter the natu- 
ral difpofitions of people—making the placid and fweet tempered, 
often petulant and peevifli—the courageous, timid, fearful, and 
irrefolute—the moll patient, rettlefs ana unquiet—-the lively and 
volatile, languid and defpqnding—and the moll a£tive, inflolent ; 
—fo may the air, as it conduces to throw the conftitution into 
flates nearly morbid, produce, in fome degree, fimiiar effects— 
as has been repeatedly experienced by men, not diverted of ob- 
fervation. 
A weft wind, in general, is efteemed the moft lalutarythen 
a north-weft—after which fucceeded, in degrees of falubrity, in 
the following order—eaft, north-eaft, and laft, fouth and fouth- 
eaft—and thefe may be accounted for, from the different qualities 
of the air, in proportion to the excefs or deficiency of heat, cold- 
nefs, moifture, drynefs, weight, or levity—or the different noxi- 
ous or contrary combinations they bring along with them. 
From what has been advanced, the fituation of our habitations 
will be a very material confideration, in conducing to the prefer* 
vation of our health. 
The moft healthy expofure, we have been told, in any place 
fixed for refidence, is to be found by cutting one of the trees 
near the place where the houfe is to be built, tranfverfely with a 
faw, then clofely to obferve the rings which appear on fur- ON THE NON-NATURALS. 
face of the fe£tion ; the fide of the tree on which the didance of 
the rings from each other is greated, is the mod healthful expofure* 
And this is obvious, becaufe there has been the greatefl accre- 
tion of matter by the healthful difpofition of thofe parts fo made, 
from always being blown upon by air from the mod falubrious 
quarter, which it faces, and being hid from that which comes 
from the oppofite, which feems to produce a different effect—• 
and it is an admitted fadl, that in all places, or parts of country, 
where vegetation is mod vigorous, manifeOed by the drength 
and richnefs of the vegetable clafs ; there will aifo animals enjoy 
the fame confequences—hence Oiould the windows of the houfe, 
all other circumdances being the fame have a fimilar afpecl. 
That houfe is confid&redas healthy which is fituated on riling 
ground, or fide of a hill, and gravelly foil, becaufe it is lefs ex- 
posed to damps and ftagnant waters, in an open dry country; 
the rooms fhould not be fmall, but rather large—though not cold ; 
the expofure prudently adapted to the nature of the climate, hue 
fo contrived, that it may be perflated by the ead and north winds, 
whenever you pleafe, which fhould be at lead once a day—to 
blow away animal fleams, and other noxious vapours ;—but the 
air of the bed-chamber, (fpecial/y, fhould be pure and untainted, 
not near the ground, or any kind of dampnefs. We may in ge* 
neral conclude, thofe fituations are mod falutary, where thefe 
different properties of the air commonly attend in degrees of 
mediocrity, deerng in a medium between two extremes—nor 
will it be a fmall addition, if they are near a river or brook, 
whofe dream is condantly running over a gravelly or fandy bot- 
tom—for danding water is always detrimental. 
The country is more healthy than cities* or large towns, which 
a re populous, from the greater purity of the air, if they are in 
fimilar fituations ; but fome countries are extremely unwhole- 
fome, from the noxious vapours with which the air is impreg- 
nated—as thofe near the marlhes of Eflfex, fens of Cambridge-ihire, 
or contiguous to lead mines, and fmelting houfes ; for in grounds 
cJofe to thefe two latter, animals which graze there are often 
dedroyed, and vegetation greatly impeded : indeed the miners, 
frhelters, and people in the vicinity, are fubjeft to the dry or 
convulfive colic, and paralytic affeclioris. 
Thefe are the principal effedls of the air—we mud proceed to 
examine 
2. ALIMENT; 
Under which term is comprehended all thofe efculent animals 
and vegetables, as well as liquids, by which we are i'upported, 
and which we ufe in common for the purpcfe of nutrition ; and 72 
ON THE NON-NATURALS. 
thefe are fuppofed to poffefs different degrees of nouriftiment, 
mold of them having palled through fome culinary procefs, more 
or lefs adapted to our nature, before they are received into the 
ftomach, but which have particular portions proper to be affi- 
milated, and form parts congenial with thofe of the human ma- 
chine to which they are applied. , ( , 
But before we enter on the particular nature of our various 
aliments, as we are writing to people who are not thoroughly 
converl’ant with the animal csconomy, it may be neceffary to pre- 
mife fome account for their information, of the different pro- 
cefies nature has affixed towards the completion of this affimila- 
tion. 
As foon as the morfel 13 put into the mouth, it undergoes, by 
the teeth, and action of the mufcles of the jaws, a confiderable 
divifion, by the office of maftication or chewing, in order that 
its texture may be broken, and mixed with a due proportion of 
f'aliva, before it paffes into the ftomach—fome more fluid being 
acquired in its defcent;—when it arrives at the ftomach, it there 
gets blended with the juices of that organ, fuppofed, and proved 
by Spallanzolli, to be a powerful folvent of ,our food, and fome 
fmall portion of bile; and, during its reftdence there, experienc- 
ing the effedt of heat, and mufcular affion, from the coats of the 
ftomach, and motion of the diaphragm, lungs, intercoftal and 
abdominal mufcles, and the large blood-veflels and parts which 
lay contiguous ; it thence paffes gradually over the pylorus, or 
lower orifice of the ftomach, and there meets with the bile from 
the gall-bladder and liver in much larger quantity—the pancre- 
atic juice, or that of the fweet-bread, fimilar to the faliva, but ra- 
ther more vifeid—and the fluids feparated by the inteftines ; and 
here it is fubfervient to the further aftion of the mufcular coat 
of the inteftines, and their periftaltic motion—churning, as it 
were, their contents and minutely mixing and blending together, 
the food taken in ; and the different juices, which it has received 
in its ftate of comminution and folutionv-from all which a mil- 
ky juice is formed,called chyle—this is feparated from the fecu- 
lent fordes, and taken up by a fet of fmall abforbent veffels call- 
ed ladteais—which open upon the inner coat of the inteftines, and 
pafs through the mediumofthe mefentery, which is thevconne<ft- 
ing membrane of the bowels, to the lower vertebrae of the loins, 
and there empty themfelves into a veffel, called the thoracic duft, 
or receptaculum chyli—but there are, through the mefentery, 
various glands interfperfed, through which thefe la&eals pah, 
and where the chyle is mixed with a thin lymph feparated there 
for this purpofe, in order to rend it more fluid. It is by thefe 
lacleal veffels, the motion of the inteftines, and the force of the U)F THE NON-NATURALS. 
feirculatton unavoidably carried forward to the thoracic daft, as 
it cannot regurgitate, on account of the valves in various parts of 
thefe la&eals, which prevent its rctroceeding motion—becaufe 
they open only forwards—and are {hut clol'er by any fluid pref- 
fittg backwards : thus then is the chyle thrown into the recep- 
tacle—which continues its couric, to the fubclavian vein, along 
thb vertebra—into which it enters, and from whence the chyle is 
poured, and thence immediately thrown into the right auricle 
and ventricle of the heart, where it mixes with the blood, and 
paifes into the lungs—here it receives a confiderable trituiation, 
receiving material alterations from thence, and from what it re- 
ceives from the afmofpberic air infpirtd into that organ ;—irom. 
the lungs it returns through the pulmonary vein .'into the lefc 
auricle of the heart, then into the ventricle—from whence ic 
pa ties, mixed with the fanguinary mats, into the aorta, or large 
artery; and is diffufed univerially through the machine, where it 
is completed for the purpofes of nutrition—being perfectly af- 
iimilated into the nature of animal juices—and by its proper ap- 
plication to particular parts, wanting the addition of nutrient 
fluids, renews what has been abraded, and thus keeps the machine 
in a ftate adapted to the performance of its riecefiary functions, 
lupplying portions proper for the recjuifite fecretions. By thefe 
various means is this affimilating effect produced—a contrivance, 
which nothing but divine and beneficient Wifdom could be ade- 
quate to beftow—for let the animal be fed upon food, ever fo 
various, and diiTonant in their own peculiar properties, dill that 
power can convert materials fo dlfagreeing to the advantage of 
the creature feeding upon them ; nay fome, fuch as goats and 
afies, will be nourifhed by the products of nature—which, to 
liories, Oxen, fheep, &c. prove the mod fatal poifon. 
It is mod probable that bur fird food was of the vegetable 
clafs, in the felebtion or which, man was diredted by experience, 
led to it from the fmell and tails ; and the fupport and increafe 
of drengtb from thence confeauent, would confirm their ul'e. 
But beads being troublefome to the cultivators of the earth, and 
vegetable diet not being proper to fupport fufficiently thofe who 
were employed in fuch labour, the field of animals made a neccl'- 
fary addition; of which we.find a great variety at prefent are 
appropriated as common food, and the catalogue of which luxury- 
bath, in no fmall decree, augmented. 
Notwithstanding iood is required to repair thofe particles 
which have been worn away, and diffipated by perfpiration, dill 
a conftant and quick repetition is alfo requifite ; for the blood, 
frefm its own difpofition apt to run into the nature of lixivial 
faltt, continually approaches near to putridinous acrimony, from 74 
or THE NON-NATURALS. 
the circulatory motion and heat it perpetually fuffers, by which 
the animal humors are greatly difpofed to putrefa&ion. 
But the blood alfo from perfpirable matter palling oft, acquires 
a difpofition to coagulate, and the reftitution of the watery fluid; 
that its globules may be feparated, and preferved in a date of ftu- 
pidity ;and confequenily the reft of the humors in a proper difpofi- 
tion for fecretion. 
Thefe truths are demonftrable, not only by their caufes, but 
the appearance of men and animals, who die of hunger—for it is 
common for them to have an acrid, fetid, ofifenfive breath ; their 
teeth loofened by corrofive faltnefs—violent pain in the ftomach 
—acute fevers, and delirium. 
The nutritious part of the food, from animals, confifts of a 
gelatinous lymph ;—from vegetables of a farinaceous fubftance 
—in which is a portion of vegetable acid, oil, and faccharine or 
fugarv matter ; confequently, where the digeftive powers are 
perfect, thofe which abound moft with fuch matter in their ref- 
pe&ive clafles, are the moft nutritious. 
But animal lymph, or the finefl or moft fubtile part of the 
fluids, affords the quickeft and ftrongeft nourifhment, as it is 
nearly elaborated into juices fimilar to our own ; vegetables lefs 
fo, as moft of the efculent roots, plants, and fruits, are of an ace- 
feent nature, few are alealefeent, or replete with ftimulant or 
aromatic particles ; few are pofteffed of gelatinous lymph, and 
only are nutritious from their farina ; not many changing into 
thofe humors called indigenous, or natural, after having paffed 
often through the coutfe of circulation. 
Wotwithftanding which, it would be extremely improper for 
men to live alone on animal food ; left a habit fhould be induced 
too full of blood, and too replete with putrefeent juices ; creat- 
ing ferocity, feurvy, faetor, leprofy, and all kinds of lixivial cor- 
ruption ; as in the cafe among the anthropophagi, or thofe who 
feed on human flefti ; -all which mifchlefs, by change of diet, and 
living folely on vegetable food, are conquered. 
Hence, in warm conftitntions, hot climates and feafons of the 
year, men who are indifpofed, as well as thofe in health, have a 
greater propenfity to acefcent vegetables, in proportion as the 
heat is more or lefs exceffive ; and hence men in very hot coun- 
tries, commonly live on-vegetables, feldom or not without dan- 
ger, on animal diet; but in cold countries, the pradlice is fafer, 
and more free from inconveniences : for this reafon, bread, 
or farinous fubftances analogous to bread, is univerfally 
made ufe of; but we fhould obferve, that vegetable food, befides 
its acefcent property, is replete with fixed air. 
From what has been faid of the nature of aliment, the utility 
of mixed diet, vegetable, and animal, will be obvious ; as they OF THE NON-NATURAI.S. 
are correctors of each other ; hence likewife will be allowed, the 
propriety of uniting acids, or four fauces with high-feafoned diffi- 
es, or eating them with the flefti of animals, whofe juices tend 
to promote faline acrimony ; as fiffi, wild fowl, &c. and we may 
deduce alfo the following conclufion That ANIMAL FOOD 
is moji nutritious, heating, and Jlimulant, difpofing to put refuB ion. 
—VEGETABLE—lefs nutritious, coding, diluent, acefcent, fight- 
ly aperient, and corrective. 
Wc mull now advert to our third point— 
3. EXERCISE and REST. 
And when we fpeak of exercife, we include that of the mind, 
with the body ; for thefe two are fo intimately connected, that 
they produce a variety of effects one on the other. 
To exercife, the ancients have, as well as the moderns, indeed 
ever attributed great utility, particularly in purfuing it with pro- 
priety, and have allowed, that great conftilutional rnifcbief may 
be derived from its abufe or negledh 
It has with great juftice been confidered the foie inflrnment of 
the cure of many difeafes, efpecially thofe of the glandular fyf- 
tern ; and SYDENHAM had fo high an opinion of it, particu- 
larly riding on horfeback, that he affirms, “ Mercury for the lues 
“ venerea, nor the bark for intermittents, are not more certain 
“ fpecifics, than riding on horfeback for a confumption though 
here he feems to be fanguine in his opinion, and has given too 
great latitude to the falutary effects of this remedy ; for, certain- 
ly there are cafes of confumption where riding becomes injurious 
—but the (onfideration of the fubjeft belongs not to this place 
—we lhall fpeak more minutely of it, when we come to give 
particular directions on that complaint. 
Exercife confifts in local motion of the body, and that motion 
more powerful of the limbs. It has been divided into ferious, 
and amuling : that belonging to labour is of the firff clafs—-di- 
verfions the lecond. GALEN hath written pretty copioufly on the 
fubject, and pointed out when it might be falnbrious, and other wife. 
Severe exercife, when we exert quick motion, called gymna- 
flic, extenuates the body; the contrary renders it grofs ; long 
continued, diffipates its moifture, and cccafions drynefs : mode- 
rate makes it fat. However, well-regulated exercife, we find, 
in general, produces a freedom of circulation, aiTifls digeltion, 
promotes perfpiration, and increafes glandular fecretion and ex- 
cretion ; by which mean fuch as is proportioned to the ftrength 
—carried beyond that, it occafions fatigue, and becomes inftru- 
xnental in producing thofe evil confequences, it otherwife is cal- CF THE NON-NATURALS. 
ciliated to remedy ; for when too freely ufed, it is tlie fource of 
lofs of appetite, great third, loathing of food, heat in the 
bowels, coftivenefs, chillnefs, rigors, and fainting. And 
this mud be the cafe, when we confider the effedts produced in 
the fyftem, by that which is judicionfly adapted ; as by increaf- 
ing the ofcillatory motion of the veffels ; that is, making their 
contractions and dilatations quicker, their contents are properly 
comminuted; all crudities deft royed—-the blood rendered bland 
and mild—the forcles, or grofs part, thrown out of the habit— 
the vafcular fyftem" ftrenuthened, by which the nervous power, 
becomes equable in its adtion, and, confequeqtly, the folids of the 
animal flrcn, and the fluids pure. 
The mind rdfo has its influence, for though by its exercife it 
may be made ’ll ron-er—-dill, if not kept within proper hounds, 
jt brings on fatigue, and hebetates, or renders the moving powers 
of the machine inert and dead. lienee the exerciie intended to 
promote and preferve health,- fbould be fuch, as is united with 
mental amufemer.t, rather than labour—inafmuch as in the for- 
yier, the mind is exhilirated; will communicate agreeable fen- 
lation?, and give firmnefs to the moving powers. 
REST is alfo neceftfary to relieve both the mind and body ; 
fuch as is fufficient to free the veffels from the flroriger exertions 
of their elaflic force, recruit iheir ifrength, and fet thinking facul- 
ties at reft; from their labour. But this, if carried to excefs, be- 
comes indolence, and lays the foundation for thofe di(orders, 
which strife from inactivity—and this brings on yniverfal relax- 
ation of the folids---glandular obfb uftidns enervates the fvf- 
tem, vitiates the humorsj creates pains in the flomacli, flatulencies," 
indigeltions, &c. and renders the affection? of hypochondriac 
people, and thofe who are gouty, in a great meafure incurable. 
brom what lias been advanced on this fubjedl, the fubiequent 
dedndtion? maybe drawn—- 
1 hat EXERCISE and REST may be conftdered mental as 
well as corporecHa: the FIRST, in moderate, degrees, fhould be 
efteemed properly Jlimulanf a Jlrengthever of the fyftem, promot- 
ing digtjlton, circulation, fecretion, and excretion ; the SECOND, 
re/lor at rue chiefly., cut both in extremes, debilitating. 
.The next of me non-naturals which prefent themfelves to our 
confideration, are, 
4. SLEEP and WAKEFULNESS. 
And thefe produce nearly the fame effedhs as the former—only 
mufcular force is lefts employed in wakefulnefs than exercife, 
and the animal receives mod of his detriment from vafcular ac- 
tion, and debilitating the nervous influence ; and by too much 
Pespthe body is apt to become foonerrelaxed—have the mind mere or the' non-naturals. 
77 
inert, and, confequentl)', more liable to thofe complaints which 
arife from univerfal indolence—-though thefe, in moderate de- 
grees, are cffentially rieceiTary and falutary ; for moderate Jleep 
increases perfpiration, promotes digeftion, cherifhes the body, and 
exhilirates the mind—whiljl the contrary extreme renders the ha- 
bit phlegmatic and inactive, loads it with crude humors, venders 
the vafcular fyftem fluggifh and inert, difpofes the folids to re- 
laxation, impairs the memory, and (lupefies the underflanding : — 
on the other hand, excejjive watching diftipates tiie ftrength, pro- 
duces fevers, dries and waftes the body, and anticipates old age. 
It has been thought that different ages of life, as well ns coniti- 
tutions, require more or lefs deep—for youth, or manhood, fix 
or feven hours ; for infancy, or old age, eight or nine ; but the 
infirm ought not to be limited, they Ihould be permitted to indulge 
in fuch a meafure, as is found from experience necefthry for ie- 
frefliment. 
From the general cffedls produced byJleep and wahefulnefs, 
they may be confidercd as nearly fimilar to thofe of exetcife and 
reft, and may alfo be concifely marked down---as ftimu ant and 
Jedative—producing every good effect by their moderate ufe, and 
proper adaption ; and a variety of miicliiefs by their abufe, or 
excels. 
The next in order follows the fifth feries— 
5. REPLETION and EVACUATION. 
But little can be faid relative to thefe in this place—for if what 
ihould be evacuated is retained too long, or in too great quantity ; 
if what ftiould be retained is evacuated too freely, they all con- 
ftitute difeafes—and will be treated under their refpeftive heads. 
Jf psrjpirahle matter faffs off not as it ought, hut is obJbuEied 
—plethora/or toogreatplenitu.de, fevers, "head-ach, giddinefs, 
inflammations, cvc. will enfue. 
Jf what we eat lies too long on the Jlomach—indigeftion, heart- 
Iburn, pains of the ftomach, flatulence, &c. 
If there is any retention in tie lungs—coughs, inflammation, 
:j aflhma, Ike. 
I Jf in the liver—inflammat on. 
Jn the gall-1 la .icier- - jaundice 8: c. 
Jn the boweL—coftivenefs, and its conf.quences. 
Jn the l,ladder—difficulty in making water, inflammation, &c. 
As the retained matters, from their delay, may acquire differ- 
ent properties according to their nature, and may create difor- 
ders confident with their acrimony, vifclduy, quantity, cr 
weight. OF THE N0>i NATURAL! S. 
If too great a Jinx happens from the falivary glands—it confii- 
tutes a ptyalifm, or falivation* 
If from the liver, pancreas, or fweet-hrea.I, or intejlines—chole- 
ra morbus, or vomiting and purging of bilious matter, alirn enti - 
ry flux, white flux, loofenefs. 
If from the bladder—diabetes, or morbid efflux of urine. 
If from the genitals—feminal gleet. 
If from the Jhin—morbid fweating, called ephidroffs, befides 
a variety of others, which may produce general affections, ei- 
ther by fympathy or acquired acrimony, as the nettle-rafh, in- 
fantile hedtic fever, 8cc. And thefe retentions or evacuations 
are to be remedied by fuch applications as the medic art affords. 
Nor need thefe have been mentioned here, only to fliew their 
eonfequence in the animal oeconomy—as for the well being of 
the machine, it is neceffary that parts where thefe retentions and 
evacuations occur, fhould perform their functions properly.— Of 
thefe nothing more pan be laid, we {hall, therefore, advert to 
©ur lafl lubjeft. 
6. PASSIONS, and AFFECTIONS OF THE MIND. 
Every man is truly fenfible of the ill effefts arifing from giv- ; 
ing way to thofe variety of affections which we call pafTions ; ' 
and fatal experience often convinces and makes them lament be- 
ing fo prone to aft obedient to their impirlfes. So ftrongly do 
they affeft the human machine, that the njoft furprifing confe- 
quences have been known to originate from thefe fources on the 
corporeal, or folid parts, as well as the fyftem in general. 
There are innumerable in fiances of fear creating a fudden and 
powerful aft ion of the bowels and urinary palTages. Fright has 
put off a fit of an intermittent, when all remedies had failed ; a | 
piftol fired in the chamber of James the Firft had this effeft, oc- 
-mffoning alfo a fudden aftion of the inteftinal canal downwards ; 
it has alfo given rife to an indiffoluble tumor in a woman’s \ 
bread; excef of joy has caufed fainting and ftupor : anger, indue-, j 
cd apoplexy and phrenzy. 
We cannot account for the precife mode in which thefe hap- 
pen for a certainty. favs a learned author, “ We muff 
“ content ourfelves with knowing they are poiitive fafts, for, 
“ till we are informed by what means the mind and body are 
“ united, we cannot even form a probable conjecture, how the 
“ operations betwixt them are performed.”—In thefe cafes, how- 
evet, I think that the peculiar Hate of the conflitution, with re- 
gard to its nervous incitability, vafcular irritability or torpor,- 
renders people more or lefs liable to feel thefe impreffions, if not \ OF THE NON-NATURALS. 
79 
totally, ftill in a very great degree ; for all thefe, which we call 
nervous, are more fubjeCt to tnanifeft the aCtion of thefe fudden 
or mental affections, than thole who have an apparent firmnefs of 
the nervous fyftem, and whofe vends are not fo irritable as very 
readily to feel the impuifes of their affe&ions—to me it has 
appeared to be univerfally the cafe. 
However, with refpeCt to the paffions themfelves, they may 
be medically reduced to two heads—volatile and jaturnine or 
active and fedcitive. 
But as difquifitions of this fort would lead us more into the 
field of fpeculative curiofity, than practical utility, I fhall con- 
tent myl'elf with taking a quotation or two from a judicious wri- 
ter on this fubjeCt—and from thence make the application to as- 
certain the propriety of the divifion. 
“ Fear, grief, and thole paffions which partake of them—as 
“ envy, hatred, malice, revenge, and defpair, are known by ex- 
“ perience to weaken the nerves ; retard the circular motion of 
“ the fluids ; hinder perfpiration ; impair digeftion; and often 
tc to produce fpafms, cbftruCtions, and hypochondriacal difor- 
“ ders ; and extreme terror has fornetimes brought on death.” 
Thefe I term— Jaturnine or fedative-*—becaufe they affeCt the 
nervous l’yftem in fuch a manner, as to impede its influence in 
general—confequently, the aCtion of all thofe parts that are de- 
pendent upon it, and where any of them feem to aCt fupernatu- 
rally, that aCtion is occafioned more by irritability, or pre-dif- 
polition of the part, than from any other caufe. 
“ Moderate joy or anger, on the other hand, and thofe paffions 
and affections of the mind, which partake of their nature— 
‘‘ as cheerfulnefs, contentment, hope, virtuous and mutual love, 
*{ and courage in doing good, invigorate the nerves, accelerate 
the circulating fluids, promote perfpiration, and affifts digef- 
‘‘ tion -but violent anger, w hich differs from madnefs only in 
duration, creates bilious, convullive, and fome- 
“ times apoplectic diforders, efpecially in hot temperaments— 
“ and excefs of joy deftroys deep, and often has fatal and fud- 
“ den effeCts/’ 
Thefe 1 term volatile or adlive—becaufe they fo affeCt the fyf- 
tem of the nerves, that they* increafe its influence—confequently 
the aCtion of all the parts dependent upon them, which, whiHl 
moderate, produces falutary efl'eCts ; but when too violent, ne- 
ceffary deleterious or dangerous ones, from too great an excefs 
©f aCtion. 
Hence, though we cannot influence the mind in the particular 
manner we wifh always, we fhoald endeavour to raife fuch fenfa- OF THE NON-NATURALS. 
tions, as may be productive of thofc purpefes, we are defirous 
by other means of promoting. 
Where the a&ion of the vafeular fyftem is too violent, we 
fhould attempt to inculcate fear—where too torpid, Cheerfulnefs; 
for thefe may in fome degree, have effects on the moving pow- 
ers. , 
In treating of the non-naturals, though we have lpoken of 
the l'olid aliments by which we are nourifhed, we have not faid 
any thing of the liquids we in common ufe, we mult, therefore, 
in order to render our labour completely ufeful, advert to them, 
as much benefit is to be derived from a thorough knowledge of 
their properties and effe&s, and no fmail degree . of fniiehief 
avoided. 
It is indeed a melancholy ednfideration to ref!e£t, that, though 
health is the only foundation of all pleafure, and may, by eafy 
methods, be preferved, men fhould negledt thefe means, which 
would enable them to purfue their dariibg Goddefs through all 
her varied feenes of rational delight; but fo it is, for notwith- 
flanding innumerable authors have written profeiTedly on the 
dketeric regimen, from the unwillingnefs valetudinarians have 
in complying with rules, which lay a reftraint upon the gratifi- 
cation of their appetites, though calculated to preferve health, 
it has been too much neglected. 
Ele5iio?i treats, PariJJj dinners, SeJjlon and City Feajls, and free 
luxurious indulgence, have numbered many with the dead, which 
proper abftinence might have preferved. However, as men 
will not refrain, but rather become Haves to excefs, duty calls 
upon us to apprize them of their danger, at leaft to inform 
them in what things they may exceed with the leaft poffible in- 
convenience. In addition, therefore, to what has been already 
advanced, it appears neceffary to take a furvey of the properties 
of thofe liquids we in common drink—which have been confi- 
dered with regard to their powers—as either 
DILUENT, SHEATHING, NUTRITIVE, STIMU- 
LANT, ANTISPASMODIC, or SEDATIVE, which in their 
order we fhall now attempt to explain. 
1. The DILUTING LIQUORS—are all fuch, ns added to 
the circulating mafs of fluids, renders them more fluxile—by 
producing no other effefts than what arife from mere mixture 
and divifibility of the integrant parts, and folution of the acri- 
monious and faiine particles therein inherent.—Of this clafs there- 
fore, vve conlider 
Water, Small Beer and 'Tea. 
The former of which appears to be the moft eligible beverage, OF THE NON-NATURALS. 
Sis it is free from faline matter, and abounds net with air, in fuch 
a proportion as might oceafion fermentation : that is preferable 
which flows from mountains through fatdy foils . is the eokkll, 
limpid, mofl light, and iufipid to the tafte—as it is better cal- 
culated to afford a well-diluted chyle: but of all, that v%h,ch is 
diftilled is the moil eligible, as being thrown inioa date of vapour 
by heat, it is diverted almoft totally of tliofe earthy, heterogeneous 
materials with which other waters are apt to abound- -hence, 
Confequently, in its pureft rtate. 
This fluid, befldes thinning the blood, and difiolvihg the fa- 
line and fcorbutic acrimony of the juices, renders the circulation 
eafy and uniform by attenuating any vifcidiry ; it refltains, by 
by its coolnefs, the quick motion, and intenfe heat of the huthours, 
moillens, and mollifies rigid fibres-—and if a glafs ot cold water 
is taken going to bed, it promotes perfpiration, and often brings 
on gentle fw’eats. 
Good Jmall beer has the fame properties, but is more apt to 
bccaliou fermentation from the faccharine fubllances with which 
it is, though ilightly, impregnated, and is more vilcid—and from, 
thefe it may be conlidered as rather more nutritious. 
Tea is alfo a proper diluent, and affifts digeftion, drank a pro- 
per time after dinner, where it does not difagree with the 11 o- 
niach, as in fome peculiar conftitutions, affedfing the neives of 
that organ, ar.d the fyItem of them in general, fo as to occafioa 
ficknefs, tremors, and fainting. 
7 O > ' : , 
2. Thofe liquids are called SHEATH NG which are milted 
with mucilaginous lubftances, and produce their good effedls, by 
involving the acrimonious particles of the blood—incrcaiing us 
vifcolity, and preventing them from producing, or at lead lellen- 
ing their ftimulating powers on the valcular.fyilem in general— 
or guarding the tlomach and inteiliues from feeling the effedfs of 
any irritating materials which may be therein contained---the 
principal of which are water mixed with oatmeal or vhea. flour, 
called -gruel—or with hartfhorn ihavings, lalop, fagoe, tapioca— 
and boiled till the mucilaginous parts of thefe are diiholved, and 
then are conlidered as emollients or demulcents- -or where lub- 
flances are replete wTith oleaginous particles, iinhering flmilar 
folntion in the fame menltruum—hence partake they alio oi a 
nutritious propertv ; here then to the 1 ill may chocolate be added 
—-fat broths—milk mixed with fuel—the iait, a food not uncom- 
mon, and very ulefnl to fuch its are lu* ject to coultant diarrhoea, 
or loolenefs, from acrimonious humours poured upon the bowels 
—which is improved by the addition of a little flaich—and all 
thefe are conlidered much more nutritious than thofe of the for- 
mer clafs. 82 
OF THE NON-NATURALS. 
3. The NUTRITIOUS—are all fuch whole particles are ca- 
pable of being affimilated to the nature of the animal juices by 
the digeftive powers Of the conftitution, atid partake of thefe pro- 
perties in a greater or lefs degree, as their parts approach nearer 
to, or are more diftant from, the nature of our fluids, before they 
are taken into the habit :—hence the moft nutritious are—beef 
mutton, or veal tea, as replete only with the finer juices—-foups, 
Irotbs—the foups fometimes, in the firft digeftion, are more fti- 
mulant, owing to the fpices with which they are feafoned, confe* 
quently the moil; heating. Any of thefe above, however, made 
from the flefh of the older animals, are moft nutritive—as they 
partake lefs, of vegetable nathre, and have their juices more per- 
fedftly elaborated, and lefs fubject to promote vifeidity, than thofe 
from the younger fpecies—and here may be enumerated thofe 
made from hartjhorn, or the jelly J'rom that and ifnglafs. 
The next is milk, which approaches very near to the nature of 
chyle, whilft in the bread of the animal, though more clofely 
allied to its perfect juices. It is divifible into ferum or whey/ 
eream, curds—of which lafl is formed common cheefe. 
Milk, when cold lofes fome of its finer parts, and boiling robs 
it of more, by more copioufly difiipating them : it is demulcent 
and nutritious, and partakes of a middle nature, between vegeta- 
ble and animal, and is apt to curdle on the ftomach, if it meets 
with a flrong acid, too fuddenly, or in many febrile difor- 
ders. 
To fome conftitntions it is perfectly agreeable, creating no un- 
eafmefs, be the ftomach in what date it may ; dill in others it 
increases acidity in the firft paflages—it, in fome, produces di 
arrhcea—others it renders coftive ; in fome it occafions the head- 
ach ; in# others an uneafy fenfation in the ftomach, and pain— 
and many cannot enjoy the lead eafe, till it is ejected by vomit- 
ing : but where it agrees, no food can be more pleafant or falu- 
tary, where it does not increafe corpulency. It has been the 
food of feveral adults for a feries of time—and thofe who refrain 
totally from animal food, in this acquire an agreeable fubfti- 
tu»e. 
The milk of an healthful young woman is, to the human 
frame, infinitely the moft preferable, fo is that of any animal 
to thofe of their own fpecies,as more completely finilhed to their 
particular nature.—For medical ufe next fucceed, the milk which 
has the greateft affinity with that of woman—in which relpc£t 
thefe are thought to purfue the following order—a/fes, mares, 
goats, that of Jheep and cows. 
The next which lucceeds to this is— 
Chofolate— though it partakes not of animal nature, ft ill from Of THE NON-NATURALS. 
its being more replete with oil and faccharine fubflance, it is not 
&nly nutritious but demulcent—though it is apt fometimes to 
fit uneafy on the ftomach, if it is made too thick, or not well 
milled or ground—but more particularly when the nut is badly 
prepared, or when it is decayed, greafy, and rancid- —made thin, 
it is light : therefore when chocolate, from its richnefs, creates 
any uneafy fenfations on the llomach, a glafs of water taken af- 
terwards, by rendering it more dilute, will prove a remedy 
but from its abounding with a quantity cf oil, it requires the 
powers of digeflion to be very adive for its aflxmilation : hence, 
it fliould never be drank in too large quantities at a time. The 
leaft nutritious of this clafs are fome of the fheathing liquids we 
before mentioned, as gruels, [ago, falop, tapioca—becaufe they 
partake folely of vegetable nature, and are not fo replete with 
oleaginous or faccharine jfubflanc.es, but are merely mucilagi- 
nous. 
4. The STIMULANT are— 
Coffee, wine, punch, perry, cyder, ardent fpirits ; taken in mo- 
derate quantities—in larger, they exert fedative effeds percepti- 
bly ; but as we conclude they always exert this la ft etiecl, though 
in a degree only proportionate to the quantity taken, we think 
it right to take a view of them in their flate of combination 
to avoid perplexity—and therefore we mark them clown 
as 
STIMULATING and SEDATIVE. 
The firfl of which confift of fuch materials, as by their adive 
powers, irritate the llomach, occafion warmth there, communi- 
cate it to the conflitution in general, either by fympathy or vaf- 
cular irritation--- increase the circulation of the blood for a time 
—exhilirate the fpirits, increafe perfpiration, and invigorate the 
whole fyflem—or, taken in large quantity, produce fuch effeds 
fympathically upon the common lenforium, or force the blood 
fo copioufly and powerfully upon the brain, that it is incapable 
of feeling the efred of pain or rather uneafy fenfation—indeed, 
fometimes this infenfibihty may be carried fo far from this caufe, 
that people become apoplectic from the increafed p refill re on the 
brain—or from impeding fympathically, or mechanically, the 
power of nervous influence, expire. 
Of this clafs, we conftder 
Coffee— though never attended with any of thefe violent con- 
ferences, mull be ranked under this head, a3 one of the flight- 
eft kind—-for it is of a more heating nature than tea-—gently ili- 
mulant, aftringent, and refills putrefadion ; it alfo moderates 
alimentary fermentation—though, like tea, it is not agreeable to 84 
OF THE NON-NATURALS. 
e very conftitiition ; as in fome it will produce, particularly in 
thole who are delicate, nervous fymptoms : it decreafes corpu- 
lency, a.;d i ferviceable to grofs, phlegmatic habits. 
Di. Cullen, fpeaking of coffee and tea, fays, 
“ Then effects, in my opinion, are very much mixed, depend- 
ing on the viann watei ;—the afuilmg digel1 ion--relieving 
“ the ftomach from a load of aliment—from crudities—allevi- 
“ ating head-achs arifing from them—promoting the ieci-etion 
“ of urine, -and, perhaps, perfpiration, may all fairly be attribut- 
“ ed to the warm water. Thefe are the chief virtues to be at- 
“ tributed to tea and coffee. 
“ 1 he weakening the tone cf the ftomach by frequent ufe—- 
“ and the fyftem, in confequence, inducing tremors and fpafmo- 
“ die affections, are the effe&s of the tea itfelf, though, in fome 
“ mealu e, of the warm water.” And, certainly, great miff 
chi. Is a e done by drinking them too hot—a very common prac- 
tise b, very delicate conftitutions ; for, by thefe means, the fto- 
m id) is brought into too great a (late of relaxation—indigeltion 
occalioned—crude chyle thrown too freely into the habit—ob- 
it. uCtions formed in vaiious parts, and a general Hate of debility, 
wit: a variety of painful confequences, occalioned through the 
wnole fyftem. 
IV ine, fpirits, ale, porter, cyder, perry, punch—may all come 
under the fame defeription with regard to their powers, if we 
make fome allowances with refpect to a few trifling peculiarities 
winch occur; for they all of them are ftimulants to the ftomach 
and fyftem in general; poffefs fome antiipafmodic powers, and 
increaie circulation. 
Spirits are more powerfully ftimulant than wine, lefs antifpaff 
mod.c, and riotdifpoftd to run into the acetous fermentation. 
Wine is endowed with ftronger antifpafmodic effects ; cyder 
and perry next ; porter and ale the leaft. Wine is more pow- 
erfully liimulant than thefe; lefs difpofed to acidity, if pure, 
than cyder and perry—and all of them fiee from that tenacity 
or vdeidry in ale and porter. 
Ale and porter are apt to load the ftomach more, and require 
flrong digeltive powers to affimilate them; porter is fuppofed to 
poffefs ftronger diuretic effeels than ale—though they ail have, 
them in fome degree—but amongft the fpirits, that called Gene- 
va f.hews them the moll manifeltly—of which the common fort, 
formed of ardent fpirits, impregnated with terebinthinate fub- 
llances, is the ftrongelt—tlioi'e impregnated with juniper berries 
the weake!t. 
But, as vve can never get wine, though fo valuable an article, 
whether conftdercd as a luxury,'or a medicine, completely per- OF THE NON-NATURALS. 
85 
fefted, even that efteemed the moll pure ; and as it is made fuch 
general ufe of—it will be advantageous to examine the parts of 
which it confifts, by which means, we (hall be enabled to dif- 
l cover how its aClion may be varied ; and, perhaps, the fame holds 
j good in all the reft, except fpirits, though moll probably in an 
' inferior degree. 
WINE has for its bafts faccharine fubftances, of which it is 
formed by the procefs of fermentation, which converts the whole, 
pot at once, but progrefiively, into a vinous fluid ; one part re- 
ii plains unaffimilated—one is affimilated—and one becomes acid. 
| Hence wine is compofed of three parts, 
Muft, pure wine, and vinegar. 
Mufl, HIPPOCRATES defcribes the juice of grapes, recently 
■ exprelfed, crude, flatulent—only having one good property, it is 
: aperient; and if it does not a£t as a laxative, it becomes fo much 
J the more noxious to the body. It is, perhaps, owing to this 
i that new wines, or other fei men table liquois, drank too early, 
prove purgative as they generally do. 
Some authors have laid, that mujl is, properly fpeaking, what 
is called Jwcet winer. It (hould, with more propriety, be confi- 
de red as fomething different, formed by the fermenting procefs; 
becaufe, by fermentation of fugar on theftomach, a fubtile fluid, 
| called by the teholialts, gas fylveftre, and conuriered by them as 
I a fixed, factitious, and fixable air is produced, which a&s on the 
0 bile, pro es laxative, &c. But mufl acts in a lefs quantity than 
j lugar, and therefore muft be fomething altered from the facciia- 
! rine fubftance, now changed in its properties :—whatever it is, 
' it deflroys toe tone of thiJlomach—difbofes it to fpafmodic eontrac- 
(ions, and, ccnfequently, dijiurbs and interrupts digejhon. If aci- 
I dity is produced, it will join with the gas fylveftre in weakening the 
I Jlotnach—the acid thus formed will unite with the bile, produce a 
I jtrong Jhmulus- -thus occajion a flow of mere bile to the intejlines, 
'1 ana cauje vjhat is called the cholera morbus, a copious evacuation of 
1 bile upwards and downwards, with violent, fpafmodic ajfeEHom— 
but thefe effects are feldom produced to fuch a degree of vehe- 
Vmence. 
The active part of the juice of the grape is called ALCHO- 
a HOL, or the Jpirit of wine, but weakened in its a£tion in its 
?! compound ftate. 1This exerts itfelf cm the nervous fyflem, chiefly, 
I if not altogether, by means of the flomacb ; hence it is flimulant, in- 
cre flng circulation, and the force of the nervous power univer- 
fal'y. 
In large dofes—alchohol destroys the mobility of the 
NERVOUS POWER—WHENCE, FROM ITS STIMULANT AND SEDA- 
TIVE effects—confuflon of ideas and delirium i still repeat- OF THE NON-NATURALS. 
ED, the nervous flow is ctrreflect---voluntary and involuntary moti- 
ons defrayed—jleepy lethargy, apoplexy, and death, are the coufe- 
quences. 
Jn WINE, the effects are almoA never fo rapid, on account of 
their dilute ftate, and frna-11 dofes in which the alchchol is throws 
in ; ©n which account it proves only more flimulant and exhili- 
rating—it may produce ftupor, but as it is. apt to be rejeCted by 
the ftomach, and by oilier matters with which it is mixed, the 
powers of alchohol is moderated. 
PUNCH, which is only an artificial wine, is lefs noxious than 
alchohol and wrater, though more fo than wine. 
Xhough an acid is evolved, and enters into the compofition of 
wine, and alchohol, Hill another, and more copious and feparate, 
is formed—which is 
VINEGAR. This commonly contains fome fugar, may 
he laxative—have the effefts of unconverted fweet wine—generate 
gas fyhejlre, that fubtile fluid ; and, in Jloort, have all the pro- 
perties of frejlo juices: when thoroughly converted, it determines 
other vegetable juices to acefcency—weakens the jlornach-- -proves 
fpafmodic—-and has all the confequences of acids there generated. 
But combined with wine, thefe qualities are more innocent; 
as the action of muft, alchohol, and vinegar, feparately may pre- 
vent each other’s Ample and deleterious effedls ; and alio the wa- 
ter may, in the proportion in which it is mixed, have its efficacy 
in weakening the properties of the other component parts. 
CYDER and PERRY may be confidered as having the fame 
properties, though in much lefs degree than wine, with regard to 
their flimulant and fee'ative effigfts ; but are more replete with 
acefcency—generate too great degrees of flatulency, run quicker 
into the acetous fermentation, and produce uneafy gripings, and 
more painful fenfations cf the bowels, befides being more pro- 
ductive of calculous complaints, and the ccnvulfive colic> or dry 
Leliy-ach, terminating often in pally. 
From this review we can eaflly judge of the effeCts, whether 
advantageous or otherwife, which ate likely to enlue from wine, 
and alfo from the different compofitions fold by our retail ven- 
ders and wine merchants, under that title*; which produce dif- 
agreeable confequences to thofe who drink freely of it—laying 
the foundation for a variety of dangerous, lingering, and fatal 
complaints. In order to fnew which, v. e have been at the pains 
of going more minutely into this lubjeCt, that w e might explain 
the particular parts of which wine was compofed—declare the 
properties of them feparately—rnanifeft what wrere falutary, 
what otherwife ; as alfo the neceffity of a proper combination to 
form their utility ; and hence b« enabled to difeover how the OF THE NON-NATURALS. 
87 
poifonous compofitions, fold under that appellation, mull Inva- 
riably produce their baneful effects ; for thefe are made of the 
unfermented juices of fome vegetables—fweet raifin wine, cyder, 
and Britiih fpirits ; and this jumble is coloured with fome in- 
gredients agreeable to the wines intended to be imitated—with 
the addition, fometimes of a fmall portion of wine, and constant- 
ly of that noxious material called fugar of lead, or lead itfelf, 
forming this fubflance by the union with a portion of acid they 
contain. Now compounds like thefe mult be replete with thofe 
miichiefs which we have enumerated under muji and vinegar—. 
and others brought on by the fedative aftringent powers, occafi- 
oned by preparations of lead—rendering the aftion of the fto- 
mach and inteltines torpid, relaxing thefe organs, obfirnfting the 
exit of materials which ought to be thrown out of the body— 
filling the machine full of crude and acid humors—contaminat- 
ing the whole mafs of fluid—and preventing digeflion, that pa- 
rent of almofl: all chronic d.feafes. When we, therefore, fpeak 
of wine, we would not be undentood to mean thefe baneful com- 
pounds : but that which is pure, as can be imported, which 
MACKENZIE fays, “ is an admirable liquor, and, ufed in mo- 
il “ derate quantity, anfwers many purpofes of health ; and beer, 
I “ well brewed, light, of a proper flrength and age, if we except 
, “ water and wine, is, perhaps, the molt ancient and belt fort of 
;j “ drink in common ule among mankind.” 
But with refpect to wine we may carry the matter farther, 
ji for it is generally allowed to be the mod agreeable and powerful 
(cordial we can have recor.rfe to in the laft ilage of fome fevers, 
completing of itfelf the cure. In low nervous, and putrid fevers, 
it is beneficial throughout—when there appear fymptoms of great 
| debility— and it may be very often taken in large quantity, where 
I the moving powers of the fyftem abate much of their falutary 
I action, and the fluids feem to be running rapidly into a ftate of 
.« putrefcency. 
j How much, therefore, is it to be lamented, that we fliould be 
ii deprived of l'o valuable a liquor—replete with fo many ufeful 
| properties by the avarice of a fet of beings, who are buffered to 
|impofe upon, and injure the public with impunity, and amafs 
fortunes, by felling poil'ons for our deftruction, infteadof wine for 
our prefervation and recovery of our health. For, I am perfuad- 
ed, thoufands have fallen devoted victims to this illicit and infa- 
mous pra&ice. In lieu of thefe, where people are under the ne- 
eeffity of purchafing wines, rather than depend upon the worldly 
integrity of thefe dealers, 1 would recommend the wine properly 
made cf raifins, or the fruits of our own country, they are infi- OF THE NON-NATURALS. 
nitely lefs noxious, nay, indeed, may be made equally efficacious 
to the others in their purer Hates. 
5. The next which are to be fpoken of, are ihofe invcfled 
with 
DILUTING and NUTRITIVE POWERS. 
And thefe are chiefly- all thofe where water abounds, and are 
impregnated with fai inaceo'us, faccharine, and animal fubflances; 
in which will be included, gruels and weak broths—the latter of 
which, as alfo foups, when thrown into the habit, may be confi- 
dered as poiTcihng fo.ne degree of ftimulus, adequate to the na- 
ture of animal food in its folid date, but weaker in degree : and 
thefe will be more or lefs diluting and nutritious, in proportion 
to the quantity of water and other fubilances 'hey contain—the 
diluent property depending upon the former—the nutritions up- 
on the latter ; the particulars, relative to each of which, may be 
collected from what we have delivered in our firft and third fec- 
ticn on this fubjeCl. 
6. Our laft are* 
The NUTRITIVE, STIMULANT, and SEDATIVE ; 
Such as, in Come degree, poffefs thefe feparate properties—which 
may be confined to 
Ale and Porter—the fiimulant and fedatiee powers of which 
have been fpoken of when we treated of wine, of which thefe 
may be confidered as fpecies, made of malt—though to porter 
there is a mixed and ftrong fedative power, inafmuch, as it ap- 
pears to have fome narcotic ingredient infufed it, as the cocujus 
mdicus, the Indian berry, opium, or iome materials of a fimilar 
nature. However, that they are very nutritious, needs no ar- 
guments to prove, we have only to depend upon fails ; for it is 
obfervable, that all who drink copioufly of thefe liquors, are 
corpulent, if they have powers of digeflion adequate to their af- 
limilation—common porters, coal-heavers, chairmen, &c. chief- 
ly exift on this—drinking fome gallons in a day ; and indeed 
fuch, whofelabour is veryfevere, requireit : but in all filch, itis 
neceiTary for their digeflion tobe extremely good, for thefe liquids 
abound with a great lhareofvifcidity, which requires great confti- 
tutional flrength, and itrong labour to fubdue. To delicate, relaxed 
habits, whofe flomachs are weak, they create great load and op- 
prefiion, much heat, and febrile alfeiltons temporarily induced. 
What we have here delivered, perhaps may be by fome thought 
of too trivial confequence ; and is by many too much, even in 
the practice of medicine, neglected—itill will be found, on ex- OF THE NON-NATURALS. 
peritnee, worthy of very rlofe attention : for the knowledge fiom 
thence to be colleHed and properly applied, as vve lhall foon ha Co 
bccafion to fliew, fomis oi e part of ihfedicine; comprehend; eg 
that which is filled—proph lactic or preventive—is, in many 
Cafes, folely curative, and fhould n all go hand in hand wifh 
the adminiitration of the moie aclivfe and powerful remedies i,; 
the cure of difeafes. Indeed ignoiance in thefe points, br an in- 
judicious dicetetic eburfe, will counteract remedies the molt f.i- 
lutary on the one hand, wfiilfl, on the bl er, an accura e knowledge, 
and proper combination, will greatly add to their efficacy. 
Having now laid down the principles on which we fhall pro- 
ceed through thecourfe of the fubi'equent work, almoft folely i: 
that part which is intended as the preventive, and, in a pea 
meafuie, in the curative—wre lliali proceed to the former, after 
recapitulating fome particulars, in order to form general rules 
for our proceedings, and render all our directions eufy and intel- 
ligible. 
SECTION VI. 
CONSTITUTIONS MORE PARTI CUE A RLT SPECIFIED. 
TTT H BN fpeaking of conftitutioh in our former Seftions, we 
have enumerated that variety which is generally adopted, 
in order to fhfew what ought to be undet flood by the dillerc,: 
terms, and by what cbuflitutional caufes they were produced—* 
ana have divided them into Jim pie and general—mixed and gene- 
ral—and peculiar—as 
The ftrdng and rebuff* 
Weak, relaxed, and delicate, 
Nervous, or incitubie, 
Tritable, 
Torpid, 
And their combinations—that is, the union of two or more, a< 
they happened to be poiTeffed of incitabdity. irritability, and tor- 
por ; and thcl’e could only occur, with iclpeci to the folids— 
but as the fluids alfo are concerned, it was neceffary to take then) 
into the accounts ; we therefore conjoining them with the former, 
with relpefl to their quantities, qualities, and effects—nave title., 
them hllXED—as when affociated with 
I’iethora, 
Acrimony, 
Beat, 
Cold, 
Or haying Confumptive tendency. As for thofe we denomina'- 90 
CONSTITUTIONS SPECIFI2D. 
ed peculiar, they depended on accidental circumftanees, as a re- 
view will convince us, and unneceffary to be taken into the ge- 
neral account, as to thofe alone muft our modes of prevention, 
mitigation, or cure, be directed ; for it is by regulating their 
operations alone, that we muft in all cafes expert to derive be- 
nefit. Some alfo of which may be omitted, as they deduce their 
origin from particular affections of the other in combined ftates, 
as the hot, cold, and confumptive. 
We, therefore, ftiall arrange Conftitutions under the following 
heads. 
A. The ftrong, and robuft, 
More or lefs irritable, 
torpid, 
—* incitable. 
Plethoric, 
Acrimonious. 
B. The weak, relaxed, and delicate. 
More or lefs incitable, 
irritable, 
torpid. 
Plethoric, 
Acrimonious, 
With refpcdl, then, to the fir ft of thefe Conftitutions ; i. The 
Jlrong, r obit ft, and irritable. 
They aie fubje£t to many inconvenience?, chiefly from the ra- 
pidity of the blood’s motion ; hence are liable to fall into violent 
continued fevers,and inflammatory diforders. To prevent which 
all excefl'es of hot or cold air Ihould be avoided ; ftimulating ali- 
ment, high feafoned difties, and fuch as are extremely nutritious ; 
too fudden and violent exercifes, repletion, and the more boi- 
flerous paftions. They ftiould obferve temperance iu all things, 
and efpecially keep free from immoderate drinking, and take 
care that none of the natural evacuations, ftiould be checked, or 
obftrutSed, fuch as that of perfpiration, urine, faeces. They 
fhould have recourfe to occafional bleeding, when the head feels 
loaded, giddy, or when they are drowfy, and prone to deep, or 
fymptoms of general fullnel's are prevalent, but not ufe it un- 
neceflarily, or too frequently, and empty the habit now and then 
by purgatives ; they (hou-ld drink diluting liquors, as water, or 
luch where that is fuperabundant; in general be fparing of ani- 
mal food, and rather eat freely of vegetable diet, ior thefe are apt 
to be plethoric, or loaded with too great a proportion of fan- 
guinary mafs : for fuch, a moderate, warm, and moift atmof- 
phere is the moil eligible fituation ; in fine, nothing ftiould be 
a Slowed them that will increafe too powerfully the action of the 
Irving fulids, or octafion too great an increafe of the fluids. Thefe 
Conftituticiii arc in general warm. CONSTITUTIONS SPECIFIED* 
2. The Jlrong, robujl, and torpid. 
- Where, though the (lamina are firm in too great a proportion 
there is a defedt of irritability the vafcular fyflem being in toq 
torpid a ftate. Thefe require not any particular attention, as 
from the want of proper fenfibility they will not be expoied to 
feel particular changes arifing from common caufes, or fuch as 
would effedt thofe which are more irritable. Thefe con ft itutions 
bear all evacuations well, as they are not apt eafily to have their 
folids too much relaxed, but are rather prone to become ple- 
thoric, from indulgence, which they are apt to run into, from 
not feeling thofe effects, whicli people of different habits fo fre- 
quently experience. They Ihould endeavour to prevent an over- 
fulnefs either by abftinence, or proper evacuations, which they 
bear in general without inconvenience, though bleeding in thele 
is lefs advifeable than purging, owing to the toipid flare of the 
fyflem ; and, which, being negledted, Ihould a plethora be the 
confequence, fome of the internal parts of the habit, as the brains, 
lungs, &c. might be affedted by dangerous, or at leaft trouble- 
fome oppreflions, and we very often find men of this Conftituti-? 
on for w’ant of timely care, and from indifcretions, afflidted with 
fudden vertigos or giddinefs of the head, coughing, or {‘pitting of 
blood, apoplexy, &e. and thefe are fometimes of a cold habit, 
though plethoric, and apt to fall into hypochondriac affedhons 
from vifceral accumulations, and languid circulation. 
3, The Jlrong, robujl, and incitable. 
This Conftitution fometimes, though more rarely occurs, and 
when it does, it generally is united with vafcular torpidity. In 
this there is too great incitability of the nervous fyflem ; and 
men of this habit are fubjedt to a mixture of hyfteric, and hypo- 
chondriac difeafes ; irafcible at trifles, delponding nearly approach- 
ing to melancholy, they are apt to be afflidted with various fpaf- 
modic affedtions, particularly of the throat, and fto- 
mach ; fometimes make profufe quantities of pale, limpid water ; 
at others, fmall, but turbid and high coloured ; they are fre- 
quently tormented with flatulence, and perplexed with whimfi- 
cal and inconliftent ideas ; the extremities are generally cold, and 
moving from place to place, or any motion almoft is performed 
with languor—moll of the evacuations are leflVned. or irregular- 
ly performed ; fleep is imperfedt, they are troubled with fright- 
ful dreams, and are fubjedt to the incubus, or what is called the 
night-mare, and all thefe are derived from the fame conftitutional 
fources, when torpor attends; for from the want of due power 
ef the mufcular fibres, the circulation of the blood is not carried 
cm with full freedom to the extremities, the internal parts con- CONSTITUTIONS SPECIFIED. 
1 ‘ [uently a>-e loaded, hence in thofe parts there is an additional 
iullneis and (fmulus, tor the dim ulus is always in proportion tq 
the quantity of blood flowing to a part or collet ed in it, from 
the evolution ofq.be heat, and the fuperabundance of gcrimony, 
lor the Ovids' of thefe confiitutions generally abound with acri- 
mony, particularly fucli as i3 produClive of the uettle-ralh ; hence, 
' • the internal parts become more fenhble to the nervous in- 
i’ ;ei:ce,.epnfequcntly folicits it the more iitely j and hence arifcs 
t. ; appearances above enumerated 
In thefe habifs—friCliops on the extremities, warm clpathing, 
V aun bath, riding on liorfeback, are cffentially neceffary ; gene- 
ts diet, wine, flimulating vegetables ikould be adhered to, 
.1 of eaty digeftion, the mind llrould be kept perfectly at eafe, 
ecrful company, change of lcene, and fuch amufements as di- 
- t the .attention, produce a moderate degree of mental hilarity, 
old be procured ; ar-d as for medicines, tl ey fl.ould be fuch, 
" ; at the tame time, that they allay the incitable power of the 
\ an3 fjhetn, diffu.fea general warmth through tire habit, and 
; .ffe given occanonally, as afai’cetida, mulk, vitriolic tether, cam- 
; but all opiates mult be avoided, becauie they are apt tp 
v.-.der the. mi cular fibres too totpid—in general chalybeates 
r be per fitted in, and Bath waters fhould be recommended, 
d-ut where inftead of torpor, vafcular irritability is a conco- 
i• : <. btfides being l'ubjecl to inflammatory complaints, ami 
. . ;ntd febrile affeflrons from (light caufes,they are fubjefl to 
.• aneiit tpafrnodic affeflions, fuch as thole which are denomi- 
J fy medical men, tetanic complaints, v\here, when fpafms 
a , the tnufei iar fibies 'emain in a fixed (late, not contrafling 
a - laxirig alternately, nor fugitive as in common convnlfions : 
i j arc T. ble to be feized with a locked jaw% and continued, 
kular rigidity. In thefe conllitutions, warm baths are pecu- 
;.iy lefuli, gentle and conftant exercife, cooling diet, and co- 
.-i dilution with acjueous liquids, thin acefcent wines, milk 
. v getable d’.et, evacuations of all kinds fhoitld be conllantly 
; d modetately produced, particularly perfpiiation, ar.d the body 
■./■;ld never be coflive; 1 have faid moderately, becaufe in en- 
ouring to abate the irritability of the fyHem, we mud be 
k etui not to increafe the incitability, which is apt to be the 
. k, from evacuations too copious. Opiates are in thefe habits 
■ remedy ufeful. and may be freely given under particular cir- 
;.mdances. With regard to regimen, what we have laid before 
; i lie beginning of this ledlion may be adhered to, taking efpecial 
i re to avoid all mental uneafinefs. Thefe conllitutions are apt 
to be plethoric and attended with heat. 
What we have delivered appertains to thofewho are confidered, CONSTITUTIONS SPECIFIED. 
93 
to poffefs flrong degrees of mnfcular ffmnefs, differently com- 
bined. We mult now proceed to fuch as have a WEAK, RE- 
LAXED, DEUCATE HABIT, JOINED WITH TOO 
GREAT EX Cl 1 ABlLtTY. And this c rcumftance .gene) ally 
occu-i in theie habits, that they have alio too {. icat a {hare of ir- 
ritability'. 1 he 'e are lubjcd to painful and E a'modiq difeafes ; 
and the more delicate lex or this conllitution ate prone to hvlte- 
r.ic affections from the relaxation and irritability of their habits. 
rl hey alfo are conftantly' a tacked on every flight cold, w ith flow 
fevers, and have their digeltive poweis loaded with iaburra, or 
different kinds of ill digelled matters in the ltomach and bowels, 
making their u’ay into the habit in this noxious form. 
To thefe, a dry, clear air is effentially nectfiary, moderate ex- 
e.rcile, particularly riding, cold bathing, and chalybeate waters; 
animal food eafy of digellion, and free from fat, and a temperate 
ufe of aftringent wines. Vegetables Ihould be adminiltered fpar- 
ingly, and thofe of the lefs flatulent kinds ; food and liquids, 
vilcid and tenacious, fuch as flour puddings, potatoes, oyflers, 
ffrong foups, and m/lt liquors, ought to be prohibited. Every 
thing calculated to ftrengthen the tone of the fyftem, and preferve 
it in an equable {fate ought to be had recourfe to, and all things 
likely' to weaken it mult be defifted from. Cheerful company 
and moderate amufements are ferviceable, but purfued too fieely, 
the reverfe ; for all fatigues, both of body and mind, are pte- 
judical—the cuftom of taking vegetable acids too copioufly is 
alio pernicious—hot tea, or any thing diank too warm -for thefe 
all contribute to relax and load the llomach and inteflines, with 
foul, vifcid materials, which produce therein internal Itimulus, 
create flatulence, and communicate general irritability through 
the iyliem. Blood Ihould neve; be taken fioin people of this ha- 
bit, but upon the moll u gent occafiotr, and then only fparingly, 
in which cupping is preferable to the lancet; and it is fafer to 
take it away at two opcations, thanatjpne, fome little didance 
of time from each other, if more than lix ounces Ihould be re- 
quired. All fudden changes Ihould be avoided with the utmolt 
i caution, either with tefpecl to cloathing or diet, the mind kept 
■ free from anxious ca es—hence watering places are ufeful, where 
thefe impregnated with chalybeate particles, or iron, may be 
| drank ; in fine, every thing ought to be advifed, w'hich, in a mo- 
derate degree, can exhiliiate the fpiiits, and contribute to give 
ftrtngth to the folids. 1 hefe conflitutions are generally warm, 
fubjtd to irregular flulhing heats, and have for the molt part no 
fmail degree of acrimony in the habit. But there are fome who 
poli’efs too great a fhare of torpidity, and then they fotm that 
kind. CONSTITUTIONS SPECIFIED. 
94 
2. Where a WEAK, RELAXED HABIT IS JOINED 
WITH A DEFECT OF SENSIBILITY ; and thefe are fub- 
je61, not only to nervous affe&ions, but to chronic and deftruc- 
tive difeafes ; for the circulation in all thefe is languid, and the 
abforbent fyllem afls not with proper freedom. Hence will arife 
thofe complaints which depend on an acrimonious date of the 
humors, and an accumulation of the fluids in the whole, or par- 
ticular parts of the fyllem—as dropfy, jaundice, corpulency, fcor- 
butic complaints, green-licknefs fo called, obllruCted menfes, glan- 
dular tumors, &c. 
In thefe torpid habits, ftimulants are ufeful, as alfo are eva- 
cuants ; to thefe, a dry air and high fituation are moft fuitable, 
with a generous diet of the more pungent clafs—fuch as the juices 
of the older animals. fi(h, muftard, horferadilh, cabbage, and all 
of that clafs : brilk exercife on horfeback, emetics, and frequent 
purging, in order to lhake the vafcular and glandulous fyllem, 
prevent accumulations, remove obltrudlions, hinder the bile from 
ilagnating, and the mucous fluids from collefting. All the na- 
tural evacuations Ihould be kept free from fuppreffion, to ac- 
complilh which, the fyllem ought to be perpetually roufed to 
aflion ; hence indolence and indulgence in bed is to be particu- 
larly avoided ; the thinner llimulating liquids, as white wine 
diluted with water, Ihould be the common beverage, and the 
mind kept in a Hate of cheerful activity, free from all gloomy 
and defponding reflections. 
Were the rules here laid down obferved before our mafs of 
humours had been contaminated by indiferetions and various fpe- 
cies of debaucheries, which weaken and difturb the fyllem in its 
performance of the proper offices alloted to her various parts, 
perhaps there would be little occafion to conlider of thofe things, 
which are neceiTary to prevent difeafes ariling from a default of 
the natural humors of the machine ; but as that is not the cafe, 
they call upon us for our conlideration, as well as thofe which 
are fortuitoully thrown into the Conllitution. And thofe we 
fball divide into fuch as are firft, 
NATURAL, 
And thofe which are 
ACCIDENTAL. 
The natural fluids are divilible into 
or 
Partial. 
t. In the firft or general, the blood offends by its too great constitutions specified. 
quantity or Hate of acrimony. From the too copious Hate of 
this fluid, a variety of complaints may arife, and, therefore, when 
fymptoms of oppreffion appear from this caufe, which will ge- 
nerally manifeft itfelf by languor, a fenle of weight or fullnefs 
in the head, when riling in the morning from bed, or in Hooping, 
and fullnefs alfo of the pulfe ; abftinem e, indulging lefs than u- 
fual in deep, incyeafing the natural evacuations, and tiling more 
exercife, will effectually reduce the body to its proper flandavd, 
if thefe things are had recourfe to in due time, and peifevered in 
for a proper period ; the diet fhould be the lead nutritious, 
more of the vegetable than animal cJnfs, the laft eat of fparingly, 
confining themfelves to one difli, and having it only once a day, 
and water fhould be the only beverage; but fhould inanition, or 
a want of a proper quantity of blood be induced by any caufe, 
nutriment fhould then be given of the moH quick and eafy di- 
geftion—as teas, and broths made of the fiefh of older animals, 
thin jellies, and the flefli of the younger animals, as chicken, 
rabbits, lamb, veal, &c. and in fuch quantities, though that can 
be readily converted into chyle—for it is a miffaken notion, to 
fuppole the larger the proportion of nutrition thrown into the 
habit, the fooner it will be recruited ; the reverfe will happen, 
for by thefe means the digeftive powers being overloaded, will 
be weakened, and confequendy even a fmall portion be prevent*- 
cd from being properly afiimilated, or reduced to the nature of 
our own healthful fluids, which they muff be before they can 
anfwer the purpofes for which they are intended—as on the con- 
trary, if fo much is only given as thofe powers can conquer, they 
will gain frefli ftrength every day, by the application of that 
which has been converted into a nature peculiarly adapted to the 
end propofed ; and this quantity may be repeated as often as 
the conflitution requires it. By this a further walle will be pre- 
vented, which may alfo in this view be aHilted by the ufe of fto- 
machics, which chiefly confift of bitters—as gentian, orange peel, 
q lallia wood, flight chalybeates, gentle aromatics, and fuch 
like. 
2. But the blood may become acrimonious, and this acri- 
mony may be confidered of different natures. They have been 
divided into acid,putrefcent andmuriatic, io called from MURIA. 
brine, a liquor made of common fait, w hich this muriatic humor 
is fuppofed to lefemble ; but we fliall not pretend to advance 
this as a certainty, but coniine ourielvcs io the efledts of feme 
acrimony, which feems different from the two former. 
The JirJl then, or the acid, is fuppofed to anfe from weak bow- 
els, and particularly obferveable in our infantile Hate, and, per- 
haps, the ftomach and inteftines are the only place where fuch 96 
CONSTITUTIONS . SPECIFl F.D. 
acidities,arc to be fouud. To prevent which, vve mu ft endea- 
vour to ftrengthen the digeflive powers that they may make good 
chyle; he ce after clearing the bowels with thefal polychTeli; 
or fmall dofes of calomel, and rhttbard and gentle emetics, flight 
dofe-, of chalybeates may be had recourfe to, mixt'with rhubarb 
to keep the hovels gently open—weak broth ibotild be given 
once or twice a day—panada, with a fmall portion of fotrie agreea- 
ble aromatic well boiled; and fuch things as have in themfelves 
the leaft tendency to acidity ; fridlions on the abdomen or lower 
belly, ftomach, legs, and feet,with fmart exercife, will be highly 
ferviceable — as thefe will invigorate,the fyftem, promote a br ifisc 
circulation, and increafe the a&ion of thofe organs intended topro- 
xno'te the formation of good chyle. 
The fecond, or putrefdent ; where the fluids tend to a Hate 6? 
putridity, fhews itfelf generally by the face being puffed up, as 
it were, and tinged with a hue, foftiewhat approaching to livid ; 
the breath eftenfive; the gums fpongy, and bleeding on the flight- 
eft touch, hay, fometimes voluntarily :—here freth air, aaflere 
wines, fuch as give a fenfe of roughnefs, or aflringency to the 
tafte, vegetable diet, ripe fruit, water impregnated with fixable 
air, fmart motion, and corroborating bitters, with abftinence 
from animal food, particularly fi(n, promife fair for flopping the 
effefls, which might otherwife arife, by che< king the putrefac- 
tive difpofltion, and meliorating the fluids ; mpift, warm fit nati- 
ons fhould in this cafe be par' icularly avoided —and living in clofe 
places much crowded with inhabitants—for nothing conduces 
more to bring on, and increafe fuch a Hate of the conflitution as 
thefe—by relaxing the folids, and furmihing a conftant ftippiy of 
putrefeent effluvia. 
The tbi*-d, or what has been Ailed the muriatic, is indicated 
bv hot eruptions, which itch much, attended with uncommon' 
thiifl and (Induing heats ; to alleviate which, ibe fulphureousy 
faline waters are recommended, particularly thofe of liar row;-ate,- 
Thorp-Arch, and thofe of VloiTat, avoiding at the fame time alt 
beating, acrid food—fuch as turtle, high feafoned di(lies, and rich 
loops—whey and mdk in thefe cafes are extremely beneficial ; 
the SCORBUTIC JUICES, made of the juice of garden feur- 
vy grafi, water creffes, both exprefled from frefli herbs, and of 
Seville oranges, two pints, fpirituoi/i nutmeg water, half a pint, 
thele are to be mixed together, and after they have flood till 
the feces have fubfided, the clear liquor muft be poured offl for 
u:c.—Of thefe juices, from two table-fpoonsful to eight, may be 
taken two or three times a day; or a DECOCTiON OF THE 
YvTXJDS, made of guiacum, or lignum cvitte Jaw-duff three 
ounces j raifms of the fun, two ounces \ Jaffafrat wood' fo CONSTITUTIONS SPECIFIED. 
97 
ed liquorice Jliced, each an ounce ; water, ten pints :—tl e 
guaiaciun and rain ns are to be boiled over a gentle lire, to the 
confumption of one half, adding towards the end the faiiafras and 
and liquorice ; drain off the liquor, and having differed it to reft 
for fome time, pour off wh .t is clear—a quarter of a pint of this 
may be taken two or three tunes a day, and all fuch as are diu- 
retic, and cooling ; hence fome of thole waters are of fervice, 
•which abound with l’aline fubftances, that are gently aperient, 
and move the urinary paflages—as Epfom waters, thofe of Chel- 
tenham, Stcke, or jejpjp waters, thofe of Pancras, Holt in Wilt- 
fhire, Stretham, and tome others. 
Ail cofmetics and repellent lotions are dangerous ; for if the 
acrimony cannot be coredted or carried out of the habit, its mod 
lalutary nutation mud be external ; and, perhaps, it may be the 
only means which nature has to unload the habit, or prevent the 
deleterious effedts, which would be occafioned, were any of the 
more noble organs fubjeided to the depredation of humors fo in- 
veterate. To v aletudinarians of this deferiptiona cool air ftiould 
be recommended, and fummer fituation near the f'ea-coaft ;— 
all falted meats and fill) ftiould be prohibited ; the body kept 
cool by faline aperients, and the mind unruffled by violent pafh- 
ons, and ail excefs in drinking refrained. 
Thefe conditute the fird clafs of natural humors—the fecond 
are the 
PARTIAL.—Where they only affeft fome parts of the con- 
ditucion, and are not diffufive, but produce particular difeafes 
from a peculiar fpecies of morbific matter ; and thefe are either 
generated in the habit fpontaneoufly, or teem to arife from errors 
i i diet, indulgences, or irregularities with refpeft to the ma- 
nagement of the animal ceconomy ; but thefe, if incapable of be- 
ing eradicated, may be alleviated, and in fome degree prevent- 
ed. 
The FIRST of which vve shall mention is the gout; refpe£t- 
! ing which, though fo painful, fo dangerous and common a inala- 
jdy, I believe little doubt remains but it may be weakened in its 
attacks, even in thofe who have been long lubject to it, by tem- 
perance ; that is, by properly regulating confutations confident 
.with the powers they poded : and 1 am firmly perfuaded it may 
be prevented from returning in the younger clafs of mankind, 
would they, on its fird onfet, preferibe to themfelves and follow 
jfuch regulations, as experience has, in many fimilar cafes, proved 
|to be conducive to thefe ends. 
| Adhering ftriclly to a milk diet has in many cafes put a dop 
to returns of the gout; and regularity of living, with propeex- 
jercife—abllaining from wine and high-fealoned diihes, pickles, CONSTITUTIONS SPECIFIED. 
and other incentives, that ftimulate the appetite, and occafion 
men to overload, and weaken the tone of the ftomach, and diges- 
tive powers, have rendered this malady infinitely more mild in 
its paroxyfms. Men, with this propenfity to the gout, Ihould 
avoid every excefs that has the leaf! tendency to reduce the habit 
below the proper ftandard of health—either in eating, drinking, 
or venereal enjoyments : for it is by the flaviih and conftant pur- 
fuit of th.efe particulars, and the great indulgence which they al- 
low tliemfclves, tl>at we fee fo many martyrs to gouty devas- 
tation. 
Early rifing, moderate exercife, and that daily ; bland mild 
food : abdinence from inebriating liquids, or a very moderate 
life cf them, as alfo of concubinage, will ever be fucceeded with 
inch confequences, as will amply repay us for philofophic for- 
bearance.—People of this conftitution ought to refrain from 
weighty cares—the labours of the mind—much thought, anxiety, 
and folicitode : they fhould avoid all vexation, particularly as no 
thing dil'pofes more to bring on fits of the gout, by occafioning 
crudity, and indigeftion, from weakening and rendering the ac- 
tion of the ftomach too torpid. 
Various modes have been recommended for preventing the 
nccefiions of the gout—but what feems to have gained credit 
from the experience of feveral intelligent men, is the ufe of ful- 
phur ; of which a drink is made by impregnating water with 2 
proper proportion of it, and this has proved falutary, in not on- 
ly mitigating fits of the gout, but fome fay of totally preventing 
their return. Indeed if wTe conlider the aclion of fulphur on 
the habit, we fhall not be averfe to think favourably of its 
ufe. 
Dr. CULLEN fays, “ It is certainly a mild and fafe cathar- 
4< tic, never producing any confiderable evacuation, but keeping 
“ up the natural excretion by the inteltines, without any irritat- 
“ ing or heatingeffett.”—And Dr. LEWIS—“ That pure ful- 
phur, in dofes of from ten grains to a dram or more, gently 
‘‘ loofens the belly, and promotes perfpiration ; it feems to pal's 
“ through the whole habit, and manifeftly tranfpires through 
“ the Ikin, as appears from the fulphureous fmell of thofe who 
“ hava taken it, and filver being flained in their pockets 
** to a blackiih hue, as by the vapour of fulphureous foluti- 
*l ons.” 
But we mufl obferve in this, as in every other conftitution, 
we muft be dire£led in our fpecific courle by the particular na- 
ture of the habit, according as it tends to one or the other, which 
xve have before fpecified- Hence in this cafe we muft fometimes 
enforce an abftemious regimen altogether from animal food— CONSTITUTIONS SPICIFIED. 
99 
fometimes allow its moderate ufe, proportioning the degrees 
of exercife to the degrees of tone, or ftrength of the fyflem, al- 
ways prohibiting the ufe of wines and other fermented liquors, 
except in cafes of great debility, or long habit; and preferving 
the (trength of the ftomach and digefiive organs. 
ad. RHEUMATIC.—In thefe, the fame rules will hold good 
as in the former, and not be attended with diffimilar effects, and 
thofe very often more certain ; for it has fometimes been pre- 
vented by wearing a flanqel ftiirt, which keeps up an increafed 
degree of infenfible perfpiration, and uling the cold bath or lea- 
bathing without interruption. 
3d. That difeafe, which in inland countries we feldom or ne- 
ver fee affedt the natives, called the PUTRID SCURVY—by 
exercife, warm cloathing, drinking acefcent wines, and living 
chiefly on frefh vegetables, or eating freely of them, will be pre- 
vented. it generally affedts thofe who live on fea-coall's, and 
feed on hill, and failors ;—hence four crout has been confidered 
as preventive. 1 have heard captains of forne fhips fay, great 
beuefu has been derived from vinegar, and they give it the pre- 
ference to lemon or lime juice—-why, 1 know not, unlefs from 
the faccharine fubilance in vinegar, a degree of fermentation 
takes place, and affords feme portion of fixable air, from whence 
poffibly tome antiputrefeent effects maybe produced. 
4th. Where we have real’on to fear a feropbylous taint, or the 
feeds of that difeafe called the king's evil predominate in the ha- 
bit—thofe means exerted, which give itrength to the folids, be- 
gun in time, bid fair to a£t as preventive in this cafe; at lead 
hinder the offenfive matter from producing its unhappy effects m 
a violent degree. 
Living in a free country air, particularly on the fea-ccaft, tak- 
ing exercife and nutritious diet ; moderate ufe of wine and a 
courfe of gentle chalybeates, or drinking the chalybeate waters 
once or twice a year, might anfwer the intention. 
5th. Where there is a redundancy of bile, or a collection, 
thofe conftitutions, we have fa id, are called bilious, and have of- 
ten a bitter taite in the mouth. The flomach and bowels of fuch 
Ihould be always kept clear, by taking aperient medicines every 
now and then, and fuch as are not likely to leave the body cof- 
tive after the operation. In thefe habits, aloes and foap are ufe- 
ful, callor oil, faline purgatives—as Glauber or Epfam fait, or 
the natural purging waters—-as thofe of Thorp-Arch— Northaw 
—Colchefter—Dulwich—Epfom—AHion—and Cheltenham — 
Fat and oily fubitances Ihould be fparingly, if at all thrown into 
the habit. Exercife fhould be per filled in, and fome fpecies of CONSTITUTIONS SPECIFIED* 
vegetable food preferred to any other, as the dandelion—endive 
—and fuch like 
6th. Ihe ltomach and bowels are apt to be loaded with differ- 
ent kinds of noxious materials, called faburra—and thefe are ei- 
ther acid, rancid, or vifeid. In all conflitutions that have one 
or more of thele particular tendencies, they generally arife from 
Weak, digeltive powers. Emetics and purgatives are now and 
then to be preferibrd on that account, and thofe things which give 
force to the weakened organ. 
lithe acid is mod prevalent, which will difeover itfelf by four 
belchings and heart-burn—animal diet is moll proper ; crude 
vegetables, milk, butter, and other oleaginous fubftances fhouJd 
be iortiborn, and alfo fermented liquors ; the mod proper drink 
is water alone, or warmed with a little ardent fpirits, or having 
ginget lutuied in it—liomachic bitters with elixir of vitriol, or 
bark ; abfoibent powders, as hartlhorn burnt and prepared, chalk, 
magneha, are ufeful foi immediate relief. In all relaxations of 
the llomach we mull aim at krengthening its tone, preventing 
fermentation, and promoting the expulfion of its contents ;—the 
alkaline waters, as thefe of Upminller, Brentwood, Seltzer, and 
iilbury, may be recommended. 
It tile eructations thou id be rancid, or occafion a putrid, ojfen- 
five tajte, caried nidorous, like that of bad eggs, and raufea at- 
tend, with the throwing up of liquids, that will blaze in the fire 
like oil , a diet containing a large proportion of acefcent vegeta- 
bles will be proper, with a very iparing quantity of butter and 
oil—made dilhes ihould nGt be allowed, nor rich fauces, or much 
gravy—acid fruit, luch as are ripe may be indulged in, and water 
generally the pi open cft liquor to drink. 
But if tue matter ihould be vifeid and ropy, that is there gene- 
rated—fuch things as will affifl in dividing in carrying it off, are 
the mo eligible—as calomel and rhubarb occasionally, 01 aloe- 
ttc purges— elixir proprietatis with bitters, cr pilulce Rttffi with 
Venice ioap—exercife, chiefly riding, is necefiary, and ad things 
which have in their own nature too tenacious a vifeidity, fuch 
as puddings, thick gruels, potatoes, Ihould be avoided—the fleflt 
or juices of older animals are preferable to thofe of the younger 
foi t—and alfo vegetables of the warmer clafs, muflard, horle ra- 
diih,. water creifes, Sec. 
And in all cafes where the digeftive powers arc too languid, 
where there is not too great an acrimony of the humors, and the 
habit is not liable to be heated from flight caufes ;—chalybeate 
waters, fuch as Pyrmont—i'unbridge—Hampltead—-Iflington,-— 
the fulphurcous, as Buxton—Bath—Aix-la-Chapelle— CONSTITUTIONS SPECIFIED. 
101 
Harrowgate—-and Llandridod, will always promote fome good 
purpoi'e in this refpeCt, without being in others detrimental. 
Butfometimes the lungs will be fubjeCt to be loaded with vif- 
cid, tough kind of phlegm, in order to prevent which, the mode 
above laid down will be highly conducive, and what will con- 
tribute much towards being more fuccefsful—are emetics taken 
occafionally. 
3. Befides what we have above deferibed, there are fluids 
which get into the habit from contagion or infection, and will 
produce difeafe by the action of their morbid matter, if not pre- 
vented, before they have manifefted their effeCt—-and thefe we 
call 
ACCIDENTAL.—The FIRST of which we fhall take notice 
of, is that creative of the lues venerea—or pox ; and where there 
is ft rung fufpicion of having had commerce with an infected ob- 
ject, the malady may be prevented by luch applications, as will 
walh off all the natural mucus of the parts, and thereby carry 
away the virus, or venereal poifon, which lies entangled in it : 
and thefe are folutions of the cauftic alkali ; foft or common foap, 
corrofive fublimare, &c. in water, with which the external parts 
fhould be well walhed, as foon as may be after coition, at lead 
W'ithin the fpace or fix or eight hours ; and fome fhould be in- 
jected within the urethra ; but great care fhould be taken not to 
make the folution too ftrong, left the parts fhould be excoriated, 
#and inflammation brought on by that means, with its painful and 
dilagreeable conlequences. It will be fufficient if the folution is 
of f’uch a ftrengch only, as will give a flight fenfaticn of pungen- 
cy on the tongue or infide of the lips. 
The SECOND—the poifon of the viper.—The ill confequences 
generally attending the bite of vipers, by which means they pour 
their virus into the wound, and i’o communicate it to the habit, 
have been prevented, it has been afferted, by the immediate ap- 
plication of the fat of that reptile to the wounded part.—It was, 
in the more early periods, confidered as a fpeclfic in that cafe—• 
but olive oil has been known to anfwer the purpefe full as effect- 
ually.— I hefe means may alfo be ufeful in abating the pain origi- 
nating from the liings of wafps --bees---hugs—gnats—or prevent- 
ing the effects from burns, or fealds, before the flcin is raifed into 
bliit ers ; but the more effectual modes are the immediate appli- 
cation of fpirits of hartlhorn, or of i’al ammoniac, or lpirit of wine, 
and continued fome time. 
1 he 1 HIRD.— I he fahva of a mad dog, or another mad animal* 
communicated by a bite, gives rile to the moil dreadful of all 
human calamities ; and its eft’eclr, if not prevented, generally 
terminate fatally : but thele have been faid to be warded off, by 102 
CONSTITUTIONS SPECIFIED. 
ufing the cold bath, and perfevering for fome time in taking the 
PUL VIS AN11LYSSUS,* a dram and a half of which was to 
be taken in half a pint of cow’s milk in the morning, on an emp- 
ty ftotnach, for four mornings together, and occafionally perfiftcd 
in, lo much recommended by Dr. Mead—or applying to the 
Ormlkirk medicine ; but tbefe have fo repeatedly failed, that I 
fliould not depend upon them—but where peopje are ftrongly 
wedded in opinion to thefe compofitions, 1 Ibould advife their ad- 
jninifiration—but not till after the following mode had been com- 
pleted :—Immediately after the wound was given, I would ad- 
vife it to be fucked fome time, which may he done w’ith the 
greateft fafety, the mouth of the operator being guarded with 
oil, for his fatisfaCtion, and the faliva not fwallowed ; then the 
part, where it can, Ibould be cut out, or burnt vvith a hot iron, 
deeper, and more extended than the wound itfelf ;—after which, 
the wound Ibould be filled with mercurial ointment, and a blilter 
applied over the part—kept open for fome time—and mercury 
thrown into the habit, fo as to raife, and maintain a fidivation, 
for fome weeks. For by thefe means, the poifon will be prevent- 
ed getting into the habit; and fliould a portion of it have made 
its way inwards, by the quick action of the abforbent veffels, it 
might be thrown out, by quickly and conftantly promoting fali- 
vary fecretions and excretion. 
The FOURTH —The noxious particles, which by inflation oc- 
ca/ion malignant ulcers of the throat, putrid fevers, or dyfentcry— 
and which are generally ufhered in with fhiverings, ficknefs, and* 
fudden lofs of flrength, have had all their confequent mif- 
chiefs prevented, by the inflantaneous exhibition of emetics ; and 
fliould thefe fail, fo that the whole fymptoms do not immediate- 
ly go off, a large bliller applied between the fhoulders has com- 
monly removed them. Nurfes, in the naval hofpitals, have, it 
is faid, from the moff undoubted authority, by this mode pre- 
vented mifehief. 
The FIFTH, and LAST of which I fliall take notice in this 
place, are the putrid particles, apt to be taken into the habit, by 
perfons wounding them fives by difie Sling of putrid bodies, or parts 
mortified—and of which many inilances have recently occurred, 
where the unfortunate, though praife-worthy, curious inquirers, 
have fallen facrifices to the deleterious effects. 
In cafes where, under thefe circumftances, wounds occur, I 
fhould recommend fucking the part immediately, and having it 
■well wafiied with vinegar ; then the application of ffrong mercu- 
rial ointment, and mercurial purges, taken occafionally at proper 
intervals ; for I know of no medicines which fo effectually clear 
n See p. J73—•liy. Lewis’s New.DIljjenf.itory, 8vo, Edinb. 1785. j CONSTITUTIONS SPECIFIED. 
the ferous, and lymphatic fyftem as mercury.—And in the in- 
termediate days a courfe of antiputrefcent medicines and diet 
Ihould be perfifted in—as bark—moderate quantities of wine— 
or vinous liquors—and vegetable diet—and bark may be very 
judicioully united with fuch other materials as promote perfpira- 
tion, and thele Ihould be indited on, and perfevercd in for fome 
time, and 1 have little doubt but they would prove a feeurity 
from future danger. 
Having now delivered fully what may be thought neceffary 
for understanding the nature of conflitutions in their limple, and 
mixed general liate, and alio peculiar, with the modes neceffary 
to be purfued, in keeping them in an healthful date, or of pre- 
venting difeafes, as far as refpeft thefe particular points; we would 
obferve to the young praftitioners, or thole who third after me- 
dical information, or love to engage in practice from motives of 
philanthropy, where medical advice may be far diftanty that the 
eye Ihould not only be carried to thefe conftitutional points ia 
cafes where prevention of difeafes is lludied, but particular at- 
tention Ihould be paid to them in difeafes, wherein they will be 
found altered from their natural (late, and fome different combi- 
nations taking place from the effects of the malady itfelf; which 
deviations, when difcovered, Ihould regulate the conduft ; and 
it will be perceived that medicines highly proper in the begin- 
ning of a complaint, are as improper in the conclufion, and fo on 
the contrary, and this alone owing to the alteration made in the 
habit : for inftanee, in inflammatory remittent fever, where at 
the onl’et, the conllitution is poffeffed of great firmnefs—ftrong 
vafcular irritability—-and equable nervous incitability—to give 
bark would be madnefs, little lefs than butchery, becaufe it 
would too much increafe the already too heightened powers, and 
occaflon the word conlequences : but at the latter end, or during 
the progrels in its later ftage, the fame is a cure, owing to the 
conllitution being altered by the violence of the dileale at this 
time ; for it lofes its firmnefs—inereafes vafcular weaknefs—and 
induces too great nervous incitability, all which are conquered 
by bark augmenting the tone of the fyftem. But as we have 
examined particular conftitutions in an healthful ftate, and point- 
ed out their variability, and fpoken of fome points neceffary to 
be obferved in our ccndudt, in order to preferve them in that 
ftate, we lhall now make the application on a more extenfive 
fcale. SECTION V. 
’ -mm):.;' 
Necessary Cautions rcfpe&ing Food, Exercise, &c. 
'flTHEN men’ are in a flate of perfeft health, the moving 
powers of the conftitution adl in unifon with each other, 
the force of one being in exadl proportion with that of another, 
fo that they perform their funftiens with eafe and regularity— 
neither exercifing themfelves fuperabundantly nor defectively j 
tlie machine is lively and a£tive—the thinking faculty alert a id 
clear—the blood and humours are bland, moderate in quantity, 
and free from acrimony, which may be diftreffing—the appetite 
is good*—the digeftion fufficiently ftrong—all the fecretions and 
excretions performed in due order—fieep found, and refrething 
-—and no perceptible defeft manifefts itfelf in any of the vital, 
animal, or natural a£tions ; and this fituation of the machine is 
the greatelt bleffing human wifhes can defire, and empowers man 
to enjoy every pleafure of moderation and propriety, within his 
reach, with the greatefl: zeft and inward fatisfattion. But unfor- 
tunately, men under thefe circumftances often plunge themfelves 
into the oppofite extremes, by itnprudencies and indulgencies ; 
for it muft be obferved, that the tnoft perfect llate of health is 
not far dillant from difeafe, and very often trifling indiicretions 
lay the foundation for great mifchief, if the coufequences occur- 
ing from thence are not foon put a flop to ; which, indeed, by 
a little care and attention, might frequently be prevented -cer- 
tain rules for which we (hall endeavour to point out, which one 
would fcarce think neceflary, if we confider the latitude given by 
CELSUS, to thofe in health, did not experience every day con- 
vince us, that the documents he lays down require feme reftric- 
tions.—He fays, “ A man, who is healthful, and at his own dif- 
“ pofal, ought not to be confined to any particular regimen ; as 
“ he wants not the advice of a phyfician, his mode of life ihould 
be varied ;—he fhould fometimes refide in the count y. fome- 
*' times in cities, but oftener in the former ;—he ihould now 
“ and then fail, hunt, or live at eafe, iu perfedl reft ;—he fhould 
“ ufe fometimes the warm bath, fometimes the cold ;—eat, in 
“ common, all kinds of food ;—fometimes be in company, and 
“ feait himfelf ; fometimes live retired, and abflemioufly ; now 
“ and then take more or lefs nutriment than might he cxahlly pro- 
“ per ; but refreth himfelf rather twice with diet, than once a 
“ day, and that in a plentiful portion, if it can he conco&edi—but 
4‘ though exercife and food in this mode are neceffary, in inordi- NECESSARY CAUTIONS. 
4‘ nate degrees they are not ferviceable ; for bufinefs, preventing 
“ the exerciie, which may happen on account of attendance in 
“ various avocations, the body will be injured, a| thofe which 
44 receive nourishment in their ufual way, will quickly decay 
44 and become difordered.” 
Though this latitude is given, we mult obferve it is only to a 
man in full vigour of health ; but even here, during the hate of 
allowed indulgence, feme caution becomes necefiary, efpeciaily 
againlt every fpecies of excefs ; for it is a known and allowed, 
truth, that excefs of every kind, whether corporeal or mental, 
dilorders the human frame, and lays the foundation for a variety 
of complaints ; evert in thofe things, a modem e iharc of which 
is necelfary for the fupport of our machines—conduces to invi- 
gorate our mental powers, and promote our pleafure. 
In eating and drinking, this is an obvious truth, though in the 
latter it is much lafer to exceed than the former; in proof cf 
which, let us examine them. 
We find that by drinking a quantity of vinous and fpirituous 
liquor, in which all thofe which caufe inebriation are included ; 
the vital principles, or that xhich fupports life, and renders the 
maciiine adlive, is rendered extremely powerful by the fiimulus 
applied partially to the flomach, or more diffnfiveiy ; the fpirits 
are elevated, fometimes even to madnefs ; a more than common 
flreis is laid upon the conilitution ; t’ne habit becomes fuller io 
long as this fiinuilus continues, and liquor is poured into the flo- 
nvacn ; which llimulus ceafing from conftirufi'oi a! fatigue, the 
fyllem feels too much loaded and enervated ; the flomach relax- 
ed, and ail the vital powers incapacitated to perform their func- 
tions properly: hence pain, ficknefs, heai-ach, languor, or a tem- 
porary lever, perhaps after a debauch, the whole, or molt pare 
of tiiefe meonveniencies are experienced. 
To remedy which, lying in bed and plentiful dii ition with 
watery liquors—as Weak, tea—fmall btoth.-thin gruel, &c fiiould 
be peril lied in, to promote perfpiration ; or recourfe lhould be 
had to riding on horfeback,- by which means the fuperabundanc 
load will be carried olF, and the body reltored to its proper tone. 
Either ot thele method? may be purfued, as is moil agreeable to 
the conilitution : the former 1 lhould recommend to plethoric 
habits, and thofe of a llrong ilamina ; the latter to the more re- 
laxed whofe flomach is generally in a weaker flatc. Sometimes 
taking plentifully of the following :—One dram and a half of 
fait of tartar, called now' prepared kali—four table fpoonfuls or 
five of lemon juice—water which has been boiled, half a pint—- 
brandy three or four table fpoonfuls, and this fvveetened with 
fugar; or if the Itomach is very weak, a dram and a half cf aFo- 106 
NECESSARY CAUTIONS RliSFECTfNC 
matic confe&ion, or two table fpoonful- of tln&ure of bark mai» 
be added;—a tea cup o* more of which may be taken often in 
the day :—c#v\ hat is better, the fait of tartar may be dififolved 
in the liquid, without the lemon juice ; and after every fix 
fpoonfuls drank, let a mble fpoonful of lemon juice be taken, and 
this repeated in the fame manner ;—or fome warm and grateful 
cordial, as ratfia—ufquebaugh—brandy, mixed with peppermint 
water, may be adminitiered, which will give immediate relief to 
thofe whole ftomach is afFedled with naufea, ficknefs, or oppref- 
ft on, a common pisdiice with men devoted to liquor ; but this 
ihould be had recourfe to only on very particular occafions, for it is 
a cuflcm may be attended with difagreeable confequences, if too 
frequently ufed, becaufe the ftomach, once accuftcmed to any 
particular flimulus, tequires the ccnftant rcpe.ition of that fti- 
jnulus, which, in time, deftroys its tone, and lays tire foundation 
for thofe maladies which arife from inebriation ; and it is this 
which often induce men to turn drunkards : lew fpiiited women, 
frequently from taking things of this fort to exhuirate their fpi- 
Tit>, are converted into fhamelefs fots, and become the difgrace 
of their own fex, and contempt of ours. However, this furnilh- 
es one proof of the power which the liomach contains over the 
fvflein in general ; as by the ftomach being ftimalated, all that 
laflitude—lan uor—naufea—ficknefs—and every uneafy fenfatiou 
attendant on its relaxation, are removed, except heat. 
By excvfx in eating, the ftomach is apt to be cver-diftended— 
the digeltive powers weakened—the veflcls filled with crude 
chyle—lefpiration retarded ; hence a fenfe of weight at the (to- 
ri, aen—pain and flatulence—propenfity to deep—inactivity, and 
fiillnefs of the head—obfti uifed vifee a---jauadice—«dropfy— 
afthma—apoplexy--and a number of chronic complaints, if the 
pr; dice is continued 
But if an error has been committed, and efpec'ally if that lias 
been with high-feaforied diflies, a draught oi cold water, acidu- 
lated with elixir of vitiio!, taken foon after eating, will relieve 
the ftomach from that weight with which it is often oppreffed, 
nfliat digeftion, reft rain fermentation, and prevent flatulency ; from 
Lei ce, perhaps, the life of ices may be approved. 
1 remember an account given me of a dignified clergyman, 
ivho was lb great a (lave to his appetite, that he was obliged con- 
Hantly to have vecousfe to (bine application to prevent indigef- 
tion, he gormandized lo abem uably; as a proof of his gluttony, 
1 cannot give it a gentler term, the following is recited : 
He was invited to dinner, where every tari y die place afforded, 
was provided, of wInch he eac in his ufual m mner j Lot the gen- 
tleman, with whom he tuned, huowing he was extremely load fOOD, EXEPvCISE, 
of-venifon, and being well acquainted with lm difpofition, re- 
ferved the haunch in fuccelilon, of which he had advertifed he 
red of the company, on its appearance, the already fatiated di- 
vine, after exprefling his furprife a: not being intOrmed of this 
luxury before, retreated into the yard, difgorged the load he had 
before fwallotved, and returned to the attack of the venifon, with 
his aceuitomed vigor and prowefiq to the aftonifhment of his 
companions. Heuce we may infer, vomits in many cafes are al- 
fo ferviceable ; however, at an early period, he became the victim 
of dii'eafe, and died of adropiy, facceeding an irremediable jaun- 
dice, brought on from this comfe of living. 
With regard to our food, however, in quantity and quality, it 
fnould be properly proportioned to our exercife. The farmer, 
who follows his plow, and is perpetually toiling from morning 
till could not exilt on food appropriated to thole who pur- 
fue not the feverer exercife of the body; his diet rau » be of the 
coarfer kind, fuch as old milk cheefe, faked meats, bread made 
°f rye, potatoes, &c. oec. and thefe in pierty large quantities. 
This rood anfwers to him the purpofes of nature, keeps bis body 
in a Hate of health, becaufe his digeftive powers are very active, 
ai d form from thefe materials good chvle, on account ot the 
occupation in which ne is engaged ; which in the more delicate 
and lei’s laborious, or indolent, would occanon great indifpofition. 
In Hsrefordfliire, and fome other counties, men are not allowed 
fit for fervice, nor get hired, without, as it is termed, they can 
bait bacon ; that is, fwallow it unmalticated, cut into pieces, a- 
bout an inch and an half, or two inches lon;>, and half an inch 
fquare, or thereabouts, and this in tolerable quantities; and this 
is done in order that they may attend clofeiy to their labour, 
without fpending any time in taking in nourifhment for their 
necefiary fupport; for bacon being fat, and of a firm texture, 
from being hardened by lalt in its curing, will lie a long ume in 
an undigelted ftate, by’ which means the craving-, of the appetite 
are kept oft, and the ftrengih fapported. 
But ffiould abftinence be unavoidable, a man, during that pe- 
riod, iliould not undertake any laborious employment . as in . it 
cafe, the confumption of the thinner fluids would be too great, 
the folids would be rendered weak for want of proper fupport, 
and the liquids difpofed either to form concretions, that is, dege- 
nerate into tco thick m a lies, cr run into a itate of putreicent a- 
ci imony. 
There is one cuftom to which the generality of mankind are 
apt to be addicted ; when they have fufFered fatigue, and that 
perhaps fevere, from hunting, lhooting, cricket playing, walking, 
ike. they commonly indulge their appetites by eating copioully NECESSARY PRECAUTIONS RESPECTING 
of folid food; and think it one of the benefits rrom thence arif- 
ing, that they are enabled to throw down fn. h a load of g;ofs 
materials ; r;ay, not content with this, they make them float in 
pot ter, ale, or tome other vifcid liquor, and aftei wards, i.idulge 
themlelves with a jolly bottle ; and this they think lupported by 
reafon, lor whcie the machine is weakened, it let ms natural to 
fuppole it requiu-s much refielhment. If we examine the effects 
ot uch ind'leraet condudl, we carjnot h rate to pronounce it 
erroneous, and condemn the practice : fo. after eating and drink- 
ing, in this manner, they grow dull and heavy and general laf- 
Ittule co nes on ; the pulle grows quick ; t e face flulbes , a tem- 
poral \ terer luccetds ; fleep is dillurbed; prolule iw’eats break 
out or a too g.ear general heat, with diynefs of the fkin, is per- 
ce; iole ; the mouth is clammy : ch ill is an attendant: and they 
life m ili morning .veary, and atTr-lcd with pain, of It i flu elf in 
th jo nt wa. ting that alacrity ai d afti' ity they ought to pof- 
feis, r o tiie nr ads indulgence, lnaeed, ofremirpes a founda- 
tion ia laid tor infinitely more ferious complaints, accoiding to 
the pe u iar nature of the lever ; nay, ft metimes immediately 
brought on, fuch a-; inflammatory or flow fevers, local ii flamma- 
tions, rheumatilm, dec. Nor can it be otherwife, for all the vi- 
tal, natural, and r.nimal powers aie weakened, and a load laid on 
ru'ure i i her debilitated date, for hei to conquer, before the vaf- 
cular fyilem has recovered its llrength fufficiently for the per- 
formance ol fuch an office. 
Were they to confine themfelves to liquid food, or that fort 
readily digeltible, fuch as weak broth, milk, light bread pud- 
ding, dec, with wine and water for their beverage, all thefe in- 
conveniencies would he prevented ; the body would only receive 
that nutriment it could readily digefi, and the veflels from not 
b. ng over difiended, a id their actions too powei fully folicited 
by a co nil ant liinulus, loon recover, by reft, their natural elas- 
ticity ; then with impunity nrght they ptufue their fellive joy. 
It it aljQ prejudicial aft er fujfering fever e hunger, to eat immo- 
derately—or after a full and conjlant feeding, to fajl ahfolutely. 
Neither is running into the extremes of reft; and labour fuccef- 
fively, by any means attended with faiety. 
The conllitution may be brought to bear many alterations, 
but thefe mull be accomy.lilhed in a gradual manner, for few of 
any confequeme happen, but they occalion an alteration in fome 
of the folid cf the lvltern, producing either a greater degree of 
extension or contratlioi-i—confeqnently alfo a change is created 
in tilt fluids : and it any detedl ihould happen in one part, from 
tlie mode of producing thole changes, nature provide- again ft 
fuch deled! by adapting fome other parts to the performance of FOOD EXERCISE, &C. 
their duty, in a greater or a lefs degree, or a duty that is not na- 
turally intended for them ; as we fee in the decreafe of one eva- 
cuation, it often promotes the increafe of another : and veflels 
appropriated o the difchaige of one fluid, will often emit ano- 
ther, a in cafes ofobilrudtcd menles, where blood has iiTued pe- 
* ic .i e illy from the eyes and lungs , i'o that all fudden changes 
ina) b productive of a variety of complaints, not only on ac- 
co .. of me pa ts being unaccultomed to perform their pioper 
obices, and tio . varit o; uie being rendered too weak, but want 
o time or natu e to make fuitable difpoiitious, to alleviate dif- 
trefs a ling Irom l'udden contingencies. 
' herefore, if a man has laboured under fevere hunger, his Ho- 
rn eh will be 11 a Hate o contractility, lefl’ened in its capacity 
more than ufual; loading it copfequently too heavily, will either 
pccafion vomiting, or uneafy fenlatipn of weight: heart-burn, 
perhaps inflammation, or a fpafm of both the orifices, or either of 
them—or mitchief might be created in other parts of the machine, 
from filling the veflels, which muft alfo be in too contra&ile a 
flate, too iull ol crude ill iorrned chyle ; (or in this lituation, nei- 
ther the peculiar juices of the liver-—fwee -bread—nor thofe of 
the ftomach itfeli, can be fepaiated in their p oper quantity, nor 
will be endowed with their natural qualities, fufiicicntly perfeft- 
ed tor the bufinefs ot digellion—all which aie abfolutely necef- 
fary for forming the nut.itious fluid ina falutary Hate. 
And what on the contrary will happen, if a man, after full 
feeding, filling the habit copioufly and conliantly with liquids, 
flioulcl fubmit to abfolute fading? 
As it is neceflaiy to keep up a plenitiude in the veflels, that 
the fluids may preferve their power of reaflion, as a Stimulus 
aililling powerfully the promotion of vafcular contraction, and 
thus maintaining an eafy and equable circulation, we from time 
to time throw in food to fupply the defcft of the fluids, which 
arifes from the conftant and natural a£tion of the veflels ; and 
this not only continues a requilite equilibrium, or neceffury e- 
quality in the powers of the cnculatory fyflem, but alio fupports 
a continuance of preflu re upon the brain, which is very mate- 
rial for the performance of its duty in the body; fence we find 
in proportion as that organ is deprived of that prefi’ure, it per- 
forms not its functions regularly—hence convullions- -laintings 
— death ; and we alfo find the more plethoric a man is in a 
llate of health, generally the more warmth he has in his h", 
bit. 
Now if a man is filled with fluids from eating and drinking 
inordinately, the conlhtution will act under the impulfe ot in- 
creafed ftimulus. NEC3ESSARY CAUTIONS RESPECTING 
Sudden 3nd total abflinence therefore would prevent the regu- 
larity of the brain’s aftion, and render the fyftcm languid Bom 
withdrawing: the ilia)ulus, by which it had been actuated—the 
vefiels would collapfe—circulation would be carried on with 
difficulty—the heart pppreflTed—and in the firft inftance, fangui- 
nary concretions might be formed. But fhoujd the caufe be 
permanent, the humors, for want of freih fupply of new fluids, 
would grow (harp and acrimonious—-general irritation take place 
-—a fever enfue—an inflammation of the brain come on—and a 
delirium clofe the fcene. 
Having examined the effi-Ss produced by fevere hunger, and 
gratification of the appetite copioufly and constantly, and ludden- 
ly changing from one tcvthe other ; let us now examine the con- 
fequences of the extremes of reft andlaboui, fucceeding each o- 
»ther in the fame manner. 
And firft— What will be the refult if total reft fhould fuccecd 
hard labour? 
The conftitution being habituated by cuftom to arty particular 
practices, cfpecially where the motion of the fclids are principally 
concerned, is fo ufed to the impreflions made by thofe practices, 
that they become neceiiary to its welfare.Hence a man accuf- 
tomed to hard labour, enjoys a better ftate of health, under that 
circumftance, than if he was to fall entirely into habits of indo- 
lence; for the fyltem being divefted o! thofe particular impulfes, 
ufual to be given, would experience a degree of torpor, or flug- 
gUlinef’s'—-the fluids conftantly increaled to fupply the dtfpendi- 
um or confumption, having no occafion to be appropriated to 
that purpol'e, would form collections in the vafcular, glandular, 
and cellular fyftem—and hence would arife a variety of com- 
plaints from fullnefs, and corpulency—and a foundation be laid 
for numbevlefs chronic difotders. 
And we may obferve many men, retiring from avocations 
which require bodily activity into the arms of idlenefs, though 
pofleffing their health under former fituations, plunge into dif- 
<t afe— and numbers of them die apoplectic—-paralytic—althma- 
tic— or dropfical. 
But, on the contrary, if men apply to hard labour fuddenly, 
from a ftate of abfolute reft—the conftitution will become lan- 
guid, from want of proper fupport, and be affetted with differ- 
ent kinds of confumptions, not of the lungs particularly, but 
gradual wafting away—dropfies—fevers, &c.-~for the vcflels 
liot having been foliated to ltrong aCtion, arid the fluids, though 
abundant in quantity, not properly elaborated to repair the lots 
fevere exerciie occafions, the former will be weakened by a hid- 
den increaie of action, and want of adequate fupplies j-—while FOOD EXERCISE, &C. 
the latter may form congestions in the head, or internal parts, by 
being pulh d fuddenly forward, and too violently, and foon ac- 
quire a dangerous and noxious acrimony from crudity, or defi- 
ciency. 
But though extremes in thefe particulars are highly injudici- 
ous, becoming the prolific parents of many maladies, yet puiiu- 
ed under proper limitations, are reolete with innumerable ad- 
vantages—for exercife aud red a»e the certain Supporters of a 
pleafurabie life, as lar as it depends on general health—Hence 
mult we allow every fpecies of the former very beneficial—but 
then it mad be limited by the (irength—for when in proper 
piopoition it gives coullitutional vigour, and mu feu lar firmnefs 
-—while inaction renders Mie body liftlefs, and relaxed—arid, 
indeed, if exercife is purfued to the diftrefs of the natural pow- 
ers, it c.eates a number of injuries, which its judicious ule would 
inevitably prevent. 
ISefides we mufl obferve, that all exercife, of whatever nature, 
whether walking—running—fencing—riding on horfeback — 
or in a carriage—playing at cricket, tennis, &.c. fhould be adapt- 
ed to the prevention of any difeafe the perfon fo ufing it may 
have a tendency to fall into—to thofe liable to fall into grandly 
compilin'!, riding o 1 horfeback fhould be recommended ;---to have 
collections of phlegm upon the lungs, reading aloud—finding; — 
thofe fuhjeCl to the gout, walking -indig eft ion, or vifceral objlruc- 
Hons, riding ; fubjetl to catch cold, walking -thofe of ftror.g 
mufcular ltamina, having giflj circulation and coldnefs, play- 
dug at cricket or tennis ;—to hyjleric difsafes, or melancholic af- 
fections, where the mind broods too much over imaginary cala- 
mities—driving a carriage-- (hooting-— hunting, or tome, where 
their reflection may be withdrawn from unpleafant objects, &c.— 
and thofe exercifes which are more or Iefs violent, fhould be ad- 
vifed according to the ends we with to promote for the grand 
buii iefs of thefe are to incieafe the tone of the lolids—make the 
different glands perform their functions ; promote infenfible ptr- 
fpiration; and prevent the fluids from becoming detrimental to 
either by then thinnefs, Acidity, or acrimony. 
Exe cifc may be divided into thefe three degrees—-the 
STKONGES’l of which are, 
Firji— Playing at tennis, cricket, fencing, and running, 
8c c, where .rear m lfculu exertions is nectflary. 
Second—Walking, reading aloud, riding on hoiieback, or in a 
carriage: 
Lajt—Sailing, chamber-horfe, dumb-bells, and frictions : 
which lalt are appropriated to old age, where mufcular force 
begins to gro;v effete; and arc neceilary for thu prefeiva wn of NECESSARY CAUTIONS RESPECTING 
health, by promoting the circulation of the blood, and motion of 
the fluids, through the minute veflels. 
But Jleep is efteemed the grand preferver and reflorer of health, 
fuch as is well-timed, and properly proportioned ; for fome con- 
ftitutions require much more than others.-—It is one thing the 
moil effer.tialiy neceifary to life, as this is the time when the fyf- 
tem is freed fiom all incumbrances, undifturbed by mental re- 
flections, which often diforder the animal economy, and prevent 
the human frame from acting, through all her departments, with 
equality and full force, in which the nutritious particles, pro- 
perly perfected by the operation of the ccnflitution, or chiefly 
anplied to repair the walte, and replace thofe which have been 
abraded, and waflicd off by the labor and exercife of the day. 
Thus fituated, the moving and ftfiimilating powers of the bo- 
dy have only that bufiuefs by which the parts are renewed to per* 
form, and the veffels are properly difpofed to receive fuch addi- 
tions as are required, and co-operate to that end ; but if the ma- 
chine is too much indulged in this particular, it becomes much 
dilpofed to be corpulent, languid, and weak, and feel a number 
of inconveniencies from thence arifing. 
With regard to the time neceifary for the producing the good 
eftedts it is various in different constitutions : fix or leven hours 
reft is l'ufficient for many ad alt conllitutiows, though fome re- 
quire n m or twelve.—A lad .- whom I attended, of aielaxed and 
d beate habit, fubjeefc to hyiterie affections, and an acrimonious 
ftate of humors, though by no means indolently difpofed, was 
advifed to rife early, and g adually leffen the time fbe uied to de- 
vote to her bed, w hich was conllaatly twelve hours, and v, hich 
was fuppofed to contribute much to the relaxation of her habit 
—flie made the attempt for fome time, but could never enjoy lo 
comfortable a ltate of health, as when fbe indulged herfelf in her 
ufual rultom. 
btill in many this indulgence enervates the fyftem—-renders 
them hypochondriacal and hysterical—relaxes the folids—dif- 
pofes the humors to be vifeid, or acrimonious—blunts the vital 
powers—and brings on a difeafed, ar.d early old age. 
But, notwithftanding, we will allow that m ture herfelf re- 
quires, in different conilitntions, fuch variability ;—the cuftom 
of deeping long, and indulging in bed, is very frequently the re- 
fult of indolence, early induced, aqd long encouraged :—iuch a 
difgraceful wafte of time fliould be difcountenanced, and the ha- 
bit conquered, wrhich may always be accomnhihed, in the ear- 
ly' and middle part of life, where it arifes not trom conffitutional 
neceffity, naturally implanted ; but it mult be done by flow de- 
crees, for all extremes of change are detrimental. FOOD EXERCISE, &C. 
It is the practice of numbers to indulge themfelves in deep- 
ing in the day-time ; feme immediately after dinner—dill, not- 
withftanding what has been advanced by fome authors, that deep 
is ufeful even at thofe times, as it promotes digeftion, I think 
the rule, very often, more falutary in the breach than the con- 
formity ; for it creates giddinefs and languor, efpeciaily in thofe 
addicted to ftudy—deadens their thinking faculties, deftroys per- 
fpicuity, and clouds the imagination ; but if no fuch effects are 
perceived, and people find themfelves recruited, alert, and a£tive, 
it may be allowed. 
In proportion as the powers of digeftion are more or lefs ftrong' 
in different ages, with refped to DIET, they have claimed dif- 
ferent kinds. 
To the younger clafs of fubje&s, and children, therefore, vi- 
ands of the milder, and fofter fort, are confidered as the moft pro- 
per, as being more readily affimilated. 
To grown perfons, thofe which are more fubftantial and folid— 
and 
For old people* it has been thought advifeable to retrench o£ 
their folid, take that nouriihment which is more fluid, and in- 
creafe rather in drinking ; becaufe they not only digeft lefs free- 
ly, but the machine approaches more to drynefs, from a defici- 
ency in their juices. 
Were the regulations here laid down obferved with tolerable 
attention, and thofe adverted to which have been ipoken of, when 
treating of the Noh-naturals, adapting them to the peculiar cir- 
cumftances of different conftitutions, a plan may be formed by 
every individual fufficient to contribute towards the continuance 
of health ; nay, be fully adequate to infure its prefervation, if 
clofely purfued. 
Thefe rules, though, are calculated for thofe who are arrived 
at the years of maturity, or at fuch a time of life, that they may 
become fubjedt to the dire&ions of others, who have made thefe 
things their ftudy, and have from thence acquired a competent 
knowledge. 
But before we conclude this part of our work, it feems pro- 
per to take notice of what is neceffary to be done in the infan- 
tile ftate, in order to promote for our offspring, in their tender 
years, the fame benefits—and this leads us to confider the good 
or evil confequences of proper or injudicious Nurfing, which we 
fhall make the fubje£t of our next Section* SECTION VL 
On NURSING. 
TF We look into and examine the bills of mortality, to be ia* 
formed at what ages the greateft number of people die, we 
iliall find that half of them go off under the age of five years :—•* 
to what are we to attribute this? That nature is defective in 
her operations, and that half of mankind are born in fo imper-i 
fed a date, formed of materials fo bad, or fo defectively united; 
that they cannot fupport the operations neceffary for the conti- 
nuance of their exigence any longer ? Or are we to conclude 
that in that period they are fubjeCt to more fatal maladies, and 
die the victims of difeafe in greater proportion than at any o- 
ther time ? Were fuch conclufions to be formed, we fhould bs 
acculing the Omnipotence of Providence, or arraigning the prin- 
cipal Agent of Heaven, NATURE, of executing her office wan- 
tonly, or rmprovidently. This, then, cannot be the cafe ; for 
if we look through the vegetable or mineral kingdom, we fhali 
never find that any of their productions are fubject to be deitroy- 
ed, merely becaufe they are in a date of primary exiltence—or 
in the brute creation, becaufe they are young. When deftruc- 
lion happens to them, it is from being placed in fuch fituations, 
and under fuch circumflances, as are not congenial with their 
peculiar nature:—fo happens it, 1 have no doubt, with the hu- 
man fpecies that this mortality in the infantile date is owing to 
bad riurfing, where, by thefe means, the operations of the con- 
llitution are impeded, or perverted from the indolence, igno- 
rance, or fuperdition of thofe allotted to rear the infant in its 
tenderer years—and it is adonifhing, that, in a bufinefs requir- 
ing the utmoft fimplicity for its fuccefs, fo many, and fuch great 
errors ffiould be committed, as to become too certainly, and too 
commonly fatal, particularly in children born of delicate and 
weakly parents; who, partaking of their conditutions, are liable 
to be feverely afflicted from indifereet management, and want 
drength to druggie through calamities originating from that 
fource. 
Let us cad our eye amongd the hardy fons of the ruftic race 
—compare thofe with the offspring of the more refined and po- 
liffled—what a difference in appearance ! Amongd the former, we 
find the children firm, lobud, lively , healthful, aCtive, and drong ; 
amongd the latter, weak, puny, relaxed, and fickly. Amongd: ON NURSING. 
the former few die, but from the accelfion of unavoidable illnefs, 
as mealies, fmall-pox, chin-cough, dentition, &c. Among the 
latter numberlefs expire from gripes, loofeneffcs, hectic fevers, 
worms and convullions. 
But there are greater evils than dilTblution in this Hate from 
this caufe ; for from hence difeafe itfelf is generated, and fo fix- 
ed in the habit, that the life of many is oftentimes one conti- 
nued fcene of miXery ;—nay, I have no doubt but, from this 
fource, the temper and difpolition acquire fo fretful a-call, and 
oftentimes is fo foured, and rendered fo petulent and peevifh, 
that, whilll they do exill, they continue unhappy and miferable 
in themfelves, as well a3 troublefome and offenfive to their at- 
tendants and their afTociates ; for it has been allowed, that the 
faculties of the mind, very often depend upon the organs 
of the body; for when thefe are in a tolerable perfect 
Hate, fo as to perform their feparate functions properly, the 
thinking part is more alert, aClive, and cheerful; and good-hu- 
mour the confequence of fuch freedom—whilll the contrary ef- 
fects are produced, when the organs are dillurbed, or difeafed. 
To avoid, then, which difagreeable elFeCts, it is our bufinefs to 
lay down fuch regulations as are founded on rational principles, 
fupported by experience, and which confilt in bringing up chil- 
dren in a plain and fi.mple manner, the mode molt confonant 
with nature ; and if we ohferve the method Ihe invariably pur- 
fues, we lhall find that Ihe delights in fimplicity atone. View 
but the brute creation, and thole of the leathered race—fee what 
occurs in them; examine what method they, rearring their young, 
infti&ively adopt, and mark their fuccefs .cleanlinefs, proper feeding 
and exercife, comprehend in thefe the infinite wifdom of her laws and 
if we add judicious cloathing, fo Ihouldthey thatof the human Ipccies. 
As foon as quadrupeds bring forth their young, the firlt care 
of the mother is properly to clean them, and keep them per- 
fectly warm, till all the moifture is exhaled from the furface of 
the body; fo happens it with birds : after which the young deep 
for fome time—almoft cotlftantly for the firlt few days ; in brutes, 
fupported by the mother’s milk alone, which is ready in the 
brealt at an early period, the young foon walk, and become play- 
ful and fportive, by which means they procure to themielves 
fufiicient exercife, and in this manner are brought up with eafe 
and certainty: with refpeCl to cleanlinefs, the feathered race do 
the fame, never leaving their young after they are hatched, till 
they are perfectly clean and dry ; the mother, as foon as the egg 
is freed from the young, placing it under her in the warmeit 
part; but as they are di veiled of milk, in order to nourilh them, 
if of the granivorous kind, ilie endeavours to render their nutri- ON NURSING. 
inent the mofi eafily digeftible, and as nearly fluid as poffible, 
by picking up grain, macerating for fome time in her ftomach, 
and then throwing it up into the mouths of her young, who, 
vvhilft feeding, flutter their wings, and agitate their whole bo- 
dies in a furprifing manner, which ferves as a fpecies of exer- 
cife, and this univerfaliy prevails in all fuch as lay in the neft 
fome time before they can ufe exercife by flight, or running about, 
and feeding themfelves. 
In raiflng up our young, we therefore cannot do better than 
imitate thefe laws, fo univerfaliy prevalent, of which we fba.ll 
take a general furvey ;—which confifl in, 
1. Cleanlinefs, 3. Exercife, 
2. Cloathing, 4. Food, 
under which all will be included neceflary for the proper con- 
duct of thofe who make nurfing their particular bufinefs, or un- 
dertake that office from neceffity or inclination.—And full we 
TOufl obferve, 
ihat numbers of children, as foon as they are born, are cover- 
ed with a mucus, or white fordes, which ought to be wafhed off 
with foap and water ; but fbould it be very adhefive, there is 
no neceffity of rubbing the infant feverely at firft, for on 
the fecond dreffing, if any remains, it will readily come off; and 
long continued or violent friCtion is apt to create uneafinefs, fub- 
je£i the child to catch cold, and produce inflammation ; and as 
cold, at this very early period, occafions feveral difagreeable 
ccnfeque ices, particularly fore eyes—cough—Huffing at the 
breait gripes—loofenels—or floppage in the nofe, at the birth, 
it fhould be wrapped up in a flannel receiver, lined with fine old 
linen, and kept from the contaCl of the cold air, for a quarter or 
half an hour, before it is cleaned, and this ffiould be performed 
before the fire ; indeed, before the infant is taken from the mo- 
ther, it will be prudent to cover the eyes by a foft linen bandage, 
and fallen it at the back part of the head. As foon as the child 
is cleaned, and well dried, the naval firing ffiould be carefully 
folded up in a piece of fcorched rag, in two or three folds ; for 
this not only prevents the infant from running the rifque of be- 
ing- griped by the coldnefs of the naval firing, but abforbs the 
dive liquid which is generated by its running into a corrupt 
ftrte. 
it is the cuflom next for nurfes to rub the child’s head ex- 
tremely’- well with ;heir hand after waffiing, a: d apply brandy 
or fome ardent fpirits at the fame time, and then forcibly prefs 
the head in different directions, under the notion of aiding in 
joining the bones, where the futures are open, a contrivance of 
nature, apparently that in labour the dinaenfions of the head may ON NURSING. 
be leffened by the different bones riding one over the other, and 
delivery, by thefe means, be facilitated ; after which the child’s 
head is tight bound up with with a forehead cloth. 
This over officioufnefs is highly detrimental and derogatory to 
the intent of nature ; for by preffing the head too forcibly, and 
keeping it in a confined date, prevents the proper circulation of 
the blood through the veffels of the brain, and brings on convul- 
fions and other complaints from congeftion ; and all this without 
in the leaft anfwering the intent for which this abfurd cuftom is 
pra£lifed. For the bones join not by the edges of them coming 
in contact with each other, but from bony matter depoiited in the 
cartilaginous and membranous fubftance of the cranium, and 
forming a jun&ion in this way, and therefore the head fhould be 
left entirely to itfelf, after being cleaned, without the labour 
has been very fevere ; then fometimes the vertex will be great- 
ly dwelled by the long continuance of labour, occafioning great 
preffure upon the larger part of the head, and impeding the re- 
turn ox the fluids, by which the fkin on the vertex of the crani- 
um will be fo loaded with fluids, as fomsdnies to produce a tu- 
mor, not inferior in fize to a large egg, which may inflame and 
fuppurate, as I have obferved, particukrly where imprudently 
managed. 
Inftead, therefore, of fubmitting the head to fo fevere fri&ion, 
let it be bathed, where fwelled, with brandy—arquabufade water 
—or fome other ardent fpirits ; or rags, three or four doubles, 
may be dipped in Goulard’s faturnine water, mixed with about 
a fourth or fifth part brandy, and applied to the part affedted ; 
and then the head lhould be covered with a loofe flannel cap, 
over which may be placed a linen one, tied under the chin only 
juft fo tight as to keep it upon the head : and this operation may 
be repeated once a day till the fwelling fubfides, which will com- 
monly be in the fpace of two or three days. 
Under the idea of giving ftrength to the child’s back, and en- 
able it to fupport itfelf, it ufed to be the practice, and ftill con- 
tinues in fome country villages, to fwathe or roll the child very 
tight round the abdomen, with a very broad roller ; by which 
means the circulation of the blood was impeded, the fuperior 
parts loaded, the periftaltic motion of the inteftines, and the ac- 
tion of the abdominal mufcles, hindered from properly perform- 
ing their offices ; hence gripes—convulfions—coughs—and gene- 
ral uneafinefs. Inftead, therefore, of this roller, a fhort flannel 
petticoat, with a broad head fhould be tied round on, the waifl, 
only fo tight, as that a finger will eafjjy pafs under it; fo that if 
the child’s belly fwells, as it fometimes will from flatulence, it 
may experience no uneafinefs ; and if after this a long linen ON NURSING. 
gown is put on, the child will be fufHciently d refled, be 
ly eafy, and no obftruction occur to prevent nature performing 
her proper operations. But there is another error frequently 
committed with refpe£t to what they think neceffary to g:ve the 
infant internally ; therefore, as foon as it is dreffed, they cram 
down its throat a large lump of butter and coarfe fugar ; or give 
it oil of lweet almonds and fyrup uf violets : or Ihould the infant 
lick its lips, it muft be fed with pig, that is, it mu ft. be permit- 
ted to fuck the fat of that animal, in order to, appeafe, it is fpp- 
pofed, a feniation which nines from its mother’s having longed 
for fomething or another during her pregnancy. 
Were there nothing but the mere folly and abfurdity to be 
Confidered as the refult of this practice, it would not be neceflkr, 
ry to fay any thing .to induce its forbearance ; but thefe things 
?tre pernicious, inafmuch as they mix with the meconium, or hu- 
mor with which a child’s bowels is naturally loaded, prevents 
its growing fufliciently acrid to produce its purgative effedt, or 
fheath the bowels from feeling the effect, and thus produce ma- 
ny complaints which load, opprefiion, and diftenfion ol the in- 
teftinal canal are apt to bring on : for nature feems to intend 
this meconium to clear, at an early ftage, the firfl paffages of the 
fordes which have accumulated there. If, therefore, it is deter- 
mined to give fomething to the infant, a little caftor oil, and Am- 
ple fyrup, will be the beft, hecaufe it anfwers the purpofe intend- 
ed by the meconium. For if we conlider the ftate of the infant 
daring labour—the effects of the meconium left to itfelf—the time 
before the mother acquires her milk, and that its property is 
at fxrft aperient, we fhall obvioufly fee the reafon, why nature 
preferves this .regularity in foliciting a difeharge of fluids through 
the primer, vipe ; and fhew that if an}'- thing is to be attempted, 
her plan ought to diredi all our operations. For befides clear- 
ing the ftomach and bowels of its contents, which, by continu- 
ance there, might produce difagreeable and dangerous effe&s, it 
feems intended to prevent the too free determination of blood to- 
wards the veffels of the brain, which might be in a weakened 
ftate from the feverity of labour : for the brain very often fuffers 
great compreflion from the hones of the head palling through the 
pelvis ; indeed it is often fo great, that the bor.es will wrap con- 
ftderably one over the other, and confequently the capacity of 
the cranium be much diminiftied ; by which means the blood 
will be prevented from palling into the exterior part of the brain, 
which is thrown into the head by the arteries appropriated for 
that purpofe, confequently the internal veffels will receive a more 
than proper quantity, and by being too much diftended, of courfe 
be vveakeued, and that in proportion to the continuance and vi- ON NURSIlfG. 
©leuce of fuch prefTure ; in order, therefore, to prevent the mis- 
chiefs which would arife from fuch debility, if continued, and 
the Succeeding accumulation, I conceive * ature very wifely con- 
ftituted puiging, that the veffels may recover their due tone 
and that this is one principal reafon, I am induced to believe* 
from the firft of the mother’s milk always having a purgative 
property. 
Bur m owever, I think that the lefs any fort of thefe things are 
given the better. As foon, therefore, as the child is dreffed, and 
the mother laid in a clean and comfortable fituation, the child 
fbould be placed in bed by her, and both left to go to reft, which 
they will foon do, and fleep perhaps for fix or leven hours, by 
which means they will be refrefhed, and recover in a great de- 
gree the fatigue they have both undergone : then the mother 
Ihould be fed with fome thin broth, or weak wine gruel, and & 
little bread, or fome fuch fimple materials ; and the child, if the 
mother intends to nurfe it, fet to the bread ; notwithstanding 
what fome authors have faid to the contrary, under the idea, that 
as nature does not furnith any quantity of milk in the bread, 
till the expiration of three days or thereabouts, it is ufelefs, and 
only teazing to the mother and child, to have it fet to before. 
This I am perfectly perfuaded though is erroneous, and often 
attended with difagreeable conf'equences, both to the mother and 
infant, difpofing the former to febrile affections, and bringing on 
a milk fever, from pain created by dittention of the veffels of the 
bread, and keeping the infant too long from that Salutary food 
which nature has provided for it, and adds at fird in a double ca- 
pacity, as we have before fpecified ; befides it fupplies an oppor- 
tunity for ignorant and over officious nurfes to cram the chil- 
dren with a variety of dabs, and too vifeid food ; by which 
means a foundation is laid for a number of complaints, from 
loading and oppreffing the alimentary canal, by fuch things as 
are unconquerable by the digedive powers of the infantile date ; 
hence arife crudities, acidity, flatulence, and convulsions, which 
by a different management would be prevented. For by fetting 
the child at an early period to the mother’s bread, by the gentle 
flimulus on the nipple from fucking, the milk is Solicited in a 
gradual manner into the bread—the veffels are made by degrees 
permeable—the infant receives it at fiift in fmall quantities, ad- 
equate to its wants and digedive powers—no fuperabundance of 
milk is collected, nor a fudden flow of it into the lactiferous 
tubes, by which didenflon, pain, and febrile affe&rons to the 
mother are prevented ; the child’s domach is not overloaded, 
nor too great a quantity of fluid thrown into the habit, which 
would be injurious to Several parts of the machine, particularly 120 
'ON NURSING. 
the head—lungs—and liver—as the circulation of the blood is 
now altered from what it was before the birth, and confequently 
the veflels in thofe organs incapable to bear fudden and too free 
diftenfion ; for the parts of the human machine are always bet- 
ter enabled to fuffer changes brought on in a gradual and tem- 
perate mode, than by fuch as operate in the contrary extreme : 
and this feems, in the cafe of W’hich we are fpeaking, to be the 
intent of unerring nature ; it is fo perfectly rational, that the de- 
fcription alone carries along with it conviction. Indeed, I am fo 
clearly convinced of the great utility and good confequences arif- 
ing from the adoption of this method, both from reafon and ex- 
perience, that 1 uuiverfally recommend it to thofe who are capa- 
ble and willing to l’uckle their own children ; and in all health- 
ful fubjects, it is a practice which fliould on no account he dif- 
penfed with ; for to me, there is little doubt but that the milk 
of the mother is better adapted to the conditution of her own 
offspring than of any other ; befides the advantages attending 
the fird, as much fo, I think, as the natural foil is to any indige- 
nous vegetable : nor do I {land fingle in this opinion ; for many 
authors, who have written bed on this fubject, not only fupport 
the fame doClrine, but think that the mother’s milk is fuflicient 
for the nourifltment of the infant for the firft twelve months, and 
recommend that, to that alone they fliould adhere. 
Could we infure the health of the mother and child, I fliould 
Snot hefitate to enforce the cuftom ; but as both are liable to fall 
into difpofitions, which may either, on the one hand, render the 
milk improper, from its nutritious qualities being altered; or, 
on the other, from its increafing fome complaint in the prims 
viae. I think, daring the child’s being nouriflied from the bread, 
it fliould be fed once or twice a day with the boat; that if any 
accident fhould render it abfolutely neceflary to wean the child, 
or take it for a time from the bread, no inconvenience may arife 
from fuch an alteration ; for many children feed folely by the 
bread—take very ill to the boat: nay, fome indeed are obliged 
to be fupplied by the bread of a dranger, a circumdance often 
painful, and almod always difagreeable to the parents—and as a 
fuccedaneum for the mother’s milk that of afles is the bed, or 
artificial afles milk with a little bread, called tops and bottoms ; 
or roll, or bifeuit—not the common bread, for that has in its 
compofition too much of alum, and may, in habits where there 
is a propenflty to coftivenefs, be particularly hurtful. 
But as children are apt to have mod of their complaints ori- 
ginate from acidities in the domach and bowels, or to have fuch 
acidities very often as a didreffing confequence, it would be right 
to ufe them to the tade of other viands ; particularly weak veal ON NURSING. 
121 
broth, or that of mutton ; or beef tea, if they fhould have no 
difpofition to febrile affe&ions ;—but, whatever the food, care 
fhould be taken never to overload the domach, as is too com- 
monly the cuitom ; fo much fo, that often, in the day, thev 
may be obferved reftlefs, uneafy, and fick, and relieved alone by 
frequently puking—a happy remedy againft the midaken huma- 
nity of over-fond mothers ; for it is a common practice with 
them, and other nurfes, as foon, or as often as a child cries, or 
appears fretful, to appeafe it by giving the bread, though if 
fhould, a few minutes before, have lucked to fatiety. Indead of 
this, the child diould be amufed by dandling gently, or by iome 
other means diverted : exercil'e however is the bed, in propor- 
tion to its age. In the lird months, fuch as is moderate, and of 
the gentler kind ; afterwards, as its drenglh increases, fo may 
the exercife ; for this quickens circulation, augments perfpira- 
tion, affills digedion, and helps to clear away vifceral obdrn&i- 
ons, and prevent codivenefs. Indeed, in the early dage, it is 
ufeful, twice a day, when dreffing and undreding tin* child, for 
the nurfe to rub it well with her hands, particularly on the ex- 
tremities, down the back and abdomen, before the lire, for a 
quarter of an hour each morning and evening,—The infant will 
Ihew its approbation, and the utility, by kicking and throwing 
about its legs, Imiling, crowing, and by a perceptible bnghtnefs 
in its eyes, andcheerfulnefs in its countenance. In fome coun- 
tries, particularly in fome parts of Scotland, mothers very early 
adopt the ctfftom of dipping their children every morning into 
cold water ; on which cudom Dr Cullen makes the following 
oblqrration : That he had feldorn, or never feen the offspring of 
their women, fo treated, fubjedl to the rickets. It has long been 
recommended, and 1 think with fome advantage, to wadi the 
legs, thighs, back, and head, with cold water. In this cudom 
there appear two very material advantages—cleanlinefs, and 
gently increafing the tone of the fydem: by which the fydem, 
is unloaded, and ftrength given to the mufcular fibres. And 
upon thefe two principles, regularly promoted, is it, perhaps, 
that we may attribute, in a great degree, the prevention of that 
complaint we have juft alluded to—a complaint, the conftant 
concomitant of naflinefs, inordinate feeding, with improper food, 
and indolence. 
Though this praftice is very ferviceabte to healthful children, 
dill, in fuch as ase delicate, and difpofed tointedinal complaints, 
fome attention ought to be paid to the degree of cold ufed oa 
this occadon ; and therefore, in thefe, it may be nrudent to mix; 
a portion of warm water with that which is cold, fo that it may 
dill remain a proportionate degree of cold, compared with the 122 
ON NURSING. 
natural warmth of the comftitution, but of warmth compared 
with other common water; for we know that fome will bear 
cold bathing, or wafhing, and receive abundant benefit, if the 
degree of cold only be fuch, that the internal part of the fyflem 
fhall be capable of producing re-adion adequate to the impulfe 
of the fluids occafioned by the external application ; if not, many 
difagreeable confequences occur, arifing from a load being thrown 
upon the internal paits too fuddenly, ami too copioufly, fo as to 
overpower their adion, fuch as congeflions in, obfti notions, and 
inflammations of the brain, lungs, vifcera, and fome of the glan- 
dular parts, wherever they appear* from their debility, lobe raeft 
predifpofed to fuch affeClions. 
In this method it may be necefTary to peifiifl for three, four, 
or live months ; but as children grow flronger, they then gene- 
rally require thicker and flronger food, given them once or twice 
a day ; cow’s milk with roll, bifeuit. Tops and bottoms may 
be made ufe of, moderately fweetened, or panada, mixed with 
new milk, warm ; and this food fhould be made frefli twice a 
day in winter, and three times in fummer : the new milk fhould 
net be boiled, but mixed with hot panada, or pap ; nor fhould 
the viands be made fweeter than that of mother’s milk, nor gi- 
ven hotter than milk from the cow; for vinitials too hot, or too 
fvveet, are apt to occafion relaxation of the flomach and bowels, 
rind create morbid afeidity ; and fhould the child be of a coflive 
habit, foft Lilbon fugar, if laxative, fuperfine fugar fhould be 
made ufe of: broths alfo fhould make part of their food, minc- 
ed chicken, or rabbit, with panada, and bread puddings, parti- 
cularly after they arc weaned ; confequcntly, a little before, it 
would be right to accuftom them to fuch fort of food. Potatoes 
is a food which numbers of children are fond of, and are very 
early accuflomed to ; however, to tliofc of delicate habit, I think 
them by no means proper, nor any other that are pcflefted of 
much vifeidity, inafmuch as the accumulation of fuch tenacious 
food in the flomach and inteflines is apt to form a nidus fer 
worms ; but to thole of flrong digeflive powers, bora of health- 
ful, athletic parents, fuch as common ruflics, this prohibition is 
lefs ncceflfary ; as it has been obferved, in countries where this 
vegetable root frequently and commonly makes part, and a great 
fhare of their diet, no fuch inconvenience has been obferved; 
but thi,T depends not upon the falubrity of fuch fort of diet, but 
upon the firm ftamina, and great flrength of the digeflive pow- 
ers of thole who feed on it—to the more delicate it is certainly 
injurious ; and it is upon the flrength _or debility of the con- 
ftitutional powers by which we mull in general regulate our con- 
dud in our directions.—If children are born healthful, and flrong, 123 
ON NURSING. 
fuch. regulations as are above laid down, will be fufficient to 
conduct them forwards, with eafe and fafety, for the fivft twelve 
months, or longer; but ihould they be born fickly, as is forne- 
times the cafe, it may be allied, are the fame rules to be obferv- 
ed ? Under fuch circumltances, cleanlinefs, proper cloathing, 
gentle exercife, and the mother’s milk, certainly form the belt 
preventive and curative plan ; for, by their proper adoption, I 
have no doubt but conftitutions, weakly in their oigin, may be 
ftrengthened, and a number of complaints, the natural refult of de- 
bility not onlycured, but often prevented. Though forne caution may 
be necelTary in feeding children naturally weak, great care Ihould 
be taken never to overload the ftomach, notwithltanding the 
food Ihould be confined to that afforded by the mother ; it, therc- 
fore, fhould be advifeable to give the bread to the child much 
oftner, fo that a little milk only may be taken at aMirne, which 
will be ealily and readily digefted. This may be ccntldered 
troublefome to the mother, yet will fhe be amply repaid, by fee- 
ing her offspring improve daily under fuch judicious manage- 
ment, and meliorating a conftitution, which otherwife would be 
made worfe, and fall a facrihce to painful difeafe ; for, by over- 
loading the ftomach, that organ would be weakened, crudities 
and acidities be generated, green ftools, loofenefs, gripes, and 
convulfions be the unvoidable confequences ; for almoft all com- 
plaints with which infants are at a very early period afflicted, 
except thefe which arife from mai-conformation 
of fome particular parts, infection, or contagion, deduce their ori- 
gin from defeat in the alimentary tube, and that generally aci- 
dity, occafioned too often by indifereet and coo copious feeding. 
But when Inch acidities are too prevalent, they conftitute dii— 
eafes, and will be taken notice of when we treat of fuch as are 
incident to children ; we fnall only obferve, if there appears a 
pronenefs in the habit to produce them, befides the mode here 
diredted for invigorating the conllitution, it might be proper, 
now and then, to put a little magnefia into the victuals, if coi- 
tive: if otherwife, fome of the other prepared abforbent earths, 
fuch as chalk, crabs eyes, or prepared hartfhorn ; feed the infant 
once or twice a day upon broth, and ufe rice inftead of bread, 
for it is lefs apt to turn four than any other of the lighter fari- 
naceous fubflances. 
But many authors have, refpedt'iBg mothers fuckling their 
children, laid it down as an indifpenfable duty, and advanced, 
that almoft all, of whatever nature their conftitution may be, 
are capable of performing that office with the greateft advan- 
tage to their own eonftitutions, as well as to their children ; for, 
fays Dr. Cadogan, “ When a child fucks its own mother, which, 124 
ON NURSING. 
“ with a very few exceptions, would be bed for every child, 
*4 and every mother, nature has provided it with fuch whole- 
“ fome and fuitablc nourifliment, fuppofing her a temperate wo- 
“ man, that makes fome ufe of her limbs, it can hardly do a- 
“ mifs. dhe mother would likewife, in moil hyfterical nervous 
“ cafes, eflablilh her own health by it, though fhe were weak 
“ and fickly befoie, as well as that of her offspring.—For theie 
“ reafons I could wifli, that every woman that is able, whofe 
“ fountains are not greatly dillurbed, or tainted, would give 
“ fuck to her child. I am very fare that forcing back the milk, 
61 which mod young women mull have in .great abundance, may 
‘‘ be of fatal confequen.ee : fometimes it endangers life; and of- 
“ ten lays the foundation of many incurable difeafes. The rea- 
41 fons that are given for this practice are very frivolous, and 
“ drawn from falfe premifes ; that fome women are too weak 
“ to bear fuch a drain, which would rob them of their own nou- 
e‘ rifhment. 
“ This is a very miflaken notion : for the firfl general caufe 
il of moil people’s difeafes is, not want of nourifhment, as is here 
“ iniagined, but too great a fulnefs and redundancy of humors ; 
“ —good at firfl, but being more than the body can employ, or 
“ ccniume, they fiagnate, degenerate, and the whole mafs be- 
£i comes corrupt, and produces many difeafes.” 
However, notwithffandirig this authority, I am certain that 
there are many mothers totally incapable of giving fuck, parti- 
cularly fuch as ate of very delicate nervous conftitutrons, w’eak 
appetites, and poffeffed of bad digeflive powers—whofe fluids are 
acrimonious, and habits fubjedl to byfieric affections ; for thefe, 
in ,general, neither afford milk fuffirient in quantity, not proper- 
ly elaborated for nutrition ; hence, when the)’’ attempt to fuc- 
kle their children, they do infinite mifehief to their own confti- 
tutions, by having it debilitated by the conflant drain of what 
ihonld fupport themfelves, and lay the foundation for a variety 
of complaints in their offspring, by pouring into it fuch crude 
unwholefome fluid. The children of fuch women fliould either 
be fet to another woman's bread, or brought up by the boat. 
Tg the formes, there are fome precautions requifite to be ob- 
ferved, fuch as we are directed to by the imitation of nature— 
as tiie infant is deprived of the mother's firfl milk, which is pur- 
gative, and clears the primes vice of their lordes, art mull fupply 
the deficiency by gentle means : the infant, then, fliould have 
fome aperient ingredient mixed with yts foed, as will prove pur- 
gative—the bell of which is manna, and pulp of caffia. Thefe 
may be given in fuch quantities as will procure the child four 
flools every day for about eight or nine days ; cr a little callor ON NURSING. 
125 
oil, mixed with fyrup, may be given at proper intervals. Once 
a day, perhaps, may be fnffieient ; or the nurfe may take fome 
aperient electuary fot the firft week of fuckling, which will fome- 
!times anfwer the purpoie equally, in fitch doles only as may im- 
pregnate the milk with fome of its aperient properties ; after 
j which, the fame directions fliould be purfued as have been before 
fet down, 
But with regard to the feleftion of a nurfe much is neceflary.. 
She fhouid be young, cleanly, active, healchful, free from any 
complaint, poffefled of a good appetite, and quick, eafy, digeftivc 
powers ; and, above all tilings, her milk fhouid not be too old—- 
the nearer the time to her having laid in the better, for the milk 
will then parcake more of the nature of the mother’s milk. I 
have faid ihe fhouid be young—by that I mean between twenty 
and thirty, for, at this time ot life, they are generally in the 
mod: healthy date, mod aftive, and more capable of contending 
jvvith fatigue, and other unavoidable gafnalties, without prejudic- 
ing their milk—which fluid it will be necefl’ary to examine, for 
fome women’s milk is apt to be too thick, fweet, and rich, whilft 
others appear thin and watery—that is bed which partakes nei- 
ther too much of the one or the other of thefe extremes. 
Sometimes I have known parents very folicitous cf dieting 
nurfes, in order to keep the milk in proper order, and this I 
have feen productive of bad effects. I would by no means take 
any nurfe from that mode of living by which die enjoyed a good 
and perfeft date of health ; for though we may tell what appears 
likefy to produce general effefts in the habit, if we form our 
udgment from experiments made on different materials out of 
:he conftitution, dill the peculiarities there exiding, which can 
snly be difcqvered by effects, make fuch alterations, the caufe of 
which we are unable to inveftigate, and fhouid therefore be con- 
:ent with obferving the confequences. I diould, therefore, re- 
commend that nurfes fliould live in the csaimon plain mode, of 
,iands Ample and nutritious, compofed of animal and vegetable 
l Vibdances, avoiding all high-feafoned difhes, or halted provifions; 
j ’or thefe become difficult of digedion, create third, induce fe- 
brile affections, and promote an acrimonious date of fluids. I 
pecify this, becaufe nurfes, often taken into great families, are 
] rery deiirous of quitting their homely fare, and indulging in the 
1 uxuries of high life. 
If the boat is made choice of, a flmilar mode fliould be 
jjmrfued with regard to clearing the primse vise, and the viands 
Nvith which the child fhouid be fed, mud be fuch as mod refem- 
file the mother’s milk, fluid, not too fweet, nor given too hot, arid 
uartaking, in fome degree, of animal and vegetable nature—ad- OK NURSING. 
es, or artificial afs’s milk, mixed with thin panada, made as above 
directed, or milk, warm from the cow : perhaps, in both cafes, 
feeding children at {fated periods, about four times a day will 
be fufftcient, if that cukom is begun very early. 
bo e{feudally necekary has exercile been confidered towards 
the fupport of health, that it has been advifed by every author ; 
but it Ihould be inch as is adapted to the age and conftitution 
of the patient: in the lirlt periods very gentle, afterwards in- 
created, as the ftrength of the infant increafes, and that will be 
always the bell, which, at the fame time it gives motion to the 
body, appears to divert and entertain, for the fpirits by thefe 
means are exhilirated, and the mind, from being amufed, gives 
alio (juicknefs and llrength to nervous and vafcular action—rub- 
bing the child well before the fire twice a day we have fpecified, 
gently Twinging, or hoiking for fome time together, before fome 
objects which engage its attention, caufing the little infant to 
laugh, kick its legs, and exert its whole body by little fpbings, 
in the nurfe’s arms, will be proper ; for no child can continue 
long well that is full’ered to fit like a log in an indolent nurfe’s 
arms ; for fuch a fedentary pofition breeds crudities, occaiions 
the habit to be overloaded, blunts the activity of the veffels, re- 
tards circulation, and breeds a variety of complaints from inter- 
nal congekion ;—nor Ihould nurfes be permitted to carry children 
always in one arm, a. cukom too many acquire, buc more parti- 
cularly if the infant is inaflive and weakly ; for, from always 
reclining to one fide, dikortion is apt to take place : therefore, 
they Ihould conkaiuly be removed from one to the other. It is 
highly ufeful to fuffer little ones to roll upon carpets, and be a- 
mufed with fome little toy or other, that may entice their exer- 
tions, to creep from place to place after it. This is a pleafant 
exercife, and early teaches arra&ive ufe of their little limbs— 
and I have obferved children, fo brought up, more early get upon 
their legs, and run about, than others who have been uied to 
leading-krings, go-carts, and contrivances of thefe kinds ; it is 
moil advifeable firk to lead them oft' gently by the finger, and 
that may be attempted at a more early period than fome advife— 
for the idea of letting children upon their legs very foon, occa- 
iions them to be crooked, is not in faeft true—fo far from that, 
it gives them additional ftrength ; and it has been obferved, that 
the legs of children which have at firft appeared crooked, have, 
hY early exertions to walk, become ftronger, and perfectly 
krai ght. 
1:5 elides thefe things, children Ihould often be taken into the 
frefh air, and remain therein for fome time, at leak twice a day, 
and always be kept perfectly clean, changing their cloths imn.e- ON NURSING. 
127 
<!iately upon being fouled ; for fuftering them to continue in a 
filthy ftate, for any time, difpofes the parts to become tender 
and excoriated, creating pain, rendering children peeviffi, and in- 
active. They Ihould alfo be often waited with cold water behind 
the ears, as well as other parts of the body ; for, from negleft 
in this particular, the moifture, which naturally coliedls there, 
becomes acrimonious, irritates, and inflames the parts, and occa- 
fions an acrid difeharge, which brings on dii’agrceable and pain- 
ful excoriations. When it is from the neglect of this cullom 
that this complaint arifes, which we may cohjeffure to be the 
cafe, if the child appears healthful iri every other refpedf, wafli- 
ing behind the ears with warm milk and water, or Goulaid’s 
water, or fprcading a Very fine rag, extremely thin, with fatur- 
nine ointment,.and cleanlinefs, will generally promote the cure ; 
but fhould we have reafon to fuppofe it a drain exerted by nature 
for the relief of internal indifpofition, other management fcems 
necefiary, which we fhall fpecify when we come to treat on 
infantile difeafcs. 
As we think that a vafl deal depends upon proper Nurfing, 
in order to prefervc the human fpecies, and prevent a variety of 
difeafes, which too often end fatally, or lay the foundation for 
various morbid affeftions, which are too apt to continue the pain- 
ful concomitants of our future days, and embitter life through 
the whole of it3 progrefs, we have dwelt longer on this point 
than may to fome appear necefiary, but which we think cannot 
be too minutely obferved ; and it may not be ufelefs to attempt 
to comprize the whole in a few fhort axioms-—and, firfi, we lay 
it down as an invariable rule, 
That, immediately after the birth, children fhould be wrapped 
in a warm wrapper, to preferve them from cold ; afterwards, in 
about half an hour, be well cleaned before the fire, loofeiy and 
lightly cloathed, not crammed with any dabs, but laid by the 
mother, and fet to her bread as foon as poffible. 
That, where the conftitution will permit, all mothers fhould 
fuckle their own children, at the fame time not depend totally 
upon the breaft, but cccafionally ufe them to the boat, or fpoon, 
in order to be prepared againft the effects of indifpofition, either 
in one or the other, fhould they occur. 
That cleanlinefs fhould ever be invariably, and confiantly ob- 
ferved— children never have their ftomaebs overloaded, but be 
fed fully only at proper intervals, five times a day; if nut, 
efener, and more fparingly. 
That all food, befides the mothers milk, fhould be of a na- 
ture as fimilar as poffible to that milk, compounded of vegetable 
and animal materials, as afs’s, or artificial alu’s milk, cow’s milk. ON NURSING. 
mixed with thin panada, or rice ufed inffead of bread, and weak 
broths occasionally. 
That they ftiould be conftantly exercifed, agreeable to their 
age and flrength, and fuch ufed as feems to. afford them pleafure, 
and employ their attention ; they alfo fhould be much out in 
the air, and be attended by clean, young, lively, and active 
nurfes. 
SECTION VII. 
On MEDICINE. 
T>EFORE we enter on that part of our plan, wherein we in- 
tend to defcribe difeafes, and lay down their moil approved 
modes of cure, it will he proper to fay fomething on the differ- 
ent nature of the remedies which will be recommended, in or- 
der to render the knowledge in their application more fafe, ea- 
fy, and certain ;—as well as to explain the different general 
terms under which they are claffed—as to thefe general terms we 
lhall be unavoidably led very often to have recourfe. 
B it previous to the forming our arrangement, we think it nc- 
ceffary to fpecify the different modes of aftion of various medi- 
cines taken from their known effects, as wc find from experience 
they aft in various ways—and we ihall firfl obferve— 
*7hat—a&ive medicines produce their effefts, by confining their 
aftion to the moving powers of the cotrflitution, page £6, locally,, 
or fympathetically ;—if we except water, coufidered as a diluent, 
or fuch fubflances, where water abounds in a fuperabundant 
quantity. 
That no medicine afts upon the femina morbi, or particles, 
■which form the origin of fome difeafes except they lodge in 
the ftomach, inteflines, or fome other cavities, where they come 
in contaft in an unaltered flate with the caufe of the affeftions : 
—confequeatlv that there are very few, which can in any cafe 
be confidered as fpecific ;—and then only in this way. 
'lhat—all medicines, creteirs paribus, poffefs their own peculiar, 
inherent power in an unaltered flate, and always exert finrilar 
effefts :—that when they appear to have any variability of ac- 
tion, it is owing to the conffitution being different ;—to the fame 
conflitution having fuffered fome change,—or fome peculiarity; 
—or to fomething they muft meet with in the habit forming a 
new compound. ON MEDICINE. 
129 
*7loat—the Jlrong inherent power, or primary action of any me- 
dicine being known, its fecondary or conleque. t effedts may be 
traced in general from the fame fource—and that when t’nefe 
are altered, it is owing to fome conftitutional caufe laft fpecified, 
or to the difference of the dole, varying its action only in de- 
gree. 
‘That—fome medicines, to which are attributed particular pow- 
ers, have no fuch powers inherent in themfelves ; but are in- 
active, and have their adlion dependant on fome other materials 
with which they meet, and form combination in the habit, mak- 
ing a new iubltance, different from the principles of which 
they are compofed, and to which mull be attributed their adtive 
powers. 
‘That—-fome medicines, when thrown into the habit, have not 
the power always of exerting their primary adtion of themlelves 
alone, but when joined with other materials, produce the effect 
intended, confident with the power allowed inherent in them. 
That—medicines do not always in fimilar dofes produce the 
fame effedts, on diffimilar confutations—nor, before the tiial, can 
the adtive dofe be difeovered therefore in the exhibition of 
all powerful medicines, this general rule fhould be obferved— 
to begin with fmall dofes, and gradually i tier cafe them, till the pro- 
per conftitutional dofe is manifefled ;—that is, till nauiea, fick« 
net's, or fome uneafy fenfation in the flomach is created, then 
by leffening the dofe in a flight degree, the full one may be af- 
certained—and this holds good in all adtive medicines—except 
fuch where benefit is fuppoled to be derived from occafioning 
naufea, or ficknefs—as occurs often in the adminiflration of quills 
—ipecacuanha—and fome antimonial preparations. 
Now, as we find a number of thefe adlions depend upon the 
flomach, and its intimate connections with different parts of the 
human machine, we may fay every part, that are poffellcd of 
moving powers, and influenced by them, it will not be iir ;#oper 
to fay fomething lelative to the effedis produced by this intimate 
imion. 
With regard to connedtions—fympathy—or confent this viT- 
cus has with moll parts of the body, and the mind alio, it is ve- 
ry dole, known from a variety of appearances obvious to our 
fenfes ; as well as the observation of the moil judicious and fu- 
gacious practitioners.—A \ery late writer, ol no lmall eminence, 
fays—“ Nothing affedts the mind more than the Hate of the Ito- 
“ mach, and nothing draw's the flomach into fympathy more 
“ than affections of the mind.—This is evident from hypochon- 
“ driac people, whofe difeafe being chieflyfeated there, has often 
“ grievous effedts upon the fenlorium commune,” that part ON MEDICINE. 
where the fenfes tranfmit their perceptions to the mind—“ or the 
“ (eat of it. the head — Does not, in ihefe cafes, the vomit- 
** ing of bile proceed from confent between the ftomach and li- 
“ ver.” 
“ The ftomach has a confiderable connexion with the vifeera 
“ of the thorax, or cavity of the chefh—abftrafted from its con- 
41 tiguity or diftention.—In hypochondriacal cafes, the heart and 
“ lungs are varioufly affedled by the ftomach—Convulfions 
“ of the diaphragm are often occafioncd by flight irritations of 
“ the cordia, or upper orifice of the ftomach ; —many other 
“ fymptoms might be adduced in proof of the fame thing, were 
“ it necciiary.” 
“ The ftomach is corsncdlecl with the abdominal vifeera 
“ and firft, with the inteftines;—fecondly, with the other con- 
“ tiguous, as well as more diftant organs—as fpleen-—pancreas, 
“ or fweetbread, kidneys, hi adder, &c.” 
“ This vifeus is connected with the extremities, as has been 
“ experienced by the transition of the gout from the ftomach 
“ to the extremities, and vice verfa—Cold and heat applied to 
“ the extremities affect the ftomach.” 
“ It is conne&ed with the whole furface of the body, and 
“ feemmgly with the extreme veffels every where.—This is de- 
“ monftrable by many obfervations—for no fooner do forne ali- 
“ meats reach the ftomach of particular perfons, than fpots anti 
“ efflorescences are occaftoned on the Ikin.— Van SwiETEN gave 
“ i’uch another inftance from crabs eyes Dx. Cui.len had. a 
“ patient labouring under the hypochondriacal difeafe, who was 
4‘ relieved of his complaint bjr pimples appearing between his 
44 thumb and finger—-and as immediately opprtfl’ed by their re- 
“ tropuifion or difappearing.” 
‘‘ Vomiting from conftridlion of the cutaneous pores is ano- 
“ ther inftance of inch lympathy.—Such fymptoms, therefore, 
44 are lafely attributed to acrimony—-and, upon the whole, we 
“ may conclude, that the Jlomach has a general confent with the 
“ fyjlem univerfallyf* 
If we confider what has been fr.id on the aftion of medicines, 
deduced fiom experience, founded on their effects, and the fym- 
pathetic power of the ftomach derived from the trniverfality of 
its connections with contiguous, as well as diftant parts of the 
machine, we (hall be able to account for a number of phenome- 
na which would, without fuch knowledge, appear miraculous, 
and exceed all beliefand alfo be enabled to arrange medi- 
cines under their refredtive heads, all which will be extremely 
ul'eful in giving us the neccffary information bow, and in what 
cafes they ought to be applied. ON MEDICINE. 
131 
For as nothing can he done effedtually in the living machine 
without the adtion of the vital principle—and as we have no 
mode of regulating, or producing any ..effect upon that primarily, 
we are limited to direc t all our operations on the parts of the 
conftitution, that they may be put Into fuch dates, as to receive 
benefit front the falutary influence of that vital principle 
conliltent therefore with this idea we ft all form our arrange- 
ment—-which we ft all here concifely fet down—leaving the full 
explanation of each particular, till we come to treat of them 
under their refpective heads. 
The arrangement confifls of five heads : 
Firft—MEDICINES which act upon the inert fplids by means 
pf the vital principle, under which will come 
1. Nutrients 
2. Aftringents, and 
3. Emollients. 
Second—MEDICINES which act upon the Hying folids by 
yneans of the fame principle. 
Here will follow 
1. Stimulants 
2. Antifpafmodics 
3. Sedatives 
4. Errhines 
5. Sialagogues 
6. Expectotants 
7. Emetics 
8. Cathartics 
C) Diuretics 
10. Diaphoretics, and 
11. Emenagogues. 
Third—MEDICINES which a£t upon the fluids through the 
lyftem. 
To this place belong 
1. Attenuants 
2. Infpiflant, and 
3. Demulcents. 
Fourth—MEDICINES which manned their fenfible action 
only in the primse vise, or firli pafiages, from the throat to the 
anus. 
Here fuccecd 
1. Antalkaline 
2. Antacids. and 
3. Antifeptics. 
Fifth—MEDICINES which produce their confequences from 
external application, or on fubflances formed within the machine, 
and lodged without the verge of circulation—as 
1. Eoifpaftics 
a. Blood-letting 
g. Anthelmintics 
4. Lithontriptics. ON MEDICINE. 
This then the arrangement, we {hall now proceed to explain 
the different paits of which it confifts fpecifically. 
CHAP. 1. 
Medicines which all upon the inert Solids ly Means of the 
vital Principle. 
§ 1. '"THE firft of which are NUTRIENTS, from the latia 
■*- word nutrio, to nouriih—Thefe confilt of all fnch 
materials as <tre calculated to be aflimilated to our own ipecific 
nature, by the action of the digellive powers ;—and the applica- 
tion of which fo affimilated, repairs the rvalte which had been 
occafioned by the different operations palling on in the human 
machine—Hence, from their affording nourifhment, do they 
their name. 
But thefe vary in feveral refpe&s, either as to their being more 
onlefs perfected in themfelves towards thp nature of animal juic- 
es,—being of ealier or more dilBcnlt digeltions,—and alfo with 
refpe£t to their fluidity or folidity. 
But though they are poffeffed of fuch various properties, they 
are all of them reducible to one Hate, in order to promote fup- 
port to the animal ; and the changes they undergo for this end 
are brought about by three different ways in the firjl wjlance— 
for firjl, the folid food is minutely divided, and has its texture 
in a great degree broken down by chewing, and farther reduced 
by the action of the ltomaeh and inteftines—this is called Com- 
minution.—It alfo forms an union with the faliva, air, juices of 
the ltomaeh and intellines—thofe of the liver and fweetbread— 
this is termed Commixture—and add to thefe the beat it re- 
ceives, by which it is thrown into the third mode, or Ferment- 
ation—and all this it undergoes in the fiift paffages.—In the fe- 
cond, it experiences great divilibility, union, and mixture, in 
palling through the la&eal veffels, and by the force of the lungs ; 
■—and, la/lljr, it is brought into its molt perfect nutritive Hate 
by the imprellive influence of the circulatory fyltem upon their 
contained fluids. Hence we may concifely fay, that the aliimi- 
lation of our food, for the purpofe of nutrition, is performed by 
ComminurioN—Commixture—and Fermentation. 
And from this we may underftand why all nutritious fub- 
ftances Ihould be adapted, both with regard to their quantity and 
quality, to the flrength and vigour of thefe poivers colle&ively ON MEDICINE. 
crsnfidered—ar.d alfo are we taught what mifchiefs often arife 
from the indifcreet indulgence of fond mothers, and ridiculous 
mirfes, who load thofe, who are weak in feme or all thefe parti- 
culars, too freely with food, confidcred ia itfelf to be nutritious, 
in order that they may acquire flrengtly,—and by thefe means 
deftroy the effefr, by large quantities being poured into the ha- 
bit, which fmalier proportions of the fame food would have in- 
difputably fupplied for if the digeftive powers are loaded with 
a iuperabundant quantity more than they can conquer, they be- 
come, as it were, difeafed ; and even the fmall portion of food, 
to which their powers were adequate, left in a Hate too imperfeft 
for affording any nutrition. And this rule is extremely worthy 
of attention—for valetudinarians, however proper their food, 
fhould never take more than they can bear with the greateft eafe. 
Indeed, in people recovering from very fevere illnefs, where the 
adlive powers of the habit have been greatly enfeebled, though 
k is always right to throw th food of the moll nutritions nature, 
the mod eafy of digeftion, and fuch as fits the mold light on the 
ftomach, ftill fhoukl we begin with fmall quantities, jncreafing 
them, and altering the food in proportion as the patient recovers 
ftrength ; and this for very obvious reafons, which will foon ap- 
pear, as we examine the nature of our food more minuiely than 
we have done in fpeaking of the non-naturals. 
Though we have before laid, that perhaps our firft food par- 
took molt of a vegetable nature, yet as all fubltances are the 
tnore nutritious, the more they approach to that of animal, a di- 
viiion feems here requifite, in order to fhew the different de- 
grees they maintain with refpedl to the nutriment they afford, 
and the proper modes of belt acquiring and applying them to the 
tonflitution. 
■ Nutrients, therefore, may not improperly be arranged un- 
der three heads : ' . 
i. Animal 2. Vegetable 3. Mixed. 
Of the First—All thofe are the mod powerfully, and mod 
quickly nutritious, which have the lealt acidity, and are mod 
elaborated, or brought neareft to the nature of animal fluids—- 
hence the finer juices of the older animals become the moft eli- 
gible, and thefe are bell procured by flight boiling, or infnfing, 
in fuch a diluted (late as the circmnftances may require ; that is, 
in proportion to the ftrength of the digeftive powers :—for, as rve 
confidcr the very fine juices of animal fubltances the moft nutri- 
tious, becaufe more readily aftimilated to our own nature, for 
very weak debilitated habits, infufion is the moft advantageous 
procefs, as by thefe means the fubtler parts are preferred, which 
by long or quick boiling would be diflipated—but for thofe pof- 0N MEDICINE- 
fefifed of Wronger digeftive powers, there is not fo much neceffify 
for this nicety. 
Of thefe materials the moll nutritious are, beef—and mutton- 
teg.—as they are called -made in the following manner : 
Take of the lean part of beef, or mutton, one pound, cut it in- 
to thin dices, and let the texture he well broken, by bruiting if, 
then add to this one quart of boiling water, in an earthen or tin 
vefifel, keep it clofe covered till it is quite cold—or boil them o- 
ver a quick fire, for five minutes ; feparate the fcnm, and decant 
the clear liquor for life ; — but fhould we requi e more ol the 
ftronger parts of them, the liquor may boil ten. fifteen, or twen- 
ty minutes, and then proceed as before dke&ed. 
The juices of the older animals are preferable to thofe of the 
younger, becaufe thofe of the latter are more tenacious, and .par- 
take not fo much of the nature of our own fluids, confequently 
yield, in that refpeft, to the former. 
But when it is requinte that the flefli of animals fhould be giv- 
en in its iolid form—that of young ones is confidered the mod; 
proper, as their fibres are much more tender, mod eafily 
broken down by chewing, and yield their nutritious part more 
readily to the adding powers of digellion. 
MILS, of Which we have before fpoken, pages 82, 83, though 
of a mixed nature, between animal and vegetable, we confider 
next ; for it is a fluid only half perfected, and partakes, in forre 
degree, of each of the other clafies. We have, in another place, 
delivered our fentiments on the allowed degrees of pre ever.ee 
one fpecies of milk has to another, and have fhywn that of afifes 
to be the belt of any which could be procured in proper quantity 
—we (hall here, therefore, only obferve, where that cannot be ac- 
quired, either from the greatnefs of the expence, or the fcarcity 
of the animal, the following, called artificial ctjfes milk, is not 
an inefficacious fuccedaneutn : 
Take of candied eryngo root, one ounce ; pearl barley, half 
an ounce ; liquorice root, three drams ; boil them in two pints 
of water till they are reduced to one, then add one pint of milk 
f refit from the cow, boil them gently together, and if rain for ufe. 
Half a pint of this Ihould be drank, in general, two or three times 
a day ; but fhould that quantity be too large, it may be reduced, 
and repeated oftener. 
The VEGETABLE CLASS has been confidered as more 
difficult of affimilation than either of the other, becaufe it is more 
ciiifant in its nature from our fluids ; and perhaps thofe may be 
found the mod nutritious that approach nearer to milk, that is, 
more impregnated with oil, not eflential—faccharine fubftance—■ 
and a fmall portion of vegetable acid ; for it is from thefe qua- ON MEDICINE. 
lines that all nutrition, in food of this fort, is fuppofed to be de- 
rived. 
We have fpoken here, and in another place, of thefe things, 
merely as appropriated to afford nourilhment only to the animal; 
but they mud be allowed to have oilier properties, which it is 
neceffary to fpccify, as by thefe means different changes are pro- 
duced in the confutation. 
ANIMAL FOOD, particularly fith, is more dimuIant and al~ 
calefcent, becaufe more'prone to run into that Hate, which gene- 
rates pungent acrimonious ialts, confequenily becomes more 
heating. 
VEGETABLE, more diluent and acefcent, from its being 
more replete with aqueous particles, and having fitong propenfi- 
t’ies, from their very nature, to become acid—hence more eool- 
ing. 
Milk, in this inflarce, partakes more of-the latter, as it is fub- 
jefit, left to itfelf, to become acid ; befides, vegetables are more 
emollient and ilieathing, as moil of them abound not only with 
Watery particles in great proportion, but alio with thole which 
are mucilaginous ; and feem to have inlpiffating, or thickening 
powers, from their mixture with the fluids : lienee, if we take 
in the account the quantity of fixed air with which they are re- 
plete, we may be convinced of their utility it. cates of the lea or 
true feurvy, and in all thofe morbid habits, where the fluids have 
acquired too great degrees of thinnefs, from inherent or accident- 
al acrimony. Milk alio retains the fame propeities. 
Roalted—broiled—or fried animal food, is more flimulant than 
boiled, and runs quicker into a if ate of putrefcency—from the 
diifcrent culinary proceffes they undergo: the firfl being prepar- 
ed only by the action of flrong heat, by which means the fluids 
are rendered more pungent, and more highly alealefeent—the laft 
receiving a lefs degree of heat, and through an aqueous medium, 
with which part of the animal juices are mixed, rendered more 
dilute, and lefs highly fubtilized ;—but when dewed down, to a 
great degree, and eat with the fluids with which it is prepared, 
it approaches nearer to the former, than when only infufed, or 
gently fimmered ; nay, indeed, often exceeds them ; and hence 
becomes alfo more difficult to be concohted or conquered by the 
digf/tive organs. 
Of the vegetable clafs, we have faid farinaceous fubflances arc 
the moll nutritious, and thofe which have undergone feme culi- 
nary proceib, becaufe their fibrous parts are rendered more ten- 
der; and thofe which are moil eafily aflimilated, which contain 
the molt oil, faccharine fublta'nce, and a iinall portion of vegeta- 
table acid; confequently thofe which have fuffereu maceration ON MEDICINE. 
and fermentation, as they become fwceter, and have their vifeid 
parts rendered thinner, and mote flexile, by thofe means are more 
eaflly digeftible :—But we muft in this place make one obferva- 
lion, which affords an objection to what is advanced,—There are 
Another clafs of vegetables, which are fuppoled to he more nutri- 
tious—and thefe are the Fungi, or thofe fungous extubcrances, 
called Mujhrooms, or Champignons—4Irujjles—Monties, named 
by Nero, the Victuals of the Gods—they are coniidered to afford 
more nutriment, from yielding, cn their chemical decompofition, 
materials flmilar to animal food. Dr. Cullen fays, “ if they are 
“ truly vegetable matters, of which lorne have doubted, they are 
“ very different from every other vegetable with which we are 
“ acquainted—tor in the flvft part or their dillillalion, without 
“ addition, they give out no acid, but a large proportion of vo- 
“ latile fait ,—and expofed to undergo a fpontaneous fermenta- 
“ tion, they manifeft no acefceoe'y, but become immediately pu- 
“ trid—hence fhew they a very near refemblance to animal fub- 
“ fiances ; and it may be prefumed, that they are more confl- 
“ dcrably nutritious than almolt any truly vegetable i'ubllanc- 
4 4 >> 
t S. 
1 have inferted thus much relative to thefe fungi, in order 
that we may be acquainted with their particular ules, not as cor- 
rectors of animal food, like other vegetables, but rather as ani- 
mal food itlelf, and correctors of acidity in the itomach—and on 
this account become a pleaflng delicacy to fuch, who are forbid 
the ufe of all vegetables, on account of a prevalent redundancy of 
acid in the hi ft pafiages. 
All the acrid—bitter—or highly flavoured vegetables, as they 
conflft of parts which are not readily fubdued by the digeftive 
powers, but pafs iu an unaltered Hate in the courle of circula- 
tion, come more properly under the clafs of medicinal fub- 
ilances. 
Under this head of Nutrients welhall have no occafion to fnp- 
ply a general catalogue, for all thofe things fall under this clafs 
which we employ as food, and include whatever we eat and 
drink for the purpolc of fupporting the animal machine, and re- 
pairing its watte.—And if we revert to what has been faid in 
treating on aliment, p. 70, and on thofe liquids we in common 
drink, p. Ho, with what we have here advanced, we lb all be 
iupphed with knowledge fufficient propeily to divcct us in our 
leiection ; for 1 am fully perfuaded, that we oftener err by the 
quantity of food that we take, than the quality ; as it is certain, 
Inch is the power inherent in our habits, that though our food 
may be in its own nature in any particulars diflimilar, ftill if we 
only fupply fuch quantities as are juditioufly approportioned to ON MEDICINE. 
our digefiive powers, whatever the aliments on which we feed, 
they will all be reduced to the fame Hate, adapted to the prefer- 
vation and nourifhing of the machine ; we lhall therefore advert 
to our next fubjedt. 
§ 2. ASTRjNGENTS, from the Latin word ajlringo, to bind, 
or condenle, which are all fuch fjbiiances as by their adtion 
render the lofter parts more compact, give a greater firmnefs to 
the iolids, and a cohefive tenacity to the fluids. Their parti- 
cular power in condenflng the l'olids is obvious from the effedls 
which they produce in tanning, or making of leather. 
Boerkaave was of opinion, that, when applied, they bring 
two dillant parts of a moving fibre into clofer contadl, and into a 
more firm cohefion, and this by infinuating between each particle 
of the fibre another of the lame kind. 
Dr. C ULLEN thinks, that as a fibre is compofed of lolid and 
fluid, the cohelion of the whole is increaled by diminifhing the 
watery, or by addition of the iblid fubfiance : but is rather a fa- 
vourer of the firil opinion. 
With reipedl to the addition of any folid fubfiance, it may be 
the cafe when adling on the inert folids, free from the influence 
of the vital, or nervous power ; hut in the living machine, we 
cannot luppofe medicines of this clafs derive from this i’ource 
their operation ; lor under tbofe circumftances the medicine mull 
be univerfally diffiifed, and come in contadl immediately with 
the parts upon which it adts. 
Thisj therefore, cannot be true—if we confider the very fmall 
portion of thofe which fhew their general aftringent power, 
when taken upon the ftomach, and the very quick mode in 
which they produce their effects ; befides, the variety of fnb- 
ftances which manifeit a conftringent efficacy, when the machine 
is varioufly affedled from different caufes. 
In proof of this we lhall mention tome few particulars : 
ALUM, when given in dofes of a few grains, has been known 
to Hop profufe bleedings, arifing from a relaxation of the folids, 
in a fhort fpace of time. 
WHITE VITRIOL—BARK—STEEL—and fome other of 
the ftrongly adling medicines, havecaufed the ceflation of other 
dilcharges, by invigorating the fyftem, and nut from the locality 
of their application. 
PUNGENT STIMULANTS have produced infiantaneous 
effidts, though not durable, in cales of laxity. 
SEDATIVES, or thofe medicines which manifefi their ef- 
fects by alleviating pain, and abating the quicknefs of vafcular 
o _ cl: ON MEDICINE. 
aftion, have early (hewn their power in the abatement of acrid 
defiuxions. 
Now it evidently that all thefe produce their influence 
by their aftion on the Itomach fympathetically conveyed to the 
roaclrne in general, and to the parts particularly aff'efted, which, 
as being in a more morbid Hate, they experience more power- 
fully. 
With regard to the fluids, thofe medicines which have the 
power of ftieathing acrimonious particles, from whence difeharges 
have proceeded, may be confidered as afti ingents. In fine, what- 
ever will promote a contraction of the folids, or coagulation of 
the fluids, come under this clafs. 
But it mult be obferved, that many of thefe excite their aftion 
inllantaneoufly, but do not give the fyftem the power of conti-* 
tiuing the efteft ;—whilft others aft more flowly, Hill occafion, 
as it were, a permanency to that aftion in the conflitution. 
Volatile fubftances—eflential oils, and others of this clafs 
promote veiy quickly the influence of the vital powers, by which 
means the conflitution very early is made fenlible of their pow- 
er ; but as foon as they ceafe to aft, which they do in a ihort 
fpace, the morbid eflfefts, they feem to have conquered, are re- 
produced.—Alum alio labours under the fame difadvantages. 
But the more flowly afting aflringents continue their force 
longer, and appear to give a flrongcr and more lafting cohelivc 
power to the particles of the folid fibres, as if they increafed 
their attiaftive influence inter fe. 
from this knowledge we fhall be able to deduce a mode of 
preferibing, of infinite ufe in praftice, which would at an earlier 
period have been confidered as contradiftory, and ridiculous* 
becaufe deviating from the commonly received opinion—for, 
from what has been advanced, vve fee that volatiles and aftrin- 
gents may be judicioufly united, and will be the means of affift- 
ing the effefts of each other, by producing them fooner, and 
making them more lafting—as I have often found in the courfe 
of praftice, particulaily where the conflitution has been defec- 
tive in vafcular irritability, and nervous incitability ; for, by ad- 
ding volatiles and pungent Aimulants to bark, in many cafes, 
the wilhed-for effefts have been produced, which could not ba 
attained by bark alone. 
1 o thefe, where the humors are acrimonious, ftieathing medi- 
cines, called demulcents, may be joined ;—and fedatives occafion- 
ally had recourfe to, wher e fpafms attend relaxation of the folids. 
But we mull here obferve, that where the aftringent faline 
minerals, fuch as thofe of fteel—white, and blue vitriol—the 
preparations of lead— alum, &c. may be thought proper, vola- ON MEDICINE. 
139 
tiles muft not be joined with them, as they will occafion a de- 
compofition, and render the allringent power of the compound 
mineral lefs aftive, nay, perhaps, deflroy it altogether. 
J he catalogue, pr*fcnted to us by various authors, is extreme- 
ly copious, but we Ihall content ourfelves with a lew, which ar© 
in general allowed to be the molt efficacious. 
ASTRINGENTS from the Mineral Kingdom. 
Iron, filings, or ruft prepared—dofe from five giains to 30. 
Ammoniacal iron, 3 grains to 13 or 20. 
Tartarized iron, ic grains to 30. 
Vitriolated iron, 3 grains to 20. 
Tinfture of muriated iron, 10 drops to 60. 
Alum, burnt, from a to 15 grains. 
Whey, from 2 to 4 ounces. 
Curd, externally. 
Chalybeate Waters— 
Tumbridge Hampflead 
Pyrmont Iflington, See. 
Zinc—Calcined zinc, 2 grains to 6. 
White vitriol, 1-2 a grain to 2. 
Copper—Blue, or Roman vitriol, 1-4 of a grain to 2. 
Lead—Water of acetated litharge,from 1 to 3 drops. 
Acetated cerul's, 1-2 a grain to 1 and 3. 
From the Vegetable Kingdom. 
Roses—Conferve, 1 or 2 drams to 1-2 an ounce. 
Infufion, a ounces, or more. 
Tormentil Root—r 
In powder, 8 grains to 40. 
In decoftion, 2 to 3 drams. 
Kino—powder, 1- 2 a fern pie to 2 fcruples. 
Madder—powder, 20 to 30 grains. 
In decoftion, I ounce in 3 pints boiled to 2— 
dole, 2 ounces. 
Wood Sorrel—Conferve. 
Water-dock Root— 
In decoftion, 1-2 a pound to 6 pounds of water 
reduced to 4—dofe 8 ounces. 
Cup Moss—in decoftion, faid to cure the chincough. 
Quinces—-Marmelade. 
Mulberries—Syrup. 
Medlars—Fruit, not to be eaten before long keeping. 
Si 0E&—Conferve, dofe 1 or 2 drams. 140 
ON MEDICINE. 
N ETTLE, flinging—Juice, or decoflion, 2 to 4 ounces. 
Beaks Wortll Berry, the leaf--- 
Powder, 1,5 to 30 grains. 
Decoction or Infufion, 1 or 2 drams in a pint and M of- 
v-ater reduced to one pint—dofe 
from 6 to 8 ounces. 
Ti NCTURE of Catechu, which was called Japan Earth, 1, 2, 
or 3 diarns. 
Pomegranate—In deco£tion, An ounce to a quart of milk and 
water reduced to a pint. 
Oak and Ash Bark—-Slight decoction, gradually increased, 
Simarouba, or Guiana Bark—Powder, from 10 to 20 grains. 
Logwood—-Rixtraid, 10 to 40 grains. 
Deco&ion, i-2 an ounce to a pint and 1-2 re- 
duced to 1 pint—dofegounces. 
Galls—externally, 1 part of powder to 8 of hog’s lard. 
All the acids, vegetable as well as mineral—all the bitter Stimu- 
lants-— Sedatives---alii all the flimulant Balfams. We (hall not 
fupply any formula here, from the different combination at thefe 
articles, but fpecify them more particularly, when we come to 
treat of thofe cafes where fach applications are required. 
Though we have fet down the dofes according to what is ge- 
nerally held proper for adults, expecting they will be varied ac- 
cording to the age and conflitution of the patient, and the exi- 
gence of the cafe to which they are neceffary, one obfervation it 
is proper to lubmit here, for the information of the reader; 
which will apply in all the other departments on the fubjedt of 
medicine, as well as iri this place. 
That, as the fame dofe of any active medicine will not be ade- 
quate to produce the intended efFe£t on all conjlitutions, the dofe 
fpecified being too large fpr fome, and for others too fmall—we 
fbould always begin with a very moderate dofe at firft, and in- 
creafe it gradually, till the full proportion can pe difeovered ; 
thence we fliall be certain of deriving every advantage which the 
medicines can procure. Befides, we {hall avoid producing too 
violent effects upon thofe habits which have a natural antipathy 
to any particular medicine, which can only be difeovered from 
experience. 
§ 3. EMOLLIENTS—fo denominated from the latin word 
to grow foft or fupple. 
Thefe a£l in a mode oppofite to the preceding clafs, inafmuch 
as aft. 1 ingents give firmnefs to, thefe induce a relaxation in the 
tfolids. 
They have been called Relax ants, and may be confidered 
as fuoh? if we include their mode of action in a double fenfc ; ON MEDICINE. 
141 
for though they have been thought to produce fuch a change in 
the foluis as occafioned them to be extended, more than they 
were before, without rupture ; if ill they have been acknowledged 
to reduce a part of the body, indurated and compacted in one uni- 
form bulk, into its Hale of contained liquid, and containing fo- 
lk!. 
It has been conjectured, that emollients a£t chiefly upon the 
folids, by introducing their particles, which confift moilly of the 
watery, mucilaginous, and oleaginous kind, between thofe which 
compoie the tolid fibre, thus forcing them farther from theic 
fphere of attraction, and bringing them nearer to a ftate of fluid- 
ity ; for folids and fluids differ but in proportion to the ftrongec 
or weaker attractive power of their component parts. 
But notwi hitanding this may be the cafe in many, nay, per- 
perhaps molt inflances, ftill they may produce their effeCts'ge- 
nerally over the fyftem by their aCtion on the Aomach ; for if 
that organ is relaxed, fo will ail the other parts, dependent upon 
it, without having any watery particles introduced to weaken 
their texture. 
Fear and Grief are powerful relaxants, but thefe may be 
faid to afteCt the mind and vital power, and hence pioduce their 
effeCts. 
Inebriation has with numbers the fame confequenee, but 
this avifes from the relaxed date of the ftotpaph, which is foon 
taken off by ftirnulating that organ, as has before been fpeaified 
in the be inning of this work. 
Women in general experience fimilar mifehiefs, from repeat- 
edly drinking hot tea, and other liquids under the fame circuin- 
Itances. 
Emetics given only in fmall naufeating dofes, enervate, and 
relax the fyflem from the fame caufe. 
Sedatives (chap. 2. § 3.) may alfo be confidered in fome de- 
gree under this head. 
7’hofe, however, which produce their effect upon the machine 
in general by fympathetic power, will be confidered under differ- 
ent heads. Under emollients we mean to rank only fuch fub- 
liances as a£t from their watery, mucilaginous, and oily particles, 
of which they confilt ; and thefe prove molt effectual on the parts 
to which they are more immediately applied, which Dr. Cul- 
len conceives to aCt in one of thefe two ways ; “ the one by 
“ being infinuated into the fubftance of the folid, and thereby 
“ diminifhing the denfity of the whole of the mixt, they dimi- 
“ nifh its force of cohelion. The other is, when, by being infi- 
‘‘ nuated into the interftices of, or fpaces between dry particles, 
** they dirainifli the friction which might otherwife occur, aud ON MEDICINE. 
“ thereby render the whole more flexible. The former feems t<* 
“ be the operation of water, the latter of mucilage and oil.” 
And theie three feem to include all the emollients, if we were 
to examine the articles, multifarious as they are, which confli- 
tute this clafs. Indeed, for internal ufe, the writer above fpecifi- 
ed rejecis the whole, and gives the preference to the infufion or 
deca£Lion ot lintfeed ; which is fully as efficacious as any other. 
And here, though we mull obferve, that as in many f«:>rile 
complaints the ufe of emollients feem abfolutely neceflary, where 
the degree of febrile affection runs very high, we are rather to 
adhere to thofe of the watery, mucilaginous and farinaceous kind 
of the vegetable clafs, than to thofe abounding with oil, or ani- 
mal fubflances ; becaufe, from feat, they are apt to grow rancid, 
acquire acrimony, and hence become too flimulant, and much 
increafe the febrile effects we wifh to reflrain. 
The catalogue of Emollients ftirnifhes us with a great vari- 
ety of fubflances, out of which we form the following fele£tion 
—which, as they are fo very Ample in their own nature, and 
produce no powerful action in the habit when taken internally, 
require not to have any particular dofes annexed to them. 
EMOLLIENTS from the Animal Kingdom. 
Weak broths, crude yolks of eggs, honey, milk, cream, 
butter, fuet, fat, fpermaceti. 
From the Vegetable Kingdom. 
The feed of quinces, line, fenugreek, white poppy, wheat* 
rye, oats, barley, particularly the farina of thefe, figs, raifins, 
dates, marfh-mallows, balm.—Decodlions or infufions of thefe 
are pleafant and efficacious for common drink. 
Oil of almonds, alive oil. All bland expreffed oils. 
Bete, fpinage, white lily root, boiled onions. Liniments, 
ointments, fomentations, or cataplafms formed of thefe fubflances, 
which we fhall, in their particular places, hertiafter fpeci'fy, have 
fimilar effecls—perhaps the warmth with which they are applied 
may have fome gently tlimulating power®, and hence prove alfo 
in fome degree efficacious in thole complaints for which they 
aie advifed. 
To thefe we fhould have added the warm vapor of an animal 
recently killed—for we have inftances of the arm, and other parts, 
put naked into the body of an animal immediately after it has 
been fiaughtered, receiving great benefit, in cafes where relaxing 
ap[ lications feemed requifite ; and where many of the others had 
been tried without any advantage. 
But the moll emollient of ail is VAPOR, either received by the «N MEDICINE. 
143 
mouth, or injedled by glyfter, moderately warm—and indeed it 
is almoft univerfally eiteemed fo, whether applied internally or 
externally. 
Thefe form the clafs, it has been faid, of medicines which adl 
upon the inert folids by means of the vital principle. That af- 
tringents and emollients may adt upon the inert folids alfo, per- 
haps, without the aid of that principle, in many cafes, when 
brought into contadt with them, may be allowed—but that in 
the living machine they do, is much to be difputed—and that 
the nutrients cannot, is evidently clear ; for if that principle is 
defedtive by which the nutritious matter is applied to particular 
parts for their fupport and reparation, the matter itfelf wiil a- 
vail but little. This feems clear from our obiervations on pa- 
ralytic limbs, receiving fuch flight degrees of fupport, and of be- 
ing fcarce at all benefited by the application of aflringents or 
emollients, where fuch deficiency takes place. However, in a 
work of this nature it feems not necefiary to go too minutely in- 
to a fubjedt of fo much intricacy ; it is enough for our purpofe 
to point outeffedls produced by the particular materials fpecified, 
without being very folicitous of inveftigating the precile mode 
by which they are accomplifhed. 
Our fecond pofition leads us to treat 
CHAP. II. 
On Medicines which aEt upon the living Solids ly Means 
of the same Principles. 
HPHE firft of which are, 
§ 1. S rLWJL\M TS, fo called from the Lafin word Jlimuh% 
to prick or goad :—and thefe are all l'uch medicines as increafe 
the ofcillatory or vibrating motion of a fibre, or excite the action 
of the moving fibres in the living animals. 
How ftimulus increafes adtion we cannot point out the pre- 
cife mode ; but this we know, that all thofe things w' ich caa 
increafe the influence of the vital powers, either diffulively 
or partially, are real ftimulants, and as fuch mult be confider- 
ed. 
They have been concluded to he of two kinds—direct and 
indirect. The firjl are imagined to adl diredily on the mov- 
ing fibres ;—the /econd on the organs of fenfe, by which means a 
perception is excited on the common fenforium, which adt’ng 
there, determines the nervous power to flow more copioufly in- 144 
ON MEDICINE. 
to the whole, or particular parts of the fy ftem. Thefe are the 
moll common and univerfal. But ftimulants do excite motion 
in the moving fibres ihemfelvbs independent of any connexion 
with the commoii fenlorium; for if the heart, or fome other of 
the mulcular paits, are feparated from the body, they may have 
their action excited by the application of particular ftimuli : 
this then is a certain proof of an irritable power inherent in 
themfelves independent of connection with any nervous power. 
yind again., it is as clear, that a ftimulns applied to the ftomach 
will diffufe its power to the whole habit ■, or if to a part, other 
parts far diflant will experience its influence, as in cafes of ge- 
neral heat being occafioned by the uie of cordials or volatile fub- 
iiancea—vomiting from irritation of the kidneys, &c. Hence 
then we may fairly conclude, that action is produced by fympa- 
thy, as well as local itimulus. 
Belides, in many of thefe aftidns, mental power is the firft 
caufe, as we may difeover in longings, dtlire for tliat food off 
which we fee others eating with uncommon relilh ; by which 
means the ftomach is liimulated, and a iirong fenfation of hun- 
ger is induced, which did not before exift—weeping alfo froni 
i'orrow,—vomiting and ficknefs from recolle&ion and reflection, 
&c. Thefe are incontedable proofs of the truth of our atTer- 
tions. 
Hence, then, ftimulants may be properly divided into three 
elaffes : 
General—and thefe are fuch materials as are taken into the 
ftomach, and communicate general affection through the fyftem, 
owing to the connexion of that organ with every ocher part of 
the machine. 
Local—where irritation is produced on the part affe&ed. 
Mental—cvhere, without the application of any material lub- 
ftances, applied to the ftomaeh, or any other part, limilar affec- 
tions will be produced by the powers of the rnind. 
Indeed, slmoft all active medicines might be ranked under the 
head of ftimulants, were we to clafs them according to their 
known operations ; fubmitted to different div lions under this 
general term, agreeable to the effects they produce—but we (ball 
confine ourfelves to fuch lubftances as invigorate the fyftem, 
increafe the afclion of the nervous and vafcular power locally or 
univerfally, 
And from hence fball we fee their ufe, by facilitating the pal- 
fage of the blood through the parts in which it moved too flow, 
or was morbidly obttrvnfled by augmenting the force and cJeri- 
ty of the circulation—they quicken the fades where morl dly 
stFered, route the mental faculties when in a lethargic ftats, and 
exhilirate a defponding condition. MEDICINE. 
They reflore the powers of faction where morbidly defective, 
and alio the .ftrength of motion where morb'dly weak. 
From their ufes have they been divided by fome authors into 
fuch as are did u fable—cordial—and topical by their ail ion—that 
is, fuch as have their action conveyed over the fyilem—luch as 
exhilirate the fpirits—and fuch as are applied to fome particu- 
lar parts morbidly afFecled. Examples of the Fir ST have we iii 
Volatile alkaline falts, . Electricity, Heat. 
Of the second in 
Cinnamon,, .Nutmegs, Wine. 
Of the THIRD in • 
Mallard, Cantharides, Preparations cf mercury. 
1 hefe we have Ipecilied for the eafe of feledting the particular 
i'ubftances, according to their ufes, from the following catalogue of 
STI iVi Ok. ANTS—molt of which, when taken internally, have 
a power of increasing the force of circulation, and invigorating 
the fyflem—and fome proving alfo more immediately cordial,, 
by revivifying the fpirits. 
Of the first cl ass are 
Horfe-radilii Myrrh 
Muilard Guaiucum wood 
Garlic jSallafras 
Onion Contrayerva 
leek Mnake-root 
Turpentine (lafcarilla 
Balfams of Copaiba, Gi- Wake Rohm 
lead, Peru Volatile falts, 
Gum Guaiacum 
Of the secOKi>i 
L a v e n d er N u t rh e g 
Rofemary Cloves 
Pennyroyal pimento 
Pepper-mint .Pepper 
Aniieed Ginger 
Carraway Caphcurrt 
Cardamom feed Grains of paradife 
Cinnamon Wire . 
Callia wood Efkhtial oils 
Mace 
Thofe ufed topically twe 
Millard Volatile alkaline falts 
Horle-taduli And thele made either into plaiflers* 
Cow-itch epithcms. cataplafins, ointments, or 
Cantharides liniments. 
Euphorbiiun 
Preparations of mercury 146 
ON MEDICINE. 
The following, though truly confidered as polTeffing 3 great- 
er or lefs degree of llimulating power, produce not the effects 
before fpeciftecl fo fenlibly : 
*£edoary Qyiaffia wood 
Genfing Hops 
Cafcarilla Dandelion 
Common and Roman Millipedes 
wormwood By Hop 
Camomile Giound-ivy 
O range and Lemon peel Hedge-hyffop. 
All the Nutrients and Astringents arc of this ciafs ; and 
many others of the fucceeding daffes, though Itimulant, are more 
particularly appropriated to other purpofes, under which heads 
they will be arranged. The catalogue here given will be fuffi- 
cient to anfwer the purpofes Co which ftimulants, merely confi- 
dered as fuch, are calculated to be of any ufe. 
But as fome of them have been thought, by very refpe£table 
authority, to poffefs fame peculiar powers, and are calily attaina- 
ble, we {hall beg leave to fpecify them. 
HYSSOP has been reputed to be attendant, fefolvent, pecto- 
ral, in coughs and aflhmas occafioned by vifeid phlegm; thought 
to produce expectoration, drank in form of tea, and fweetened 
with honey ; and to have the pow’er of promoting the menfes 
attributed to it. 
GROUND-IVY, drank in the fame form, or'in deco&ion, has 
been eifeemed corroborant, aperient, and detergent, tiled allo in 
coughs and afthmas, to attenuate vifeid phlegm and mucus, and 
to brace and {Lengthen the velfels of the lunt’s; formerly 
much ordered in confumptive cafes, and ulcers of the kidneys, 
as an efficacious remedy". 
PJENNYROYAL. This has been conlidered cordial—of great 
life in hyfleric cafes—-to increafe the tone of the fyflem—-and 
the chief vehicle for other medicines, to which were attributed 
the power of promoting the monthly difeharges of the female 
fex. Indeed, in this lafl cafe, by feme practitioners, it is held 
in no litile eilimation. 
SPEAR-M'N T. To this has been sffigned cordial virtues, 
and a powerful reflrainer of vomiting---tea made of this heib 
often anfwering this purpofe, where every other effort lias failed. 
Ic is recommended in flatulent cafes, fluxes, worm cafes, and ma- 
ny other diforders •, and, though cor ndered as a ftimulanf, it is 
not heating, a peculiar advantage it pofiVffes over many other of 
the cordial clafs. Feppei-miut items aifo t*o poffefs the fame 
power. ON MEDICINL. 
HEDGE-HYSSOP. This is named a hydragogue, or an e- 
vacuator of watery humours from the body—hence ufeful in 
droplical cafes, and alfo worms, from its purgative power. In 
fubltance it is faid to promote vomiting, Iweat, and urine, to be 
of lervice in maniacal and venereal cafes, after mercury had been 
given freely without effect-—the dofe, in powder, from 10 tc 30 
grains. 
DANDELION. This has been eonfidered as peculiarly ufe- 
ful in vifceral obftructions, particularly thole of the liver, as it 
feems calculated from its ftirnulant deobftruent powers, to pro- 
mote bilious difeharges—and, from experience, has been conclud- 
ed highly efficacious in all biliary infarctions of the liver. 
WAKE ROBIN, Much has been laid by men of the firft 
medical authority in favour of this medicine, and ufed to be re- 
commended as promoting watery excretions, quickening circu- 
lation in cold phlegmatic habits, and in difeafes from viicid 
phlegm. 
' In deep feated, fixed rheumatic pains, it has been given with 
fuccefs, in dofes of from ten grains to a fcruple of the freih root 
two or three times a day. 
Geoffroy and Bergius fpeak highly of its powers, as re- 
ftoring loft appetite, curing intermittents. In the jaundice, green- 
ficknefs, hyftericai, hypochondriacal, and other dil'eafes, it has 
been found ufeful. In cafes alfo of obftinate head-achs, which 
return at intervals, without fever, mixed with alkaline aromatics 
and abl'orbents, It is given in the following manner : 
Take powder of wake robin, vitriolated tartar, of each ten 
grains powdered rhubarb, five grains. If thefe purge too vio- 
lently, the quantity of the arum may be leffened. 
Geoffrqy ufed to give it in dofes of from half a dram to a 
dram ; and by being boiled in vinegar, he fays it becomes pow- 
erfully diuretic. 
Lewis gives from ten grains to a fcrtiple of the frefti root 
twice or thrice a day, made into a bolus, or emulfion with oily, 
or mucilaginous fubftances—it generally produced, whilft the pa- 
tient was warm in bed, a copious fweat. It is now kept in the 
fhops made into a conferye, half a dram of which may be given 
as a dofe, and gradually increafed. 
Thus much has it been thought neceffary to fay of ftimulants, 
in order to furnifh a general idea of their extenfive utility, under 
proper management j but as their ufes are fo multifarious, and 
almott the whole catalogue become repeatedly under our confi- 
deration in the fucceeding part of this work, wherein we fliall-be 
more particular in the fpecification of their dofes, and the pecu- ON MEDICINE. 
liar cafes to which they are applicable, we fhall quit this part of 
our iubjeCl, and proceed to our next head. 
§ 2. ANTISPASMODIOS, derived from antijpnfmata, medi- 
cines which take oft’ fpafms, or what are commonly lliled con- 
vulfive afteCtions of the human machine. 
Though there certainly appears a difference between fpafm and 
convulfion, as they never run one into the other ; yet there hava 
been many difputes relative to tlie definition, fo that their dif- 
tinctions may be properly marked. 
Some have faid, if the folids are drawn into involuntary con- 
tractions, and they do not continue long, but go off, and frequent- 
ly return again, thefe aff Clions are termed convuljions—but if 
they remain a confiderableMime, fpafms. 
Gaubius defines a fpafm, a violent, involutary, inordinate acc. 
tion of tlie moving fibres ; and fays, they who diftinguifli a fpafm 
from convulfion, call the fir ft a continued, the latter an alternate 
contraction of the mufcles. 
They have been diftinguilhed by the terms tonic and clonic, 
from the Greek words tei/io, toftretch or fix, and kloineo, to {hake;* 
Hence, by the former are to be underftood, fuch fpafms as are 
continued by the latter, fucli as are tremulous ;—or, in other 
words, spasm we would underftand thofe mufcular contractions 
which, once excited, remain in that ftate of contractility for fome 
length of time—by convulfion, fuch as are irregular, and have' 
relaxations and contractions alternating quickly with each other. 
Though this diifinflion is neceffary to be known, for the bet- 
ter imderftandmg the authors who have written fyft'ematically on 
the lubject ; yet Hill it will be of little ufe in a practical view ; 
as we fhall find, according to the caule, what will be ufeful in one 
fpecies, will alfo in the other. Indeed, there are fucli a variety of 
caufes, fo very different in their own nature, which may produce 
fpafmodic or convulfive affections, that there will neceffarilvappear 
to be a great diverfiry of medicines which ought to be ranked un- 
der this head. 
Spasms arifing from laxity, are removed b y ajlringents ; from 
an over diftenfion, by emollients, from acrimony, by demulcents, 
fir fuel) medicines as iheath the offending particles ; from acidity 
in the firil paffages, by ubforbent, or alealejeent fubjlancis, which, 
by uniting with the acid, form a third fubitance, inoffeniive in 
its action, and1 thus remove the caufe ; from wind, by thole ma- 
terials which dil'perfe wind by their Simulating powers, and are 
called carminatives.-; from worms, by thofe lliled anthelmintics, 
©r dcflroyers or ev&cuators of them, &c.—but thefe are confi- 
dered, in regard to their known action, under their refpe&ive 
heads, calculated to operate againft, and remove the afling caufe. 
But what we underftand in thi3 place by antiipafmo* ! dies, are fuch medicines as are ferviceahle, from their influence 
on the nervous energy, or increafed nervous power, by remov- 
ing fpafmodic contractions Taking place in different mufcles ; and 
by allaying convulhve agitations, where the caui'e is too latent 
! to be difeovered precifely ; or, if conjedured at, too obftinate to 
be removed by medicinal applications with any degree of cer- 
tainty ; lo that the cordtitution being relieved from the violence 
| of the!e effects, nature ’ may be left more at liberty to exercife 
her power for the extirpation of the operating morbid caufe. 
ON MEDICINE. 
And in our adminitlration we muff obferve, where the confli- 
j tution appears to have an inflammatory dil'polition, we mull fe- 
j led fuch as are the leaft ifimulant ; where relaxation or debili- 
ty i'eems prevalent, thole which are mote powerful. 
Betides, as the clal's of antifpafmodics conlilt of medicines dia- 
j metrically oppoiite in fome of their tenable properties—forne be- 
] lag highly foetid-t-others as greatly odoriferous2—and are confi-' 
I dered as medicines of equal efficacy, we might fuppofe that there 
is no limitation in our fe left ion—buc we tliali find that fome will 
I be efficacious in one constitution, and not in another—tor where 
j fcctids agree, the odoriferous ones will, very often do not—and 
j fo on the contrary ; therefore, where one clafs has been tried in. 
I effectually, we mull have recourfe to the other. And here alfo 
I it will be ufeful to oblerve, that very often, for want of giving 
j thefe medicines in full doles, their effeds have not been produc- 
ed ; confequently it is proper to increafe them, very often free- 
ly, till that point can be properly aicertained. 
The following fupplies the ufeful catalogue of Antispasmo- 
DIGS. 
From thj Vegetable Kingdom. 
Pennyroyal— 
Ir.fufion— 
Di {filled water—* 
Eilential oil, frotn l to 5 drops. 
Rue—Extrad, from 10 to 20 or 30 grains* 
Sabine—Extract, kPage 151. from 6 to 20 grains. 
Powder, J 20 to 30 grains. 
Asa foetida— from 5 grains to 20. 
1 inclurs, f dram to a dram. 
Gum Ammoniac— from 10 to 23 grains. 
Milk of, 1 ounce to 1 and 1-2. 
Galbanum—Tin&ure, from 10 drops to 6d 
Camphor— from 5 to 20 grsins. 
Mixture, 1-2 an ounce to an ounce or more* 
Spirit, for external application. ON MEDICINE. 
Valerian—Powder, from 1-2 dram to 2 drams; 
Tincture, I to 2 drams. 
Volatile, I to 1 and a 1-2 or 2 drams. 
From the Animal Kingdom. 
Musk— from 10 to 30 grains. 
Mixture, from 1 to 2 ounces. 
Castor—Powder, from 10 to 20 grains. 
Tincture, from 20 to 60 drops. 
A MMOInia prepared, arid 
Salt op Hartshorn, 
from 3 to 20 grains. 
Liquor, from 20 drops to Go. 
Oil, or animal oil, from 5 to 30 drops. 
From the Fojlile Kingdom. 
Amber—OH, re&ified, from 5 to 20 drops. 
Salt, purified 5 to 15 grains. 
Though this fait, notwithflanding it is fometimes given in hy- 
fteric cafes, more properly belongs to the diuretic clafs, as allows 
cd to be a promoter of the urinary evacuation. 
Rock Oil —externally applied, as is alfo the oil of amber, in 
rheumatic and paralytic cafes. 
All the elFential and cmpyreumatic oils are of this clafs. 
iETH er—vitriolic, 
externally applied—dofe from so tc 
60 or bo drops. 
Spirit of vitriolic sether, 20 to 6s> or 8o drops. 
To two articles, which we have fpecified here, befides their an- 
tifpafmodic power, others have been attributed of no lefs cor.fc- 
quence—which, as medicines eafily attainable, we {hall parti- 
cularize. 
RUE has been recommended in cafes where vifcid phlegm has 
abounded, and the circulation of the blood been languid. As’ 
an atteuuant, rcfolvenf, and deobftruent it has been much extoll- 
ed ; alfo in hyfterical cafes ; and as a promoter of the menflrual 
difcharge. Boeriiaave had the highefl opinion of it. Cul- 
len fays, it is certainly an ufeful medicine. It is bed given in 
conferve, from half a dram to half an ounce, two or three times 
a day. 
SABINE. This is confidered as a warm aperient medicine, 
increafing glandular fecretions, ar.d a powerful promoter of the 
menfes. it is a very heating and acrid fubftance, and therefore 
requires much caution in the adminiftration. Dr. Cullen 
thinks it more powerfully determines to the uterus than any o- 
ther medicine—of which trtuh experience has often convinced ON MEDICINE. 
me. Dr. Home, out of five patients labouring under ob ft ruc- 
tions of the menftrual difeharge, cured three, or rather four, bv 
giving half a dram of the powder twice a day, thou, h a dram 
is the dole commonly recommended. Of the extract, from fix 
to twenty grains is a dofe. Externally applied, it lias been e- 
fteemed a powerful deftroyer of fungous excrefcences, in taking 
of venereal warts, where other applications have failed. 
§ 3. SEDATIVES. This is derived from the Latin word 
jedo, to affoage, refl, calm ; and they properly belong to fuch. 
fubflances as diminifh motion in the fyftem, and the force of the 
moving powers—and alfo alleviate pain. 
Hence, whatever diminifnes motion in a part, or in the whole 
or the fyflem, whether by rendering it infenflble to any painful 
ffimulus, or byr arreiling, by an*/neans, the impulfe of the vi- 
tal powers, may be called fedatTfe. All medicines, therefore, 
which cool the habit, or take 01Tinflammation—fome of the acids 
—neutral falts—emollients— aftringents—and antlfpafmodics, 
may properly come under this head, as they’ diminifli motion in 
the fyftem—but in this place our cbje£ls are limited to the con - 
of fuch fubflances only as are thought particularly to 
act on the nervous power. 
With regard to the precife mode of action of thofe felefted 
to form tliis clafs, wef can fay very little, as our knowledge of 
the nervous fyftem is fo incomplete. However, thus far we 
may venture to aflert, that they act either by having a peculiar 
power of retraining the violence, or tendering more equal the 
irregular motions of the nervous power, by their influence on 
the common fenforuim, and its appendages primarily, (56) or by 
blunting the irritability of the living folids, and thus preventing 
the fame power from exercifing too forcibly its influence. And 
this they do either fympathetically, by having their action more 
cluTufiVely communicated from the part they firil afifefi ; or by 
the locality of their action, when they are applied to the parts, 
themlclvcs ; for it has been proved, that the heart taken out of 
the bod}', has been made to act by the application of fome fii- 
nfulus, and confequently, that this power of contraction was de- 
pendent on fometiiing foreign to the influence of the common 
■fenforium, or nerves, which was certainly inherent in the muf- 
eular fibres themfelves ; and if opium is diflfolved and thrown 
upon the heart fo feparated from the machine, no action from fti— 
mulus will take place—which proves, that, by means of this fe- 
dative folution, irritability is deflroyed. 
And it is commonly known, that if a fmall dofe of opium be 
taken on the ftomach, it will alleviate pains of the extremities, ON MEDICINE. 
and other parts dillant from that organ, very expcditicufiy, as 
well as procure fleep. 
If then we take the influence fedatives have on the common 
fenforium, and the irritable power, inherent in the mufcular fi- 
bres of the fyflem, we ii.all be pofl’ejfed of the molt certain known 
idea of the operation of medicines of this clafs ; and be furnifhed 
■with the kno v ledge where, how far, and in what mode, the ap- 
plication of thefe fabftanccs may be fervjceable, or hurtful, in 
lo far as they aft as fedatives ; but it muff alfo be remembered, 
that fprne of them are ilimulants. , 
Hence then, in ail cafes where there is too great a rapidity 
in the circulatingfiuids, or pain, or fpaftn from an inflammatory 
caufe, they would be hurtful, otherwife they are in general fer- 
viceab’ie. In cafes rdfo of infarction, or ftrong obfiruftion, which 
iorneiimes happens in.the lungs, though attended with fpafms, 
they muif be cautiomly ufed. But wheie neither, of thefe ob- 
jections occur, they may be allowable, and attended with ufe 
in dim ini (hi rig the foiee and celerity of the blood’s motion, 
where morbidly augmented, or the impetus of the blood again ft 
parts flmilarly affected, in abating violent pain, and procuring 
deep in cafes of preternatural watchfulnefs, in relhaining inor- 
dinate rtiotiohsj and rrioderating excefliye evacuations. 
But where the circulation is preternaturally languid, or there 
is a lethargic or d rowdy difpofition, or a high degree of torpor 
in the ijftem, to them in thefe cafes we fhouid not have re- 
courfei 
According to the purpofes they have been given to effeft, they 
have received different appellations—it to alleviate pain, anodyne ; 
if to abate it by their demulcent power, paregoric ; if by bring- 
ing on llupoiy narcotic- if by inducing fieep, hypnotic ; howe- 
ver, their action is fimilar,' and requires no fuch dibinftioh. 
They are more properly divided into inch as produce deep, as 
opium, henbane, poppy ; and fuch as alleviate from their cool- 
ing property, as neu nd (alts, acids. 
Our catalogue oi SiuDATiVifib, df which opium is the prin- 
cipal, confuts of 
Poppy—Syrup of, 2 drams to 1 ounce or more. 
Opium—purified, (bom 1 to 2 grains. 
Tiu&ure S as a Pcom 5 to 10 drops—- 
\ as procuring deep, 10 to 25. 
Camphorated, from 5 to 60 drops. 
CIC 'J T A — lie vn lock, 
Inl'piHated juice, 2 grains and gradually increafed. 
Powder, ON MEDICINE. 
153 
Henbane— 
Powder, 
Extra#, 
Tobacco— 
1 grain to £ and mere. 
Smoke, 
Infufibn, 
Glyfter, 
Extra#, 
See page 155. 
Of all thefe medicines, however, wTe think it neceflary to give a 
more particular account—and, firft, 
The Poppy Head is in ufe for making a fyrup, pofiTeflfed of 
virtues to relieve pain, and procure fleep—foi thefe purpofes, it 
is chiefly given to children, in dofes of from half a fcruple to 
half a d ram dr more ; and it will be efficacious fometimes, where 
opium and its preparations are apt to difagree with the confU- 
tution. 
It is alfo ufed for making fomentations for alleviating pain, 
particularly after proper evacuations in inflammations of the eyes 
and breads. 
Opium is anodyne, from its relieving mcfl painful aftbdtions 
—-hypnotic, from procuring deep—incrajfant, from thickening 
the humours—diaphoretic, from increaling perfpiration ; and, 
joined with ipecacuanha, antimonials, camphor, volatile falts, 
and fuch like, the mod powerfully fo of any medicine with 
which we are acquainted—-fedative, from allaying the too great 
irritability of the nervous l'yflem—and the molt efficacious anti- 
Jpafmodic in the materia medica ;—taken in quantity, 
it renders the nervous fyltem fo totally infenfible, produces fuch 
general relaxations; that lethargy, convulfions, and death, are 
the eonfequences ; but, in a variety of cafes, given judicioufly. 
it is one of our mod noble remedies, particularly where ner- 
vous incitability, or thinnefs ot acrimony of the humours ar& 
too prevalent in the conditution, admit too great degree of fe- 
ver, or heat, or fixed obttrufltions, do not its 
ufe. 
Hence the benefit arifing from its adminiflration in hyfteric 
and hypochondriac dileafes ; in convulfions from violent pain ; 
in too great watch fulnefs, at the latter end of fevers, fmall-pox, 
and mealies; in coughs, from acrid, {limulating defluxions; in 
loofenels, and dyfenteric complaints, called bloody fluxes, very 
often. It has been faid to cure the venereal difeafe. That in ir- 
ritable habits it affifts the operation of mercury, by preventing 
the too powerful exertions of mercurial Aim ulus, alleviating pain, 
and promoting infenfibleperfpiration, will not be denied ; "unt it 154 
ON MEDICINE. 
being of itfelf curative, I cannot believe—though, after the hu- 
mours have been rendered too thin and acrimonious by the ufe 
of mercury, I will not difpute its power; for I have feen its 
good eifedls in totally removing what have been called rheu- 
matic pains from that fource. 
Afa-fcetida joined with opium is faid to weaken its narcotic 
effedds, and prevent that ftupor, heavinefs, ar.d vertiginous affec- 
tions, which opium is apt to occafion after its operation. 
Befides, this medicine not only alleviates pair, and takes off 
fpafmodic affedlions, when adminiflered internally—but when 
applied externally, as in fomentations, cataplafms, lotions, lini- 
ments, or injections, it produces the fame confequcndes. 
Hemlock has been ufed much in fcrophulous, fchirrous, and 
cancerous cafes ;—in the lalt highly recommended by Dr. Storck, 
as a fuccefsful medicine, though net anfweririg the expedlations 
of the phyficians of this country ; notwithflandiog which, I he- 
fitate not to declare, 1 have found it in fome degree ferviCeabfe 
in fchirrofity—in fcroplmious tumours, joined with bark, it has 
been ufefui ; as alfo in ulcers, and foulnefs o'f the hones from 
that cauls ; in fome obfdinate rheumatic cafes it has been efiica- 
ciou , and 1 have evidently feen it produce good effedds in the chin- 
cough. joined with mercury, it has been ufefui in venereal 
complaints, and has been fuccefsfully given in fome cutaneous 
diforders. 
lt is commonly given in dofes from four or five grains to' a 
fcruple, and puihed on to one or two drams in twenty-tour hours 
half an ounce has been given in that time ; and, in one or two 
cafes, Dr. Monro fays, he has known an ounce. However, 
Dr. Cullen remarks, and that with great propriety, that if fome 
fenfible effect is not perceived, when the dofe is about twenty 
grains, lie Chould difpute the goodnefs of the medicine, and have 
recourfe to different parcels of it. 
Henbane. This lias been con.fid.ered as a narcotic, not pro- 
ducing heat like opium ; and, befides, it is, in large dofes, laxa- 
tive—evident advantages over opium. In palpitations of the 
heart, it has been laid to be ufefui—in cafes of mania and con- 
vulfions, in dofes of the extract from one grain to five. Though 
Storck extols the remedy in fpafmodic affediions, and profule 
bleedings ; }et, from Dr. Home’s experience, it appears in thefe 
affeddions not to produce any good effedds. It feldom produces 
fleep, or alleviates pain, except till the dofe is arrived at eight 
or ten grains, nay, often it has been obliged to be increafed to 
fifteen or twenty ; though, in full dofes, it is more apt to occa- 
fion delirium than opium. Sometimes it will agree where cpi- ©N MEDICINE. 
155 
«m will not ; and it is not, except in large dofes, that its aperi- 
ent effects are very remarkable. 
From a cafe related by Sauvages of its curing a cataract, I 
once, under thofe circumffar.ces, tried it with evident utility ; but 
during the trial, my patient left town, nor have I heard what 
was the ultimate refult. However, fuch -were its effects under 
my infpe&ion, that I fhould, in all cafes of recent cataraitous ap- 
pearances, recommend the trial. 
Tobacco, though in common ufe, and certainly confidered 
as a luxury, from being chewed, taken in inuff, and fmoked for 
pleafure, is a deleterious and noxious herb, poflefled ftrongly of 
thofe powers producing ftupor ; hence confttjereri as n vmcctic. 
It is highly Hiraulant, a powerful emetic, purgative, and promot- 
er of the falivary difeharge ;—applied by way of poultice to the 
llomach, we are told it excites vomiting, and produces the lame 
effects applied to wound;,. In the iliac pafilon, incarcerated rup- 
tures, and obllinate cqftivenefs, thrown up into the bowels, by- 
way of fmoke, Oi' in llrong infufion, it has proved efficacious— 
and alfo in cafes of worms, particularly thofe very fmall white 
worms, called afearidgs, which afFe£f the lower part of the large 
bowel, called rectum, oceaficning itching in the anus :—Indeed, 
it is faid that no remedy is more powerful in opening.the bowels, 
procuring ilools, and in delfroying and bringing away theft worms 
than this—though it mult be obl'erved, that given in this me- 
thod, it will often produce great licknefs and vomiting, efpeci- 
ally if pulhea far into the intelhnal canal. 
In Sweden it is a domeltic medicine, and often given :o vomit 
and purge, in the beginning of putrid fevers. An extract made 
of it, which renders it more mild in its operation, has long been 
ufed in Germany as a pectoral in coughs—and, of late, in this 
country, recommended as a powerful diuretic, and of great ufe 
in droplies ;—but its inefficacy in fmall dofes, and from its pro- 
ducing levere licknefs and vomiting, in large ones, facii as were 
fufficient to make its diuretic effect apparent- -from the naufe- 
oufnefs of its preparations, and the roughnefs of its action ; it 
has not yet been brought into general ufe internally. External- 
ly applied, Bergius conffders it as efficacious in difeuffing that 
tumefa&ion of the prepuce (55) called phymofis. 
§4. ERR HINES. This clais of medicines, fo called from 
the Greek en in, and rin nafum, the nofe, or STERNUTATO- 
RIES, from producing fueezing, are all Inch as ftimulate the in- 
ternal membrane of the nofe, occalioning a How of mucus from 
thence, or cauling that action from whence they derive their 
name. 
They a<R.altogether by their flimulusj and though they have ON MEDICINE. 
been faid to have effeCl upon the fluids, they do it in other way, 
than by increafing the action of the folids on their continued li- 
quids. Indeed all evacuants are general ftimulants. Even thefe 
medicines carried into the flomasb, or thrown upon other parts 
of the machine, yvould produce fuch effeCts as were confident 
with their irritating power, and might vomit, produce gentle 
1‘weat, or urine, or become expeCtorant, according to their elec- 
tive properties. 
The ufe of thefe medicines, though much iufifted on by the 
ancients, have, by the mode:ns, fallen into negleCt, though they 
may in fome cafes certainly be of no fmall fervice, either in un- 
loading the parts contiguous to the nofe, or removing obftruc- 
tions by the fhocks given to the fyftem in ineezmg. 
Where the mucus fecretton is defective in the nofe, produc- 
ing a morbid diminution, by determining the fluids there, they 
might be of fervice ; or by occahoning a derivation from parts 
morbidly affected in the neighbourhood of that organ—alfo by 
agitating the fyftem in general, and by obviating nervous affec- 
tions of the convulsive or fpafmodic kind—but where there is 
great fulnefs of the habit, morbid debility of the vifeera, un- 
common fenfibility of the note, or ulcerations of that part, 
and thofe which are contiguous, the ufe ought certainly to be' 
forbid. 
From confidering the operation of thefe medicines and the 
effect1* likely to be producrd by the application, we may learn 
how they become ufeful in rheumatic affections of the head ; for 
temporary relief has not only been acquited by them, but the 
rheumatic difpofition conquered—the tooth-ach alio, and other 
rheumatic affections. In chronic and long-continued inflamma- 
tions of the eyes, in opacities, or cloudinefs of that part of the 
eye called cornea, beginning cataracts, and in fome cafes of deaf- 
nefs. 
In fome complaints of the head of the fpafmodic kind, they 
promife much utility; but in all full habits, or in cafes where 
theie appear any preternatural load in the head, they are not on- 
ly dodbtful, but may fometimes become dangerous. 
And notv'ithflanding it has been afferted, that their ufe tends 
to remove lethargies, epileplies, palfies, apoplexies, head-achs 
vertigos, catarrhs, gutta, ferena, &e. and may, in home particu- 
lar fpecies of thefe complaints, where the nervous fyftem is pri- 
marily affetted, be attended with no fmall advantage ; Hill 
ihould there be fullnefs of habit in people thus affli&ed, prudence 
Ihould diiefl us to have that fullnefs taken off before the appli- 
cation of fternutatories. During their ufe, we lhould carefully 
avoid cold, for that has fometim.es produced impleading effects ; ©N MEDICINE. 
■—they ffionld alfo be adminiftered at intervals of epe or two 
days, and then the patient ihould be kept warm. From the ge- 
neral fhock they give to the fyftem, they have been faid to be 
more beneficial than vomiting, and hence aifo greatly ufeful in 
removing theremoteft obftruction. 
Errhines eonfifts of two claffes— 
Mechanical, Medicinal. 
The First are, duft—feathers—auimalcales vellicating the 
membrane of the nofe, and blood accumulated, either from ob- 
ftru&ion or inflammation—whence it happens that in a begin- 
ning catarrh, the mucus ofthe noftrils ufually flows pretty plen- 
tifully. 
The Second—- 
Hj’ffop White Hellebore 
Savoury Orrice-root 
Bete Peliitory 
Betony Pepper 
Marjoram 
Euphorbium 
AiTarum Turpeih Mineral 
Herb Maftich Corrofxve Sublimate. 
Tobacco Snuff 
The firft are efteemed the mildeft, the feven fucceeding more 
aflive, and the three laft tha moft violent in their operations ; 
;—but corrofive fublimate is conlidered as invefted with the moft 
fuperior power; for patients who have applied it, have fneezed 
for fome hours, although it has been ufed in very fmall quanti- 
ty* 
There are different ingredients added together to form Here 
Snuff, 
A'e the dried leaves of Afarabacca 
Sweet Marjoram 
Syrian Herb Maftich 
Dried Lavender Flowers— 
equal parts of each—but three parts of affarum and one of mar- 
joram, beat into a fine powder, are fuperior to moft of thole 
fold under the name of Herb Snuff—and indeed are the more 
agreeable and efficacious errhines. If taken to the quantity of 
five or fix grains at bed time, they are faid to operate the fuc- 
ceeding day as a powerful fternutatory, inducing frequent fneez- 
ing, but ftill more a large difcharge from the nofe— and are of- 
ten employed with great advantage in cafes of obftinate head- 
achs, and inflammations of the eyes, refilling other modes of 
cure. 158 
OH MEDICINE. 
Sometimes in obflmate deafnefs they have been given with 
fuccefs, with the addition of a fmall portion of turpeth mineral, 
and repeated at fhorter or longer intervals, in proportion to the 
tffeft they produce of greater or lefs violence in their operati- 
on. 
§ 5. SIALAGOGUES—derived from the Greek words, 
Jbalon, faliva, and ago duco, to draw forth, comprehend all fuch 
medicines as produce a flow of faliva into the mouth, from the 
glands named falivary, there fituated. 
They have been divided by fome authors into three clafies. 
The FiRSq—fuch as immediately aft upon thefe glands, as 
fomentation, friction, and fuction, either internal or external of 
thefe parts ;—hence, moreover, cataplafms applied to thofe glands, 
called parotid, from their fituation under the ear, and chewing 
tobacco moiften the mouth ;—all pungent fUmujants alfo. 
The Second, are all fuch as occaflon a flow' of faliva into the 
mouth, by intercepting a flux of moiflure into other parts; for 
it is obfervable, that if any of the vifeera lhould be obtlrufted, 
as the liver, fpleen, pancreas, at the fame time the kidneys, or 
inteflinal duels, then is the mouth always moift—whence hypo- 
chondriac people arc called Sputatores, from their fpittingfo 
much; and, therefore, whatever prevents a fecreticn of lymph in 
thole plt.Cis, fhould be efteemed lialagogue. 
The third Class takes in all thole fubdances which are fuppof-* 
cd to break down the Janguinary metfs, and by that means fupply 
the mouth with too great a proportion of fluids, thus diflolved. 
Of this tribe quickfilver is the principal, aud may be applied 
in various modes. 
From its external application a falivation may be raifed, though 
in its crude flate—but it may be applied in form of liniment c+ 
fumigation ; for if twelve grains of quickfilver are placed upon 
a Are, or a heated iron, they will emit a fmoke, which, received 
by the noflrils, in two or three days will occaflon a fpitting. It 
may be taken internally with the fame intent, and fucceed, if 
given in a fmall quantity ; but if in too large, it is apt to 
off by the bowels ; if handled much, and for a long continuance, 
lirpilar effects will be produced, as we learn from gold-beaters, 
who make great ufe of quickfilver, falling into falivations. 
Quickiilver formed into a ialt by fublimation, if taken in fmall 
dofes, if applied externally to wounds or ulcers, or if attrafled 
bv the ncfe, has fxmilar confequencec, from its reception into the 
habit. 
It was the opinion of Boerhaave and others, that all thefe 
effects were produced by dilTolving the fluids, either by its me=. 
cha'aical action, or by its dilTolving or putrefcent power. ON MEDICINE. 
Had not thefe doctrines been previonfly refuted by fuch argu- 
ments as are uncontrovertible, from the ccnfiderations, that me- 
chanical force never divides mixts, but aggregates only ; that, 
from the minutenefs of the divifion of gold, even it may be made 
to become incapable of overcoming the cohedon of water or fpi- 
rit of wine, and be fu'pended in them—and aifo that the fmall- 
nefs of the quantity introduced would be inadequate to produce 
the effect. And, with regard to its djjjolvent or psrtrejcent power, 
that, during the operation of quickfilver on the habit, no fymp- 
toms of putrefeency appear in any part of the fyfleiq,— that there 
is no alteration of the blood in that refpedt duriagga falivation, 
but its texture appears as ftrong then as at any other time ;—- 
that falivation is attended with an inflammation, and the blood 
ffiews an inflammatory cruft ; and * finally, that after the opera- 
tion ot the falivation is over, r.o taint appears in the bfood, but, 
on the contrary, the perfon is in better health than before, and 
gives marks of a firmer Hate of it;—one Angle iflftatice would 
be fufficient to overturn them, if we conflder that a few grains 
of calomel has in many conftitutions raided a falivation very iud- 
der.ly, which has continued for fome days, nay weeks, jnuanc- 
es oi which have ialleu within the courfe of my own oblerva- 
tion. 
I cannot myfelf doubt of its producing its action in the faliva- 
ry glands by the means of its elective ilimulus, though it is ca- 
pable of exerting its flimulus in other parts of the machine, as 
on the ftomach, intedines, kidneys, and perfpiratory veffels, pro- 
ducing, according to the parts &tfe£ted, vomiting, purging, dif- 
charge of urine, and gentle perfpiration. 
Indeed, upon the whole, it fhould be confidered as a flimulant 
in general, in particular, a falivary one, and an evacuant, more 
peculiarly ot the ferous or lymphatic fluid, or both ; and one of 
the mod univerfal aperients and deobflruents we have ia the 
whole catalogue of the materia medica. 
In its combined ftate, forming metallic falts, quick filler 
fooner exerts its activity on the fyftem, but lefs certain, 1 think, 
in its efrefts ;—it appears more efficacious, having its parts only 
divided by fome un£tuous or oleaginous fubftances ; and, per- 
haps, its virtue depends upon its being fo entirely unconquerable 
by the affimilating powers of the conftitution, and capable of fuch 
minute divilibility, for it will pais through any body except 
glafs. 
Quickfilver, though here ranked as an internal fialagogue, or 
a promoter of the excretion of faliva, becanfe its elective power 
leems to be more determined to the.falivary fyftem, than any o- 
thcr part of the machine, may fairly be confidered as an univer- 
r i 160 
ON MEDICINE. 
fal ftimulant, deobflrucnt, purgative, and general evacuant, in- 
creating the whole of the excretions of the human body. 
It was thought that, from the great difeharge it produced from 
the falival glands, and the feeter accompanying it, that it diffolv- 
ed the texture of the blood, and difpofed it into putrid acrimo- 
ny •, but experience proves the cafe to be far otherwife, as we 
have proved above. 
The great effe&s produced by qtiickfilver feem to proceed 
from its increafing the whole of the animal excretions, and thus 
carrying off the virus of the pox, for the cure of which it is the 
moft remarkable and certain ;—and, indeed, it has been, and Hill 
continues to be, by many, confidered for this difeafe a specific ; 
•—but as it will not, by itfelf, in all cafes, cure that complaint, 
nor prevent the venereal poifen from taking effeft, even in con- 
ilitutions loaded with it, that idea muff fall to the ground. 
Though quickfilver, in its original ffate, is inactive refpe£ting 
the human machine, and only has been given in this ffate to con- 
quer obffinate obffrudiions of the inteftines, though incfficaciouf- 
ly, flill from mechanical divifion, as united with vifeid, oleagi- 
nous, or unctuous fubftances, rubbed down with dry powder 
calcined, or united with different acids, forming mercurial falts, 
it has been rendered extremely active ; and though preparations 
of this abound, the chief ufe are confined to a few. 
Gummous mercurial pill, from 20 to 30 grains. 
Mercurial pill, from 8 to 12 grains. 
Quicksilver acetated, from 1 to 6 grains. 
Calcined, from | of a grain to 2 grains. 
Muriated, or corro- 
five fublimate 
from 1-8 of a grain to 1 grain. 
Mild miiiated 
Calomel prepared, 
1-2 a grain to 2 grains or more.' 
Quicksilver with chalk from 5 to 20 grains. 
"White calx of quickfilver, or 
white precipitate, 
too acrid for internal ufe. 
Sulphurated quickfilver, or 
aethiops mineral, 
from 10 grains to 40. 
Red fulphurated quickfilver, 
or fadlitious cinnabar, 
ufed chiefly in fumigation. 
Red nitrated quicklilver, or 
red precipitate, 
ufed as a defiroyer of fungous 
flelb, or for dreffing venereal 
- ulcers. 
Vitriolated quickfilver, or 
turpetii mineral, 
from I grain to 4. 
Quicksilver ointment, 
from external ufe—from 1-2 a 
dram to 2 drams. ON MEDICINE. 
161 
Now feveral o£ thefe preparations are appropriated to differ- 
ent purpofes. Th<| milder sort, as alterants— 
G ummous pill Acetated quickfilver 
Mercurial pill Quickfilver with chalk ; 
or the more a£tive preparations in very minute dofes, which in 
this view are considered as the mod efficacious. 
As a purgative, calomel claims the preference, joined with rhu- 
barb or iome other of. that clais;—in dofes of from 3 to 8 or ten 
grains ; and in fmaller dofes as deobdruent and alterant. 
In venereal cafes, the gum and mercurial pill-—calomel—cor- 
rolive fublimate diffolved in brandy—calcined mercury joined 
with opium—are chiefly had reeourfe to. 
Againd the itch, the white precipitate, made into an oint- 
ment. . • . . 
The quickfilver ointment is alfo ufed for railing a fallivatiou 
where thought neceffitry, or loading the conditution fufficienthy 
without producing that effect, for the cure of venereal com- 
plaints. t , ... 
Indeed calomel, and fome other of the a 6) ive preparations, 
have proved efficacious in the early dages of inflammatory corn- 
plaints of the. bread, brain, pleura, &c. when given freely, in 
repeated dofes, fometimes with, fometimes without opium ; which 
has been, in thefe cafes, rendered more effectual by joining fmali 
dofes of the antimonial powder . along with it. ,ln fpafmodic 
complaints, imited with camphor and opium, they have been, 
fa,id to be effexlual—as alio in dropfical cafes, given in conjunc- 
tion -with diuretics and aromatics, particularly the fquill pill. 
But thefe we fhall particularize more minutely when we come 
to treat of difeafes to which they are appropriated. 
Now, from keeping in view the peculiar virtues of this medi- 
cine, the reafon >vill readily occur why in a variety of complaints 
it is fo beneficial—-as in the venereal difeafe—glandular obflruc- 
tions—cutaneous complaints—obdruided menfes—dropfy—worms 
—Tome inflammations of the lungs and other parts, properly ap- 
plied, and judicioufly united with other well-adapted reme- 
dies. . ....... 
Thus much have I thought requifite to to this fo 
cLtenfively uffiful a remedy ; though in this place we Ihould con- 
fider it merely as a promoter of the falivary difeharge, in order 
that we may be better prepared, for discovering its utility in a 
variety of different caies, on which we (hail in future treat. Mete 
it Hands as a fialagogue, and the only internal one of which we 
make ufc—the others in this catalogue are filled topical, irom l6.l ■ 
ON MEDICINE.' 
their promoting the flow of faliva from application— 
the principal of which are 
Squills Cloves " 
Tobacco Mafter-wart 
Angelica Pellitory. 
From what has been faici, we fliall readily difeover their utili- 
ty to conffd in diminifhing the force of the blood againft parts 
morbidly affected in the neighbourhood of the falivary glands ; 
and alfo the aCtion of the veffels when morbidly increafed in the 
neighbouring parts, as in fome cafes of tooth-ach and rheuma- 
tic affeCtions ; and in promoting the circulation of the blood 
freely through the falivary glands when morbidly obftrudted 
there :—Befides, as they fo freely promote evacuation, they will 
he beneficial in evacuating morbid accumulations of ferum ; in 
producing a thorough change in the fluids of the body when mor- 
bidly vitiated , 
But when there appears to he an uncommon determination to 
the falivary glands—any prasternatural fenfibility in the glands— 
•when the ferous part in the circulatory fluids is defective—or 
there is a high degree of inanition, or general debility of the fyf- 
Cem, we mud avoid ufing them. 
§ 6, EXPECTORANTS, fo named from the Latin word 
eKpe&ora, to throw out of the bread, or expectorate ; and are all 
fuch fubdances as expel morbid matter through the windpipe 
adhering in its branches, called bronchia (28, 29,) ,oS. the lungs. 
To promote which purpofe, leveral particula«tere neceffary 
to be oblerved. It is required, first, that the contained 
within them iliould be rendered moveable, and capable of being 
expectorated, taking care that the molt fluid part Ihould not be 
diflipated, led the remainder fbould be left too vifeid, and not 
calily pumped up from the lungs ;—lienee medicines to heating 
and ftimulating are hurtful j—Second, that the paffages of the 
lungs ihould be open, cleanfed, and lubricated ;—Third, that 
the excretion of the offending matter fhould be promoted, which 
is bed performed by coughing, to which end proper flimulus, 
and proportionate ftrength are required ;—Fourthly, that the 
obfl rinded veffols Ihould have reft, by which means they may be 
relaxed—for ftiould they be continually irritated, the humour 
from the giands of the windpipe would be eje&ed with a fort of 
pain. 
To accomplish. the first intent, all aromatic bitters, and, at 
the fame time, mild oleaginous fubftances are neceffary, fuch as 
ho re-hound, hyffop, elecampane, pennyroyal, valerian, &c. and 
fulphnreous medicines mixed with alkalies--an fixed faponace- 
ous materials, as Venice foap in pills, or mixed with milk ;--- ON MEDICINE. 
all volatile oily foaps, and volatile fixed falts, and, in general, all 
diluents and Himulants mixed together. 
For the second purpofe, we mnfl apply to aperients and de- 
tergents, as oil of poppies, almonds, olives, honey particularly, 
as it is aperient, inciding, attenuant, detergent, and lubricating 
—here alfo belong emulilons, loaps, yolks of eggs, with oily 
fubflances, laccharine fubflances, at leaf! in fmall doles ; like- 
wile balfams, as that &f turpentine, Peru, Gilead, Copaiva, &c. 
which act both as flimulant and lubricating-—to thefe w7e may 
add ali relaxing -and emollient decoctions. 
For the third are ufeful all thofe which excite a cough, as 
wine, vinegar, acrid fpirits, fleruutitories, fquills, gum ammo- 
niac, See 
And, for the last, demulcents, anodynes, and narcotics, are 
proper, of which the principal is opium; for when the windpipe 
is once excoriated, it is eailiy thrown into violent fpafms, and 
cough, which cannot be reftrained by that powerful fqdative. 
However, we may in general obferve, where there is no in- 
flammatory tendency, and the moving powers are torpid, forne 
of the Hronger Himulants are extremely ufeful, and are the 
things which chiefly contribute to promote expectoration ; but 
they fhould be very eautioufly ufed in difeafes of the brealt, and 
particular care taken, that the habit be free from any inflamma- 
tory difpofition, or, at leafl that no inflammation is fixed there—for 
where thefe take place, relaxing the veffels, and taking off the 
fpafms is all that is wanted, for in l’ueh conflitutions the mucus 
itfelf fupplies fufficient irritation, either from its acrimony or 
weight, or diflenhon of the cells of the lungs. 
From what has been faid, the utility of expe&orants appears 
—when the fecretion of mucus in the lungs is obvioufly dirni- 
nilhed, by promoting that fecretion, and rendering the mucus 
thinner, when too thick or vifcid—where the excretion is infuf- 
ficient, by evacuating morbid accumulations of mucus in the 
lungs, and fupplying irritation to that organ when defective. 
When the lungs labour under a Hate of morbid infentibility, 
by removing that, and promoting a free circulation through 
them, when it is there morbidly impeded. 
But when there is a high degree of increafed fenfibility in the 
lungs, and an uncommon quick excretion of mucus from them, 
the flimulant expectorants ought to be prohibited ; and when 
there is too great a Hate of torpor, of the relaxing ones we fhould 
by no means make ufe. 
Our general catalogue of Expectorants, of which we Ihall 
furnifh, for the reafons above advanced, a proper divifion, con- 
tilts of 164 
ON MEDICINE. 
Hyffop, Hore-hound, Gum Guaiacum Squills 
Ground-ivy, Penny- Myrrh 
royal, Colt’s foot, Afafcetida 
chiefly ufed in infufion Gum Ammoniac 
or dccodion, and Opium 
fweetened with honey Tobacco fmoke 
Garlic ■'■■■? Acid vapours 
Muflard Bliflers 
liorfe-radifh Warm baths to the feet 
Onions Watery vapours received into 
Leeks the lungs, 
Balfatn of Copiava 
Now, as we find expectoration is to be promoted by different 
means, agreeable to the caufe ading in the lungs ; and as our 
fieledion here has fuch different properties, all of which are cal- 
culated to promote the defired end by judicious application, a 
divifion of them, agreeable to their powers, becomes neceifary. 
First, into fuch as act by ftimulating the lungs taken inter-- 
nally. »> •- - ■ ’ - 
The infufions of HyfTop, 
! ■ • < Ground-ivy, 
Hore-houhd# 
Coltsfoot, 
Pennyroyal, made into tea, and fweetened w;th 
- honey. 
Garlic, 
a clove of it taken now and 
then in fubftance, formed in- 
to pills, or made into fyrup. 
Muftard, ' 
Horfe-radifh, 
Onions, 
Leeks, 
eat plentifully with other vi- 
ands. 
Balsam Copiava, Dofe, 20 to 40 drops on fugara 
Gum Guaiacum—* * 
Powder, from 6 to 20 grains. 
Tin&ure, j-2 a dram to 1 dram. 
Myrrh—Powder, 10 grains to 60. 
Second, fuch as ad from taking off fpafmodic affedions— 
Asa ioetida 
Gum Ammoniac, 
See catalogue of Antifpaf- 
modics. 
Opium See Sedative* 
Blisters, 
Warm baths to the feet, 
Watery vapour inhaled into the lungs. ON MEDICINE. 
fuch as irritate— 
Tobacco fmoke, Acid vapours. 
Fourth, fuch as lubricate and relax. See the catalogue of 
Demulcents, all which belong to this place. 
§ 7. EMETICS. This is a Greek word, from emeo, romo, 
to vomit ; by the Latins they are called vomitoria, and are all 
fuch fubFances which, by their action, caufe the Fcmach to re- 
ject its contents UDwards. 
The effe&s produced by this adtion have been divided into 
eight heads ; in 'confidently which we fhall he enabled to per- 
ceive the utility to be derived from the application of thefe re- 
medies *, on which, as we go along, we (hall furnifh fome remarks 
necefiary for the more clear elucidation of different parts of the 
fubjedt ; 
First. “ Vomiting evacuates the contents of the ftomach 
itfelf ; though it is not eafy to know when that is fully perform- 
ed. Many have got into a method of promoting few repetitions 
in vomiting, ar.d giving fmall ablutions ; but it has by others 
been thought that frequent ablutions are required to clear the 
folds of various matters, or mucus, which maybe detained with- 
in them.” 
If we wifh to evacuate the contents of the Fomach complete- 
ly, frequent and copious ablutions are certainly right ; but it is 
fometirues necefiary to give gentle fhocks only to promote fome 
particular purpofes, and thefe muF be often repeated, fo that it 
would be hurtful to pulh vomiting to its extent, as, from violent 
Framing of that organ, it would become too relaxed, and our in- 
tent fruit rated ; for it is from the repetition of the operation gent- 
ly, not from unloading the Fomach, fuccefs is expedted. 
Secondly. “ Vomiting caufes a flow of liquids to the Fo- 
mach, clears it, and emulges its nrucus glands.” And, 
Thirdly. “ It not only emulges the mucus follicles of the 
Fomach, and promotes a flow of gaftric liquor, but has the fame 
effect on the neighbouring glands, especially the fweethread and 
the liver.” 
Fourthly. “ WhilF the vomiting continue?, it not only in- 
verts the regular motion of the Fomach, called pcrijlaltic but 
a'lfo of the inteftines, which pour out their mucus to be carried 
to the ftomach, and evacuated with its contents. 
“ Hence clo we Fuel vomits ufeful in loofenefTes and dyfente- 
ries ; but, independent of that, they are beneficial, more proba- 
bly, as purging the inteilines, occafioning a greater flow of liquors 
into the inteFinal canal. If the vomiting ceafes, the mcreafed 
fecretion is carried elf by Fool, fo that at any rate the adherent MEDICINE. 
foulnefs is waflied away, by fqueezing the tradl of the intedines.” 
Piftiily. “ Vomiting fyueez'es, and occafions a conHridlion 
of the whole abdominal vilcera, efpecially the mefenteric glands, 
(4b) and in confequence the whole Lymphatic fydem ;—- 
on this account increafes abruption, as well as from its evacuat- 
ing property ; hence for thele purpofes emetics anfwer equally 
well with purgatives, and ufeful in dropfical cafes.” 
But here we fliould he no Hrong vifceral obdrudtions 
hath taken place, or any great acrimony in ihe humours, and ten- 
dernefs of the vafcular fydem,, for in thefe cafes they may be 
produdlive of the mod fatal effidls 
Sixthly. Dr. Cullen thinks, “ vomiting has the power of 
affedling the kidneys, for as irritation of the kidney v.i 11 produce 
vomiting, fo, on the other Hand, it is reafonable to think, that 
vomiting may alfo adt upon the kidney—hence it would feeni 
uieful in p opelling Hones in the kidneys.” 
Notwithstanding fome have repourfe to fuch a pradtice, and it 
appears imitative of nature, Hill I {houlc! conceive it almpjl inways 
a dangerous experiment, always doubtful, and often not necetfa y j 
for if the dune fnould be fo impadted with the kidney that it 
cannot pafs, irritation on...the part would be ftron-ly increased, 
oi courfe pain and inflammation in limilar proportion, mod like- 
ly abfeefs, and iheir conlequences. Betides, we can never be 
certain whether the done is of fuch a fize as to pafs through the 
ureters by any propulllve force ; and if it fliould, by relax- 
ing the ureters as much as we can, by proper remedies, we are 
more likely to produce the effect, and certain to avoid all danger 
from too raili a practice ;—however, if the attempt at propuliion 
was to be made, every n\ea/s fliould be previoully ufed to render 
the palfages as didenfiblt as pofiible before the trial:—birt ot this 
we fhall have occafiorf to treat more fully in future. 
Seventhly. “ But the effects are extended, perhaps, to the 
vifeera of the died, .us expedtoration has been promoted by vo- 
miting.” 
Eighthly. “ It alio increafes the conftridtion of the fauces, 
and forcibly emulgqpthe wqole of the falivary glands. It has 
had the efFedl of thofe medicines called mailicatories, which, by 
chewing and increafmg a difeharge of faliva, relieve rheumatic 
affedlioi\s of the head, tooth-ach, &c. 
“ By preventing infpiration, vomiting occafions a regurgita- 
tion of the blood att the encl of expiration. The accumulating 
blood, which ufually happens, produced by vomiting, is only mo- 
mentary, gnd may be foon counterpoifed, as will be feen by con- 
fidering its advantageous effects on the fylletn in general. 
64 During the rime of vomiting, the nulfe is final!; weak, and ON MEDICINE. 
167 
ntermitting ; but when it is over, r the flimnlus continues, the 
irculation is increaied, a fullncfi. anct ioltnefs of the pulfe, a de- 
ermination of the fluids to the furfaee of the body, and fweat ; 
—this laft may be fuppofed to proceed from an increafed citcu- 
at’ori, but Dr. Cullen thinks ’t may alfo from the confent of the 
f nach ar.d furfaee, and that antifpafraodic virtue takes place 
vith regard to the extreme veflels, which is illuilrated from 
1 his , that emetics combined with other antifpafmoclics, (148) as 
»piuia, inereafe the power, fo that combined they become more 
. fficacious diaphoretics,” or prom Hers of infenjibie perj'piration or 
i weat, “ than each when alone.” 
i Thefe are their primary effe&s, which, if we confider ciofely, 
viil be productive of a vaiiety of others, infinitely a gs eater m:m- 
>er, than by any clafs of medicines with which we are acquaint- 
:d ; and indeed from them 1 have fee a the moil ferviceabie con- 
equences accrue. Not but I think their ufe, in many cafes, 
hould be confidered with the nicelt caution ; for advantageous 
.s they are, when properly applied—in the hands of ignorance, 
hr inconfiderate vafhnels, they become too often latal. 
j If we confider the general fihock which emetics give to the fy- 
tem, the evacuations they produce from the ilomach, and the 
ffi Cts they have upon the nervous power, we fhall be convinc- 
d of their utility ; by reitoring equality to the circulation, pro- 
lucing lymphatic abforption, and removing obftruCiions in the 
yftem of blood veflels—and in thefe lenles they may be confider- 
d as irritators of the habit ;—as evclcuants, from cleaving t he flo- 
nach of its contents, and morbid accumulations of fecreted 
natters lodged there, and difcharging alfo ferous accumulations 
n different parts of the machine :—as au t if pafm o dies, from fli- 
nulating the nervous fyflem, and the moving powers through 
he machine in general, and alfo obviating violent affections of 
he nervous power. 
Bat in all cafes of ruptures, or relaxations of containing mem- 
»ranes—in local inflammations of the internal viicera—a high 
egree of morbid debility in thefe—and in fixed obRruftsons, 
inconquerable by the force of the circulation, it has been adv f- 
d that their ufe lhould be avoided. 
\ Still, notwithftanding all thefe prohibitions, fo apparently w-11 
banded, from the confideration of the action of emetics, t 
hey have been adminillered in cafes of fcitirrhous vifcera, in >- 
al inflammations, and fupernatural effufions of blood , tho ;,h 
n the two latter they fhould never be attempted without .oft 
deeding; though perhaps hsemonha es n ay now and chen . e- 
[uire this operation ; but of thefe there are veiy raie iniismccs, 168 
ON MEDICINE, 
as they are almoft conflantly attended by an inflammatory difpo- 
lition of the conflitution. 
In all congeftions of the head, thev are faid to be dangerous, 
in apoplexy, palfy, and in fmaller collections in the veins of the 
brain. They would, doubtlefs, be extremely dangerous where 
thel’e maladies arife from too great fanguinary plenitude; but 
where from mere weaknefs of the nervous fyffcem, or inability 
of the moving powers, I fliould prefer their ufe to other reme- 
dies, at leaft on their tirft appearance ; nor fliould I hefitate in 
prescribing them in ferous coliebtions, where { was not afraid 
of any great relaxation of the veffels, or fyflem of the folids. 
The clai's of EMETICS in ufe are not numerous—indeed, three 
or four, where we coniider their action only in this point of view, 
are fufficient, arranging them according to their mode of opera- 
tion, or peculiar appropriation. 
If expeditions vomiting is required, without much regard to 
more extended action, 
White vitriol, Dofe, from 10 to 20 grains. 
El ue vitriol, 2 to 6 grains. 
f 1 ounce to a point of boiling 
i, r r , J water—1 ounce or more 
Jnfuuon of tobacco, \ , r ■ rr - 
I to a dofe, will be iufnci- 
l cnt. 
If fomething more is wanted, particularly a determination of 
the fluids to the fkin, 
Tartarized antimony, Dofe 1 grain to 5. 
Antimoniaf wine, 3 drams to (>. 
Wine of tartarized antimony 1 dram to 2. 
Ipecacuanha—Powder, 5 to 20 grains. 
Tin&ure, 2 to 12 drams. 
And in venereal cafes, 
Vitriolated qiiickfilver, or (Dofe 1 to 4grains, 
turpeth mineral J 
]n large doles, i'ome of the vegetable bitters and cathartics 
come under this clais, as do alfo fq-uills, afarabacca, fox-glove,' 
muftrad, and horfe-radifh. .Strong infufions of the two lull are 
given with fuccefs in torpid, cold, phlegmatic habits. 
Svlrematic writers hence, from their peculiar power, have 
divided them into 
Irritating emetics—as 
Tartarized antimony, 
Vitriolated zinc, or white vitriol, 
Qiiickfilver, or iurpeth mineral. ON MEDICINE. 
169 
Evacuating—as 
Tpecacuanha, -— Afarabacca, — Squills* 
Heating— as 
Muftard, — Horic-radiflr. 
Narcotic—as 
Tobacco, — Fox-glove. 
'•-» § 3. The next fet of medicines in our catalogue are CATHAR- 
TICS, io named from the Greek word cuthairo, purge, to purge, 
and comprize all fuch medicines as evacuate by flpol. 
Purging, fays Boerhaave, is ah evacuation of all thofe things 
which can be thrown cut of the body bv itool from any part oc 
the machine. And moil authors have been very prolix on this 
fubje£t, as the operation feems to be, and really is, of Juch ma- 
terial confequence to the conibtution. 
However, we (hall content mi1 Lives with a more concifs 
yiew pt their eftedts, and from thence be fufficiently empowered 
to deduce their utility. 
By their operation they unload the internes, and increafe 
the motion of the bowels downwards; by which me:.n> they 
clear the inteflinal glands, and derive a greater quantity of li- 
quids, into them; they alfo empty the ftomach downwards; 
they evacuate the pancreas and liver, atid afFedt tfie fpleen, and 
all the vifeera of the lower belly ; they promote the absorption 
of watery and other thin fluids, flagnating in any cavity ; and, 
by continuance, purge the whole body ; but in this lull <a"a in- 
uuce debility, if too long perfevered in ; hence are preferable to 
other evacuants. 
. 1 hey are apt to produce inflammation in the parts on which 
they immediately aid. i hey caufe revullion trom the head, by 
determining the blopd into the large artery of the body, called 
the def ending aorta, (29, 30) and hence may be ufeful as pro- 
moters of the menftrual difeharge, walking of virulence in go- 
norrhoea, in ulcers, by evacuating the fyftern in general and in 
thofe of the interior parts, by caufing a greater flow of liquids 
to the part. They excite, or, at lead, increafe inflammation in 
the inteifines, nay fome propagate the lame over the fyftem ; 
and, when thrown inro the blood, are mod of them expe&orant 
and diuretic, caufing evacuation of ph-egmi from the c’nelf, and 
brine through the kidneys. 
Now thele purgative etFefts are produced chiefly by fuel; things 
as irritate the fibres and mufcular parts of the inteffines ; but 
pajjions of the mind will alfo promote inteflinal difeharge ; and- 
i'ome will have that occafioned from [mell alone, others from ex- 
ternal application, foine from the diminution of inferfible pet fp. ra- 
tion, but this happens in a' moift thick atmofphere, and ochers ON MEDICINE. 
from eternal motion, as that of a fhip or carriage ;—upon the 
whole, it is tolerably conclufive, that purging arifes from intef- 
tinal ftimulus, either mental or corporeal. 
But, notwithlianding the ufe of purgatives are fo very faluta- 
ry in their different degree®, according to the caufes requiring 
them, yet, by being too frequently renewed, they are apt to wea- 
ken the tone of the inteftines, and indeed their lenfibilitj. Hence 
are produced, if we add the confequences of evacuation, often 
irregular fpafmodic affedtions. 
Dr. Cul LEN fays, that all purgatives are endowed with an 
inflammatory acrimony, not only exciting it in the part to which 
they are applied, but adling in the lame manner, as poifons ; 
their ftimulus, extended to the fyflem, produces and aggravates 
fever, and an inflammatory difpefnion ; and as it is chiefly di- 
rected to the redtum, they increafe the piles, and extend their 
irritation to the paffage from the neck of the bladder, called ure- 
thra. 
We are led,to difeover, from the concife view we have ta- 
ken of the fubjedf, from whenee their utility arifes ;—First, 
as evacuants from removing any morbid retention of the contents 
of the ftomach and inteftines—diininifhing the quantity of cir- 
culating fluids, when too abundant for the ftate of the fyftem at 
that time—and carrying off morbid accumulations of ferum. 
Secondly, as Jlimulants, by promoting the free circulation 
through the inteftines in thofe cafes where it is morbidly imped- 
ed—diminiftiiog the force of the blood againil parts morbidly 
affedted—removing torpor in the mufcular fibres of the inteltines 
—and restraining inordinate motion in thefe mufcular fibres, 
by {Emulating them to regular and move conftant adtion. 
But we find that fome of thefe have, befides the powers 
enumerated, thofe which are cooling, cjlringent, and emollient. 
Hence, lb on; Id there be in the bowels any high degree of irri- 
tability, and the circulation Ihould there be morbidly accelerat- 
ed, of the fimulaiing cluj's we ihould make no ufe—if the circu- 
lation thould be. uncofnmouly (low and languid, thofe which are 
ftiled cooling will be. improper—if habitual coftivenefs be an er- 
ror of the habit, the ajlringaits mult be wrong—and where un- 
common relaxation oi the inteftines is prevalent, the emollient 
ought not to be applied. 
The whole catalogue of Purgatives are Evacuants, and 
in this view differ only in degrees of power. The MILDEST of 
which are all acefcent fruits. 
Of the second order are 
Tamarinds, Cailia, bugar, Honey, Manna, Water drank ON MEDICINE. 
171 
copioufly, Milk whey, Butter-milk, Spinage, Bete, Cabbage, 
Succory, Dandelion, Endive, Lettuce, Celery, Afparagus, 
Artichoke, Muvhroom. 
Of the THIRD 
All mild animal and vegetable oils, Venice Soap, Muffard, 
Sulphur, Animal Bile, Gum Guaiacum, Tartar, fixed alkaline 
Salts, neutral Salts, Magnefia, if it meets with an acid, not o- 
therwife. 
Of the fourth—or more acrid, 
Aloes, Rhubarb, Senna, Jalap, Scammony, Buckthorn Ber- 
ries, Gamboge, Hedge Hyilop, Bitter Apple, Wild Cucum- 
ber. 
Of the fifth—or mofl acrid, 
Solutions of Gold or Silver in particular acids ; but t'nefe, from 
the violence of their effects, are out of ufe. 
Emetics alfo got into the bowels prove purgative. 
But as we find great ufe may be derived from a judicious le- 
le&ion under particular circnmftances, we ibail puri’ue the fub- 
fecpient divifions. 
COOLING APERIENTS AND PURGATIVE5(* 
Acefcent Fruits 
Sugar 
Honey 
Water drank copioufly 
Milk Whey 
Butter-milk, 
Spinage Salary 
Bete Artichoke 
Cabbage Muihrooms. 
Succory Thefe may be confidered as food 
Endive proper to afiifl in promoting 
Lettuce , the defired purpofe. 
Afparagus 
Tamarinds— taken in ptifan or decoction,. 
Cassia—Electuary, dofe, 1 to 6 drams. 
Tartar— 
„„ 1 , to 3 drams or more. 
Cryffal of Tartar, J J 
Magnesia, io to 30 grains. 
NEUTRAL SALTS. 
Acetated Kali, or diuretic Salt, from 1 to 2 drams. 
Tartarized Kali, orlbluble Ta tar, 2 to 6 drams. 
Vitriolated Kali, or polichreft Salt, 1 to 3 drams. 172 
ON MEDICINE. 
Tartar 1 zed Natron, or Frn- 
cbelle SAP, 
6 drams to 1 ounce. 
Vitkiolated Natron, or Glau- 
ber’s Salts, 
6 drams to 1 ounce. 
Epsom Salt, from 4 drams to 1 ounce. 
Sulphur— 
The Flowers walked, from 1 fcruple to a dram. 
Precipitated, or Milk of 
Sul] hur, 
1 1-2 fcruple to 1 1-2 dram. 
EMOLLIENT APERIENTS AND TURGATIVES. 
All bland animal and vegetable Oils, the moll powerful of. 
which are 
CAsiOR Oil, Dofe, from 1 dram to 1 ounce, 
and, except this, few7 are given alone with this intent, but only 
to a fil'd in the operation of other purgatives, where lubricating 
or relaxing materials are requifite. 
Manna, ’ from 1-2 an ounce to 2 ounces. 
ASTRINGENT APERIENTS AND PURGATIVES. 
Though almoft all the fmart purgatives leave the body eoft- 
ive after their operation is over, the aloctic medicines excepted, 
hill the reftringent power, when wiflied to l'ucceed, is chiefly* 
Confined to ' : 
Kh U barb—Powder, 
Ruffia, 1 fcruple to t dram. 
Halt India, 1 o to go grains. 
Vinous Tinflure, 
Spirituous Tincture, 
1-2 an ounce to 1 1-2 ounce. 
IIoses—Syrup of 
2 drams to 3 or 4 for children; 
to adults it is feldom given,’ 
with this intent. 
STIMULANT APERIENTS AND FURGATIVES. 
Mustard— 
Infufcd in wine, a table fpoonful gently aperient. 
Animal Rile, 1-2 a dram to a dram. 
Gum Guaiacum—Powder, from 10 to 2c grains. 
Hedge Hyfibp— 
Powder—Extraft, 5 grains to io» 
Bitter Apple— 
Compound Extraft, 10 to 25 grains. 
Wild Cucumber:— 
lnfpiflated juice, 1-2 a grain to 3. un medicine:. 
Aloes— from 5 to 15 grains. 
Wine of Aloes. 6 drams to 2 ounces. 
rl 1 J ure of Aloes, 6 drams to 2 ounces. 
Aloetic pill with Myrrh, jo to 3c grains. 
fjENNA - 
Powder, 
E x rad, 
fiom 1 dram to 2 fcruples* 
Senna—1 inciure, from 2 drams to i ounce. 
Compound Powder, from l to 2 fcruples. 
Jalap— / 
Powder, lo grains to 20. 
Iaa (ad, 10 grains to 20. 
1 mdurt, 2 to 3 drams. 
Rezin, 5 grains to 10. 
SCAMM ON Y-— 
Compound Powder, from 10 to 15 grains. 
Powder with Aloes, 5 to 10 grains. 
with Calomel, from & to 20 grains. 
Buckthorn Barries— 
Syrup, from f an oune to 1 ounce. 
Gamboge, • 
from 2 to 10 grains—better mixed 
with calomel. 
Before we clofe the account of Cathartics, it may be of fome 
ufe to obferve ; that, as in all conftitutions, and all difeafes where 
too great an intellinal diicbarge does not conftitute the com- 
pla u;; and a moderate evacuation from the bowels is abfolute- 
ly requifite ; or in fome a more copious one, it is necefiary that 
we iliould be acquainted with the particular nature of the pur- 
gative employed : that whilft we are attempting to be of l'ervice, 
by promoting the intefiinal difcharge, we may know what fluid 
each medicine will evacuate the molt powerfully, and not in o- 
ther refpeds be detrimental to the conliitution by an improper 
choice—as in cafes of inflammatory complaints, it would be very 
injudicious to order purgatives highly ftimulant; fo in thole 
of bilious obltrudions of the liver from thick vifcid inert bile, 
to have recourle to the ferous and lymphatic purgatives would 
be injurious ; as by thefe, though the intention rcfpeding the 
operation might be right, we fhould rather increafe the original 
cauie of the malady, by an improper eledicn of the medicines 
of which tve made ufe. However, here we only mention the 
neceffity of fuch a fpecification, whi,ch we {hall point out, on 
treating of particular defeds of conliitution, which require the 
neceilary difcrimination. 
§ 9* DIURETICS, taken from the Greek word dioureo, pet- 
meo, to make water, are all fitch fnbftances as caufe urine to be 174 
ON MEDICINE. 
fecreted by the kidneys, and excreted by the bladder, which laft 
is the repofitory for that fluid. 
Notwithftanding. the great labour different authors have be- 
jflowed in properly fele&ing this clai's of medicines, and the con- 
fidence with which many have fpoken refpe&ing their operati- 
ons, Hill their effefts are indifputably uncertain. 
How fome tilings pafs off by urine fo immediately after be- 
ing taken into the Itoraach, is Hill a matter of difpnte. 
Some aftriagents have been conlidered of the diuretic clafs, 
from their adtion ; and doubtlefs have produced this way very 
good cffedls, as the leaves of the bear’s wortle berry, and bitters; 
nay fome have publicly declared the power ot aftringents in 
expelling a calculus. As diuretics act not by dillolving the 
blood, but by their local or fympathetic ftimulus under fome 
circumftances, 1 fee no reafon why altringents may not become 
diuretics in relaxed and torpid habits—many of the operations 
of the animal ceconomy may be produced by relieving the parts 
from any defeat they may labour under, which defedt may re- 
tard, or prohibit their action. 
Palfy of the kidneys will hinder a fecretion of urine ; torpid- 
ity in thofe parts of the fyflem, or relaxation, will proporti- 
onally weaken their power, which being removed, they will be 
enabled to act ; and certainly altringents bid fair to produce the 
deft red effect. However, in order to be acquainted with their 
utility, we muff now inquire what are the general effects pro- 
duced oi'the fyftcm by their application;—where there is a 
fuperabundant quantity of ferous fluids in the blood, and the ab- 
forbents appear to be in too inactive a ftate, they become bene- 
ficial, by removing the former, and increafing the abfovbent pow- 
er of the lymphatic lyftem—hence drawing off water accumu- 
lated and ffagnating in any of the cavities of the body. In fcor- 
butic habits, they remove morbid acrimony from the blood, by 
carrying off the faline and putrefeent particles of the mafs t>£ 
blood, which are generally diffolved in the ferous part of that 
fluid— and when there is a fuperabundar.ee of circulating liquids 
too great for the ffate of the fyftcm, by diminilhing them they 
become ferviceable—hence we find, their chief action is to pro- 
mote evacuation. 
When the natural fecretion of urine is morbidly defective, 
they reflore that fecretion, by foiiciting a flow of fluids to the 
kidneys, and hence diminifli other fecretions when morbidly 
augmented : and hence remove obflru&ions in the canals of the 
urmary paffages, and irom them wafli out all acrimony. 
But, in order to promote their operation, they fliouid be given ON MEDICINE. 
175 
in the mod dilute date ; we might fay, it is always proper to 
throw in with them much aqueous fluid, except in cafes of clrop- 
fy ; and, even in this cafe, there have been cures performed by 
drinking large quantities of mineral and common water. But 
where the intention of any medicine is to pafs off by urine, the 
patient (hould walk gently in a cool air, and avoid all {ituatioHS 
calculated to produce a determination of fluids to the lkin ; for 
there is fo intimate a connection between the kidneys and the 
fkin, that diuretic medicines, when thrown into the habit, will 
oiteil prove drong promoters of infenflble perfpiration. 
According to the particular nature of the ieparate action 
of diuretics, we (hall be enabled to judge where they are impro- 
per. 
Should there be too high a degree of fenfibility in the kidneys, 
a considerable increafe of urine, or any fixed obltruclions in the 
urinary pati’ages, the adminidration of thole which artjlimulani 
mud be difadvantageous. 
It there (hould be a deficiency of ferous fluids in the fyflem, 
the above alfo are improper, and thofe of the cooling c/afs—but 
where there is a redundancy of ierofity, the prohibition of dilu- 
ent diuretics are fairly pointed out. 
Though we know not of any of this clafs that will always in- 
fallibly exert its diuretic power, dill the catalogue given Us fay 
a variety of authors is extenfively prolix ;—we ihall (elect fuch 
as are confldered the mod efficacious according to the particular 
dates of the conflitutions which may require them ;—and thefe 
we (hall comprife under three heads—of jlimulant, cooling—and 
diluent. 
Of the FIRST CLASS, or STIMULANTS, are 
Nadurtium Onion 
Korfe-radilh Celery 
Afparagu's Par (ley-feed. 
Turnip All thefe may be taken as food, in 
Radilh decoflion or infufion. 
Fennel-leed 
Leek 
Garlic, 
Balfam of Copaiva, 
See Expeftorants. 
Hedge HyfTop, 
Wake Pvobin, 
See Stimulants. 
Juniper Berries, 
1 or 2 ounces in a pmt 01 water, 
boiled or infufed. 
Spirits of, from 1-2 an ounce to 1 ounce. 176 
DN MEDICINE. 
Oil, from 2 to 10 drops. 
Quassia Wood— 
Powder, 10 to 20 grains. 
Infufion; 
1 or 2 drams to a pint of water,’ 
2 ounces the dole 
Broom—Infufion, 
Decoction, 
1-2 an ounce to a pint of water 
—dofe 1 ounce. 
Fxtracf, 1-2 a dram to a dram. 
Grass and Roots— 
4 ounces to a quart boiled to a 
pint. 
Wild Vine—-Powder, 15 to 30 grains. 
JJecodion, 
4 drams to x pint boiled dow n 
from I 1-2 pint- dofe, £ 
ounces. 
Tobacco— See Sedatives. 
Sqjjills—-Powder, from 1 to 6 grains. 
Fretti Root,1 5 to 20 grains. 
Pill, 8 grains to 1 5. 
Meadow Saffron— 
Oxymel, from 1-2 a dram to a. dram. 
FoX-GloVe—Powder, 1-2 a grain to 2 grains. 
Infufton; 
1 dram to 1-2 a pint of boiling' 
water—-i-i an ounce to an 
ounce the dofe. 
Bath Waters, 
Harrowgate Waters; 
Stimulant and diluent.' 
The COOLING CLASS are,5 
NlTkE— from 5 to 30 grains.' 
or fweet fpirit of, from 10 to 30 drops. 
Amber—-Salt, from 5 to 15 grains. 
Diuretic Salt— 6 or 8 to 30 graphs'. 
Fixed Sal Ammoniac-— 15 to 20 grains. 
Cream of Tartar— 1-2 a dram to a dram'. 
Ad IDS—-Fermented, 
Native, 
1 dram to 1-2 a ounce. 
Mineral Acids— 3 drops to 6. 
The following, of this clafs, we confider as ailing on the prin- 
ciple of neutial fairs, from the union with the acids they meet 
with in the ItomaCh and inteftines : ON MEDICINE. 
177 
Testaceous Animals— 
Crabs, 
Lobfters, 
Cockles, 
Mutfels, 
Oyfters, 
Scollop, 
Periwinkle, 
Thefe are taken by way of food. 
Soap— 1 fcruple to 1-2 ounce. 
Kali, or vegetable Alkali, from 5 to 30 grains. 
Absorbent Earths— 
Crabs Claws, 
Eyes, 
Hartihom prepared, 
Chalk, 
from 10 to 30 grains'. 
Lime Water— 2 to 4 ounces. 
The diluent are—which alfo may be efteemed cooling—all the 
fweet acefcent fruits : 
Dandelion Potatoes 
Endive Boiled Onion 
Lettuce Water 
Corn Sallad Milk Whey. 
Artichoke 
Malvern 
Cheltenham 
Water, 
Acidulated Waters, 
§ io. DIAPHORETICS, derived from the Greek diaphoreo, 
transfero, to carry through, include all fuch fubftances as increafe 
perfpiration, or fweat. This clafs ufed to be divided from fu- 
dorificf, or fuch medicines as promoted fenftble perfpiration, but 
nnnect Jfarily ; for they l'eem only to differ in their degrees of ac- 
tion, promoting the fame effect, more or lefs copioufly or per- 
ceptibly. Rut as different purpofes may be anfwered by the dif- 
ferent degrees of action of thofe parts which produce thefe efte&s, 
it may be neceffary to make fome fpecification refpe&ing the 
two. 
Infenhble perfpiration is promoted by all fuch materials as 
produce an aftringent effect upon, or contract the folids in a mo- 
d-rate de ree, by occafioning an increafe of elaftieity or ffpringi- 
n- ■ of the veffels; < ,d hus promote the circulation—hence Pe- 
r ■ ian bark—all the aftringent roots --auftere wines—-come un- 
der this diviuon, as do exercile which is moderate, either walk- 
ing, riding on horfeback, or in a carriage—-mild ftimulants, or 
thoie of the ftronger clafs weakened. 178 
ON MEDICINE. 
Or, by fuch things as determine the matter of perfpiration to 
the ikin, fuch as moderately warm air, temperate exercile, an e- 
qual circulation of the fluids when the body is at ref), as well as 
in motion. 
Or, occafion fuch a temperature of the fkin, that it fhall nei- 
ther be too relaxed nor more rigid than iequifite—-hence fric- 
tions, lotions, and deterfion are recommended ; and it is from 
producing this effect that thefe things are found fo beneficial to 
the itudious, inactive, and thofe who are advanced in life—-un- 
loading the fyftem by thofe means, without weakening it in the 
fmallelt degree, but, on the contrary, increafing its power. 
Now sweating is promoted by nearly the lame means, for 
all iucti things as relax the veflels, and determine powerfully to 
the fkin, will produce this effect, whether internally or external- 
ly applied. 
Hence come under this clafs all thofe diuretics which a£l not 
Upon the kidneys eledlively—warm water, or barley-water fiveet- 
ened with honey, excite a copious fweat-+-a glafs of cold water 
dra.uk going to bed—alfo thofe things which take off fpafm, whe- 
ther they are demulcent, or moderate or correct acrimony, as o- 
pium— teflaceous powders. All ftrong frictions, warm vapor, 
particularly of water, warm bathing, or whatever will render 
the ikin relaxed or foft. 
Nitre, and its preparations, and all thofe fubflances which 
dilpofe the veffels to a£t upon their contained fluids—thus vine- 
gar fweetehed with honey, and diluted with water, is the befl 
ludorific in acute cafes, and was a favourite remedy preferibed 
by Hippocrates, in the following form, called Hydkomel, 
from udor, water, and mel, honey : 
Take of Vinegar, 
Honey, 
each one ounce. 
Mace, a fimll portion, to give it an agreeable flavour. 
Water, twelve 01 fourteen ounce* ; let this be drank 
in bed after the manner of tea or coffee ; and the patient there 
wait the refillt. 
Care thou; h ibould be taken, that honey does not difagree with 
the conftitution ; for, where there is any natural antipathy, it is 
apt to produce violent affections on the flonrach and bowels ; fu- 
gar fhould therefore, in thefe cafes, fupply its place, or treacle 
will have a better effect. Whatever is taken hot, as well as heat- 
ing aromatics, opiates, as alfo violent motion, are highly fudo- 
rific. 
Befides, fuch things as diminifh the external preffure of the 
air, and thole which mcreafe the ft length of the heart, with re- 
fpett to its number and force of puliation*, come under the head ON MEDICINE, 
of fudorifics—fuch as Rlienifh wine, frefli juice of citron, pene- 
trating aromatics, volatile l'alts, &c.—thofe things which fiimu- 
late externally, as all aejid matters applied to the fkin, as vine- 
gar and ginger, which is the mod fubtile and penetrating and 
much recommended by Helmont—and laflly, whatever, reftores 
impeded motion in the internal parts, as paflions and affeftions 
of the mind reproduce retarded perfpiration. 
Though a number of the medicines mentioned above are ftiled 
diaphoretics ; Thill, ffrictly fpeaking, and confideving them as 
fuch, independent of their connection with fudorifics we have no 
one of which we can fpeak with any certainty that has been tri- 
ed by llatical experiment, the only mode we have of difcovering 
them, except as a foetii}A, as handed down to us by Sancto- 
Rius—yet I ibould fuppofe, that the power of all fudorifics 
weakened might be juftly cordidered as diaphoretics ; for vrc 
find all thofe things which can increafe the circulation, determine 
the fluids externally to the fkin, and take off the fpafm from the 
minute veflels, are certainly entitled to the character of diapho- 
retics and fudorifics ; and thefe three particular circumftnnces 
fhould be adverted to, when we want to promote a di’fcharge of 
this fort for any good purpofe ; for though ftimulants and f da- 
tives, or medicines pofleffing bo"h thefe powers, may in many 
cafes be very proper, they may iu fome, conjunctively or feu a. e- 
ly confidered, be detrimental—and indeed there may be com- 
plaints where fweating would be improper, though the promo- 
tion of gentle perfpiration might be ufeful, as in the feurv1 — 
but in the venereal difeafe, if the effedf could be produced with 
eafe, fweating is the belt method of cure, and prefeiabie to ei- 
ther evacuation by flool, or falivation. 
From what has been advanced, we (ball find that all general 
Simulants of the lyltem, as motion and heat, are powerful fu- 
dorifics ;—particular ones are either applied to the excre te ie=, 
thofe pores from whence the fvveat ifl'ues, or to the parts conic it- 
ing with them, as the ilomach and inteffines ; hence their action 
is either general, local, or fympathetic, 
The catalogue of Diaphoretics contains 
2 ounces in 3 pints boiled to 2, 
taken every hours. 
Burdock—Decoiftion, 
Seneca, or Rattlesnake-root— 
Powder, Dofe from 20 to 60 grains. 
Powder, 1 dram. 
2 ounces in two pints of water 
to 20—dofe 1 to 2 ounces. 
Deco£tion, 
Snake Root—Tiniture, from 1 to 2 drams. ON MEDICINE, 
Powder, 10 grains to 1-2 a dram. 
Guaiacum Wood— 
Decoction, 
2 ounces to 3 pints boiled to 3 
—dofe 4 ounces. 
G utn, See Cathartics. 
Tindture, from 1 to 2 drams. 
Contraterva— 
Powder, from 10 to 30 grains. 
Compound, from 1-2 a dram to 2 drams. 
Sarsafarilla— 
Decoction, 
2 ounces to 4 in 3 pints of water 
boiled to 2, from 4 to 8 ounces 
ihe dofe. 
Mezereon, or Spurge Olive— 
The bark of the root, 
1-2 an ounce in 6 pints of wa- 
ter boiled to 4.—Dofe, 1-2 a 
pint. 
Opium— See Sedatives. 
Camphor, 
Musk, 
Salt of Hartshorn, 
Asa Four id a. 
See Antifpafmodics. 
Antimony—Leevigated, dofe from 20 to 60 grains. 
Calcined, to to 30 grains. 
Tartarized, 1-8 to 1-2 a grain. 
Glals of ceratcd, 2 to 20 grains. 
Precipitated fulphur of, 3 to 6 grains. 
Antimoni \l Powder— 2 to 6. 
W ine, 10 drops to 50. 
Antimony-—Tartarized wine of, 20 drops to 4c. 
Ipecacuanha— 1-4 to 3 grains. 
Wine, 30 to 40 drops. 
Water— 
W ine— 
Vegetable and Native Acids— 
Acetated .Ammonia, 
called Myndererus’s 
Spirits, 
from 2 to 6 drams. 
Water of Ammonia, dole 10 to 30 drops. 
Prepared Ammonia, 5 to grains. 
Effential an 1 Empyretimatic Oils—though they are feldom ufed 
in this view, but more as cordials and antifpaimodics. 
From con'idering the opeiation of medicines of this clafs, we 
fhall find that their utility is derived from diverting the deter- 
mination of the fluids, and prcveatin6 ihem from crowding the ON MEDICINE, 
internal vifcera—removing various caufes, which obftruft or 
impede the natural hate of the circulation on the furface of the 
body, and there reftoring the natural difcharge—and alio from, 
their evacuating power, leflening the quantity of the circulating 
fluff!', when too great for the powers of the fvftem—reftoring 
lymphatic absorption—and ditchargiug any morbid accumula- 
tion of ierum. 
But fhor.Id the fvftem be uncommonly relaxed, a great in- 
creafe in the determination of fluids to the exterior furface of the 
machine—a great want of fluids or the force of the blood oil 
the bails of the brain much debilitated, the prohibition of their 
ufe is obvious. 
The laft of which we have to treat in this feftion are 
§ 11. E \i ENAGOGUES, from the Greek words emmena 
mrnfes, and ago, daco, to produce the menltrual evacuations of 
women ; and all fuch medicines as have been fuppofed to pro- 
duce this eft eft are comprehended under this title. 
V great deaf has been written, and much time wafted, by au- 
thors, in endeavouring to account for the precife manner in 
which nature performs this operation in the female machine : the 
only prelent fatisfadlory conciufion we have on, this head is, that 
a dnefs of the uterine iyitem, from a peculiar determination 
c the blood to that organ, a permeability in the uterine and va~ 
g! i! vends, and an increased impulfive power, all periodically 
exf ed, arc neceflary or the falutary promotion of that difcharge 
—-avd when there arifes a deficiency in all or any oi thefe parti- 
cular;,, oblhuflions will take place, which require the aid of 
that clafs of medicines of which we are now to treat;—but as 
there are various purpofes often to be anfwered, e’er we can 
promote the deftred end, different medicines have been pointed 
out, and formed into divifions according to tiieir action. 
Hence have we Emmenagogues, 
Stimulating-—as 
Antimony, — QuickfilVer. 
Irritating— 
Aloes, — Sabine, — Cantharides. 
Tonic and Ajiringent—- 
Iron, — Gold-bathing, — Eitercifc. 
A ntifpufm odic— 
Afa feetida, — Caftor, — Bathing the feet, 
and a variety of others, poffeffing fimila'r powers to thofe here 
Specified. 
But in the anplication of thefe medicines, one thing is to be 
particularly obferved, that not any of them ought to be uled 182 
ON MEDICINE, 
at all times, that is, previous to, and when the mendruating 
period is at hand, except the aftringent clafs and quickfilver. 
The irritating and antifpafmodie are only to be called in aid, 
when there is an aggravation ot the fyrnptoms, and an effort of 
nature at her accuftomed time. The reafon of which is clear-— 
becaufe the former arq confiderqd only as preparatory, that by 
their operation the conftitution may be put into fuch a date, as 
to be enabled to feel, and anfwer to tfie elfedts produced by the 
more powerful and forcible action of fuch medicines as add vi- 
gour to the circulatory veffels, pul’ll forward the blood quickly 
and rapidly, and take off any obftrueftions which may be caufed 
by fome fpafmodic afte&ions. 
According, then, to the difference of the conftitution we wilh 
to relieve, lo mud we make our fele&ion. 
If it fhould be neceffary to giveJireiigth andJirmnefs to the 
JyJlem,' 
Allringents may be had recourfe to—as iron, and its prepa- 
rations—batk—and bitters. 
If to incieafe the force in trie moving powers in general, 
Cold bathing and quickfilver. 
If to produce partial action by the fame mode, 
Local Stimulants— 
Partial warm baths—-fomentations—-ftunulant vapor, or fu- 
migation of tobacco to the uterus—aloetic medicines—foetid 
gums—-cantharides—acrid puigatives—as they may communi- 
cate their ftimulus to the part, either immediately, or communi- 
cate motion to the vafcular fyftem from the exertion of their ac- 
tion on the contiguous parts. 
If to take off conftriftion, 
Antifpafmodics— 
Afa leetida—caftor— -but particularly mufk. 
There is another clafs which wc mull have recourfe to, parti- 
cularly where there appears to be a fcarcity of the fanguinary mafs, 
in order, as far as in our power, to increafe the general volume of 
fluids, that the peculiar determination may with more eafe 
be brought about, and this is the clafs of Nutrients, leledling 
fuch to which the digeftive powers of the conftitution appeals 
adequate to afiimilate. 
If now we call to our recollection what has been delivered— 
the means by which thefe appropriate remedies are rendered 
lerviceable, will be—from promoting freely the circulation of 
the blood in the neighbourhood of the uterus, when too much 
obltruidcd there—from increaung the accumulation in the ute. 
rine veiTels tiiemfelves, which is neceffary to the menftrual dil- 
charge—and removing morbid obftru&ions to the pafinge of blood ON MEDICINE. 
into the cavity of the uterus—-alfo, from augmenting the ftrength 
of the fyftem in general, particularly of the veffels ot the uterus, 
when defective—and iemoving any i’pafmodic conltriftion taken 
place in them. 
But Itrong objections may often arife to the ufe of fome of this 
clafs—if the rectum Ihould be in a particular irritable date—or 
there mould be any local inflammatory affection, we mult avoid 
tliofe which are irritating.—If the blood circulates with great 
force, or there fhould be particular debility of any other parts, 
the Jlimulant mnft be avoided ; nor mult thofe denominated tonic 
be meddled withal, if there ihould be any morbid rigidity in the 
l'yltem. 
Our catalogue of Emm eNAGOgues fupplies the following ar- 
ticles : 
Pennyroyal, 
Rue, 
Sabine, 
Asa foetida, 
Galbanum, 
Ammoniacum, 
See Antifpafmodics. 
Myrrii— See Expe&orants. 
Tincture, 1-2 a dram to 2 drams. 
Quicksilver, See Sialagogues. 
Ikon—Rufl prepared, from 5 to 30 grains. 
Tincture of muriated 
Iron, 
from 10 to 60 drops. 
Wine of, 1 dram to 1-2 an ounce. 
Ammoniacal Iron— dofe from 3 to 15 grains. 
Tartarized Iron— 10 to 30 grains. 
Vitriolated Iron— dofe 3 grains to 20. 
Cathartics—Diuretics—and Emetics — may, if we conlider the 
nature of their actions, he fairly included, on particular occafi- 
ons, in the lilt of Emmenagogues. 
CHAP. III. 
WE are arrived at the third part of our arrangement, and 
mult proceed now to treat on Medicines which act up- 
on the Fluids through tih. System, i . the iarne manner as 
we have before fpoken on thofe which acted upon the folids ; 
and thefe include Attenuants—Inspissanys -and Demul- 
cents—And, fitft, ot 
§ i. ATTENUAIMTS, from the Latin attcnuo, to make thin, ON MEDICINE, 
perfeSly expreffes the nature of all the medicines of this ck-fsi 
at\d comprehends • hatever can be underftood by diluting, incid' 
ing, and rejedving medicaments ; three terms into which this 
ciafs have been, by many, divided, becaufe they all contribute 
to lender the fluids more'thin and fiuxile. 
Butas this point may be accomplithed in two ways, either 
by fubtlances mixing with a fluid, and rendering it more thin, 
but not changing or altering the particles of which it was com- 
poled ; or having the power of diminifhing the coheflon of the 
blood, and thus rendering its texture lefs firm and tenacious ; 
they may be certainly, and ought to be divided, according to 
their adiion, into diluent and rtfolvcnt. 
Among the firit we cannot be properly faid to hare any other 
than water, which is produ&ive of a variety of good effects up- 
on the habit—but not merely by its diluting property, it a£ts 
more particularly, immediately, and univerialiy, by ita coldnefs. 
Now, as a diluent, it not only thins the fluids in the way we 
have above lpecifled, but it affifts digeflion, (ic6j quenches third 
—is an univerfai vehicle for folid food, corre£ts acrimony—pro- 
mctes fluid fee ret ions—and is by many efleemed, much more 
than any other medicine, an univerfai remedy. 
Now, as it is clear that all diluents lliould be more fluid than 
the humours which are by their intervention to be rendered thin- 
ner; and have at the fame time, when mixed, the property of 
making them retain their acquired fluidity—we fliali find, there 
is not any thing except water that poke fifes this power. 
Though wine—oil—faline fubftances—fermented fpirits— 
and fome earthy fubltances have been laid to enjoy tfcefe vir- 
tues, dill it is obvious, that they are defective, and have not 
them in that degree fo as to become really diluent---for wine, 
as a diluter, depends upon its watery particles joined v., b its 
ilimulating power—oil renders the mat's of fluids rat: more 
vifeid—faline fubtlances rtfolve by their flimulus—ft. ■ ed 
fpirits are more apt to coagulate—-earths are of themfelvc d 
and inert, and can never be taken in this view, but as they r y 
mix with fome acidities in the ftomach arid inteftincs, and t;ms 
change their form, and become active from their affuming that 
of neutral falts, and with them may they be clafied ; thereiore it 
is to water we mult refort, when we wilh to call in aid alone a 
purely diluting power-—to which, it has been faid, if we add 
gentle heat, or faline particles, as fea fait, Polychreft la.lt, lal 
ammoniac, or borax, we {hall improve its power, by the addi- 
tion of their Ilimulating efFefls, but this is adding a efolvent 
property—Moderate motion is alfo faid to improve its powers. 'ON MEDICINE. 
But as for refolvents, they aft by increafing the force of the 
moving powers by the ftiniulus they poflefs in a limited degree; 
for fhould they aft violently, they would, by difllpating the thin- 
ner part of the fluids, render them thicker, and become incraffants ; 
but by gently flimulating* though they produce evacuation, 
they permit the veflels to aft more freely upon their contained 
fluids, and hence become refolvent. 
On confiaering the action of this clafs, we fliall be empowered 
to difcover, that their beneficial effects arife, from removing any 
morbid vifcidity in the blood, and refloring a free circulation, when 
in the fmall veifcls it is morbidly obftruCled-—from increaling the 
quantity of ferous evacuations, when too greatly diminiflied— 
and rendering them, when too thick and vifcid, more fluid. 
But their ufe muff be prohibited in conflitutions labouring 
under too great thinnefs of the general mafs of fluids-—having a 
propenflty to morbid ferous accumulations—or a remarkable 
increafe of fimilar lecretions. 
The catalogue of Attendants are, 
Water, 
Milk Whey , 
All Liquids abounding with water, 
Cucumbers, White Lily Root, 
Melons, Celery, 
Bete, 
Spinage, Artichoke, 
Boiled Onions, Mushroom, 
Corn Salad, Englih Mercury, 
Cabbage, And fome others. All the sweet a- 
Dandelion, cid Fruits. 
Endive, 
Alkali— 
Fixed vegetable, 
Fixed folfile, 
Volatile, 
in fmall dofes, and continued for 
fome time. 
Neutral Salts— See Diuretics and Cathartics. 
Soap— See Diuretics. 
§ 2. 1NSFISSANTS-— thefe are aHo called Incrass ant 
from the Latin words infpijfo and incrajp), to thicken. '1 hefu 
terms, like the former, give us a perfeft idea of their import— 
from whence we underhand all fuch fubftances as give a degree 
of vifedity, to the circulating fluids. 
From experience we know that our fluids do fometimes rua 
into a (late of morbid thinnefs ; but by what means, is very- 
doubtful. Oft MEDICINE. 
Some have fnppofed it to arife from too great a proportion 
of fluid aliment ; whilfl others have been led to believe, it origi- 
nated from a retention of fome of the ferous fecretions. But if 
we relief!:, that children and many adults live upon food totally 
liquid alfnolt, yet no fuch appearance is the refult; and that 
nature always fupplies the defeft of one feCretion by the increafe 
of fome other, and the retention mull be partial, it cannot 
be univerfal; both thele opinions feem by no means fatisfac- 
tory. 
1 rather think that it is oceafioned by a relaxation of the fyf- 
tem, particularly of fome, or the whole of the digellive organs ; 
ior ltrong, mul'cular, laborious ruflics, whofe digellive powers 
are good, have generally,-nay, I believe always, the blood tend- 
ing to the oppoiite extreme—whillt the more delicate and relax- 
ed, whofe digellive powers are weak, have the fangurnary mafs 
too fluid : indeed people whofe blood has polTelTed a proper tex- 
ture, have, from illnefs, had it reduced to a Hate manifelling a* 
too weak cohefion, and that apparently by the fyltem being de- 
bilitated. 
Whatever may be the caufe, it is our bulinefs to remedy the 
eflfefts ; and thefe we attempt by reproducing a proper proportion 
of vifeid fluids, and by increaling their attractive power one with- 
another; and their confequences may, we think, be acquired by 
the following catalogue of Jnspissants : 
Wine, Farinaceous Grain, 
Acids vegetable' Mucilaginous and Oily 
mineraly Subltances, 
Alchohol,; Sago, 
Radilh, Salep, 
Turnip* Almonds, &c. 
Carrot, Gum Arabic, 
Parfnip, Tragacanth,- 
Skirret, Starch, 
Potatoes, Ifinglals, 
Leeks, Arrow Root, 
Ccmfrey Root, Auimal Food** 
Cucumber, Filh, 
Poppy, and E Sgs, 
Melon Seed, All the Altringents,- 
Onions, Bark, 
It has been remarked by fome authors, that acids—-wine—a!-- 
ehohol—-and in fome meafure, the altringents ufed internally, 
have been laid not to produce their infpiffating effeCt ; and 
fhould therefore only be employed externally, in cafes of profufe 
bleedings ; and that the nutritious and demulcent cfafs, of which ON MEDICINE, 
W>e Shall next treat, muft, for reftoring the vifcid fluids, be de- 
pended upon. 
However, I cannot avoid thinking the whole, alchohol except- 
ed, may be ufied with much advantage ; and greatly ailifiant in 
rendering thofe, which act merely on the blood, more quickly 
efficacious, by invigorating the fyitem, increasing the Strength of 
its vafcular power, and confcquently the action of the veflels 
upon the contained fluids. 
On this head authors have confined tbemfelves to fetch fub- 
flances as were either farinaceous, as barley, wheat, rye, and fueh. 
—or mucilaginous, as marth-mallows, gum arabic, ifinglafs, &c. 
and conceived their utility to be derived from removing morbid 
tenuity in the blood-—preventing the tranfmiflfon of red blood 
through veflels not naturally fitted to receive it—diminishing the 
quantity of thofe Secretions which were ferous, and too copious, 
and rendering them more vifcid where morbidly thin and fluid- 
and have prohibited their ufe in morbid vifcidity of the blood- 
preternatural diminution of thfe Secretions in general—-and a 
high degree of debility of the digeftive organs. 
I am perfuaded that in many cafes, particularly in thofe where 
a weak digeftion is preyalent, the ufe of Some of the Stimulant 
aromatics, mixed with die invigorating aflringents, fueh as bit- 
ters, bark, iron, would greatly conduce to conquer many of thofe 
defeats for which incrallants are preferibed, and I have repeated- 
ly feen their good effetts ; indeed 1 very often unite them, and 
find, that, conjoined, they proves more efficacious than when ad- 
miniftered Separately. 
§ 2. DEMULCENTS, from demulceo, to appeafe or mollify. 
Thefe by fome have been conlidered to a& in a double capacity, 
by blunting or Sheathing the acrid particles of our morbid hu- 
mours, or promoting an entire change in fueh as were offetifive 
from their acrimcnj', and forming a third fubflance, perfectly 
different in its nature with refpedt to its asftion, Hence have 
they been ranked as general and particular demulcents. In the 
latter clafs are enumerated all the acids and alkaiines, as well as 
Some metals, with regard to their influence on each other ; as 
if one was creative of any ditturbance in the habit, by exerting 
a morbid Stimulus frqm its acrimony, the other on being given 
proved corrective, and cured the affection ; hence was filled de- 
mulcent ; but thefe are more properly arranged under other heads, 
as the antalkaline and antacids, of which we {hall foon treat in 
their Separate places. 
At prefent we fliail confider tliem only as obtunders of, or 
blunting acrimony, by mixing with and preventing the acrid ON MEDICINE, 
part of the fluids from exerting themfelves on the folids, fo as 
tp create pain, or other uneafy fenfatiqns. 
And it will appear then, that of all this clafs, in this view of 
the fubjeft, are either mucilaginous, oily, or a cotnpofition of 
both ; and thefe manifell their a&ion immediately in the ilomach 
or inteftines ; or, after having palTed through the emulation, in 
the fecretory organs. 
For it is imagined, that acrimony takes not place in the blood 
veffels, but in the feevetions, as the l'erum is thought to be the 
vehicle of acrid fubftances. Thefe demulcents, therefore, mix- 
ed with tile blood are feparated with the ferous, or thinner parts 
of the fluids, in tbofe places of the fyilem where fecretions hap- 
pen ; and thus, by enveloping the irritating particles, prevent 
them from ftimulating. 
Thus they defend the kidneys, the lungs, the veffels of the 
vagina and uterus, in nephritic or gravelly complaints ; in de- 
fuxions on the lungs ; and cafes of the whites •, and are highly 
vfeful in haemorrhages, which are often maintained by acrimo- 
ny ; for increafed fecretion of mucus is always acrid, till its 
thinner parts are diffrpated, by lying fome time—hence their ufa 
in coughs, defluxions on the breaft, the whites, and thofe dii- 
charges after child-birth, called lochial. 
Whatever good we may perceive can be derived from medi- 
cines of this nature, may be acquired from fome of the following 
fplectipn of Demulcents : 
Larger Cqmfrey Root, Hips, 
Seeds of Cucumber, Liquorice, 
Poppy, Gum Arabic, 
Melon, Tragacanth, 
Sugar, Starch, 
Honey, Iflnglafs, 
Raifins, The Nutrients, 
Dates, Emollients, and 
Figs, Sedatives, 
though thefe lad can fcarce be faid to adt in the mode we have 
deferibed of common demulcents ; but rather take oil' the acri- 
mony by diminilhing the fenflbility of parts ; and produce a 
vifcolity of the fecreted fluids, it is obvious from the appearance 
of the matter, in thole who have taken opiates, after their nar- 
cotic effects have epafed. 
And this I take to be owing to the veffels being by their pow- 
er tbvpwn into a Hate of torpor, and thus fuffering the fecreted 
fluid, to become more denfe by its continuance, and confequerrtly 
Jefs acrimonious from the diffipation of its more ferous parts. 
They have been divided into lenient Demulcents, fuch as ON MEDICINE. 
Starch, Gum Arabic, Olive Oil—and tnofe which are diluent, 
as Water, and watery fubltances ; but thefe lalt come not pro- 
perly under this head, without being mixed with fome of the 
former ; as they are apt, without fuch mixture, to pafs off too 
quickly by fome of the emnndtories. 
The ufe to be acquired from the adminiftration of thefe mate- 
rials are, a diminution of the action of the ordinary ftirr.uli upon 
parts affe&ed with too great fenfibility, and a fupply of the na- 
tural coverings of the parts where tqo defedlive—diminiflhing 
morbid acrimony in the fyllem in general—and rendering more 
mild thofe fecretions which are praeternaturally, or too violent- 
ly acrid. 
But their adminiftration would be pernicious, if there was 
any defecl of a natural pungency in the fecreted fluids—a great 
degree of vifeidity in the coverings of the fenflble parts—or an 
uncommon want of fenfibility in the excretory organs. 
CHAP. IV. 
\T7E are now come to our fourth divifion, whereiq we pur- 
’ ’ pofe to confider 
Medicines which manifest their sensible Action 
CHIEFLY, IF NOT SOLELY, IN THE FIRST PASSAGES RESPECT- 
ING the Fluids. 
The flrft of which prefent themfelves to our view are, 
§ i. AN I'ALKALINES, from the Greek words anti, again!!* 
and alkali, alkalies, confequently all acids and acefcent materials 
come under this defcription ; as do all fuch medicines as conquer 
alkalies, and deftroy their power of action as fuch. But in this 
place the acids and acefcents are only to be confidered as correc- 
tors of alkalefqent fubftances ; for we have before feen the di- 
verfified power they appear to maintain as ajlringents, Jlimulantt, 
fedatives, infpijfants, cathartics, diuretics, and they will alfo rank 
with antiputrejcents ; at lead fuch of them as have been feledted 
agreeable to the effects they have been thought to produce on 
the human machine : and here their chief action appears to me 
to be in the firft paflfages only, where, coming in contact with, 
alkalefcent: fubftances, there they neutralize them. 
I am of opinion, that where there happens to be, from any 
difeafe, an alkalefcent ftate of the fluids, they are not of much 
fervice by acting in them merely againft, and correcting fuch al- 
kalefcency ; for when our fluids are affedted to any confiderable 
degree with this, little is in our power j but in cafes of this kind, ON MEDICINE. 
fliould they be of any fervice, I am perfuaded it is more from 
their aftion communicated to the folids, particularly the mineral 
acids, than from any other caufe. Perhaps the utility derived 
from the native acids depends more upon the fixed air, with 
which they are replete; for we have not a more powerful cor- 
rector of putrefeent acrimony than this fpecics of air. 
They have been divided into vegetable and faline antalkalines 
—but the better divifion is, into native, of which forrel, barber- 
ry, and tamarinds, form examples—and into artificial, as the a. 
cid of vitriol, lea fait, nitre, and vegetable. 
The catalogue of Antalkalines, with which we are fuo? 
plied, are, 
Sweet acescent Fruits. 
Pears, Tamarinds, 
Apples, Currants, 
Oranges, Grapes, 
Lemons, Cherries, 
Strawberry, Railins, 
Rafpberry, Dates, 
Barberry, Figs, &c. 
Most ©f the culinary Plants* 
Cucumbers, Cabbage, 
Melons, Nafturtium, 
Bete, Endive, 
Spinage, Dandelion, 
Corn Sallad, Lettuce, 
Salary, Parfnip, 
Afptragus, Skirret, 
Artichoke, Potatoes, 
Radilh, Leek, 
Turnip, Onion, 
Carrot, Garlic. 
Olive, 
Water Dock, 
Sorrel, &c. 
Wine, 
Vinegar, with the artificial mineral A* 
Ctos above fpecified, 
Salt of Amber. See Diuretics. 
And likewifc the whole clafs of Demulcents ; but thefe aft 
by mechanical, not chemical mixture—that is, from merely mix— 
jug vith and fbc&thmg the offending particles, not from altering 
then), by forming a new combination, fo that each body lofes 
totally iu natural properties, and becomes a third, differing from ON MEDICINE. 
feoth—and, perhaps, fome others here fpecified, may aft in the 
fame mechanical mode. 
It will, from this concife view, appear obvious from whence 
the whole of the virtues of this clafs of medicines may be col- 
lected—and where their ufe ought to be prohibited—their power 
of neutralizing alkalies. 
For, on the one hand, by this power they are capable of 
removing any fenfation of alkalefcency in the full paffages—re- 
ltoring the natural difpofition to acidity in the ftomach—and 
coireding in the alimentary canal prseteruatural putrefcency.— 
On the other, if there ftiould be, from an acid eaute, any na- 
tural difpofition in the ftomach to that painful fenfation, called 
Gardialgia, an uncommonly flow and languid circulation, or 
any confiderable diminution of animal heat, thefe defeds they 
would iucreafe ; confeq.uently, uuder fueh circumftarrees, ought 
to be prohibited. 
§ 2. ANTAC1DA, Antacids, from anti, again#, and acidav 
acids. 1 hefe comprehend all alkalefcent fubftances, moft of the 
abforbent earths, and fome neutral falts—and are fuch fubftances 
as eounterad acidity in the fame manner as acids conquered al- 
kalies—and are in this light here only to be confidered, as we 
have before taken notice of them with refped to their different 
operations in the habit, feleded agreeable to their various pow- 
ers, acting as Jiimulants, ant ijpaftno dies, attenuants, antijeptics, ca- 
thartics, and diuretics—and in this place they l'eem chiefly to ex- 
ert their efficacy only in the ftomach, now and then, perhaps, ira 
the inteftines. 
The catalogue of Antacids with which we are prefented,, 
fufficient to anfwer any purpofe they are capable of effeding, are 
Testaceous Animals-. See Diuretics. 
Animal Food— 
Lime Water— Dofe 6 ounces to 16 in a day. 
Chalk— 
Crabs Eyes and Claws— 
prepared, from 10 grains to * 
drams. 
Burnt Hartshorn— 
Decod ion of, 
£gg and Oyster Shell pre- 7 c „ „ , 
1 l from 10 grams to 2 drams, 
pared— J 0 
Alkali—V egetable, 
Foffile, called So- 
da, or Natron, 
from 5 to 30 or 40 grains. 
Volatile, from 3 to 20 grains. 
So r ax— from 4 to 10 or 12 grains. 
Tartarized Kalt, or 
Soluble Tartar— 
12 to 20 or 30 grains. ON MEDICINE, 
Soap— See Diuretics. 
Stimulants— 
Antispas mo digs— 
Sedatives—and 
Demulcents— 
Though moft of thefe act by coming in contact with the prevail- 
ing acid immediatelv, without confidering the folids—yet thofe 
under the general titles, except the demulcents, which become 
ferviceable by their fheathitig property, produce their effefts by 
the influence they have on the moving powers, which we have 
in their proper places before fpccified. 
As the adtion of thefe, like the former, is fo very limited, on- 
ly to be confidered in this place as counteracting acidity in the 
firft paffkges, we fhall have occafion to fay little more than will 
be fufficient to fhew where they will be beneficial* or in what 
cafes their exhibition would be improper; 
When there is a morbid prevalence and fenfation of fournefis 
in the alimentary canal ; when; from the fame caufe in the fto- 
mach, the natural appetite is vitiated, and the aCtion of that or-; 
gati and inteftines is dilbrdered, they are of fervice in remov- 
ing the former, and reftoring the two latter to their healthful 
llandard. 
But when there is it prevalence of alealefeency in the ftomach 
and bowels, or a tendency to putridity in the general mafs of 
blood, they muft be highly detrimental. And, perhaps, in this 
laft cafe, the mifehief which would arife from their ufe may be 
more owing to the deftruction of the acid in the firft paffages, 
' than from joining in their alealefeent date with the fluids, as a- 
cids have been confidered antiputrefeent. 
i 3. ANTISEPTICS, from anti, againft, feptica, putrefaci- 
entia, fubftances occafioning putrefadlion. Thefe include all 
fuch materials as obviate the too great putrefcency of our 
fluids. 
Now as the putrefcency of our humours may be brought on 
by excefs of heat and motion, as well as receiving any putrid 
ferment into the valcular fyflem—as it, when once fixed, and 
begun to exereife its deleterious action, induces languor and 
great debility in the moving powers, we may fee the reafon ot 
our antifeptic clafs of medicines, exhibiting, according to the 
conception we have of their aCtion, fuch apparently contradictory 
views—for in the fame arrangement we fhall find, that we have 
the volatile fait, and thofe of the neutral kind—the former con- 
fidered as highly heating, and a ftrong ftimulant of the moving 
powers—the other as cooling the fyflem, and mitigating vafeu- 
lar motion. ■ON MEDICINE. 
, ?rcm thence I prefume, that they are only applicable in dif- 
ferent ltages of putrefcent action ; or in different conditutions 
affedfed with putrefaction ;—and not unlikely the fame may 
hold good with acids add alkalies, for they are both enumerated 
under antifpalmodics. Of thefe different fubltances it therefore 
behoves us to be careful in the application. 
In the firft ltages, where a putrid tendency may be accompained 
with high degrees of circulatory motion and heat, or in conllitu- 
tions -where thele are prevalent, neutral falines and accidents may 
bi the molt proper ; but in languid habits, or thofe made fuch by 
the continuance of the enervating power of putrid particles, vo- 
latiles and cordials challenge the preference. 
Nitre has been faid to be ftrongly antifeptic, when applied to 
inanimate animal matter, but not fo in the living fubjedt, as it 
lcllens the powers of the vital adiions—but this is only applica- 
ble in the advanced ftage of putrefcency ; and it is to that Hate 
of the difeafe alone they muff mean to advert, who advance, that 
cordials, and whatever invigorates the folids, by increaling the 
vital heat, are properly antiputrefeenf, and by what alone relief 
can be obtained in putrid complaints. 
However, our chief intent in thefe cafes is to keep up a due 
adtion of the moving powers, and a proper tone of' the folids, 
that is, an adtive firmnefs—which effedts, we conclude, may be 
produced by the fubfequent l'eledtion of Antiseptics : 
Thofe Fruits which have fweetnefs coupled with acidity, 
Cherries, Oranges, 
Apples, And fuch like. 
Acerb Fruits, 
Quinces, Sloes, &c. 
Medlars, 
Wine, 
Vinegar, 
Nitrous 
Muriatic 
V itriolic 
Acid, 
See Diureticsj 
Some Neutral, 
Mentalline, and 
Earthy, 
Salt of Amber, 
Salts. 
Effential Oils, 
,, Em pyrematic Oils.' 
Acetatcd Litharge_from j t0 3 drops, 
Nitrew Page 194 
ON M EDI C1N£. 
Alchohol, QuafTia, 
All Vegetable Oil of Turpentine, 
Nutrients. -Ale—Porter—Cyde? 
Aftrinyents, —Perry, 
Stimulants, Camphor, 
Sedatives, Afa Fcetida, 
Antifpafmodics, Muik, 
Wormwood, Myrrh, 
Chamomile, 
but, in cafes of languor, certainly the mod eligible arc* 
Wine— 
Bark— 
Extrad, 
lie fin, 
defe from 12 to 1-2 dram. 
x ounce to 2 pounds reduced to i pound 
---dofe 2 ounces. 
Eecodion, 
Bark- 
Powder, So grains to 2 drams. 
Tindure, Ample, r. to 2 or 3 drams. 
compound, 
or Auxham's 
i to 2 or o dr arris. 
lJ 
They have been properly divider into fuch as are tonic, in- 
treajing the ndivity and Jlrcugth of the fyjlem, of which Peruvi- 
an Bark—Wormwood—and Chamomile are examples. 
Such as are cooling—Acid Salines—Neutral Salts. 
Stimulant, as Wine—Alchohol—Oil of Turpentine. 
y-bitifpafmodic, as Camphor—Afa foetida—Mulk. 
The utility of thefe are derived from refilling and correding 
putrefadion—-by preventing the affimilating quality' of any pu- 
trid ferment received into the machine—corrcding*?h« putrid 
difpofition of the humours—-obviating the progrefiion of putre- 
fcency taking place in the folids—and veiloring to a found Hate 
folids morbidly putrid. 
But in cafes where a peculiar fenfibility of the ftcmach is pre- 
valent, thofe called tonic are to be avoided—the refrigerant, 
where a debility of the vital powers are manifeH—the stimu- 
lant, when we perceive to® great a degree of irritability, cir- 
culation too highly accelerated, or ftrong difpofition to profufe 
bleeding —and the sedative antispasmodics, when there is a 
too languid circulation, a lethargic difpofition, or a confideiable 
degree of torpor in the fyilem. C II A P. v. 
TN our fifth and laft divifion we include Medicines which 
PRODUCE THEIR CONSEQUENCES BY EXTERNAL APPLICA- 
TION;— OR ON SUBSTANCES FORMED WITHIN THE MACHINE, 
though lodged without the; Verge of Circulation. 
The firft of which we fhall tonfider are, 
§ i. EPISPASTICS, or VESJCATORIES, from epifrao, to 
draw, and vtjicatorium, as railin'), a blifter. They are therefore 
ftimulants, in the firll fenfe, locally fuch ; and, if continued, be- 
come evacuants. 
But their adion is not confined to thofe places where they im- 
mediately act ; they communicate that adion to the fyftem in 
general, and often in particular to the urinary paffages ; but 
this effect is chiefly produced by cantharides, or Spanilh flies. 
They have been formed into three divifionsv viz. 
1. Such as only occafion heat in the part—of which clafs may 
be conndered the fighter ftimulants. 
2. Such which create heat, with fome degree of inflammation, 
as Horfe-radifli— Muftard—Volatile alkali. 
3 Thofe which raife blitters, as cantharides, Euphorbium ; — 
to which may be added a fourth. 
4. Thofe which produce a difeharge of pus, as Setons and 
Ifines. 
They are often applied with different intents, either as they 
ad on the nervous power, alter the balance of circulation, or 
produce evacuation ; hence are their particular ufes difcoverable; 
—in removing torpidity, or languor in the fyftem—conquering 
the effects of more than ufual fenfibiiity—-decreafing violent pain 
--weakening the circulatory force of-the blood againft any part 
morbidly affeded —-and alio of ndion in vefifels of the neigh- 
bourhood of thofe to which they are applied. They alfo decreafe 
the volume of the circulating fluids when too great in the habit, 
and evacuate morbid accumulation of ferum. 
But fhould the fyftem be in general highly irritable, the blood 
prceternaturally thick, or the fluids in general too defedive in 
quantity, thefe circumftances demand the prohibition of their ufe. 
§ 2. PHLEBOTOMIA, bleeding, from pbleps, vena, a vein 
or artery, and tcm.no, feco, to cut. 
Under this term are arranged all thofe modes by which blood 
is evacuated from the machine by the medical art; and thefe 
operations are confidercd as either producing general or partial ON MEDICINE. 
effects, by relieving the fyftem in general, or only in fume of its 
parts. 
The divifion of this clafs has commonly been general, and to- 
pical, or local; and inftanced, in opening a vein, or an artery, as 
belong to the firft; as to the fecond, fcarifications, or cupping- 
glaffes, which are called cruentev, from the drawing blood—and 
the application of leeches ; but the terms, it has been thought, 
would be more judicioufly confined to the quantity taken, as veins 
or arteries mull in all cafes of blood-letting be opened. In ge- 
neral bleeding we commonly take away fuch a quantity as will in 
fome degree decreafe the power of the fyftem—in local, fuch a 
proportion only as may contribute to relieve a part of the fyltem 
near which the operation is performed—or, we ought to make 
fuch diftin&ions, for the lake of propriety, by which we fhould 
nnderftand, that in general bleeding, the larger branches of the 
veins or arteries are opened—in local, only the capillary, or ve- 
ry fmall branches." 
From whence the ufe accruing from this operation is derived 
may be eafily conceived—as it proceeds either from leffening the 
quantity of blood, altering the Hate of its motion, or changing 
its courfe. 
Hence it relieves in all cafes where the mafs of blood abounds 
too much in quantity ; or, when there is a too great tenfion or 
diftenfion of veffels in the fyftem, when the force of circulation 
is highly increafed, or the heat immoderate, or when in particu- 
lar blood-veffels there is a morbid increafe of action, or the force 
of the blood is too great againft parts morbidly affeiled. 
But where there is too great a fcarcity of blood, the circula- 
tion remarkably weak or languid, or too great a debility in the 
voluntary motions.—thefe are powerful objections to its ufe. 
Though from this operation it is apparent that the higheft ad- 
vantages; may accrue ; and indeed, in many cales which are in- 
flammatory, or arife from l’anguinary conpefttion, nothing can he 
done efticacioufly without it ; It ill I think it is made infinitely 
too free ufe of, efpecially in tliofe places and climates where 
people are liable to fall into putrid, and fome malignant com- 
plaints. 
Where the patient is ftrong and athletic the pulfe full and tenfe, 
and there appear evident figns of too great plenitude, it is tiniver- 
fally right to bleed, othervvife there is fome caution required ; 
for it very often hurries the habit into fuch a date of extreme 
debility, in fome fevers, that nothing can compenfate the mifcliief 
it occafions. 
In all doubtful cafes, therefore, where it may be thought nc- 
ceffary for blood to be taken away, I would advife the opeiator ON MEDICI 
to lay his finger on the pulfe of the oppofite wrift to that where- 
in the operation is performed ; if, during the flowingc-f-the blood,, 
tjie pulfe rifes, it is an indication to peril ft ; if it ihould'flag, we 
mould immediately defift. 
§ 3. ANTHELMINTICS* worm medicines, from Anti, a- 
gainft, and elmim, vermis, a worm : or VERMIFUGES. ~ 
Thus are called fuch fubftances as deftroy or expel worms, whe- 
ther fituated in the gullet, in the paffages to the ftomach, the 
ftomach itfelf, or the inteftines ; but, though it has been fuid, 
worms are formed in various parts of the machine, and have been 
found in different places, as the liver, kidneys, lungs, membrane 
furrounding loofely the heart, brain, cavities of the teeth, ike. wte 
confine ourfelves to medicines which perform their office on thofe 
which lodge in the firft palfages, 
Boerhaave ufed to divide this clafs into two, viz. thofe which 
deftroy and thofe which expel worms ;—but there may be cafe's 
where the exhibition of thefe may be improper, becaufe of the 
particular (late of the ftomach and inteftines being unable to-bearr 
their action—hence modern authors have more jiidicioufly divid- 
ed them into four heads : 
Pirst. Thofe which are fuppofed to deftroy, by poifoning 
the worms, termed venenoja, paiiotious as 
Quicksilver— See Sialagogues. 
Tin—Powder, dofe 6 to 20 grains or mofcu 
Sulphur—Flowers of, See Cathartics. 
Second. Thofe .which eypel worms, or cathartics, 
Sc ammoxy— 
Jalap — 
Aloes—• 
Gamboge— 
See -Cathartics. 
Third. Thofe which have lubricating properties, called lit- 
bncuntia, lubricating, as 
Oil of Olives— Linseed Oil— 
Fourth. Medicines fuppofed to have a tonic power, or giv- 
ing activity and ftfength to the bowels, named tonica, as 
Sabine—■ See Emmefiagogues. 
Worm Seed—Powder, dofe 1-2 a drain to a dram. 
Tanzey—Tnfulion, f a pint to 1 pint in 24 hours. 
Powder, 10 to 30 grains or more. 
Befides thefe there are a number of other articles exhibited 
for this purpofe— 
Indian Pink Root— 
Powder, 8 to 40 grains. 
Fern Root—Powder, 1 d;am to 3. ON MEDICINE. 
the hairy part fcraped off the 
pods, and /nixed with fyrup, 
to tiie confidence of an elec- 
tuary, dofe 1 to 2 tea-fpoonf. 
COWHAGE— 
Salt— in ftrong folution. 
Camphor— bee Antifpafmodics. 
Bitters—Oil jx Gltsters— 
Harrowgate Waters, 
But I believe Calomel in general one of our mofl fuperlcr 
vermifuges. * 
The utility of tliefe medicines naturally refult from their ac- 
tion on the worms themfclves—alfo on the fyflem—by which 
means they either deftroy, expel, or prevent their generation, 
in the machine. 
But fome exceptions may very properly arife to the ufe of 
each under particular circumffrmces—if the inteftines fhould be 
in an inflamed ftate, or be abraded, the venenofa, or poifoncus, 
4houId be avoided—the luhricantia, lubricating, if there fnould 
be accumulation of fordes ia the firfl pafTages—if a peculiar fen- 
fibility of the ftoroach, the tonica—and the cathartic, if any to- 
pical inflammatory affect ion iiiould occupy the inteftines, or 
lliould the conflitution labour under any deficiency of fluids. 
§ 4. LITHONTR1PTICS, from lithos, lapis, a done, and 
tlrr/pto, frango, to break. By this term we fliould mean all 
fucb materials as dilTolve the done ;—but our catalogue, under 
that idea, would not, I fear, comprehend any, notwithftanditfg 
the variety of pompous pretenfions fome have publiflied on the 
certain evidence of medicines endowed with this folvent. proper- 
ty. But it is the general opinion of the candid and rational prac- 
titioners ; that thofe who write now on the power of medicine, 
though they lrtatn the term, only mean fuch fubftances as pof- 
feis a power of removing the rL-fpofition in the body to the form- 
ation of calculi, or flouy concretions. 
Indeed, we have had much faid on the difiolving power of al- 
kalies and quick-lime—foap ley taken in broth freed from its fat 
—Mrs. Stevens’s folvent, and lime water—for a long feries of 
time ; full few have found the wilhed-for fuccei's ; but how far 
they may aft as preventive remedies, as well as fome others, 
cannot be poffibly determined. From the ufe of bitters end the 
uva urfi, or leaves of bear’s wortle berry, in this view, 1 have 
known fome benefit to arife in patients i'ubjeft to gravelly com- 
plaints, from a collection of flony or gouty matter. Much is 
faid at prefent of, and indeed the many experiments lately made 
fieem to prove the utility of a folution of the VEGETABLE AL- 
KALI, called iali, impregnated with fixed air, half a dram of the bN medicine. 
fait given at each dofe, difiolved ia any proper liquid, twice s 
day, and this increafed to two drains or more, and continued lor 
fome time. 
They have, however, been divided into faeh as are ANTA- 
CID, as 
Lime Water— 6 ounces to 16 in the day. 
Soap— 20 grains to 1-2 an ounce. 
Caustic Alkali— 
Soap Let— 
in veal broth 10 to 
drops. 
Kali with fixed air, 
in infidlon, 2 ounces to a 
quart of water—dole, 6 to 
S ounces. 
Such as have an ASTRINGENT POWER, as 
Bitters— 
Uva Ur'si, or Bear’s Wcrtle 
Berry, 
See Aftringcnts. 
Bat it has been alledged, that all alkalies in general poflefs 
this ftoae-d’flolving power, therefore in their cauftic ftate they 
are by fome rejected ; becaufe thev are a??t to difagree with the 
ftomach, and fiom thence are they obliged to be employed in too 
fatal! doles. 
As folvents, I am of opinion, little can be faid of the ufe of 
the dal's here enumerated; but as preventives, having a power 
to obviate the generation of (tony concretions in the machine, 
they may be confidered to be beneficial in two ways—in alter- 
ing the ftate of the fc-lids, by preventing a particular ftate or 
laxity of the ftomach, and in the kidney—and in producing fuch 
an effect upon the circulating fluids, that they become lets liable 
to furniill ftony materials to be fecreted by the kidneys, 
But certain objections will arife to the ufe of the antacids, if 
in the ftomach there fhould be a difpofilion prevalent to generate 
alcalefcency-—to the ajiringents, if there fttould be a rigidity, or 
contraftion in the coats of that organ. 
On vermifuges and hthontriptics we have been more con cite 
than on other parts of our fubje£i ; becaufe they each are appro- 
priated here only to the alleviation of jingle complaints fpecifi- 
ed under their refpective heads ; of which, wheu we come to 
treat hereafter, we (hall be obliged to fpeak more fully ; and 
enlarge more on the particular nature of the remedies in each 
cafe administered: at prefent it has therefore been thought fuf- 
iicient to furnilh a general idea, in order to prepare oar readers 
pioperly for more eafily underftanding what we have to deliver 
on thefe heads. 
And now we rnuft obferve ; that, notwilhftanding, in treating 
on medicines, we have enumerated a great variety, which many ON MEDICIItE. 
profeffors. have thought effeniially neceffary to be produced 
there have not been wanting fome in the medical world, wlio 
Idem to defpife all this labour, as Well as the authority ot Hip- 
po crates, Itoerhauve, and all the men of eminence,, who have been 
confide red as (billing ornaments of their profeffion ; and pub- 
licly avow, tliat a very few medicines, properly applied, will 
fcrve. every pur pole of the medical ait—and thefe aie, 
Cantharides, uftd Jal ap, 
qhielly as bliffers, Salts, 
Calomel, Opium, 
"haR-TArizED Anti- With the fife of nutritious diet1 
mony, and domeftic cordials. 
Aloes* 
Senna, 
How ever, vve cannot avoid confefling, that we think this cata- 
logue infinitely, too concife ; particularly as there are fome me- 
dicines omitted, which have furprifing effedls, for which we can- 
not fo readily account ; but whofe efficacy has been confirmed 
tip us by prabiice; and others of which, from daily experience, vve 
8.re forbid to doubt the utility. I would, therefore, in order to 
render the catalogue more complete, fubjoin the following arti- 
cles : 
<DlJ; OF CASTOR, Asa FOETID A, 
Animal Oil, Musk,' 
Oil of Amber, Camphor, 
Volatile Alkali, Ipecacuanha, 
Flowers op zinc, Iron, 
White Vitriol, Rhubarb, 
Peruvian Bark, Sabine. 
Before I quit this fubjeel, I would beg leave farther to obferve, 
tliftt though I ha\ e placed the dotes of medicines as ufually ad- 
l'ninifltered to adults ; in all adlive medicines, I fliould recom-' 
mend them to be given in fmall dofes at firff, and gradually in- 
Cjeafed, till we have arrived at the fulled that the couflitution 
■can bear with eafe, as the only mode of trying what good effedl 
may he produced by their powers : and here vve (hall often find 
a lurprifing difference in the quantity neceffary to promote the 
end defiicd—for 1 have known two grains of a very adlive me- 
dicine produce as powerful an effect on the conffituticn, as eight 
or ten would on another ; and this knowledge can only be obtain- 
ed by particular experience. Indeed, 1 have known complaints 
cured by the very fame medicine under the management of one 
j.U.adiiiioner, that had failed in the hands of another 5 which on- ON MEDICINE. 
201 
ly arofe from the different modes of management reflecting the 
quantity adminiftered. 
With regard to the forms in which medicines ought to be 
exhibited, the intent to be anfwered ihould be particularly con- 
fidered ; whether the expeditious or permanent aBion is moll eli- 
gible—if the former, they ihould be given in liquid—if the lat- 
ter, in folid forms—becaule in their diffufed date they aft moft 
quickly. 
For a very great variety become effeftual by communicating 
their power from the lftomach to the reft of the machine fympa- 
thetically ; confequently the larger furface of the ftomach they 
touch at the fame time, and ftronger their aft ion, the quicker 
and more powerful wiil be their effeft—Jn acute cafes, therefore, 
thefe purpofes will be bell anfwered in a ftate of folution : but, 
on the contrary, in chronic cafes, folid forms are preferable ; be- 
caufe they occalion medicines to aft {lowly, and, of coinfe, make 
that aftion more durable, by remaining longer on the flomach ; 
—betides, all medicines which are not eafily fufpended in any 
liquid, Ihould be adminiftered in form of bolus—pill—ele El nary 
—or powder mixed with i'yrup or fome other vifeid fubftance ;—• 
tiiofe which are volatile, very light, or readily inifcible with any 
menltruum, Ihould be given in mixture or draught. Where a 
greater proportion of any vegetable body is required than the 
ilomach can bear in powder, and where the aftive part can be 
extrafted by water, decoBion or infufion is the moft proper ;— 
and all oleaginous fubftances require the addition of fome inter- 
mediate vifeid body, to make them properly incorporate with 
watery fluids, or fyrups, and are moft elegantly adminiftered in 
form of emuljlon or linBus. 
Though fome fmall difficulty may arife to readers {lightly con- 
verfant in medical refearches, on the pernlal of this part of the 
work which treats on medicine—{till, by beftowing a little pains 
on each diviflon—from the advantage they will receive, they 
will not find their labour ill bellowed—for they will be taught 
the fimpleft, moft eafy, and certain mode of preferibing, as well 
as the moft powerful—they will alfo underftand, from the know- 
ledge of the different powers of medicine, not only where they 
are likely to be ferviceable, but where they will be of danger- 
ous confequences—a fpecies of information which every man 
ought to poffefs, who dares venture to prescribe either for him- 
felf or others:—for the fi ft law ot phyfic is, Nor TO Do harm 
in all our eff jRTS to do good ; of which no man can be 
certain without he knows precifely the aftive properties of fuch 
medicines as he adminifters ; and whether they are properly ON MEDICINE. 
adanted to the conftitution, under the circumftances of the mor- 
bid attack which he labours to remedy. 
SECTION VIII. 
On Disease in general. 
HAVING finished thofe parts of our work which were cort- 
fidered as preparatory to the more complicated, we mud 
now enter on an inquiry into the nature of difeafe3, with the 
bed modes of difeoveting and curing them.—But, previous to 
this, it will be of ufe to iay fomething general on the fubjedt, in 
order to thew what is meant by difeafe—how difeovered and 
didinguifhed—the different caufes—with the indications of 
cure. 
By Disease is meant a general or local affedtion, by which 
the iydem is didurbed, or the adhon of a part impeded, pervert- 
ed, or deitroyed—or, an appearance deviating from health, from 
fome general, partial, or local affedtion, by which the fyftem in 
general, or in a part, is oppreffed or disfigured—-and this is dif- 
eovered and dijiinguijhed by an enumeration of certain fymptoms 
or appearances with which it is always affociated.-—But difeafes 
differ ; hence it is neceflary to diftinguilh them from each other, 
with which they may feem to have a near affinity-—this is done 
by the caufes and peculiarities that are connedted to them ; and 
from whence the deviation arifes, 
The caufes of tlie difeafe are threefold : 
I. Pkedisposing—When the conditution colledtively, or in 
part, is in fuch a fituation as is mod favourable to produce dif- 
eafe : or to receive the impreffion made by its caufe immediately 
confidered ;—and thefe are either 
Inherent or hereditary, 
Adventitious or accidental. 
put into adlion, or brought about by the 
2. Remote, or inducing, which depend upon the date of 
their climate—fituation mode of life—indiferetion—or the elec- 
tive power of moibid particles, called miajmata—virus—effluvia 
—occafioning the 
3. Proximate or immediate, which are fuch as from their ON DISEASE IN GENERAL. 
203 
adion conflitute the immediate fource of difeafe—and from 
whence arife the 
Indications of Cure, which confifls in the removal of the 
operating caufes ; or the preventing the conftitution feeling too 
powerfully certain effects, till the matters occationing them 
can. be thrown out of the habit, either by the efforts of nature, 
or of art. 
But the mod eligible mode is the preventive, acquired by 
the confideration of the remote or inducing caufes, where prac- 
ticable—and hence preventing predifpohtion from being render- 
ed adive. by intercepting thefe caufes, or guarding the habit a- 
gainft their influence. 
This account, concifc as it is, comprehends the whole practi- 
cal part of medicine; from whence thou gh (hoot forth a variety 
of branches, which u>e fiiall difpofe under the following heads, 
agreeable to fuch appearances as mod ftrongly manifeft themfelves 
to our perception, whether febrile-—inflammatory-pain- 
ful—nervous—or mental—or where evacuations are con- 
trary to, or more copious than w'hat is natural, lliled fluxes— 
where difficulty of breathing is the crying fymptom, called Asth- 
matic—or where the complaint depends upon the humouta of 
the machine, or make their appearance upon the fkin. 
CHAP. I. 
Febrile Affections in general. 
A LL thofe are fo confidered where there is an alteration refped- 
ing the puife and heat ; for the moft part, an increaled 
qaicknefs of the former, and the latter augmented in fome degree; 
—many of the fun&ions of the machine injured—particulaily the 
flcength of the limbs diminiihed ; attended with chillnefs, lan- 
guor, laffitnde, and other marks of vveaknefs, without any local 
primary difeafe. 
Under this head are comprehended all the. fevers, of whatever 
nature, by which the human frame is afflicted ; bat, as they put 
on different appearances, they are divided under diftincl heads, 
according to thofe appearances, as 
1. Continued, or continent, 
2. Remittent, 
3. Intermittent, 204 
CONTINUED FEVERS. 
4. Hectic, and 
5. Eruptive. 
In which order we lhall purfue them ;—but we fhould firft. re- 
mark, that all thofe are called 
Continued Fevers, 
■where they continue from their commencement to their termi- 
nation without any intermifficn, remarkable remillions, or exa- 
cerbations, that is, increafe of violence in the fymptoms. To 
this clafs belong 
1. The fimple continued" 
2. Inflammatory 
3. Nervous 
4. Putrid 
,5. Anomalous, or mixed. 
Fever. 
Thefe fevers in general begin* with laffitude—coldnefs—fhiver- 
ing, bat without tremor or grinding of the teeth, and heavinefs 
ot tire head—then the heat increases every day till the height, 
with proftration of Orength, and a conftant delire of lying down 
—head ach—and thirll--no exacerbation1 or increafe of febrile af- 
fedbon, except from fome perceptible caufe. At the decline of 
the difeafe, there appears a moillure, fweat, or fome other eva- 
cuation. •• ,.;■■■ . • .. 
With refpcff, to fenfation, the fymptoms difcover thernfelves by 
a fenfe of wearinels all over tlie body--a heavinefs, attended with 
giddinefs of the head—head-ach—bad tails in thd mouth—often an 
imperfetl, or depraved fmell—a difficulty and tottering in motion 
—unwillirignefs to fpeak—a aefire to keep in an horizontal por- 
tion—a total want of, or fcarce any appetite—great thinl—loath- 
ing of animal food, or any lolids—a delire for watery acidulated 
cold liquids-riio laicivious inclination. 
In the coldJlate, breathing is fmall, quick, opprefled \—in the 
hot, deeper and frequent \-~iti the' cold Jlate, the pulfe is fmall, in- 
termitting, interrupted, and frequent in the hot, full and fre- 
quent in the declenfion, full and undulating. 
The faliva is fmall in quantity, clammy ;-~the mucus of the 
tongue, gums, and lips is greyilh, rather yellow, and fometimes 
black—the urine in the courfe of the difeafe becomes hotter and 
turbid—there is a moillure in the Ikin and a fweat tn the declen- 
fion of the fever— the llools are liquid, yellow, often foetid—the 
mucus of the nofe trilling; and fometimes from thence haemor- 
rhages iffuc.:. 1:. Vi. • •• • , , . 
Fevers of this kind are often ufhered in with a coldnefs of the 
extremities and palenefs of the face-very often without any 
{baking of the limbs after that there is a conftant uniform VASCULO-PLETHORIC FEVERS. 
heat, far the moil part, except that it is greater towards the 
height ; there is alio in the declenjiort a. foftaels of the fkin. 
This is the hiftory of the continued order of fevers in general, 
with fitch things as appear in the vital and animal functions with 
refpeel to fenfation, voluntary motion, appetite, refpiration, and 
the ptilfe ; and alio in the excretions and qualities of the folid 
parts. 
Now as all the fevers of this kind ha\'e a greater or fmaller 
number of thefe fymptoms attendant, under each head we mull 
enumerate fuch as will bell inform us to which it particularly 
belongs, that we may be belt enabled to make proper diftiufHons ; 
and as the iimple continued fever is the leaft complicated, we 
ihall begin with that. 
$ i. SIMPLE CONTINUED, or VASCULO-PLETHO- 
RIC, FEVER. 
Such I would name it, bccaufe an increafed adtion of the vafeu- 
lar iyftem, and fuilnefs of blood, are the io mediate caufes. 
This fever is iometimes-of very flight duration, terminating 
in one, at moll, in three or four days, and feldom requiring any 
medical afliftance. 
DESCRIPTION. It makes its attack very often fudclenly. 
There is a flight coldnefs—the whole body grows red, parti- 
cularly the face, attended with fome turgefcence, and a vapoyr- 
ous warmth. The head-ach conies on fuddenly, the temples 
throb, the breathing is frequent, the pulfe free, uninterrupted, 
quick, and full. In the decline of the difeafe, there appears a 
breathing fwear, with no remarkable change in the urine. 
CAUSES. Whatever will fupernaturally increafe the adtion 
of the vellels, and induce too great fuilnefs of blood in the habit, 
as errors in diet, too violent exercife, cold, fupprefGon of fome 
natural difcharge, retention of fome acrid matters olFenfive in the 
firil paflages, from fome external injury, happening in an health- 
ful conflitution. 
CURE. Medical aid is feldom in thefe cafes neceflary—na- 
ture moll commonly is the phyiician. Dtinking copioufly of 
watery liquids warm, fuch as tea, weak broths, lemonade, Email 
negus ; abftaining from all folid iood ; and lying in bed to encou- 
rage perfpiration, will be all that is requifire. 
Or, if medicine mufl be employed, faline mixtures, or nitrous 
powders, may be had rccourfe to. (No. i, 2.) 
But fhould the fever put on more violent appearances---fhould 
the pulfe not only be full, but rather hard, with any confidera- 
ble degree of oppreilion and heat, and the flcin/dry ; bleeding, 
according to the patient’s ftrength, to the quantity of eight, ten, SIMPLE CONTINUED, CR. 
or twelve ounces, may be advifed—and, in cafe of coftircnefs,' a j 
cooling faline purgative (No. g.) may be adminiftercd, to produce 1 
three or lour evacuations ; and in order to appeale any hurry 
which perhaps it may occasion, a quieting draught in the even- j 
ing. (No. 4, 5.) 
Suppofe thefe fhould not fucceed to our wifb, and the fymp- ! 
toms before recited increafe, the pulfe excepted with i efpedt to j 
its fullnefs and hardnefs, thefe being in fome degree abated ; and ! 
the patient has paffed a reftlefs night; we muft then fly to anti- 
monials, as the molt effe&ual in checking the violence of the fe- 
ver. The molt eligible of which are, tartarized antimony, for- 
merly called tartar emetic, or the antimonial powder of the lall 
London Difpenfatory, a medicine anfweriug every purpole of Dr» 
James’s Powder. (No. 6 to t;.) 
the liift dofe of the mixture, (No- 3.) or tbefecond, if it meets 
with any foulnefs of the itomach, generally excites vomiting, 
which fhould be encouraged by copious draughts of chamomile, 
or weak green tea, or thin gruel—-and afterwards the mixture 
continued. 
It produces alfo in general a gentle fwent, One or two eva- 
cuations by ftool, quiets the pulle, takes off the oppreffion and 
naufea ; t.iis, by its continuance, and ordering balm tea, barley- 
water, or fome fuch diluting liquor, tofbe drank plentifully, ba- 
niih, in common cafes, every complaint. 
But, notwithllanding all thefe efforts, fhould things wear a 
more unpromifing afpccf—fhould the ficknefs and oppreffion con- 
tinue ; the third, heat, and drynefs of the fkin increafe ; head- 
ach become intolerable ; the patient very reftlefs ; the pulfe keep 
rip, or increafe in fullnefs and hardnefs particularly, more blood 
muft be taken away—though, fhould there be indications of 
great debility, and the pulfe flag and grow low, it muft be avoid- 
ed—the feet may be put in warm water—and, in continuing the 
antimonials, great care muft be taken that they do not operate 
too violently upwards or downwards, for thefe would aggravate 
the fymptorns, or bring on a train of others of more lerious con- 
fequence. 
Under thefe circumftances, inftead of the faline mixture be- 
fore prefcribed, the neutral volatile faline (No. 1 o ) is more eli- 
gible, becaufe this, 1 think, determines more freely to the fkin 
■—and, trifling as the alteration may appear, I have feen changes, 
obvioufly for the better on its being adminiftered. 
Notwithflanding the above caution, if emetics have been o- 
mitted in the beginning, particularly if there has been any fick- 
nefs or naufea, they may be given at any period of the difeafe, 
if the ftrength of the patient will admit. (No, 11, 12.) VASCULO-PLETHOIltC FEVER. 
207 
Sydenham lays, “ If an) one fhould inquire at what time o£ 
“ the fever 1 would have a vomit adminiltered, I fay pofitively, 
“ at the beginning ; but {hoold we be Called in fo late, which is 
“ often the cafe, that we could not at the beginning give a vo- 
“ mit to the patient for their relief, yet certainly I thought it 
“ expedient that it might be done at any time of the fever, if 
“ the difeafe has not fo reduced the llrength, that its violence 
“ cannot be borne —1 have,” continues he, “ ordered a vomit 
“ without liefitation on the twelfth day of a fever, when all 
“ the retchings had ceafed ; nor was it unattended with advan- 
“ tage.” _ 
But, to return to our fubjert. If, by the ufe of antimonial?, 
the body fhould not be kept properly open, glyfters, (No. 25, 26.) 
fliould fupply the defert, adminiftered in the evening. 
From this treatment, a continued fever of this kind feldom 
remains longer than the fifth day ; but fhould it purfue its courfe 
to any later period, it is difficult to determine at what time it 
will ceafe. 
Here we muff, be extremely cautious in our prognoffic, both 
with refpert to its duration and danger ; for there are often in 
the conlfitution many latent mifehiefs which do notfhew them- 
felves ; or fome, which manifefl themfelves not immediately, 
'may be brought upon the internal and vital parts by the febrile 
exertions, that when we have a right to expert every favour- 
able conclufion, thefe luddenly prevent the operations of nature, 
and in an inflant overturn all our flattering profperts. 
However, if this fever goes not off on the fifth day, it feldom. 
continues longer than the fourteenth—during that fpace, we are 
then to endeavour fo to regulate the moving powers of the fo- 
lids, that they may neither art too powerfully nor too weakly— 
hence are they to be fupported in a Hate of moderation—and this 
v»e do by thin diet, fubacid drinks, fuch as the ftomach can bear 
and relifh ; as thin gruels, voatled apples, oranges, boiled tur- 
nips, and fuch like, continuing, under various forms, the ufe of 
the antimonial faline mixture. 
Betides the attention we have to pay to the fyftern in general, 
fometimes the head, ftomach, and bowels require our notice, ia 
order to alleviate the particular affections under which they la- 
bour—for the "head now and then is greatly difordered—blifters 
applied between the fhoulders, bathing and fomenting the feet 
with warm water, bring in thefe cafes relief, and diipcfe the pa- 
tient to reft. 
If fournefs fhould affert the ftomach and inteftines, creating 
pain and flatulence, we fhould unite with our mtdicines foine of 
the abforhent earths, as magnefia, chalk, hartffiorn, crabs eyes 208 
SIMPLE-CONTINUED, OR 
or claws prepared, according as the habit if. difpofed to coflive* 
nefs, or otherwiie—under the fr.tt circumdance, magnelia un- 
der the lad, prepared hart (horn claims the preference. 
In the mariner above recited Ihould we go on as occalion may 
require, till nature throws off her oppieffive load at feme of her 
accultomed periods, which will be either on the feventh, ninth, 
eleventh, or fourteenth day commonly—or, if the fever is of lon- 
ger duration, leventeenth or twentieth. After this period they 
are feldom obferved with any accuracy. 
Butfuppofe towards the clofe the flrength of the conftitution 
appears to be in a debilitated Hate, the pulfc begins to fink, and 
the machine requires feme dimulus, in order to roufe it to, and 
preferve its a£lion—here we mult have recourfe to fuch appli- 
cations as will invigorate the fyltem ; our former drinks and 
medicines mud be altered ; we muff now give wine and water, 
white wine whey, or pure wine—or, if medicines are prefer- 
ed, cordial, camphorated and dimulant medicines (No. t3 to :8.) 
But wine will belt anfwer the purpofes we require, as it is 
confidered to be the molt grateful cordial with which we are 
acquainted. 
However, if any others are thought more eligible than what 
we have fele&ed, the clais of ftimulants will fupply a fatisfadlory 
variety. 
Before we clofe it will be neceffary to obferve, that much cau- 
tion is neceffary in pronouncing the appioach of a crilis, or ter- 
mination, or its perfeft completion—for it fometimes begins and 
recede0. 
On this occafion we fhould take the fymptoms collectively; 
and, if they all appear favourable, wait for their contini ance ; 
for they will begin on one critical day, and not be complete till 
the next. If, therefore, the pulfe becomes foft and full, and 
l'ublides daily, foinething below a healthful ftandard—the urine 
depolits a fediment to the bottom of the glafs, or, on lhaking, 
it l'ublides— the Ikin becomes foft, and a general fweat fucceeds 
—if the patient’s fenfes return after having flept, we may ven- 
ture to pronounce boldly. 
After matters are brought to this plealing conclufion a dofe or 
two of phylic may be exhibited. (No. 19, 20, 21.) 
The patient Ihould return gradually to his accudomed courfe 
of life, led he ihould, by throwing food into the habit in too 
large quantities, opprefs the digedive powers, which, with the 
red of the body, mult be in a date of too great debility to per- 
form their functions vigoroudy. His, diet, therefore, Iliould 
not only be fmaii in quantity, but of the lighted fort; becaufe, 
from vifeid food, the machine would labour under the fame in- INFLAMMATORY FEVER. 
209 
conveniences as above fpeeified—he ffiould eat often, but fpar- 
ingly, take frefh air, anduie moderate exercife, fuch as his ftrength. 
wiii admit, but never purfue it to fatigue himfelf. Under fuch 
prudent management, his fpirits and vigour will return rapidly ; 
and he will every day perceive himfelf making large ftrides to- 
wards liis ufual ftate of health. 
§ 2. INFLAMMATORY, or VASCULO-SANGUINEOUS 
INFLAMMATORY FEVER. 
Becaufe not only the fame circumftances occur as in the former 
fever, with regard to the increased action of the vafcular lyftem, 
and fultnels of blood—but the vefifels have acquired a fuperna- 
tural firmnels, and the blood too great tenacity, by which I un- 
derfland an in inflammatory dil’pofition. 
DESCRIP riON. The patients at fir ft feel as if they were 
wearied and had been beaten ; are apparently weak, and have 
cold and hot fits alternating with each ether ; they tremble, and 
feel pains all over them, particularly iti the fhoulders, back, 
knees, aud head : to thefe fucceed an intenfe and burning heat, 
unextinguifhable thirft ; their eyes appear inflamed, with a red- 
nefs and fullnefs of the face ; they are fick and vomit ; are alfo 
reftlefs and uneafy ; the pulfe is full and ftrong ; the fkin dry ; 
the urine for the molt part high coloured, but fometimes like 
water ; the tongue rough, dry, brown or black, and furred; 
blood drawn 13 very tenacious, and, on handing, covered with a 
coriaceous fubftance like buff-leather ; they breathe with diffi- 
culty ; the body is coftive ; they fometimes cough ; are very 
watchful and delirious ; a ftupor and drowfinefs come on ; at 
laft tremblings, twitching of the tendons, hiccough, and an invo- 
luntary emiffion of faeces and urine clofe the fatal feene. With 
regard to the heat, it is of a particular kind, which, though it 
affects the touch very fenfibly at firft, yet feems to grow lefs 
violent the longer we hold the hand upon the fkin of the pati- 
ent. 
As to the pulfe, its hardnefs, ftrength, and fullnefs, are in 
greater degrees than are to be met with in any other fpecies of 
fever. 
And the urine is not only high coloured, but fharp, and in 
fmall quantities. 
CAUSES. Thofe which arc called the remote or inducing, 
are faid to be, perfpiration obftruded ; fudden cold; too much 
expofure to the ftrong heat of the fun ; fatigue ; anger; hard 
drinking ; too long watching ; cold water drank whilft the ma- 
chine is hot ; or, in fine, whatever can put the veffel into too 
ftrong and quick adien, and for fome time continue it. 210 
VASCULO-SANGUINEOUS 
The proximate or immediate, acrid and tenacious blood ob» 
flru&ing the very minute, ferous, and fanguinary veffels in dif- 
ferent places and increafed firength and activity of the vafcular 
fyftem, which the remote caufes are concluded to confirm, as 
well as the appearances of blood taken away—the fymptoms—- 
mode of cure—and the infpe&ion of dead bodies on diffeftion—- 
for in them the vifcera are found in a itate of inflammation and 
mortification. 
Young people in the vigour of life, ruftics, fanguineous habits, 
free luxurious livers, and all thofe poffeffed of llrong ftamina and 
tenacity of the circulating fluids, are molt prone to fall into this 
fever. 
CHARACTERISTIC SIGNS. This fever generally at- 
tacks thofe who are formed with flrong vigorous ftamina and 
denfe blood :—it is concifely defined, a great increafe of natural 
heat, a frequent, ltrong, hard pulfe, high-coloured urine, fome- 
times watery, and the functions of the fenforium a little difturb- 
ed. 
CURE. This is performed by weakening the firength rnd 
activity of the vafcular fyftem, leffening the violence of their 
a£tion, and thinning the blood. 
If we wrerc to remove the irritating caufefoon after it had ex- 
erted its action, there is no doubt but every good consequence 
would accrue; but that we cannot do in all cafes, particularly 
vvhen morbid particles have got fo blended with the juices, that 
fome time is required before they can be properly prepared for 
being thrown out of the body ;—or, after the increafed a&ion 
had continued fo long, that it had by its effects contaminated the 
fluids ; wre therefore endeavour to put the frame in fuch a fitua- 
tion, that no violent mifehief (hall be created by the progrefs of 
the difeafe ; and thus give nature an opportunity of exerting her 
falutary efforts with effe£l, and enable her to throw out the of- 
fenfive materials from the mafs of fluids. 
For which purpofe, if called in in the early ftage, we depend 
upon bleeding copioufly, and repeat it agreeable to the patient’s 
firength, until the pulfe is reduced to its proper ftandard—nor 
mult we be deceived by the apparent oppreflion of the pulie, for 
by bleeding it becomes ftronger—indeed apparent weaknefs and 
lofs of ftrength proceed fometimes from too great fullneis ; lo 
that the volume of fluids feems too powerful for vafcular action $ 
and unlefs this oppreflion is taken off, which bleeding mod rea- 
dily accompliflies, we Ihould run the rifque of their total cefia- 
tion. Indeed, fo neceffary is this operation at the onfet of thefe 
fevers, that if it is omitted, the negle£t can feldom be recovered 
during the whole coutfe. 
It is aioft proper before the fourth or fifth day, but, under INFLAMMATORY FEVER. 
211 
fome circumftances, it may be performed at a later period—in 
difficult and opprefled breathing—violent pain of the head, with 
high delirium, fucceeded by drowfinefs, in full and ftrong habits 
—for thefe fymptoms indicate an inflammation of the lungs, or a 
fuperabundant load of blood in the brain. 
Notwithftanding it may be right in any ftage of the difeafe, it 
is only to be advifed with extreme caution ; for if this operation 
is carried to excefs, fo as greatly to weaken the patient, nature 
may be difqualified for throwing off the morbid matter at the 
time when the crifis ffiould corpe on ; which matter is moft na- 
turally carried out of the body, either by difcharges from the 
inteftines, kidneys, or the pores of the Ikin. 
With refpect to the neceffity of repeating the bleeding, we are 
to be directed by the urgency and continuance of the fymptoms : 
therefore after the firft bleeding in fix or eight hours, if the pulfe 
ffiould be nearly, or equally as hard and quick as before, and the 
other febrile fymptoms fimilar, it may be repeated, though in 
fmaller quantity, and even a third or fourth time, or more, un- 
der fimilar circumftances, may be necefiary. 
We are next to advert to the ftate of the ftomach and bowels : 
-—if there ffiould be any oppreffion, naufea, ficknefs, flatulence, 
or weight at the pit of the ftomach, or fullnefs there—ffiould the 
body be coftive, we ffiould attempt immediately to clear them of 
their contents by emetics, (J$o. n.) and gentle purgatives. (No. 
3. 22 to 24.) 
But ffiould there be gny inflammation of the ftomach or intef- 
tines, vomits muft be by all means avoided, as they might be fuc- 
ceeded by the. moft fatal confequences. 
But ffiould not any of the above fymptoms occur, we muff 
then endeavour only to take off the fpafmodic affections of the 
fkin, and promote perfpiration, by creating gentle vomiting or 
naufea, by administering flight doles of antimonials alone, or 
mixed with faline mixture. (No. 6, 7, 8, 9.) Warm watery li- 
quids ffiould be drank copioufly, the legs and thighs fomented 
with flannels wrung out of warm water, or the fame liquid 
thrown in by way of glyfter ; for theie are highly beneficial in 
thinning the blood, and relaxing the too tenfe fibres. And here 
we muft olfferve, that bleeding, where necefiary, ffiould always 
be performed before we exhibit a vomit, in order to take off the 
general fullnefs of the habit, and prevent any congeition or ob- 
Itruftions taking place by its operation in the brain, 
In cafe of coftivenefs, we ffiould add fmall dofes of tartarized 
or vitriolated kali, tartarized natron to the antimonials, (No. 6, 
7, 8, 9,) caffia draught, cryftals of tartar whey, or iniulioncf ta- 
marinds may be adminiftered. (No, 22, 23, 24.) 212 
VASCULO-S ANGUINEOUS 
We mud next endeavour to allay the heat by vegetable acids 
mixed with fmall portions of nitre ; and depend on fuch things 
as are cooling, diluent, and aperient; and correftors of any acri- 
mony which may keep up the irritation—hence all animal fub- 
ftances are to be reje&ed, becaufe they are apt to become too lli- 
mulant and heating—and for the fupport and affiftance of nature, 
we mull depend upon bar'ley water—lemonade—apple-water—in- 
fujtoti of wood forrel—currant jelly mixed with water—very weak 
white wine whey mixed mith Seltzer water—in any of which may 
be diffolved fmall portions of nitre, fo that four or five grains 
may be taken at a time ; or the aethereal fpirit of nitre, ten or 
fifteen drops for a dofe—or, the Hydromel of Hippocrates, (fee 
page 178.) omitting the mace ; for thefe are diluent, affift in 
quenching thirft, preventing the blood from becoming too acrimo- 
nious, help to diffolve its tenacity, confequently weaken the force 
of the vafcular fyftem, abate the power of the circulation, take 
off fpafmodic conftri&ion, and promote perfpiration ;—and thefe 
liqu ids may be varied according to the pleafure of the patient. 
Abftinence, as long as the ftrength will permit, fhould be acl- 
vifed ; but if that becomes defective, it fhould be fupported on- 
ly by the moft light liquid food. If folids be required, which 
is feldom the cafe, not any thing fhould be allowed except thin 
panada—water or barley-gruel—roafled apple, or boiled turnip. 
Thy I weet acefeent fruits, when fully ripe, may be taken freely; 
for, as they abound with watery particles, are alio diluting ; and 
as thofe of the vegetable clafs afford lefs nutrition, confequently 
are lefs llimulant than fuch other things as approach nearer to 
animal nature. 
So long as the fymptoms continue flrong, we muft chiefly ad- 
here to the faline medicines—antimonials and nitrous powders, 
(No. 1, 2. 6, 7, 8, 9.) giving the nitre as freely as the flomach 
will bear it, and varying the form as may be judged convenient; 
for thefe medicines are thought to correfl acrimony, take off vaf- 
cular conftri£tion, and promote perfpiration. 
The room in which the patient lies fhould be fpacious, and, 
well ventilated with cool freftx air, impregnated with vinegar, 
{he effluvia of frefh flowers, and a free circulation conflantly per- 
mitted ; taking care fo to difpofe the patient, that ftrong cur- 
rents may be avoided. 
The bed-cloaths fhould only, as in health, be moderate, the 
curtains not clofe drawn ; and, in fine, every thing heating, and 
which can increafe the force and quicknefs of the pulfe, mufl be 
prohibited. 
The patient fhould now and then be got up, he will be render- 
ed lefs refllefs, preferve his ftrength more, and not fo fubjed to INFLAMMATORY FEVER. 
213 
increafe of head-ach and delirium ; for, by fitting up in an ere£t 
pofture, the blood will circulate with lefs force towards the brain, 
than in an horizontal fituation; and obftru&ions will not be fo 
JiabJe to be formed there, nor will the brain be fo likely to fuffer 
depreffion from a load of fluids. 
After proper evacuations having been premifed, fome advife 
the application of blitters ; becaul'e, they diffolve the vifeid 
blood, open internal obftructions, and foften the pulfe. 
Others are of opinion, that they never can be right though a 
delirium Jhould come on, if the pulfe keeps full, hard, and quick; 
but think the head is better relieved by bathing the feet in warm 
water, or applying cloths fqueezed out of it to them, and the in- 
dide of the thigh juft above the knee—for the nervous fyftem 
muft be difturbed and agitated too freely where the heat conti- 
nues great, the ikin dry, with the pulfe as reprefented—hence blif- 
ters, while fuch fymptoms appear, and the fibres are too tenfe, 
■will increafe the mifehief, from the additional ftimulus they oc- 
cafion. 
In delicate conftitutiong,’ where there is great pronenefs 
to nervous incitability, and mufcular irritability rather de- 
fe£tive, blifters may be ufeful, by regulating the motion of 
the nervous power, and not being capable of producing any great 
effedt on the mufcular fibres—but, in ftrong athletic habits, I 
fhould think the practice dangerous; but yet, where the pulfe 
in any conftitution grows foft, and begins to flag, either from e- 
vacuations, or weaknefs of the fyftem, brought on in the courfe 
of the fever, particularly if attended with drowfinefs, or difpojition 
to conftant /lumbering, towards the height or turn of the fever, at 
that time they will be found extremely beneficial—by roufing 
the nervous fyftem, and affifting nature in producing a reparation 
and ejedlion of the morbid caufe. 
Should what we have before advifed prove ineffedtual in pre- 
venting coflivenefs, as more powerful purgatives would be apt 
to raife too great a commotion, and impede nature in her faluta- 
tary efforts, we muft have recourfe to glyfters. (No. 25, 26.) 
Towards the evening, in almoft all acute complaints, every 
fymptom increales much with refpedl to violence, and towards 
the morning abates; but when the turn of the fever is at hand, 
the violence continues more uniform throughout, nature appear- 
ing to exert her utmoft efforts to conquer the difeafe, by throw- 
ing off the offending matter—hence the agitation of the whole 
machine is extremely fevere. 
If now the fkin grows foft and moift, the tongue lofes its dry- 
nefs, the urine begins to depofit a whitifli fediment, and becomes 
lefs high coloured, and foon after a more profufe fweat breaks VASCULO-SANGUINEOUS 
214 
out, the other fymptoms abating of their violence, we may ex- 
pe£t a happy termination, fliould thefe occur upon a critical day, 
particularly if a found deep comes on, followed by refrefhment, 
lofs of thirft, the tongue clearing away its foulnpfs, and the head 
alleviated from its pain and uneafinefs. 
From thefe appearances we may conclude a crifis is begun ; 
and in its progrefs, if the pulfe grow gradually flower, falling 
fome llrokes in a minute below its healthful ltandard, we may 
be allured that things have taken a favourable turn, and that the 
patient is fecure from danger. 
But during this contefj: in the critical period, which will be 
for fome days from the beginning to its termination, cordials 
may be thought ueceflary, the bell of which is wine, given alone 
or in whey. If medicines to anfwer the purpofe are thought 
more agreeable, to what we have delivered from No. 13 to 18, 
may be added other cordials. 
But if 1 find nature in her critical intention points more to the 
kidneys than to the Ikin, I prefer joining the cordials to the fo- 
lution of prepared kali and lemon juice, (No. i.) if to the Ikin, 
to that of prepared ammonia. (No. 27.) 
But fometimes, from all our efforts, we are not even flattered 
with a favourable iffue—however we mull not defpair—nature 
often relieves herfelf at the moment we leaf! expeCt it. 
Therefore, when the conflitution feems drooping, and nature 
.appears almolt exhaulted, when general tremors come on, twitch- 
ing of the tendons, delirium, and the patient parts with both 
faeces and urine involuntarily—which appearances are always 
confidered to be the refult of llrong nervous affections, giving 
the difeafe the molt unhappy afpeCt—in this deplorable ffate we 
depend upon the repetition of blifters, applied in the following 
fucceffion : ill, to the back—2d, under the arms—3d, above the 
.wrifts—4th, above the knees on theinfide of the thighs—and, 5th, 
upon the head, if violent pain and much dilturbance there, points 
.out the rectitude of fuch au application—and likewife muftard 
poultices, called finapifms, to the feet, (Np. 30.) and give vola- 
tile falts—camphor—mulk, (No. 31 to 35.) in order to allay 
fome of thofe convulfive affections which prefent themfelves at 
this period-—for which mulk mixed with valerian is efteeined 
highly ufeful. 
In cafes of extreme languor, fnake-root is a very valuable 
medicine, which may be given in infufion or powder. (No. 36, 
37-) 
As nature, under the violence of thefe oppreffions, being re- 
lieved in one point, may have power probably to exert herfelf 
mors generally from fuch relief, a vapor bath, as it can be INFLAMMATORY FEVER. 
215 
applied in a bed-chamber, and has in dangerous cafes been known 
to fcceedt>may be tried, as it feems calculated to take off, by its 
relaxing power, fpafmodic conllriClion. 
Sometimes in this difeafe, at an early period, people will be 
much affliCled with the head-ach, delirium, watching, or drow- 
linefs, bleeding at the temples with leeches—applying bliliers 
there—having the head lhaved and rubbed with vinegar—or 
portions of the lungs of a lamb applied warm to the head — 
bliftering and fomenting the legs, and applying milliard poul- 
tices to the foies of the feet, are ufeful auxliaries to the general 
mode cf cure above fpecified—as is alfo bliftering the head :— 
or fhould they have any pains fimilar to thofe of pleuritic people, 
applying a blifter over the part affeCled is beneficial. 
Sometimes rheumatic affections will be a concomitant—in this 
cafe, large dofes of nitre will be ufeful—and fhould any dyfen- 
teric appearances, fuch as uneafy pains in the bowels, propen- 
ficy to go to ltool, without producing any evacuation ; a grain 
or two of ipecacuanha, given now and then* may aCl as gentle 
aperient, foiicit the difeharge of the irritating matter, and carry 
it out of the bowels. To me it obvioufly appears, that thefe 
applications are only to alleviate the fymptoms arifing from the 
local affeCtion of a part, from a more general eaufe j whilfl, at 
the fame time, we mull perfift in the general mode of cure ;— 
why we endeavour at their particular alleviation, is to prevent 
nature from being dilturbed in her operations by thefe diftreff- 
lng or anamalous fymptoms ; as by inattention to them the dan- 
ger might be increafed, and the malady prolonged ; for thefe 
fymptoms, for the moll part, are fubdned by time alone, and the 
fever being kept within proper limits. 
§ 3. NERVOUS FEVER. 
This is fo named becaufe the nervous fyjlem appears to he the 
part mod affeCled. It differs from the inflammatory fever in 
the part of the conftitution attacked, and occurs in fuch as are 
diffimilar. Here the nervous fyflem is defective, attended with, 
little or no interifenefs of vafcular motion ; blood alfo poor and 
thin, and the nerves extremely incitable. This is alfo called th* 
flow fever, becaufe it is flow in its progrefs compared with other 
fevers, paticularly the foregoing. 
DESCRIPTION. This fever makes its attack with dejec- 
tion of fpirits-lofs of appetite-oppreflion--difturbed lleep, or reft- 
leffnefs-the patient often fighs and groans involuntarily—is fre- 
quently terrified, and affeCled with uncommon laffitude after ex- 
ercife, tho’ that fliould be flight, and at the fame time has cold 
and hot fits fucceed, and alternate with each other—he is troubled NERVOUS FEVER, 
with naufea, and a vomiting of infipid phlegm, which come on 
in a few days after the attack, with giddinefs and pain of the 
head—extreme proftration of ftrength—no remarkable heat--no 
tliirft--the pulfe is frequent, weak, and fometimes intermits—the 
tongue continues moilt, white, and is covered over with a vifcid 
mucus—there is an oppreffion at the pit of the ftomach, and the 
breathing difficult--the urine is pale, watery, and fometimes like 
milk whey—the face red, and flufhes, at the fame time that the feet 
are cold--the mind is flightly dilturbed by ridiculous imagina- 
tions, which continues, but without any violent delirium -fome- 
times immoderate fweats break out, or colliquative, diffolving 
loofenefs comes on-the fenfes lofe their quicknefs, and become 
dull and heavy-with anxiely and fainting attending.- 
towards the dole, when nature appears almoll worn out by 
the continuance of the difeafe ; the tongue trembles--the extre- 
mities grow cold--the nails livid--they lofe the power of fight and 
hearing—the delirium is converted into flupor, and a lethargic dif- 
pofition--the fasces and urine pafs away involuntarily—twitching 
of the tendons comes on—and generally convulfions ciofe the feene, 
in death. 
CAUSES. The remote or inducing caufes are faid to be re- 
laxed fibres, and a weak nervous fyltem—too powerful evacua- 
tions—falivations from taking mercury too frequently repeated 
—immoderate veriery—mental affliflion—watching, and no&ur- 
nal fludy—moift and ftagnant air of fubterraneous jails and con- 
fined place's; a crude and too thin diet, particularly of cold and 
watery fruit—watery and vifeid drinks—rainy feafons—a moitt 
and loft winter—and, in fine, all thole things which by flow de- 
grees debilitate the nervous fyllem. 
The proximate or immediate, great apparent incitabiiity in the 
nervous fyltem—a lentor, and vifeidity of the ferum, lymph—and 
thin humours with acrimony from contagion or obltruftion—and 
a torpor, or defeat of intenfenefs of motion in the vafcular iyltem ; 
which are obvious from the blood taken away—phlegm thrown 
up from the Itomach—and appearances agreeing with difeafes a- 
rifing from corrupted and contaminated ferum. Hence it is fup- 
pofed to exert its influence upon the molt minute, ferons, lym- 
phatic, and nervous vefiels ; but rather upon the whole brain, as 
the pale wan colour, palenefs and drynefs of ulcers, a deprivation 
of the fenfes, extreme debility, and fuppurations in the brain up- 
on difie£tion. point out. 
CHARACTERISTIC SIGNS. In defining this difeafe, ! 
fhonld fay, it was an affeftion of the nervous fyftem, in whicl| 
there was apparent incitabiiity, with a thicknefs of the ferurr 
lymph, and thin humours—a torpor, or defeat of intenfenefs c: NERVOUS FEVER. 
motion in the vafcular fyflem, independent of nervous incitabi- 
lity, difcoverable by flight chills—fhivering—and uncertain fluih- 
ings of heat—finking and dejedbion of Spirits—frequent involun- 
tary fighing—general weakneis- quick irregular pulfe—pale co- 
loured urine—remarkable propsnllty to fpafmodir affetfions—no 
diftrefling thirft-.fometimes retching, though nothing but litnple 
phlegm evacuated. 
CURE. As affections of this kind will arife from different 
kinds of foulnefs in the firft paflliges, if we are called in early, 
its progrefs is eafijy prevented, by gentle emetic, (No. 11, 12.) 
and imall dofes of rhubarb, manna, caitor oil, and fome fuch gen- 
tle aperients, (fee Emollient, and aftringent Aperients, under 
Cathartics, page, 172.)—but if in too advanced a date, when the 
fever is completely formed, which is almoft aUvays the cafe, it 
will purfue its courfe in fpite of all our endeavours. 
The indications of cure, are to guard the habit fo far, that the 
vvorlt effects may be prevented ; and, as in inflammatory fevers, 
we endeavour to w'eaken the lyflem, we mull in this attempt to 
invigorate the conllitution, and iupport it by mild and proper 
cordial ftimulants, not given at full of too powerful a na- 
ture. 
Bleeding, apt to be applied on flight occafions, is here almoft 
always injurious, no difeafe bearing that operation fo badly. At 
the attack, we fhould wait for nature pointing out the precife 
dilpofition of the malady. Sometimes, indeed, in fome epide- 
mic conllitutions of the air, when at the commencement it attacks 
habits which are full of blood, putting on the appearance of in- 
flammatory affettion, a few ounces may be taken away, but not 
repeated. 
Where there feems to be a determination of blood to the head, 
difovered by pain, heavinefs, and giddinefs there, as fometimes 
happens, leeches may be applied to the temples ; or cupping at 
the back part of the head rnay be bad recourfe to ; but not on 
trivial occafions. 
There are fome fymptoms which fhevv themfelves, fuch as dif- 
ficult and opprefl'ed breathing, and are called peripneumonic ; but 
thele arife not from an inflammatory caufe ; as the breath is nor 
hot, nor is there any cough, nor different degrees of pain ; but 
the pulle is frnall and contracted, and the extremities cold—thefe 
fliew the affeflions to be nervous, not vafcular ;—bleeding would 
therefore be highly injurious. From their local, as well as general 
effects, mild emetics are certainly ufeful, from unloading the 
ftomach of any vifeid materials, and giving an opportunity for 
medicines to communicate their effeCts to the habit and nervous 
fyllem more freely, by having the internal coat of that organ NERVOUS FEVER. 
more openly expofed to their adtion—and here ipecacuanha is prei 
feiable to tartarized antimony, as it weakens lefs the influence 
of the nervous fyftem. (No. 38.) 
The body ihould be kept open by gentle aperients (172) only, 
as common purges at the ontet have produced finking of the fpi- 
lits, faintings, and other diftrefling i'ymptoms—or domeftic glyf- 
lters, (No. 25.) may be adminiftered, in cafe of coltivenefs, eve- 
ry fecond or thiid day. 
Blifters applied through the whole courfe of the difeafe, fuc- 
ceeding one another, with moderately cordial and diaphoretic 
medicines, (No. 27 to 29.) and a well-regulated diet, are what 
mutt be chiefly depended upon ; for thefe difiblve the vifcidity 
of the ferum, invigorate the fyftem, and render the nerves more 
uniform aud powerful ini their adlion—hence promote irifenfible 
perfpiration, or a gentle moiiture on the furface of the body ; 
but they Ihould not be puflied fo fat as to induce profuf* fweat- 
ing, for a continued fweat exsfperates thfe fever. 
To the diet we fhould be particularly attentive, in order to 
fupport the ftrength of the patient ; for thefe fevers are apt to 
be of long duration ; and this fhould be of the ftimulant, cordial, 
and nutritious kind—of which the fick fhould be folicited, to 
take frequently in moderate quantity. 
White wine whey, thin gruel with wine in it, may be ufed 
freely, or wine and water—and particularly towards the termi- 
nation, chicken broth, beef-tea, thin jellies of hartfhorn, fago, 
and panada with wine. Indeed wine alone may be liberally ad- 
miniltered, efpecially if the pulfe grows fofi upon its ufe, if 
there fhould be lownefs, with a foftnefs of the pulfe, and a low 
tlrowfy delirium ; for under thefe circumftances it produces fleep. 
I have known patients, particularly one lady, take three pints in 
24 hours with advantage; but it has been affirmed, fome quafts 
haV’e been given in the fame fpace of time. 
All the liquids, if defired, may be drank cold, as they are 
only necefiary to be prohibited in Cafes of local inflamma- 
tion. 
There is little doubt but a judicious and well-regulated diet, 
with the ufe of blifters, well-timed and well-applied, will per- 
form a cure—taking care to keep the patient as quiet as poffible 
both in body and mind— He ihould be kept only of a moderate 
warmth, neither expofed to too great heat or cold; and his fpi- 
lits exhilirated- as much as poffible, by confolatovy conveifation 
of bis medical attendants, and certain promifes ot recovery, diffi- 
pating all gloomy or unpleafnnt ideas. 
With regard to the application of blifters, fo great appears ta 
•e their ufe, that fome neceffary rule's fhould be pointed out.— NERVOUS FEVER. 
219 
They fhould certainly, in order to reap the gteateft benefit, be 
applied at firft, as foon as we know the precife nature of the ma- 
lady ; but if negle&ed till the fyftem manifefts high degrees of 
incitability, difcqverable from acutenefs of fight, touch, and hear- 
ing ; they mull be omitted till fome degree of infenfibility makes 
its approach—for, in thefirjl injlance, they may prevent the ac- 
ceffion, or alleviate the violence of the fymptoms— in the feccnd, 
they would increafe them before the period Hated. 
As the blillers are only applied to promote ftiipnlus; not any 
evacuation, beeaufe that would tend to debilitate the fyftem, and 
be of dilTervice ; therefore, ag foon as the blifter is fully raifed, 
it fhould be cut, the aqueous fluid let out, and nothing applied 
to the part to increafe the difeharge. In the firft in fiance, fome 
have advifed them to be put upon the legs ; but, in cafe ofdrow- 
finefs and ftupor, upon the head, and itnapifms to the feet; 
to which fhould the laft give too great pain, they may be chang- 
ed for poultices of milk and bread. 
In order to relieve the peripneumonic fymptoms, (217) biif- 
ters to the arms, thighs, or'legs are proper, with gentle cordial 
medicines, (No. 13 to 15.) with the addition of acetate'd ammo- 
nia, or the cordial faline draught, (No. 27.) may be adminiftered, 
cordial mixtures, or julep occafionally, (No. 13, to 15. 2b, 2y.j 
or fal volatile, from .20 to 40 drops in mullard whey. 
After the continuation of this fever for ten or twelve days, or 
longer, fhould a remiffion come on ; that is, fhould it at times 
appear to abate much of its violence, and then come on again— 
or fhould fweats too pouch exhauft the patient, Peruvian bark, 
adminiftered with cordials, is highly proper, in fuch forms as the 
ftomach will beft bear, either infufed in wine, in decotlion, oc 
infufed only in hot or cold water, (No. 39 to 49.)—though the 
fird form is efteemed the beft, fometimes it is more agreeable 
to the ftomach in fome other mode. 
In the decleniion of this fever, where the remiflion or in- 
termiffion was very diftinft, Huxham gave the bark con- 
jundively with the faline draught, and found it more efficaci- 
ous. 
Bark’alfo tends.to prevent or check mortifications, which 
fometimes come on from preflure by long lying, blillers, or fi- 
napifms. 
in cafes of tremblings, twitching of the tendons, and convul- 
fions, mufle, in dofes, according to the violence of the fymptoms, 
and mixing it with valerian, as adding to its efficacy, (No. 31 to 
33.) are beneficial. 
In cafes of loofenefs during the courfe of the complaint, if 
moderate, they may not be dangerous j llill if profufe, they 220 
NERVOUS FEVER. 
lliould be checked, though not entirely hopped—they may be 
moderated by flight doles of rhubarb aild opiates, or abforbeut 
or ftringent juleps. (No. 42, 43 ) The white deco&ion and red 
wine will be a proper drink. 
Or, we may endeavour to promote gentle fweat, in order to 
divert the fluids to the fkin, by mild opiates, as camphorated 
tincture of opium, from twenty to forty drops, or the opiated 
confection, from one fcruple to half a dram to a dole, may be 
added to any of the cordial mixtures, (No. 13 to 13. 2b, 29.) 
and given as direded in the ablorbent juleps. 
And, laftly, if aphthae, or thrulh, fhould come on, attended 
with ulcerations of the throat, here detergent gargles are ufetul, 
(No. 44 to 47.) and gentle emetics, (No. 11, 12. 38.) But if fwal- 
nearly obftru&ed by a quantity of vifeid phJegm, 
ftronger may be admini-flered, which will be formed by increaf- 
ing the dofe of ipecacuanha, or tartarized antimony in each. 
1 hough, fhould a falivation come on without aphthae, and 
j;hat pretty freely, Dr. Huxham conflders it, as it really is, a 
favourable fign—for, fays he, f‘ when this happens, with a kind- 
“ ly moiflure of the fkin, 1 never defpair of my patient, how- 
“ ever weak or ilupid he may feem.” 
As there fee ms to be fo much danger in this fever, from the 
very beginning to the termination, it may afford lome benefit to 
be acquainted with th-ofe fymptoms which may give us flatter- 
ing hopes ; and to know thofe from whofe appearance W'e may 
be enabled to prepare ourfelves for the fatal cataftrophe. 
It the delirium fhould be flight, no great debility—if the pulfe 
fhould, upon the adfnmiltration of cordials, become more full ; 
and about the termination of the difeafe, a gentle fweat or loofe- 
nefs, but particularly a falivation without aphthae, come on—if 
any tumors appear about the ears—and a miliary eruption fhews 
itfelf, without any profufe fweat having preceded, w?e may have 
reafon to expert a favourable conclujion—but if a ltrong delirium 
fhould continue above four days—if there fhould be copious eva- 
cuations—a profufe unfeafonable fweat from the cheit, head, and 
lieck—the feet and legs only more drv and cold—twitching of 
the tendons—trembling of the hands and tongue—a colliquative 
or diilolving loofenefs—w'ith a weak pulfe—lofs of light—and 
impeded deglutition, accompanied with an hiccough.—fhould the 
bands grow cold—-the fauces livid—blood flow from the veflels 
-—and fpots like flea-bites appear—there can remain little hope 
ef efcaping the moft fatal confequences. 
With refpeft to a deafnefs coming on, it has been confidered 
by fome as a favourable omen, by others the reverie ; at bell it 
jls but of dubious import, and not to be depended upon j for from PUTRID FEVER. 
221 
experience I can fpeak, that I have feen it an attendant fynip- 
tom on both death and a recovery. 
§. 4. PUTRID, or SANGUINEO-PUTRESCENT FE- 
VER. 
Which term I think applicable, becaufe the mafs of blood 
appears to be materially and principally concerned in this fever 
—for in thofe of which we have before treated, the chief dis- 
turbance has been created primarily in the vafcular and nervous 
lyftem. 
But it may be afked, how comes it that this fever Sometimes 
begins its attack with flrong Symptoms of an inflammatory, at 
others of a nervous, fever ? This variation happens mod likely 
in its different degrees, adequate to the firmer or loofer cohefion 
of the particles of blood. 
For if putrid matter w;as to be generated in, or abforbed into 
the habit, whofe blood was of a firm texture, and vafcular fyf- 
tem had proper tenfion, it would be longer before indications of 
abfolute putridity having taken place in that conflitution would 
prefent themfelves, than if the nervous l’yftem had been in a 
Rate of relaxation, and the blood thin and poor. There can be 
little doubt of this fact-—and that this deviation is owing entire- 
ly to the nature of one conflitution being able to refill the ef- 
fects of the putrid caufe longer than the other. And, indeed, if 
we confider that thofe whom experience has pointed out to us 
moft Subject to this difeafe are, the infirm ; fuch as labour Severe- 
ly, and live in a ftate of poverty ; the luxurious and indolent ; 
the penfive and melancholic ; thofe who fit up late ; thofe of cold 
phlegmatic conflitutions ; wje fhall need little other confirmation 
of our afl'ertion. 
DESCRIPTION. Here we fhall enumerate the general cata- 
logue of Symptoms, and then Specify fuch as befpeak its com- 
mencement j in order, as early as we can, to be enabled to dif- 
tinguilh this fever from the two foregoing, as fuccefs greatly de- 
pends upon this knowledge ; they requiring effential deviations 
in fome refpecls in our modes of cure---for the accomplilning 
of which much depends on the method of treatment at tfie on- 
fet. 
In this fever the heat of the body is intenfe, remittent, and 
gives a Smarting fenfation to the fingers of thofe who apply the 
hand to the {kin of the fick, though at firfl not fo great as in in- 
flammatory fevers, Hill d-aily increafing—the pulfe intenfe, Small, 
and unequal—there is a pulfution of the arteries, which run up 
into the head through the neck into the brain, and thofe of the 222 
PUTRID FEVER. 
temples—extreme vccc.knefs and projlration ofjlrength, and that 
very often fudden—the patients are dejeEiecl, and forebode the 
xvorfl conferences—they are oppreffed with naufea, and vomiting 
of dark-coloured bil e---pain of the head and temples— have their 
eyes inflamed, full, heavy,—and a fixed pain, often fevere, over 
both eye-brows and at the bottom of the focket, or orbit--their 
complexion of a dingy hue—-a ringing in the ears—their breathing 
is difficult, interrupted by fighing—-and the breath ftroug, or foe- 
tid—they are troubled with pains in the flomach, bach, and limbs-- 
they lie down with uneafineis—tremble—are delirious—the 
tongue at firft is white, afterwards black and dry—the lips and 
teeth covered with a thick foul fordes—the blood livid, much 
broken, or very weak in its texture, and quickly runs into a 
putrid (late—their thirfl infatiable, attended with a bitternefs of 
the mouth—the urine in the beginning is of a pale colour, but in 
progrefs of the difeafe very red, nay fometimes black, dropping 
down a dark-coloured fediment like foot—-the fweats are foetid, 
and frequently appear tinged with blood—th6 Jlools fmell offen- 
fively, are fomeiirpes livia, black,' or bloody—fmall livid fpots, 
like flea-bites, tailed petechiae, and, if broader, vibices, make 
their appearances—alfo haemorrhages, aphthae, ulcerations of the 
fauces, and hiccough, and foetid, fanguinaiy, dyfenteric affections, 
probably from internal ulceration and mortification, determine 
haftily the fate of the patient, 
C A.USES. ' Thofe \Vhich are remote or inducing are faid to be, 
feeding too much on animal food, particularly fiffi—eating con- 
llantly, as the failors do, falted, and half corrupted fleffi, and 
drinking putrid water—being in habits of taking alkaline, fixed, 
and volatile falts, and aloes—corrupted fruit—moift foutherly 
winds, attended, or rather preceded by great heat—vapor of 
Itinking waters—or from fens nearly dried—or from putrid ani- 
mal or vegetable fubftances—the ftagnant and foul air of hofpi- 
tals, ihips, prifons, aad workhoufes—feeding on corrupted grain 
—contagion—or any kind of putrid effluvia—for thefe difpofe 
the fluids to become putrefeent, 
Thofe which are fixed to be the proximate or immediate caufes 
are, a of the humours, particularly of tne red 
particles, as we have a right to conclude from the effeCl of pu- 
trid ferments diflolving and breaking down the texture and 
tenacity of folid and fluid fubfiances wherein it takes place. 
Not only from the fymptomatic appearances of this difeafe 
have we reafoti to be apprehenfive of the moft fatal confequences 
in general, but we (hall be further confirmed, on the diifeCtion 
of thofe who die of it, which fflew the brain and vifeera, parti- SAN GUINEO-PUTRES CENT FEVER. 
223 
cularly the ftoxnach and inteftines, in sin inflamed, and often in a 
mortified ftate. 
CHARACTERISTIC SIGNS. In order to diftingnifh the 
putrid fever in its earlieft attack, or very foon after, we muft ob- 
l'erve, that the degrees of debility, oppreffon, and navfea are more 
conjiderable than in any other fever : the puflration of Jirengtb 
fudden and violent-has fof its afibciates 'extreme defpondency, or in- 
fenfibility, and want of dpprthtnflon to an uncommon degree, 
Which befpeaks great danger; 
. The lofs of appetite, or loathing of food, f chiefs, languor, and 
dull pain, of the head, fimilar to what happens in the two former 
fevers before deferibed, which attend, when it comes on, as it 
fometihies does gradually; are in the beginning always more fe~ 
vere and fudden than in the inflammatory, though feldorn fo much 
fo as in the nervous fever. Befides, the fmallnefs of the pulfe, 
the deje&ion cf fpirits, the broken texture of the blood, the pur- 
ple fpots, and putrid Hate of the excrements, diftinguifh it from 
the inflammatory fever. The degree of heat, the very high-co- 
loured urine, the thirft, the fpots, and putrdfcency, from the ner- 
vous fever: And its formation is rendered perceptible by cold- 
nefs and {hivering, which has for its aftociates naufea, vomiting, 
giddinefs, confufion of the head, extrema and fudden proftratioa 
of ftrength. 
CURE j The indications of which endeavour to iup- 
port the Urength, counteract the putrefeent acrimony, and regu-« 
late the action of the nervous fyftem, by giving fmmgth and ac- 
tivity to the debilitated fibres, correcting the putrid ftate of the 
fluids, and promoting the difeharge of morbid 
And under fome circumftances, bleedmg fever at the 
beginning has been advifed, where it has attached robuft con- 
llitutions full of blood ; and here, perhaps, once it may be right; 
but not without the fymptoms run to an alarming height, would 
1 advife the operation ; and then only in order to prevent the fa- 
tal effeCts which might be induced by the violence of fome of 
them : for, though the pulfe fhould be at fil'd full and ftrong, 
©n taking blood it foon finks, and fometimes fo much, that 
we labour in vain afterwards to get it railed. ithout, there- 
fore, we have evident figns of an inflammatory ftate of the biood, 
and that the brain, lungs, or fome other of the vital parts aie 
threatened with inflammation, we fhould never bleed and, un- 
der the above circumflances, then only m the beginning fhould a 
few ounces be taken away, merely as an alleviator of a danger- 
ous fymptom. 
Afterwards the firft paflages are to be cleared from then con- 
tents by gentle emetics, (No. n.) giving fmall dofes of antimo- 224 
PUTRID FEVER, OR 
nials, and thefe repeated every fecond hour, (No. 6 to 9.) For 
wherever the fymptoms, which feem to indicate the ufe of the 
lancet, are violently urgent, they alone are the fafeft applications. 
Hut we Ihould be careful not to occafion profufe difeharges, 
which may produce too great lownefs. If the antimonials caufe 
not too or three {tools, a gentle aperient may be given, (No. 22 
to 24—49 to 51.) or glyfters, (No. 25, 26.) which may be re- 
peated every third day. 
Thefe things being premifed, our chief depedence is on fuch 
medicines as give ftrength and power to the fyftem, and fome of 
thofe called antifeptics, or corredlors of putrefeent acrimony, 
(Page 193, 194, 195.) (No. 39 to 41, and 52 to 54.) particularly 
thole fruits which have l'weetnefs coupled with acidity, (Page 
193.)—the antifeptic whey, (No. 48.)—fermented, or mineral 
acids, (Page 194.)—camphor, (Page (No. 15. 54.)—and 
bark, (No. 39 to 41. 50. Page 194.) particularly, which has been 
known to produce a ftoniftiing effects in a highly-diffoiving date 
of the blood, where haemorrhages have from that caufe been pro- 
duced. With thefe medicines we fhould begin, as foon as ever 
we perceive the diffolution of the blood has taken place, from 
the appearance of purple fpots or haemorrhages ; not waiting, 
as in other malignant fevers, for any remiffion ; for it is on bark, 
camphor, and wine we muff chiefly depend for fuccefs in thele 
cales, coupled in fome of hse'luorrhages with aflringents ; to which 
we {hall loon advert. 
I would not advife, as in the cafes of nervous fever, the ufe 
of flimulants in conjundtion with bark, (No. 40, 41.) but where 
the nervous fyftem appears to be extremely torpid ; then, I think* 
they give great power to that, and render it more adtive ; for I 
am fully perfuaded, that it produces its good effedls, by giving 
firmnefs to the folids, equability of adtion to the moving pow- 
ers, preventing the effedls of putrid diffolution, and enabling 
them to feparate and throw off the morbid materials, rather than 
corredting the acrimony, or preferving the texture of the blood 
by7 any other means. And this feems in a great degree to be 
corroborated by the opinion of Huxham, when l'peaking of thefe 
levers, whofe pradtice in thefe complaints was very confiderable, 
lays, “ Though nature very frequently affedts to difeharge the 
‘‘ morbific matter in putrid malignant fevers by vomits and 
‘‘ flools, yet her more conftant efforts are through the pores of 
“ the Ikin ;—and 1 folemly affert, I never faw thefe fevers com- 
*‘ pletely carried off till more or lefs of a fweat enfued ; if it 
“ proves moderately warm, and equally diffufed over the whole 
“ body ; if it comes on about the Hate of the difeafe, and the 
“ pulfe grows open, foft and calm a little before, and during it* “ continuance ; but if very profufe, cold, clammy, or partial 
“ about the head or bread only, we have much more reat'on to 
“ fear than to hope from it. If profufe i'weats break out in the 
“ beginning, they are generally pernicious, fhould a fever fuper- 
vene,” 
Under the circumdances recited above, though bliders are 
faid not to be ufeful in the beginning, becaufe the nervous fyf- 
tem thews no figns of torpor ; yet are they often fucceeded with 
happy effects, when people become dupid, drovvfy, and infenfi- 
ble , a d, indeed, at any time, if the pulfe is very low, the u- 
rine and excrement pafs off involuntarily, which 1 have obferved 
in an early dage. 
Wine, as it is an univerfal cordial, fo it is the bed, which may 
be given liberally ; amongft the mod eligible of which are cla- 
ret, red port, and old rile tilth ; or, where they cannot be had, 
from their dearnefs, ale or porter may be ufed. As for Joodt 
gruel, panada, fharpened with orange or lemon juice, roaded ap- 
ples, fruit of all kinds—for drink, the wines above mentioned 
mixed with water, lemonade, orangeade, wine wheys of differ- 
ent forts, apple water mixed with wine, vinegar whey, old found 
cyder, and all thofe liquids of au acefcent nature, or which cor- 
reft putrefcency, fhould be indulged in. 
The room in which the fick is confined fhould be well ven- 
tilated, vinegar fprinkled on the beds, and round the room, freih 
flowers and aromatic herbs flrewed about; the patient fhould 
have clean linen often renewed, and the ftools be removed as 
early as poffible, whether they pafs voluntarily or otherwife ; 
for nothing refreihes the fick more than cool air and cleanli- 
nefs. 
By the means here generally defcribed we fhall commonly fo 
affift and invigorate the conilitution, as to enable it to throw off 
the more morbid matter, which is done by various ways, but 
mod frequently by fweat, to afliit in which operation, Campho- 
rated Vinegar is flrongly recommended, (No. 55.) but, if 
joined with an opiate, Huxham fays, it is the mold certain fudo- 
rific in nature—the folution though, by itfelf, promotes perfpira- 
tion and gentle fweat more certainly than any other medicine ; 
befi des where mild flimulants are necefiary, it heats lefs than 
volatiles, or ardent fpirits. 
Mature fometimes conty ives the mode of expulfion for the mor- 
bid matter by the bowel's, hence a diarrhoea, which, if attended 
with breathing fweats, or a warm moiflure upon the fkin, is al- 
ways ferviceable, and we may flatter ourfelves that this is a fuc- 
celsful effort. 
At others, fhe relieves the habit by abfceffes, formation of 
sanguineo-putrescent fever; 
225 226 
PUTRID FEVER, OR 
matter in different glands, (Page 2,5.) fuch as thofe under the ear, 
the arm-] its, or groin ; or, by throwing down highly acrimoni- 
ous and corrofive humours into the legs, about the hips,.or mofl- 
ly the lower part of the back, affifted in this effort by continu- 
ally lying—hence is mortification of the integuments induced, 
forming thick (loughs, which leave deep, fpreading ulcers, from 
a fupply of a corrofive fluid called ichor. Here we muff rely 
chiefly on Peruvian bark, to produce, by its invigorating power, 
a reparation of the parts mortified. 
But fometimes, whilft we are exerting ourfielves to promote 
every good purpofe, by a plan judicioufly conceived, and well 
fele&ed applications, fome accidental occurrences will arile in 
different parts, which, if negle&ed, or judicioufly managed, will 
fruffrate our intent, and every effort of nature. Whatever, 
therefore, threatens to fink the patient, or diilurb nature’s 
general operations, mull be, if poffible, checked, or totally fub- 
dued. 
Should a hamorrhage, as fometimes happens, come on, vitri- 
olic acid may be added to the bark deco&ion, (No. 53.) or it 
may be given with any other vehicle, or the common drink may 
be acidulated with it, and given pretty freely. Should not 
thefe fucceed, alum, or alum-whey may be added, (Page 189.) 
or given in powder. (No. ;6,j 
Should a profufe diarrhoea make its appearance, and give us 
leave to fuppofe that the conftitution by this means would be 
enfeebled, it muff be reftrained only gradually ; for if we lock 
up the matter fuddcnly, without fupplying fome other more gen- 
tle mode of paflage out of the machine for the corrnped fluid, 
internal mifehief might be occafioned in the inteflines, by the 
irritation it would there produce. 
We mull therefore endeavour to determine the fluids to the 
Ikin, by fome well-adapted diaphoretics, (No. 57, 58.) and, at the 
fame time, fhould ihe ilools continue copious, and extremely foe- 
tid, glylters of fixable air, with which fome mild watery antipu- 
trefeeuf liquid is impregnated, or fixable air may be thrown up 
alone, for this is a powerful corrector of putrefeent acrimony, 
and would take off the ftimulus of thofe veffels which pour out 
their contents into the bowels, called exhalent, and render the 
medicines given more effedual in pufhing forwards, or folicit- 
ing the humours to the fkin. 
Sometimes there will occur ’violent vomiting, which in this fe- 
ver is not unufoal. 
This ought to be reftrained, and generally our fuccefs in the 
attempt will be pretty certain, by giving the faline draught in a 
date of fermentation. (No. £9.) SANGUINEO-PUTRESCENT FEVER* 
By the means of this the offenfive and foul matters in the fto- 
mach, and flexure of the duodenum, (42.) are fuppofed to be cor- 
rected, and thus, by removing part of the fomes, (that is, mat- 
ter which created the uneafy fenfations of the ftomach, and was 
a means of fupporting the febrile affe£tions) of confequence lefl'en 
the naufea, and other fymptoms indicative of its prefence, 
as well as, in all probability, fhorten the duration of the fever. 
Another peculiar accident may happen, though perhaps very 
rarely, wrhich we ought by all means to be guarded againft. Bark, 
upon which we in this fever place fuch dependence, will not 
agree with all conftitutions, decodlion of pomegranate bark, and 
chamomile flowers, may fupply its place, and is laid to anfwer 
every purpofe, (No. 60.) 
1 hough it may be fometimes the cafe that bark w ill no a- 
gree with our patients in the common modes of adminilhauon, 
Itill I have never found but in fome of its forms it may be made 
to anfwer every purpofe. 
By begiuning with the cold infufion, and gradually increafing 
its power, I have been enabled to adminifter it in all its com- 
plicated forms, and produced its defiled effects. 
Eruptions of different colours, red, purple, black, dun, or green- 
infh, called petechige, ftrike out fometimes toward the clofe, or 
earlier, of different fizes ; but thefe feldom bring any relief from 
oppreflion, ficknefs, or other difirefling fymptoms—the redder 
they are the better—and it is a favourable fign where thofe 
which are of a black or violet colour become of a brighter co- 
lour ; for thefe coloured fpots befpeak a high degree of putre- 
i'cent acrimony, and aftivity, bringing on a dangerous ftate of 
fanguinary diflolution—fo the change of colour to that which is 
molt favourable, fhews the degree of mifchief leflening, and their 
caufes growing weaker. 
About the eleventh or fourteenth day, miliary eruptions with 
a white appearance break forth ; fometimes fucceeding profufe 
fvveats, which not unfrequeutly happen at this time. Thefe 
feldom relieve ; but if there appears a red, fmarting, itching rafh, 
or large, fretting watery bladders, they are ferviceable. But wc 
may have hopes of recovery the breaking out of a fcabby 
eruption about the nofe, lips, and corners of the mouth—the 
more angry and hot it is, the more favourable the omen. To 
thefe we may add, if the fymptoms a* mild—if a loofenefs or 
feetid fweat ihould break out at the decline of the difeafe, there 
is confiderably lefs danger, than where there is no third—the 
fauces inflamed—a large crop of black eruptions, which fudden- 
ly recede—a laborious refpiration after their eruption—a fwell- 
ing of the belly with loofenefs—foetid and ichorous ftools—cold- 228 
putrid FEVER, £tc. 
thA of the extremities—and convulfions—for thefe afford moft 
calamitous portents. 
indeed, with regard to the aphthae or thrufh, of whatever co- 
lour, they carry along with them no pleafing omen, when they 
break out on the infide of the mouth—for they are foon fucceed- 
ed by putrid ulcerations of the throat, &c. bringing along with 
them difficulty of {wallowing, and hiccough, in the firlt inftance 
—afterwards, fcetid, bloody, and dyfenteric evacuations, proba- 
bly from ulceration and mortification of the inteftines. 
But when patients have fortunately paffed the ftage of fatality, 
they often become dropfical, or have watery fwellmgs in their 
legs, we muff not, under thefe circumffances, depend on purga- 
tives to evacuate the watery fluid, as in other dropfies —but bark, 
(Page 194 ) fteel, and the natural chalybeate waters, (Page 139.) 
to ftrengthen and invigorate vhe vafcular fyftem, and promote 
abforption. (No. 61, 62.) v : 
But, in order to prevent a relapfe when the crifis is perfected, 
from putrefcent or offenfive matters accumulating in the firlt paf- 
fages, a gentle purgative or two, (No; 3, 19, 2c, 21.) is abfolute- 
ly requifite—and a courfe of aromatic bitters, joined with chaly- 
beates, (No. 63, 64, 65.) or fome of the chalybeate waters, (Page 
139.) with light, nutritious, eafily digeftible food. (Page 209O 
And here we muff obferve, that where we find any prevailing 
acid upon the ftomach, we would advife fteel to be given in fub - 
ffance—where not, fome of the chalybeate falts, of which the 
tartarized iron, (Page 139.) is fuppofed by fome to be the heft, 
and may be given inftead of vitriolated iron—and it is faid to 
have proved efficacious where all the others have failed ; and i$ 
more foluble in the animal fluids. • 
The medicines above preferibed, or fome others of the fame 
kind, are thought neceffary, in order to recover the tone of the 
vifeera, and enable the digeflive powers to affurae their wonted 
power—which being neglected, a foundation may be laid for chro- 
nic complaints, by the conftitution’s being loaded with acrimo- 
nious and ill-conditioned humours, and fubje&ing the patient to 
jaundice, dropfies, confumptions, or feme luch fimilar mifehief, 
We have now finiffied our account of Ample fevers: and as 
we confider all the others, whatever their appellation, to belong 
to one of the foiegoing, Amply, or conjointly, we ffiall be under 
the neceffity of having tecourfe to fome of the modes of cure, 
here fpecified, in all; and have therefore chofen here to add the 
forms of medicines made ufe of in thefe fevers, referring in the 
body of the work occafionally to the more general catalogue, that 
* FORMS OF MEDICINE. 
229 
our reader may be fupplied with a larger number of materials, 
'from whence he may make his own feleCtion. 
Befides, he will, by clofely ftudying thefe, be enabled to fee the 
nature of medicinal combination ; and w’ill pave the way for his 
more readily underftanaing the management of fevers in a more 
complicated Rate. 
Neverthelei's, notwithstanding we think the remedies here 
fupplied are fufficient for enabling the practitioner to be as ufe- 
ful as poflible in all febrile affections, we fball make occafional 
additions in each, where any circumftances of advantage prefent 
ihemfelves, either from their peculiarity, or any local affeCtiqns 
with which they may be combined. 
THE 
FORMS OF MEDICINE 
PRESCRIBED AND REFERRED TO IN THE 
SIMPLE CONTINUED, INFLAMMATORY, NERVOUS, 
AND PUTRID FEVERS. 
IJnTo. i. Saline Mixture. 
Take kali prepared, i dram. 
Lemon juice, 2 ounces 2 drams, 
Diftilled or boiled Water, 5 ounces. 
Sugar, 2 drams. 
Mix.—Dose. Four table fpoonfuls every two or three hours, 
' ' 2. Nitrous Powder. 
Take Nitre powdered, 6 or io grains. 
Crabs Claw's prepared, 20 grains. 
Sugar, go grains. 
Mix—and take it in the manner above recited. 
3. Cooling Saline Purge. 
Take milk of Almonds, or 
DecoCtion of Barley, 
in which diffolve 
10 ounces. 
Vitiiolated Natron, i| ounce, 
or Tartarized Natron, 1 ounce, 
or Variolated Kali, \ ounce. 
Manna, i ounce.  FORMS or MEDICINE. 
Dose. Four table fpoonfuls every third hour, till the defircd 
effect is produced. 
No. 4, Anodyne, or Quieting Draught. 
Take Diftilled Water, if ounce. 
Spirit of vitriolic Aether, 30 drops. 
Tincture of Opium, 1,5 drops. 
Syrup of White Poppy Heads, 3 drams. 
Mix.—- 
or,—5. Saline Anopyne Draught. 
Take Kali prepared, 10 grains. 
Lemon Juice, 2 drams. 
Diftilled Water, 1 ounce. 
Tindture of Opium, 15 drops. 
Syrup of White Poppy Heads, 2 drams. 
Mix.— 
6. Antimonial Mixture. 
Take of tartarized Antimony, 3 grains, 
Rofe Water, 6 ounces. 
Syrup of Sugar, 3 otmces. 
Mix.—Dose. One or two fpoonfuls every fix or eight hours. 
or—7. Antimonial Powder. 
Take Tartarized Antimony, 3 grains. 
Prepared Crabs Claws, 5 drams. 
Sugar, 1 I dram. 
Dose, Twenty or thirty grains. 
8. Antimonial Saline Mixture. 
Take Saline Mixture, (No. 1.) 8 ounces. 
Tartarized Antimony, if grain. 
Dose. Four table fpoonfuls every fourth or fifth hour. 
or—9. Antimonial Bolus. 
Take Antimonial Powder, 3 grains. 
Conferve of Rofes, 1-2 a fcruple. 
Syrup of Sugar, fufficient to form a bolus, which may be 
repeated every fixth hour—or the Antimonial Powder may be 
given with fome of the abforbent Earth's, as in No. 7. and the 
dofe of Antimonials may be augmented’ or decreafed as the fto- 
mach will bear them. 
No. 10. Neutral volatile Saline Mixture. 
Take Acetated Ammonia, 2 ounces. 
Peppermint Water, 6 ounces. 
Tartarized Antimony, 1 grain. FORMS OF MEDICINE, 
Syrup of Saffron, 1-2 an ounce. 
[Mix.—Dose, &c. fimilarto No. t. 
11. Emetic Mixture. 
Take Tartarized Antimony, 6 grains. 
Diftilled Water, 6 ounces, 
Syrup of Saffron, 1-2 an ounce. 
Mix.—Dose. Two table fpoonfuls, repeated every half hour, 
till the defired effect is produced. 
or—12. Emetic Draught. 
Take Ipecacuanha Powder, 20 grains. 
Tartarized Antimony, 1 grain. 
Pennyroyal Water, 1 ounce. 
Syrup of Saffron, 1 dram. 
Mix.—Let this be admiuifiered in the evening, and theffomack 
well wafned with chamomile-flower tea, thin gruel, or any o- 
ther fimple aqueous fluid drank warm. 
13. Cordial Mixture. 
Take Peppermint Water, 6 ounces. 
Spirit of Nutmeg, 1 ounce. 
Aromatic Contention, 11-2 dram. 
Compound bpirit of Ammonia, 40 drops. 
Syrup of Saffron, 1-2 an ounce. 
Mix.— 
or—14. 
Take Cinnamon Water, 6 ounces. 
Spirit of Cinnamon, 1 ounce. 
Ammonia prepared, 30 grains. 
Aromatic Confe&ion, 1 dram. 
Compound Spirit of Lavender, 
Syrup of Saffron, 
of each 1-2 an ounce. 
Mix.— 
15. Cordial camphorated Julep. 
Take Camphorated Mixture, 
Peppermint Water, 
of each 3 ounces. 
Tin&ure of Cinnamon, I ounce. 
Syrup of Saffron, 1 1-2 ounce. 
Mix.—Doses. Four table fpoonfuls every fourth or fifth hour j 
and three at any time, when low, faint, or fick. 
No. 16. Cordial stimulant Bolus. 
Take Prepared Ammonia, 
Camphor, 
of each 5 grains. 
Aromatic FORMS OF MEDICINE. 
232 
Aromatic Confection, 10 grains 
Syrup of Saffron, fufficient to form a bolus. 
or—17. 
Take Shake-root, 
Con t rny c r v&j 
powrdcred, 
of each 5 grains. 
Aromatic Confection, 10 grains. 
Syrup of Saffron, fufficient to form a bolus, to be admi- 
niftered every four hours, waffling it down with two or three 
table lpoonfuls of the following julep. 
18. Cordial Julep. 
Take Cinnamon Water, 6 ounces. 
TinCture of Cinnamon, 1 ounce. 
Syrup of Saffron, 1-2 an ounce. 
Mix.— 
19. Purging Draught. 
Take infufion of Senna, 2 ounces. 
Manna, 7 r , - 
Tinaure of Senna, j of each ™ 
Rhubarb in powder, 8 or 10 grains. 
Compound Spirit of Lavender, 2 drams. 
Mix.— 
or—20. 
Take Rhubarb, 
Jalap, 
25 grains. 
6 grains. 
I ounce, 
l dram. 
Cinnamon Water, 
Syrup of Orange-peel, 
in powder, 
Mix.— 
21. Purging Pills. 
Take Rhubarb in powder, 30 grains. 
Mucilage of Gum Arabic, fufficient to form it into pills 
—or fyrup may be added to make it into a bolus. 
And of thefe forms may be taken in the morning early ; and 
■when they begin to operate, worked off with weak broth, or 
thin gruel. 
22, Cassia Draught, 
Take Diddled Water, 1 1-2 ounce, 
Acetated Ammonia, 2 drams, 
Tartarized Antimony, 1-6 or f of a grain. 
Caflia Edeftuary, from 10 to 20 grain3. 
Syrup of Rofes, 2 drams. FORMS OF MEDICINE. 
Mix .—and let it be repeated once in four hours, till it produces 
the effect required. 
No. 23. Crystals of Tartar Whey. 
Take Cryftals of Tartar, 1-2 an ounce, 
cliffolve them in 
Milk, 1-2 a pint, 
and add Manna, 2 ounces. 
24. Infusion of Tamarinds. 
Take Tamarinds, 1 ounce, 
boil them m Milk Whey, 8 ounces, 
then add Manna, 2 ounces. 
Of each oi thele a tea-cupful, or more may be taken occalionally 
25. Domestic Glyster. 
Take Milk, 
Water, 
Brown coarfe Sugar, 
Common Salt, 
Linfeed, or Olive Oil, 
Mix- 
of each 4 ounces. 
1 1-2 ounce. 
1-2 an ounce. 
2 ounces. 
26. Common Glyster. 
Take the Glyfter Decoction, 
Epfom Salt, 
Syrup of Buckthorn, 
Linfeed Oil, 
8 ounces, 
of each 1 ounce. 
2 ounces. 
Mix.— 
27. Cordial Saline Draught. 
Take acetated Ammonia, 1-2 an ounce. 
Peppermint Water, 1 ounce. 
Ammonia prepared, 5 grains. 
* Confection of Alkerms, 2c grains. 
Syrup of Saffron, 2 drums. 
Mix.— 
28. Cordial Aromatic Draught. 
Take Oil of Nutmegs; 4 drops, 
rub them well with 
Sugar, 2 fcruples. 
to which add gradually 
Peppermint Water, 2 ounces. 
Mix.— 
* LEWIS’S Dilpenf.toiy improved. Tare Edinburgh, 1726. 234 
FORMS OF MEDICINE. 
No. 29. Cordial Aromatic Mixture. 
Take of Oil of Cinnamon, 40 drops. 
Fine Sugar, S drams• 
rub thefe well together, then add 
Cinnamon Water, 6 ounces. 
Spirit of Cinnamon, 1 ounce. 
Mix. The Draught, or four fpoonfuls of the Mixture, ffiould 
be given as directed No. 1,5. 
30. Mustard Poultice. 
Take Muftard Seed Powder, 
Crumbs of Bread, 
of each equal parts. 
Strong Vinegar, fufficient to form a poultice ; but when 
wifhed to be ftronger, half an ounce of bruifed Garlick ; and one 
ounce of black Soap added. 
31. Musk Bolus. 
Take Mulk, from 8 to 30 drops, 
rub them well with 
Fine Sugar, 40 grains.] 
to which add 
Ammonia prepared, 3 grains. 
Aromatic Confe&ion, 10 grains. 
Syrup of Saffron fufficient to form a bolus, to be admini- 
ftered every four or five hours, with three table fpoonfuls of the 
fubfequent Infufion. 
32. Valerian Julep. 
Fake Valerian Root bruifed, I 1-2 ounce. 
Boiling Water, 1 pint. 
Infufc in an earthen veflel well clofed, and let it (land till cold j 
to fix ounces of which add Syrup of Saffron, half an ounce. 
Mix.— 
33. Camphorated Bolus. 
Take Camphor, 
Ammonia prepared, 
Aromatic Confedlion, 
of each 5 grains. 
20 grains. 
Syrup of Saffron, fufficient to form a bolus, to be taken 
every fourth hour. 
'34. Musk Julep. 
Take Mulk Mixture, 6 ounces. 
Camphor, 30 grains. FORMS OF MEDICINE. 
Myrrh, 20 grains. 
Syrup of Saffron, 1-2 an ounce. 
Let the Camphor and Myrrh be well rubbed together, and then 
add gradually the Mufk mixture—Dose. Four table fpoonfuls 
every three or four hours, or oftener in cafes of great languor. 
No. 35. Musk Bolus. 
Take Mufk, 10 grains. 
Camphor, • 
Ammonia prepared, 
Syrup of Saffron, fufficient to form a bolus, to be taken 
every third or fourth hour. 
of each 6 grains. 
36. Snake-root Bolus. 
Take Snake-root powdered, 20 grains. 
Ammonia prepared, 8 grains. 
Syrup of Saffron, i'ufficient to form a bolus, to be taken 
every fix hours. 
37. Snake-root Draught. 
Take Snake-ropt bruifed, 6 drams. 
Boiling Water, 12 ounces. 
Infufe in a clofe veflel till cold ; to one ounce and a half of which 
add Ammonia prepared, 5 grains. 
Aromatic Confection, 10 grains. 
Syrup of Saffron, 2 drams. 
Mix. or from one to two dratns of the Tin&ure of Snake-root 
may be added to any other of the cordial Draughts, andadmi- 
niflered every fourth, fifth, or fixth hour. 
38. Ipecacuanha Emetic. 
Take Ipecuanha in powder, fiom 15 to 20 grains. 
Pennyroyal Water, 1 ounce. 
Syrup of Sugar, 2 drains. 
Mix- 
39. Vinous Infusion of Peruvian Bark. 
Take of Peruvian Bark, 1 ounce. 
Infufe it in White Wine, 12 ounces. 
Dose. Three fpoojifuls every fourth or fifth hour. 
40. Cordial Mixture, with Bark Decoction. 
Take Peruvian Bark, 1 ounce, 
boil it in one pint of water till it is reduced to 12 ounces, then 
let it be ftrained, and add 
Tincture of Snake-root, I ounce. FORMS CF MEDICINE. 
Aromatic Confedtion, 2 drams. 
Mix.—Dose. Four table fpoonfuls every fourth hour. 
No. 41. Cordial Mixture, with hot or cold Infusion 
of Bark. 
Take Peruvian Bark, 6 drams. 
Jnfufe it in ten ounces of boiling water for four, in cold for eight 
hours, then let it be ftrained, and add 
Tinfture of Snake-root, I ounce. 
Compound Spirit of Lavender, 4 drams. 
Mix—Dose. The fame as (40.) 
or volatile fubftances may be added to any of thefe vehicles, as 
Salt, or Liquor of Hartlhorn, Ammonia prepared. See Dofes, 
P- 150, 
It Bark fhould be difagreeable in every other form, it may be 
given in glylters, though in large proportion. Should the Pow- 
der, Tindture, or Extradf, be more eligible, fee the Dofes, P. 
*93. I94* 
42. Absorbent Julet. 
Take Crabs Claws prepared, 2 drams. 
Gum Arabic 3 drams. 
Cinnamon Water, bounces, 
Syrup of Saffron, 4 drams. 
Mix.— 
or—43, 
Take Chalk Mixture. 6 ounces. 
Spirit of Nutmegs, 
Syrup of Orange Feel, 
of each 4 drams; 
Mix.—Dose. Three fpoonfuls of either often in the day, par? 
ticularly after every loofe ftool. 
44. Detergent Gargles. 
Take Infufion of Rofes, 1 pint. 
Honey of Rofes, 2 ounces. 
Mix— 
or—45. 
Take Lime Water, 4 ounces. 
Honey of Rofes,- ly ounce. 
Mix— 
or—4 60 
Take Deco&ion of Barley, 10 ounces. 
Honey of Rofes, 2 ounces. 
Muriatic Acid, 30 drops. 
Mix— FORMS OF MEDICINE. 
237 
or—47. 
Take Deco£lion of Barley, 1 pint. 
Simple Oxymel, 1 ounce. 
Tin&ure of Myrrh, 1 ounce. 
Mix.— 
No. 48. Antiseptic Whey. 
Take Cow’s Milk, if pint. 
Water, f a pint. 
Let thefe be boiled together, and mixed with one ounce and an 
half of Seville Orange, or Lemon Juice ; or mix only one ounce 
of Lemon Juice, and two of good old Rhenifh, and drain for ui’e. 
49. Antiseptic Drink. 
Take Crydals of Tartar, 2 ounce?.. 
Diffolve thefe in one gallon of Water, and fweeten with Syrup 
of Orange Peel. 
,50. Antiseptic purging Apozem. 
Take Tamarinds, if ounce. 
Boil them in Water from nine to feven ounces, then drain, diffolve 
Manna, 2 ounces. 
Tartarized Kali, 1-2 ounce. 
Mix.— 
51. Antiseptic aperient Draught. 
Take Tartarized Kali, 40 grains. 
Manna picked, 1 1-2 dram. 
Lemon Juice, 2 drams. 
Diitilled Water, 1 1-2 ounce. 
Mix.—Any of thefe may be taken, (No. 49 and 50. in proper 
dofes,) and repeated agreeable to the effect wanted to be produced. 
52. Antiputrescent Draught. 
Take Tin&ure of Rofes, 2 ounces. 
Muriated Acid, 5 drops. 
Syrup of Quinces, 2 drams. 
Mix.— 
or—53. 
Take deco&ioa of Bark, 2 ounces. 
Muriatic Acid, ,5 drops. 
Syrup of Quinces, 2 drams. 
Mix.— 
°r—54- 
Take Camphor, 6 grains. 
Myrrh powdered, io grains. 
Let thefe be rubbed well together, and add gradually FORMS OF MEDICINE. 
Decoction of Bark, 2 ounces- 
Syrup of Lemon, 1-2 an ounce. 
Mix.—Any of thefe may be taken every third or fourth hour, 
or oftener, if the exigencies of the cafe require. 
No. 55. Camphorated Vinegar. 
Take Camphor, 2 drams. 
Let this be rubbed down with a few drops of Spirit of Wine, then 
add Sugar, 1 ounce. 
Diftilled Vinegar made hot, 2 pints. 
Mix.—Dose. Two or three table fpoonfuls, or more, every 
fourth or fixth hour. 
, 56. Astringent Powd er. 
Take Styptic Powder, of the Edinburgh 
Difpenfatory, 
-from 8 to 15 grains. 
Gum Tragacanth in powder, 15 grains. 
Nutrpeg powdered, 3 grains. 
Mix.—To be given every third or fourth hour, with the Draught 
No. 53, as ordered above. 
57. Ipecacuanha Draught. 
Take Cinnamon Water, 1 1-2 ounce. 
Gum Arabic, 2 fcruples. 
Chalk prepared, 1 fcruple, 
Ipecacuanha, 2 grains. 
Syrup of White Poppy, 1 dram. 
Mix.— 
58. Saline volatile Draught. 
Take Water of acetated Ammonia, 2 drams. 
Cinnamon Water, I 1-2 ounce. 
Opiated Confedtion, 1-2 a dram. 
Syrup of Saffron, 2 drams. 
Mix.—Either of thefe, or three or four table-fpoonfuls of cam- 
phorated Vinegar, (No. 55.) may be adminiflered every fourth 
hour. 
59* Saline fermentative Draught. 
Take Kali prepared, 20 grains. 
Peppermint Water, I ounce. 
Syrup ot Quinces, 2 drams, 
to which add 
Lemon Juice, 1-2 an ounce, 
and let the Draught be drank off whilft in a {late of fermenta- 
tion. FORMS OF MEDICINE. 
239 
jSTo. 60. Pomegranate Bark, and Chamomile Decoction. 
Take Bark of the Pomegranate Fruit, i ounce. 
Chamomile Flowers, 1-2 an ounce. 
Let thefe be boiled in 
Water, 24 ounces to 16. 
:hen in this Decoction, whilft hot, infufe 
Orange-peel, 3 drams. 
This mult (land in a veifel covered dofe till it is cold, then 
trained off for ufe. To one ounce of this add 
Camphorated Vinegar, 2 drams. 
Muriatic Acid, 5 drops. 
;Vlix—And let it be given every fourth hour. 
61. Steel Pills. 
Take Iron filings, or the Ruff prepared, 
Extract of Gentian, 
of each 1 dram, 
iorm thefe into 24 pills. Dose. Four. 
or—62. 
Take Vitriolated Iron, ~) c , , 
Extras of Bark, j> of each , dram. 
dorm 24 pills. Dose. Two. A dofe of each of thefe may be 
aken, three or four times a day—or, one fpoonful of Chalybeate 
[Vine—or the Decodtion of Bark, in the fame mode as before 
•refcribed. 
63-. Aromatic bitter Draught. 
i Take Quaflia Wood, 2 drams. 
nfufe in one pint of boiling water, and, when cold, to one ounce 
nd an half add 
Vitriolated Iron, 4 grains. 
Aromatic Tindture, 30 drops. 
:Iix.—and adminilier twice a day ; as may bealfo the following 
i bolus . 
64. Aromatic bitter Bolus. 
Take Chamomile Powder, from 10 to 20 grains. 
Myrrh in powder, 6 grains. 
Vitriolated Iron, 5 grains. 
Aromatic Powder, 6 grains. 
Syrup of Saffron, fufficient to form a bolus, 
r, the Steel Pills. (No. 61, 62.) may be adminiftered in the fame 
lanner, with four fpoonfuls of the following infufion : 
No. 65. Aromatic bitter Infusion. 
Take Compound infufion of Gentian, 6 ounces. 240 
FORMS OF MEDICINE. 
Tindture of Bark, 6 drams. 
Aromatic Confedtion, 1 1-2 dram. 
Mix.— 
66. Oil of Castor Emulsion. 
Take Oil of Caflor, 2 ounces. 
Mucilage of Gum Arabic, or 
Yolk of Egg, fufficient quantity to make it mix uni- 
formly with Decoction of Earley, 10 ounces. 
Syrup of Rofes, 1 ounce. 
Mix.—Dose. Four table-fpoonfuls every fecond or third hour, 
till the defired effedt is obtained. 
67. Antimonial aperient Mixture. 
Take Diflilled Water, 6 ounces, 
in which difi'olve 
Manna, 1 1-2 ounce. 
Tartarized Kali, 3 drams. 
Antimonial Wine, 40 drops. 
Tindture of Senna, 1 ounce. 
Mix.—Dose. Four fpoonfuls every fecond or third hour till 
the defired effect rakes place. 
68. Asa foetida Mixture. 
Take Afa foetida, 1 dram. 
Peppermint Water, 4 ounces. 
Tincture of Opium, 12 drops. 
Syrup of Sugar, drams. 
Mix.—Dose. One fpoonful every fourth, fifth, or fixth hour.i 
69. Camphorated Emulsion. 
Take Camphor, 1-2 a dram. 
Mucilage of Gum Arabic, 2 drams. 
Let them be rubbed together, and add gradually 
Peppermint Water, 6 ounces. 
Tindtureof Opium, 10 drops. 
Syrup of White Poppy Heads, 1 ounce. 
Mix.—Dose. Three or four fpoonfuls every fourth hour. 
§ 5. MIXED FEVERS. 
On treating on the different kinds of Ample fevers, in the four 
former fedtions, we found, that according to their differences, 
we could difcover which part of the fyftemwas in them particu- 
larly affedted, and conitituted the difeafe. MIXED FEVERS. 
In the fun pie continued, the vafcular fyftem, with refpedt only 
to its motions being quickened. 
In the inflammatory, befides the inereafe of motion, we per- 
ceive tenacity in the blood, and the ftrength and activity of the 
veffels augmented beyond what is natural. 
In the Jlow nervous, the nerves ieem to be primarily and chief- 
ly affedted, without any inereafe of vafcular adlion, but rather 
a degree of torpor, and defedt in their natural motion, with a 
lentor, or vifeidity of the l'erum, lymph, and thin humours. 
In the putrid, this nervous albeit ion was accompanied at ftrft, 
or foon after, with a putrefcency of the fluids. 
Now thefe peculiarities produce particular fymptoms, which 
enable us to difeover their, nature. Eut the clafs of fevers rank- 
ed under this head have fome of the immediate caufes of thefe 
limple fevers fo blended together, as the inflammatory and malig- 
nant, the malignant and nervous, the nervous and inflammatory 
—or fo inftantaneoufly and imperceptibly follow each other, ac- 
cording to the indications to be deduced from the fymptoms, 
that we are at a lofs where to refer them—as the diftinguifhing 
ligns of the two different kinds will prefent themfelves at the 
fame time ; for in fome we find great naufea and extreme debi- 
lity—great heat, with a quick, ftrong, and hard pulfe—here are 
the charadleriftic fymptoms of the inflammatory and putrid unit- 
ed, and form truly the mixed yever. We will, however, now 
endeavour to explain how thefe{arife. 
When fpeaking of the brain, (Page 26, 27.) It was there faid, 
that vafcular irritability might be independent of nervous influ- 
ence, though, for the continuance of that irritability, nervous 
influence is abfolutely neceiTary. We mull now farther obferve, 
that vafcular irritation always requires local (limulus for its fup- 
port, and that the veffels may be affedled without any ftrong in- 
difpofition of the nerves—and fo on the contrary—and alfo that 
they may be conjointly affedted from the fame caufe. 
We likewife farther affirm, that morbid particles creating dif- 
eale produce different effedts, from their eledlive power upon 
the folids as well as. fluids—hence from this fource arifes the dif- 
ferent natures of fpecific fevers—and hence it is from the differ- 
ent combinations of the caufes that the mixed fevers deduce their 
origin. 
It feems to be an extremely difficult talk to draw our ideas of 
thefe fevers into a fmall compafs ; or fo to Amplify them, that all 
which occur can be brought within the bounds of a concife defi- 
nition ; for every caufe which can produce any of the forego- 
ing febrile complaints ; every part which can alfo be affeaetf in 
them, may conjundtively appear fo in thefe; and in fuch v~rv 242 
anxED fevers: 
different degrees, that we are puzzled to difcriminate to which 
they can properly belong. 
I can by no means agree with the idea of Dr. Cullen, that 
the account he has given of the fever he terms Synociius, which 
obvioufly is his mixed fever, is at all adequate to comprehend 
the whole of thofe fevers, which come certainly under this term 
—for he fays, “ it is a contagious fever for the moft part, com- 
“ pofed of the inflammatory fever at the beginning, in its pro- 
“ grefs, and towards its termination, running into a nervous or 
“ putrid fever,”—which he names typhus—In all which there 
is no practical utility; for it may be only an inflammatory fe- 
ver fim ply, thus terminating; which often happens to be the 
cafe—induced frequently by the violence of the difeafe, fome ac- 
cidental circumftances, or mifmanagement. The continued, or 
vafculo-plethoric fever, which is fimple, may, from the fame caufes, 
have the fame termination. 
Though we will not fay that fevers of the above defeription 
may not fometimes occur, ftill we think that the complicated 
affeCtions may always be in a great degree obfevved, and ffiould 
be particularly pointed out. 
From what has been advanced on this fubjeCt, the great diffi- 
culty of forming a definition to comprehend the whole of thefe 
fevers which may often meet our obfervation, is fufiiciently ob- 
vious. 
However, in defining thefe fevers in general, I fhould fay, that 
the 
Anomalous, or mixed Fevers, 
were an affecHon of the nervous and vafcular fyftem, and fome- 
times conjoined with that of the mafs of circulating fluids, pro- 
ducing febrile appearances ; but, from the beginning, very often 
fo indiftinflly marked, having the inflammatory, nervous, and 
putrid fymptoms fo blended, that it is difficult to fay to what 
kind they moft peculiarly belong ; and if we add to this Dr. 
Cullen’s opinion, (Page 241.) the idea of mixed fevers will be 
tolerably complete ;—and as we have given the whole of the 
fymptoms feparately under each of cur former divifions, by con- 
ffdering fome of them here in a conjunctive ftate ; and marking 
ihofe which are moft prevalent ; we fhail be enabled to point out 
what is neceflary to be done—to alleviate that fpecies which is 
the moft powerful in its a&ion, confequently the moft danger- 
ous, and not altogether negleCt the other—but this to execute pro- 
perly requires profound medical knowledge, quick perception, 
nice difcrimination, and experienced fagacity. MIXED FEVERS. 
243 
Sydenham, to whom I (hall refer my reader, has given us 
fome hiftories of thefe kinds of fevers, under different names, 
either according to some prevalent symptom—as the fudato- 
ry, or fweating, the comatous or drowfy—or to THE intent of 
nature, as the depuratory, or cleanfng—the imitative, as the 
variolous fever, or that fimilar to the fmull pox fever—or to THE 
season, as the hyemaf or wintery. We fhall content ourfelves 
with prefenting, as a fpecimen, 
The Puerperal, or Child-bed Fever, 
one of the mod dangerous and fatal with which medicine is at 
prefent acquainted. 
DESCRIPTION. This fever generally begins on the firft, 
fecond, or third day, fometimes later, after delivery, with cold- 
nefs or fhiveriug preceding any pains of the belly, which are vio- 
lent, and has, a forenefs attending over the whole region below the 
Jlomach, fcarce capable of bearing the gentle/? touch—the belly is 
fometimes loft—fometimes greatly fwelled. The pains, though 
general, will affeft fome one part more particularly than ano- 
ther, and fhoot from the lcins to the groins and thighs, and fome- 
times affe£t the anus and neck of the bladder. 
The pull'e is quick and weak, though now and then, efpecially 
a little after the attack, Ilrong and full—the fkin is, for the mod 
part, hot and dry, though fometimes cool and temperate ; and, 
not unfrequently, intermediate fweats come on all over the bo- 
dy, and ufually afford fome alleviation—there is a conftant pain 
of the head, chiefly the forehead, and above the eyebrows, 
attended olten with a giddinefs and reftleffnefs. 
The tongue has very different appearances, commonly white, 
foft, and moift, and will thus continue till near death—then it 
becomes dry, rough, and of a yellowilh brown colour—a red line 
will fometimes run up its middle, with a whitenefs on each fide ; 
the firft is dry, the laft moift—along with thefe there is alfo a 
great thirft. 
The face is often flufhed, fometimes of a deep red, or livid co- 
lour fixed in the cheeks. There appears in the countenance and 
eyes ftrong marks of anxiety and dejection of fpirits. Irom the 
very beginning of this dijlemper, the patients feem afraid of taking 
a full infpiration, hence is the breathing quick and fhort, appear- 
ing not to proceed from any ajfe&ion of the lungs very often ; and 
as the difeafe incrcajes, fo does the fjortnefs of breathing. 
There is mold commonly a cough as a concomitant;—load of 
the ftomach—naufea—-and vomiting of yellow, greenifh, or black 
materials, frequently attend ; but not invariably, though they 244 
MIXED FEVERS. 
fometimes come on from the time of delivery, nay, now and 
then indeed precede it;—and, at the approach of death, what is 
vomited up is either green or black. 
11 blood fhould be taken away, it is in general dzy, with a 
quantity of yellow ferurn. The pain of the head, though very 
troublefome, is feldom attended, till a few hours before death, 
with delirium. 
The urine at fird is made with difficulty, and fmall in quan- 
tity, though removed by two or three (tools ; and, as the difeafe 
abates, it is declared by a depofltion of the colour of brick dufl, 
or whitidi fediment. 
At’the commencement the habit is, for the mod part, coftive 
■—fometimes regular—at others loofe, difcharging very foetid and 
brown coloured faeces—and in both dates flatulence attends— 
and the general omens of approaching diffolution are, involun- 
tarily evacuations from the bowels. 
In high degrees of this difeafe, the patient, for the mod part, 
lies on her back, feldom turns on either fide, and never on her 
belly. 
Thefe are the general fymptoms, by which the fever may be 
difcovei'ed, and which appear when the uterus is not affedled— 
but if we perceive any of the fymptoms which are declaratory of 
uterine inflammation, we may fufpect the ade&ion of that or- 
gan a participating caufe. 
CAUSES. Thofe which are canfrdered as the remote or in- 
ducing, are, 
Intemperance during pregnancy—too great fatigue, or total 
want of exercife—too high or too low living—codivenefs, or the 
reverie—excefs of joy or grief-—moid and warm atmofpher’e, 
impregnated with putrid efflnvia. In lying in, an overheated air 
—too warm a regimen—fudden frights—codivenefs after deli- 
very—and every accident which can obdruct perfpiration-—vio- 
lence, and too great hade in feparatiag the placenta—-and bind- 
ing up the trunk of the body with too tight'bandages. 
Thofe which are faid to be the proximate or immediate, are, 
Impeded circulation, or flagnation of the blood, generally in 
the vefTels of the omentum, (37.) and intedines, chiefly the ex- 
ternal coat of the fmall ones, (42.) fometimes of the womb, (51.) 
inducing in thofe parts inflammation, from the debilitated date 
of the vafcular fydem there fituated, brought on by the preffure 
of the pregnant womb ; if caufes (243,) occur which are capa- 
ble of producing febrile afFeftions in the habit—which aftedlions 
are firjd mod commonly of the inflammatory ; afterwards, if the 
fever in this date is not cured, of the putrefeent kind. 
CHARACTERISTIC SIGNS. Common febrile fymptoms, MIXED FEVERS. 
245 
attended with violent acute pains of the belly below the flomach, 
with forenefsofthe parts fo great as fcarce to bear the gentleft touch 
--dreadin taking a full infpiration—breathing quick and fhort.nor 
appearing to proceed from afFe&ions of the lungs--and increaiing 
with thedifea('e—and in coftivenefs, or the reverfe, flatulence. 
CURE. Xhc indications are to take off in the firft inflance, 
the inflammation, and prevent the humours from running into a 
Hate of putrefcent acrimony—bo:h which are effeifted by bleed- 
ing, if neceflary, at the onfet—purging—promoting the urinary 
difcharge—or fweating—for in fome of thefe ways this fever ge- 
nerally goes off, or is conquered, particularly by purging. If 
the termination is favourable, it occurs in three, four, or five 
days ; if otherwife, from the fifth to the twelfth. 
Hence, therefore, from what has been above delivered, our 
medical conduct is plainly pointed out. 
If, at an early period of the diieafe, the habit is found abound- 
ing with blood, the febrile heat great, and the pulfe full and 
ftrong, blood muft be immediately drawn from the arm ; and, 
fhould the body be coftive, an emollient aperient glyfter, (No. 25, 
I 26.) ihould be, as foon as poffible, adminiftered ; but lliould not 
this relieve by producing evacuation, fome mild or emollient 
I aperient medicine (Page 171, 172.) muft be given, till a free dif- 
| charge from the bowels is procured—for ftools muft at all events 
I be had ; on thefe, at firft, are founded our greateft hopes of fuc- 
cefs ; as by emptying the firft paflages, all diftenfion from the. 
I contained faeces is taken off—flatulence leifened—irritation from 
I the faeces avoided--and fome degree of freedom given to the cir- 
| culating powers of the parts anecled. 
.But this fhould be done by the gentle1! means—by fuch medi- 
cines as cvill not create ficknefs, as the cooling faline purge, 
(No. 3, 23, 24.) or oil of c-aftor emulfion. (No. 66.) 
Tartarized antimony, (No. 6, 7.) or antimonial wine in final! 
! dofes, (Page iSc.) are recommended to be given with this in- 
tent every fecond or third hour; but in their purgative effects, 
they are too uncertain—I therefore mix fmall portions of them 
with other purgatives, which 1 think quicken, their efFecls. 
(No. 3. 22 to 24.) or the antimonial aperient mixture. No. 67.) 
The firft evacuations are generally fcetid ; but if they become 
afterwards lefs oflenfive, and the patient feels herfelf generally 
relieved, file mod commonly falls into a fleep, and a gentle per- 
fpiration fucceeds, which muff be Encouraged by fuch medicines 
as cool at the fame time that trfay contribute to promote this 
purpofe, fuch as tartaj'ized antimony, antimonial powder, No, 6, 
7, 8, 9.) and wine, (Page 180.) ipecacuanha, (No. 57.) nitre, (No. 
2,) ialine mixture, (No. 1.) to which may be added iome flight1 246 
MIXED FEVERS. 
opiate, (Page 152.)—for tliefe alleviate pain— determine the 
fluids externally---and prevent their efl'edts from internal dilten- 
iion, irritation, or acrimony, acquired from local folicitude of 
them internally, and accumulation ; belides, they are diuretic, 
(Page 173.) and antifeptic, (Bage 192.) without altringency, or* 
being produ&ivc of heat. 
Though, in order to keep up thefe efie&s, fo effentially necef- 
fary for recovery, phyflcians in general have ordered mild cool- 
ing liquids to be drank cold, if the Ikin was dry and hot, the fe- 
ver and third confiderable-—and lukewarm, whilit the patient was 
in a ftate of perfpiration; and very judicioufly forbid the ufe of 
cordial ftimulants, caudles, wines, and heating medicines of every 
kind -yet feme preferibe a cup of chamomile tea to be drank, 
every hour ; but as this, like other bitters, is a flimulant, in the 
inflammatory ftage of this difeafe it does not appear proper. But 
when fymptoms of putrefcency are approaching, or commenced, 
it may be produdive of good effects, a3 it poffefles antileptic 
(Page 192.) powers. Small and repeated dofes of lukewarm di- 
luents, or watery liquids, as rennet, vinegar whey, lemonade, 
toaft and water, llight intufion of malt, hydromel of Hippocrates, 
(P3ge 17 8.) or things of a limilar nature, anfwer the purpofes 
more fafely, and full as effect u ally. 
1 hbugh the greatefl benefit is expected to be derived from 
clearing the firft paffages, attention fbould alio be paid to the 
llomach -and hence, if naufea, ficknefs, or vomiting, be one 
ol the concomitant fymptoms, that organ mult be attended to, 
and unloaded of its contents ; which will contribute alfo to pro- 
mote the effects before mentioned ; but as the womb is fufpend- 
ed by the broad ligaments, (3 1.) and thofe called round, (which 
are formed of a number of blood-veflels folded together, running 
from the corners of the womb in the duplicature of the broad 
ligaments, pafs through a round aperture on each fide the low- 
er part of the belly, and are loti in the fat of each groin] vomit- 
ing fhould be promoted by the eafieft means, by drinking copi- 
oufly of chamomile tea, or warm water—for by filling the Ito- 
mach fufficiently with fluid, its coats will act with eafe, and the 
diaphragm (33,) and mufcles of the belly not be thrown into con- 
tinued and too powerful contraction, which would at tills period 
be dangerous ; becaufe the ligaments are now in a relaxed ftate, 
and have not yet recovered their natural and healthful tone ; 
hence would the womb be liable to be protruded too much down- 
wards by flrong exertions of vomiting. 
The cafe here drawn up refpects only the moft Ample appear- 
ances of this fever ; but it is frequently pbferved to be attended 
with feveral untoward circumftances. MIXED FEVERS. 
247 
id. Violent stitches in the side, and pain at the 
I T OF the stomach will accompany thofe more condant ones 
f the belly, with a full, hard pulfe, fymptoms of inflamma- 
ion, and that fevere in proportion to the degree of violence. 
2d. Flatulences in the domach and colon (43.) will pro- 
uce pains in the Tides, {hooting about the fhort ribs, which 
udluate ; and occaflon diortnefs of breathing, being cnly attend- 
d with a flight degree of fever. 
3d. A cough not unfrequently is an attendant fymptom—but 
ddom of much confequence. 
4th. A looseness will fometimes appear at the very com- 
lencement of the fever, ariflng from acrimonious foulnefs in the 
rft paffages. 
Thefe we mud endeavour to alleviate by well-adapted appli- 
ations. Under the jirjt circumfiances bleeding mull be had re- 
ourfe to, and that repeatedly, if the violence of the fymptoms 
ontinues, paying proper attention to the flrength of the patient ; 
care not to be too lavifli in the quantity of blood drawn; 
ar it is fafer to bleed twice than once too copioufly. Should 
he pains be violent, and the breathing much opprefled, hliflers 
auft be applied immediately, and repeated in proportion to the 
aufe, flrfl on the lide affected, afterwards on the oppofxte 
.de. 
But fhould the pulfe grow weak, and other fymptoms of debi- 
ity come on, declaratory of putrefcency taking place, cordials 
/ith tonics, the mod powerful of wdiich are, volatiles united, 
mh bark—camphor—fpivit of vitriolic or nitrous tethermud 
■e brought to our aid and mineral acids. See Putrid Fever, 
621, § 4. from whence we dial! be referred to a variety of pre- 
emptions capable of anfwering our purpofes. 
And here we mud obferve, that the fencka root, (Pane 179.) 
ias been highly recommended in this, as well as other pleuritic 
ffefdions ; and is in this place confidered as exceedingly applicab- 
le, as it is faid to piomote dools, urine, and fweat. 
Under the fecond, we mud apply to aperients, (No. 3. 23 or 
4. 66, 67.) if thefe fail of fuceefs, by their operations, antifpaf- 
oodics and fedatives may be tried, chiefly afa foetida, cam- 
bor, (No. 68, 69.) or mulk, (No. 31. 34, 35.) with opium. 
Under the third, in flight cafes, oily emulflons may be admi- 
iftered, as in common coughs ; but fhould there be at the fame 
ime a fevere pain in the head, a blider fhould be applied between 
he fhoulders—deams of vinegar and water inhaled into the lungs 
—gentle opiates, (151-) or fpirit of vitriolic aether, (150.) admi- 
lidered. 
Under the fourth, we are not to attempt to check the difeharge 248 
MIXED FEVERS. 
by the ufe of aflringents ; for from this every good is to be ex- 
pected—we muft here rather chufe to aftift nature by the free 
ufe of thofe drinks we have in common recommended ;—but 
fliould it not come on till the ciofe of the difeafe, and be appa- 
rently critical, we mull endeavour to fupport the patient under 
it, and aim at corre&ing the putrefcent hate of ihe habit, by an- 
tifeptics and cordials, both in glyfters and by the mouth, and pro- 
per nourifliment. The glyfters fliould be emollient, diluting, 
and nutritious, compofed of broths, beef-tea, chamomile infu- 
ficn, with oil, and impregnated with fixable air ;—wine, wine 
and water," maybe given—alfo cordial mixtures with cinnamon, 
(No. 13, 14. I5> 18. »8, ■29.) omitting the volatile fubftances, 
except in cafes of faintnefs, when they may be occafionally add- 
ed—the aromatic confection may be alfo changed for the extraCt 
of logwood, or the infWGon may form the vehicle, (140.)—and 
after the diarrhoea has been checked by proper remedies, we 
muft not forget the bark joined with aromatics, (No. 39 to 41.) 
and opiates. Befides, beef-tea, chocolate, hartlhorn jelly, and 
fuch like, Ihould be given by the way of nourifliment—lime-wa- 
ter with milk ; aud, in fine, all fuch things as have the power 
of correcting putrefcency, and preferving as much as pofllble the 
vigour of the conftitution—hence reft of body, quietude of mind, 
cleanlinefs, and cool air, are eftentially auxiliaries, and fliould be 
attended to with the greateft exactitude: and as lying-in wo- 
men all have a greater or lefs degree of the predifpofing caufe in 
their habits, from the very nature, and unavoidable confequences 
of pregnancy, arifing from the diftenfion of the womb, produc- 
ing impeded circulation, and vafcular debility, the remote or in- 
ducing caufes (244.) Ihould be avoided—and from thence the ac- 
ceflion of the fever prevented : and as there is no difeafe, when 
perfectly formed, more dangerous in itfelf, fo difficult to cure, 
flill fo eafy to be produced by indifevetion and ignorance, I would 
on every confideration recommend the preventive mode to be 
clofely lludied, and afliduoufly purfued. 
Wc have now gone through that feries of fevers, of the four 
firft of which, all, either in their feparate or conjunct ftate, what- 
ever they be denominated, confift ; and it clearly appears, that 
the parts of the conftitution which are affeCted, are thofe which 
form the moving powers. (56.) and that it is by the morbid alter- 
ation of their action alone that fevers are produced ; confequent- 
]y, that it is from regulating their motions, and reducing them 
to a proper ftandard, that we can derive benefit in our curative, 
as well as preventive attempts ; for inftance : 
In the simple continued fever we find a fuperabundance 
af blood, and irritable ftate of the vafcular fyftem put into mo- recapitulation: 
249 
tion by fome remote caufe, occafioning increafe of action—in or- 
der to cure, we leffen the former, and decreafe the latter—for here 
we fuppofe not any contamination of the circulating fluids to 
have taken place. 
In the inflammatory fever we find to the fuperabun- 
dance of blood is added a morbid tenacity, and to the irritability 
a morbid augmentation of vafcular ftrength and firmnefs—in or- 
der to cure, our efforts are the fame as in the former cafe, only 
more powerfully, copioufly, and quickly exerted, with intent to 
thin the fluids, and debilitate the force of vafcular action, as well 
as leffen the quantity of blood, and decreafe the quicknefs of 
vafcular motion. 
In the nervous we find a different conftitutional flate of the 
moving powers—a torpor of the vafcular fyflem—ropy vicidity 
of the ferous or lymphatic fluids—with a morbid adtivity of the 
nervous fyflem— in order to curey we endeavour to roufe the 
nerves to the performance of their due adtion, and increafe the 
irritability of the fanguinary veffels through the habit. 
In the putrid we find, added to one or other of the ftates of 
the vafcular or nervous fyflem, a putrefcent flate of the fluids, 
either from the abforption of putrid particles, or the generation 
of them in the habit—in order to cure, we attempt to fupport 
the vigour of the fyflem, and corredt the putrefcent acrimony 
of the fluids, according to the affedlion of the moving powers— 
if of the inflammatory kind, by mitigating their too violent ac- 
tion—if of the nervous, by roufing their adtive powers, fo that 
in due time the offenfive matter may be feparated from, and 
thrown out of the mafs of fluids, by fome of the outlets of the 
machine ; which is the cafe in all other fevers that deduce their 
origin from any peccant matter in the habit. 
And we may venture to aflert, that any pradtitionerwho clofe- 
ly fludies, and perfedfly underftands the nature andmanagement 
of the four kinds of fevers fpecified above, will be fully compe- 
tent to condudt his patient, in the beft manner, through every 
kind of fever, be its nature ever fo apparently complicated. 
But, befides the fevers we have particularized, there are o- 
thers, denominated according to their form or mode of progrefs 
remittent or intermittent, though they really are of the 
nature of thofe of which we have before treated, either in their 
feparate or conjundl flate; and which we mud now proceed to 
explain. SECTION IX. 
C H A P. I. 
REMITTENT FEVER. 
T7EVER.S of this kind receive their name from the mode which 
they preferve through their progrefs, fleering betwixt thofe 
of the continued and the intermittent clafs ; for though the fe- 
ver does not preferve throughout an equal degree of violence as 
in the former, there is never a total cefiation of febrile affection 
before its termination, as in the latter. Thefe fevers, therefore, 
move betwixt the two extremes ; having, inftead of frefh accef- 
fions, as they are called in intermittents, only repeated increafe 
of action, denominated exacerbations ; between which a degree 
of vafcular contraclion and proflration of ftrength are continued, 
indicative of the prefence ol the febrile eaufe ft ill in action ; 
and from hence they take their name. 
But, indeed, the remiffions are fometimes fo flight, that they 
are with difficulty diftinguifhed by the clofefl attention from con- 
tinued fevers—though this diferimination is highly neceflary, as 
they yield more in their mode of cure to that we ffiall find em- 
ployed in intermittents, being fnbdued with more certainty by 
the bark, judiciovfiy udminifiered, than by any other application. 
Indeed, they feem to have fo great affinity with the continued 
and intermittent lever, that they fometimes run into one, fome- 
times into the other—and the continued, before it becomes in- 
termittent perfedlly, will affume the remittent type, fo will the 
intermittent before it changes into a continued. 
From fome appearances occurring in the courfe of thefe fe- 
vers, they have been divided into quotidian—tertian—or quartan 
•—according as the remiffion has happened on the fecond, third, 
or fourth day ; but in this divifion there appears to be no prac- 
tical utility—as it leads not to any particular mode of cute, nor 
affifls in diftinguilhing the nature of them, whether they verge 
mod to the inflammatory clafs, which knowledge alone muft de- 
termine our operations. 
DESCRIPTION. The}’-, like other fevers, generally begin 
with alternate chills and heat, ftretching and yawning ; and thefe 
are fucceeded by naufea, vomiting ol bile, giddinefs, and op- 
preflion—then commences the fever, and the heat continues ; af. 
ter thefe follow pain of the head, back, and limbs—heart-burn — REMITTENT FEVER." 
251 
and third—difficult breathing—anxiety—inquietude—and, fome- 
times from the firfl attack, delirium—the ftomach fwells now 
and then—the eyes are generally tinged with a yellow colour, 
and that diffufed over the whole body not unfrequently—the 
tongue is white and moift—the pulfe fometimes hard, feldom 
full—the bowels are at one time obftrudded, at another the re- 
verfe. 
Thus fituated are fome periods betwixt the fecond and eighth 
day ; which time a remiffion very rarely exceeds ; for the mod 
part a gentle fweat will comle on, and brings an alleviation of all 
the febrile iymptoms ; and this continues for fome hours ; after 
which, generally in the evening, the violence of the fever is re- 
newed, fometimes preceded by chillnefs, fometimes not. 
This repetition hath no fixed time for its continuance, in fome 
remaining a longer, in others a fhorter fpace ; but at lad gives 
way in its degree of violence, and remits a fecond time; and 
thus continues llu&uating till either totally fubdued by nature or 
art—or death clofes the fcene. 
When this lad is the cafe, the patient often dies in the parox- 
yfm, or renewal of the attack—the brain is immediately afte&ed 
—he lofes his fenfes, and the power of fpeech—his breathing be- 
comes quick—deglutition is impeded—a loofenefs comes on— 
the pulfe in the beginning foft, pot to be called weak, nor indi- 
cative of danger, in a few hours is fmall and depreffed, then cold 
fweats break out, and the unhappy victim expires. 
Thefe fevers have, by fome, been diled bilious, from the vo- 
miting of bile, fo common in their commencement, and the yel- 
low fuffufion on the fkin and whites of the eyes ; fuppofing thefe 
fymptoms to arife from the fuperabundance of bilious excretion, 
and the activity of the bile refcrbed into the habit, occafioning 
fuch febrile commotions—But it is obvious this change of co- 
lour is owing to another caufe, and that, the breaking down of 
the texture of the blood from the putrefcent tendency of the fluids; 
and thus may the colour more properly be accounted for ; be- 
caufe the bile may be returned into the blood, as in the jaun- 
dice, without producing thefe febrile attacks. 
In hot countries that are marfby, where the atmofphere is 
filled from thence with putrid exhalations, they are endemial, that 
ijs, nalive and refident—with us, and other parts of Europe, they 
have been obferved to become epidemical, that is, occafionally ge- 
neral, towards the latter end of autumn. 
CAUSES. The remote or inducing are faid by fome, as well 
as the proximate, to be fuch as bring on a continued, or inflam- 
matory, or a putrid fever, (ao<j, 221.] whilft others attribute the 
Jirjl to too great moifture in the air, the laft to infenfible perfpi- 252 
REMITTENT FEVER. 
ration impeded, and a relaxed ftate of fibres. However, from the 
hiftory of thele fevers, it is obvious, that they, at different pe- 
riods, and in different conftitutions, put on appearances which 
are very different, and according to which we are to regulate our 
conduct. Hence we fay, the 
CHARACTERISTIC SIGNS are, aremiffion or abatement, 
not a total ceffation of febrile affections, fucceeded by percepti- 
ble exacerbations, or increafe of febrile violence; which increafe 
is fometimes ufhered in with chillnefs ;—and if there are ftrong 
fymptoms of vafcular contra&ion, and great increafe of circula- 
tory motion, which are declared by extreme heat—thirjl—and 
pain—having a dry fkiti, Jlrong, hard, andfullpulfe, for their af- 
fociates, we lhall not heiitate to pronounce it inflammatory ; 
—but if attended with great debility—lownefs offpirits—naufea— 
opprejjion—vomiting—coupled with difcolour at ion of the fkin, and 
languid pulfe, its belonging to the putrid clafs is indifputa- 
ble. 
This fever is never free from danger; though the nearer it ap- 
proaches to an intermittent, or the lefs degree of fever continues 
during the remiflion, fo much more favourable the omen ; but, 
on the contrary, the more it puts on the appearance of a conti- 
nued fever, the fhorter the remiffion, and more violent the fever 
fit, fo much the more dangerous. If the urine, which was be- 
fore of a deep colour, becomes pale, we have great reafon for 
fear—If it changes its remittent for a continued type, the event 
is doubtful—and when the brain is affeded, and the reft of the 
fymptoms, as defcribed (Page -251. line 19, &c.) death is near at 
hand. 
CURE. The indications are fimilar to wh2t we have deliver- 
ed on the inflammatory (209) and putrid (221) fevers, adapted to 
peculiar Hates agreeing with them, by which this fever may be 
changed into an intermittent, or totally taken off—confequently, 
where the inflammatory fymptoms are prevalent, bleeding, cool- 
ing purges and glyfters—vomits—and fmall dofes of antimonials 
—watery diluting liquids drank plentifully—cooling acefcent ve- 
getables—will be the moft eligible aP the commencement, and 
will fo far anfwer the purpofe in fome cafes, that nature after- 
wards may be almoftleftto herfelf. 
Still, in others, fhe requires the moft immediate and powerful 
a Alliance—hence it is neceflary to point out the different pro- 
greffive appearances, by which may be difeovered the fituation 
of lafety, or danger, and the mode of proper management under 
each, as, from imprudent condud, this fever, from its mildeft 
Hate may be converted into that of extreme peril, and from this 
laft into certain death,' REMITTENT FEVER.' 
If, therefore, the increafe of the febrile afleCtions, a third time, 
fhould not be more violent, nor of longer continuance than that 
■which preceded, but nearly fimilar—if the urine iliould let fall 
a laudable fediment, without any vifible decreafe of ftrength, or 
increafcd dejection of fpirits, matters will wear a favourable af- 
pe£t; and about the fourth or fifth return of the fever, the pow- 
ers of the conftitution will commonly relieve themfelves by fome 
critical evacuation, either by the kidneys, skin, intestines, 
salivary system, or lungs, manifefled in turpid urine, prc- 
fufe fweat, bihous Jiao Is, copious j'pitting, or expebloration of matter 
of a yellow caf—for the fever generally refolves itfclf in one or 
more of thefe ways. 
But, on the fifth return, fhould there appear to be an increafe 
in degrees of feverity, in the fymptoms becoming more acute 
and dangerous—if the fit continues longer, and is more violent 
than before, and there are obvioufly a finking and lownefs of fpi- 
rits, with great debility of the powers of the fyftem, we mufl 
have recourie to blifters, which fome indeed advife at an earlier 
period, as calculated in a remarkable manner to bring on the in- 
termittent type—and bark as foon as poflible in the remiflion ; 
forty or iixty grains of the powder may be adminifiered every 
fecond or third hour—or, if the ftomach will not bear this quan- 
tity, a fmaller dofe be given at fhorter periods, or the decoction, 
(193.) hot or cold infufion, (No. 41.) with or without the vola- 
tiles or aromatics, as feern neceffary; to which alio may be oc- 
cafionally added, the other preparations of this medicine, (193 , 
194.) by thefe means many endeavour to tlop, or at leatl retard 
the progrefs of the next febrile fit, by throwing into the habit a 
fufficient quantity—and thus mull we proceed till we fhall be em- 
powered within twelve or fourteen hours to adminifler fix or 
eight drams. 
If we are not active at this period, and attempt not with all 
our power to mitigate or conquer the febrile affeCtions, we run 
the lifque of protracting the dikafe, and rendering it more re- 
plete with danger ; for now the fits become fo quick, and fol- 
lowing each other fo rapidly, that we are deprived of the oppor- 
tunity of throwing in the bark in proper quantity, and permit- 
ting a continued fever to be the confequence. 
But though bark in fome Hates of this fever is fo extremely 
ufeful, ftill, in every ftage it is not neceffary—nay, indeed, in 
the inflammatory remittents (25 1.) it is dangerous to adminifler 
it, whilft the action of the veifeis are too powerful; for from this 
we might produce the inflammatory continued fever ; therefore 
we mufl endeavour to lower the fyflem, by thofe means advifed, REMITTENT FEVER. 
(252, line 33.)—that done, the bark may then be advantageoufly 
thrown in. 
Before we clofe the account of this fever, we miifl obferve, 
that though bleeding, and that repeatedly, has been advifed in 
force of thefe fevers, and with confiderable advantage ; yet un- 
der fotne circumftarices there requires the niceft caution, with 
refpebt to the quantity to be taken away, notwithftanding the 
commencement being ufhered in with fuch fymptoms, as might 
authorife the operation ; lor bleeding has been allowed to do 
mifehitf, efpecially in hot countries, for there thefe fevers are 
generally of the putrid kind—therefore in our firfl bleedings the 
quantity fhould be moderate, feldom exceeding eight ounces — 
which may be repeated in cafe the inflammatory fymptoms con- 
tinue violent—but fhould thefe only be flight at firfl, and evacu- 
ations are neceflVy to be promoted, we can only depend upon 
the gentleil cathartics, fuch as oil of caflor, manna, tartarized 
kali, Folychrefl fait, and tartarized antimony—(See Cathartics, 
Simple continued, and Inflammatory fevers, where different for- 
mulae will be found) and alfo the faline mixture—which lafl of- 
ten repeated, is fail to be the moft certain alleviator of the vio- 
lent naufea and vomiting, which generally attend thefe cafes— 
or it may be given in its ft ate of fermentation, (No. 59.) and is 
greatly aflillant in eorre&ing the putrid difpoiition, and thofe 
loulneftfes which are collected in the ftomach and flexure of the 
duodenum—(42.) afterwards the bark mufl be freely applied. 
By thefe means thoufands have been faved ; and if they are be- 
gun with before the ftrength of the patient is exhaufted, and will 
properly puriue the advice given, feldom any die of this difeafe. 
However in the Weft Indies in this fever there is fomCthing 
very Angular, for it has been obferved, that if the bark was not 
given on the lirft remiilion, it was apt to run into the continued 
ipecies. 
There are innumerable varieties of thefe fevers mentioned by 
authors, who have given them different names, according to fome 
peculiar circumftances which attended—but all yield to the mode 
of treatment here pointed out--only in fome paying particular 
attention to any uncommon fymptom which occurred—two of 
which we fhall point out. 
Bilious remittent Fever. 
This attacks generally in the middle of Auguft, and is attend- 
ed, befidts the common fymptoms, with violent pain of the head, 
and often with delirium, which fymptoms continue in the night, 
vanifh in the day-time, after fweatirig, a haemorrhage or loole- REMITTENT FEVER. 
255 
hefs. In the beginning there is frequent naufea, bilious putrid 
vomiting, and in the end oppreffion. 
In extreme cold weather, and at the approach of winter, a 
cough, rheumatic affe&ions, and tenacity of the blood, accom- 
panies thefe fevers—but it is from the bilious purging and vo- 
miting that it derives its name. If evacuations are not directed, 
a continued fever with yellownefs comes on. The cure is per- 
formed by vomits cathartics, acids* and bark ; but we mull firft 
perlill in the ufe cf evacuants before we give the bark, and then 
it is admirably conducive to promote the cure. This remittent 
is efteemed of the inflammatory clafs. 
The other we fkall mention is of the putrid clafs. 
Marsh remittent Fever. 
This is the bilious, or putrid fever of the low marftiy countries 
defcribed by Sir John Pringle. 
This lever not only happens in moilt, but alfo in warm coun- 
tries, according to the feafon, as they come on in the months of 
July and Augult, from putrid vapours ariiing from corrupted 
plants or filh. 
This bears bleeding very indifferently, and fhould rather be 
treated in the evacuating and ftrengthening method ; at the be- 
ginning clearing the firft paflages with gentle emetics and cathar- 
tics, and continuing fmall doles of antimonials—which not l'uc- 
ceeding to our wilh, bark mull be called in to our aid to per- 
form the cure. 
In order to prevent the attacks of the remittent fevers, as they 
are chiefiy the children of moilt feafons, and low marfhy coun- 
tries, we fhould keep good fires, with intent to correct the atmof- 
pheric humidity—make ufe of aromatics—avoid the evening and 
morning air—drink red wine—ufe exerciffc and the cold bath— 
take bark once or twice a day, mixed with bitters—and fmoak 
tobacco—for people who have obferved thefe rules have, many 
of them, efcaped in countries where this fever has raged epide- 
mically, and affli£ted numbers who have defpifed thefe cautions. 
SECTION X. 
INTERMITTENT FEVER. 
nPHESE fevers receive their name from the nature of their pro- 
.1 grefs> having a perfect ceflation of febrile affe&ions from 256 
INTERMITTENT FEVER. 
the termination of one fit to the beginning of another, and 
may be confidered as continued fevers of fhort duration, confid- 
ing cf many febrile fits, the fever returning at dated periods ; 
for in every fit the courfe of a continued fever is run through—■ 
the coldnefs and fhivering is the beginning—the hot fit the height 
■—and the fweating generally attendant, or at lealt a gentle per- 
fpiration the criiis or termination. What happens in thefe dif- 
ferent ftages is thus properly defcribed : 
DESCRIPTION. In the sirst stage it begins with 
yawning and firetching, and a certain indei'cribable fenfation in 
the back and the ends of the fingers ; after thefe fucceed excef- 
five coldnefs, infomuch, that it occafions violent fhaking of the 
whole body, and chattering of the teeth ; ftill, in fad, the blood 
is in a date of increafed, ratlier than diminifhed heat—there are 
alfo naufea, and fometimes vomiting attendant, with pains of the 
back, head, and limbs—the ends of the nofe, ears, lips, and cheeks 
grow pale—the nails livid—the breathing is difficult—the urine 
pale and limpid—the pulfe weak, and extremely quick—and this 
cold fit continues for one, two, three, four, or five hours fome- 
times, at others only half an hour before the hot fit commences 
•—which forms the 
Second stage, in which there is extreme degree of heat im- 
mediately fucceeding the cold, which goes off gradually : in this 
the pulfe becomes full, quick, and flrong— the head is painful— 
and fometimes the patients are delirious—their breathing is for- 
cible and free—the tongue white, attended with great thirft—at 
the pit of the flomach they complain of much heat, have pain 
there, and fometimes fwelling—the urine is h'gh coloured—and 
when blood is taken from the arm it is move denle than ufiial, 
particularly in fpring—fometimes in unwholefome fituations arid 
feafons the fuperior part is red, the inferior black, with a final! 
portion of ferum, and that lefs cohefive than when in health. 
At the-commencement of the 
Third stage there breaks out a general and copious fweat, 
which alleviates the extreme heat, and mitigates all the l'ymp- 
foms, which, on the fweat continuing for fotne hours, totally va- 
nifhes —the urine depofits a fediment like brick-dull—the patient 
falls into a found deep—and thus the fit doles with a ceffiation. 
of all the febrile fymptoms ; and this, called the intermiuion, in 
which the patient feels fome degree of debility, has much pro- 
penfity to fweat, and little or no appetite. 
It has been thought that we could prognoflicate the violence 
of the hot, by the degrees of the duration of the cold fit, for the 
longer the latter continued, the more fevere would be the for- INTERMITTENT FEVER. 
257 
met—but this is erroneous, for the fenfation of cold grows weak- 
er in long continued intermittents. 
In fome countries thefe fevers are peculiar, as the fens of Cam- 
bridgelhire, Lincolnfhire, the low parts of Kent, the marfbes of 
Efiex, and in places where there is much moitlure, and the fitu— 
acion low ; and here they generally appear in fpring or autumn. 
They feldom vifit other places, except in feafons adapted to their 
propagation, and then they become epidemic. 
They have been divided into vernal and autumnal, endemical 
and epidemical, and into quotidian, where from the termination 
of one fit to the beginning of another the fpace of 24 hours is 
confumed—tertian, where that of 48—quartan, where of 72— 
and when longer, erratic. They have alfo been divided far- 
ther ; but they feem to be of no pradical ufe, as the modes of 
cure in all are very fimilar. 
CAUSES. The remote or inducing are, immoderate evacua- 
tions—cold moift atmofphere—irregular or improper diet of 
crude watery vegetables—lownefs of fpirits—crudities in the 
firft paflages—and, in fine, every thing which contributes teg 
produce a relaxed ftate of the folids, and poverty of th® 
blood. 
The proximate or immediate, effluvia from moift, marfliy places 
called inarlh miafma—impeded perfpiration, and relaxation of 
the folids. 
Hence are the poor more fubjed to this difeafe than the rich 
and affluent, thofe who inhabit the country more than thofe who 
live in large towns and populous cities ; for generous diet and 
warmth are p efervatives againft the difeafe as well by purify- 
ing the air, as invigorating the habit. 
CHARACTERISTIC SIGNS. Affedions of both the ner- 
vous and vafcular lyftems, from marlh effluvia running through 
the courfe of a continued fever, of fhort duration, beginning with 
cold and {hivering, fucceeded by great heat, and terminating, for 
the molt part, in profufe fweats, in one fir, which leaves the ha- 
bit perfectly free from fever for fome time, and returns at ftated 
periods. 
CURE. The indications are, to prevent the return of the fe- 
brile affedions, by taking off the too great instability of the 
nervous, and irritability of the vafcular fyftem, by giving tone 
or ftrength to the neryes and vefFels, and rendering them inca- 
pable of feeling the effed of morbid particles in the habits, 
called marlh miafmata, and ejeding them out of the conftitu- 
tion. 
But at the commencement of fevers we cannot immediately 
difeover of what particular nature they are, and one the dealt 258 
INTERMTTENT FEVER. 
dangerous may be converted into others which are more hazard- 
ous, by injudicious treatment, as an intermittent into a remit- 
tent, and this into a continued ; we Ihould at the fird onfet be 
Careful, till we are convinced of its fpecific nature ; therefore to 
general means we fnoukl only have recourfe, which may in all 
fevers bepioper, be they of what fort they may, and this will 
depend on placing the conftitution under fuch circumftances as 
approach nearer to a Hate of health. 
Therefore, in the beginning, if the pulfe give evident figns of 
fullnefs, with other concomitant fymptoms, which indicate eva- 
cuations to be proper, as we have before fpccified in the remit- 
tent and other fevers, blood may be taken from the arm. Should 
there be naufea or licknefs, indicative of foulnefs of the ftomach, 
an emetic, (No. n, 12. 38.) fhould be adminitlered, and the bow- 
els cleared by fome gentle aperient medicine. (No. a. 22 to 
24.) 
Where thefe are thought necedary, bleeding and cathartics 
fhould precede the adrainiftration of the emetic, that no mifehief 
may arife from its operation, which might be the cafe, fhould 
there be any local ccngeftion, or too great genera! fullnefs, by 
rupturing, or diftending the veflels too much, or pufhing the 
blood too powerfully into the fmall capillary tubes, particularly 
of the head. 
If thefe prove infufficient, we mud proceed to the ufe of an- 
timonials in fmall doles, united with thefaline mixture, or alone, 
(No. 6 to 9.) as has been before dire&ed—and, as foon as the le- 
ver fhews what it is, take iuch heps as its nature demands—if 
an intermittent, the molt powerful medicine, with which obfer- 
vation and experience has furnifhed us, is the Peruvian bark, 
(193, 194-)—*he quantity given fhould be generally fo much in 
the interval between the fits as will prevent their return, that is, 
in adults, from fix to eight drams. 
The moll efficacious mode of adminiftration that has been re- 
commended, is in powder mixed with red wine. 
Where the intermillion is lliort, it is given at ffiorter intervals 
and vice verfa. 1 always conlider what is molt agreeable to the 
patient refpe&ingthe form, and give a dofe every one, two, three, 
or four hours, as occahon requires—the nearer the approach of 
the ufual time of accellion, the quicker it fhould be repealed, in 
order that it may at that time exert its fulled action with its 
greated power. 
Should the febrile fits be by thefe means conquered, we mud 
not totally delift from its ufe, but for a few days repeat it at pro- 
per intervals, every fifth or fixth hour j then for a week, twice INTERMITTENT FEVER,. 
in the twenty-four hours j afterwards, once for the fame, 
fpace. 
In winter, after defifting for a week, or ten days, it will be 
prudent to return to it again occasionally for two or three days, 
and fo perfift for a few times, which will effectually fecure the 
patient from a relapfe. Add to this, the patient fhould avoid 
expofing himfelf to the remote or inducing caufes, (257.) ule gen- 
tle exercife, particularly riding—light nutritious diet—animal 
food—red port, ciaret, or any generous wine, in proper quanti- 
ties—fuch as are eafily digefted, will ferve to flrengthen the fo- 
lids, and promote a free and regular circulation. 
Large draughts of any kind of liquids, however thirfly the 
patient may be, Lhould not be allowed in the cold fit, as they 
will load the ftomach too much, and increafe internal oppreffion 
and uneafinefs ; but in the hot fit, watery fluids, fuch as l'age, 
rofemary, balm-tea, fmali white-wine whey, and fuch like, may 
be liberally adminiftered, 
1 he forms in which the bark is adminiftered, are either in bo- 
lus, pills, eleCtuary, decoction, infufion with cold or hot water, 
limple powder, tinClure, or extract. (See the doles, 193, 
194.) * 
When we want to throw in as much as pofiible in a given time, 
(ice No. 70.) and let it be adminiftered every fecond, third, or 
fouffli hour, according to the times of the febrile acceffions. 
(258.)’ 
Where bark has difagreed, equal portions of quaflia wood and 
fnake-root, infufed in boiling water, or oak bark in powder, or 
extraCt alone, joined with alum, or chamomile flowers, have been 
efficacious, given during the intermiffions every three or four 
hours, (No. 71, 72.)—the virtues alfo of cupulas, or fcaly cup, 
which embraces the bottom of the acorn, are fimiiar, in a confi- 
derable degree, to the oak bark. 
The method above laid down will generally be fuccefsful in 
the quotidian and tertian intermittents, (2,57.) particularly if we 
couple fuch medicines along with the bark as /the nature of the 
conifitution of the patient, and the apparent febrile fymptoms in- 
dicate, viz. if the habit appears robufl, the puife, in the febrile 
fit, full, hard, and quick, with other inflammatory fymptoms, 
bleeding has been greatly beneficial; and in thefe cafes, joining 
the bark with faline fubftances, as tartarized kali neutralized with 
lemon juice, (No. 1.) and the decoClion of bark, or fixed fal am- 
moniac, (176.J—-if contrary appearances, cordials and volatiles 
have fupplied their places, as volatile fait of hartffiorn, (150.) 
tincture of fnake-root. (179.) 260 
INTERMITTENT FEVER# 
Notwithflanding which, they will fometimes prove very ob- 
flinate—in thefe cafes vomits (No. n, 12. 38.) given a fmall 
fpace of time before the return of the fit, and antimonials in fmall 
dofes, (230.) purfucd through thecourfe of the hot fit, have been 
found beneficial—or, where the habit has been in a highly irri- 
table ftate, opium, (152.) adminiftered before the fit, or in the hot 
flage, feemed of ufe. 
It is only though in the quartan (257.) intermittent that they 
are often required, feldom in the others preceding, notwithftand- 
ing the hot and cold fits continue a ihorter time than the two for- 
mer, the whole fit feldom lafting above five hours. 
Bark feldom fails of completing a cure, if judicioufly admini- 
flered, and the concomitant circumftances which fometimes ap- 
pear, are properly attended to—when it does, the failure is ow- 
ing to fome of the following particulars—either it has been gi- 
ven in too fmall dofes—not perilled in long enough—-given in 
an improper form—or fuch medicines may not have been added 
to it, nor fuch a regimen obferved, as the peculiar nature of the 
Cafe required. 
Sometimes the bark has a tendency to pafs off through the 
bowels, then it is necefiary to add a few drops of tindure of 
opium to each dofe, which will prevent that effed—at others 
the habit will be too coffive, eight or ten grains of rhubarb may 
be given foon after the ceffation of the fit, to obviate that incon- 
venience—fometimes the ftomach will not bear it, it may then be 
adminiftered in form of glyfter, (No. 73.) 
It is fometimes extremely difficult, and very often impoffible, 
to get children to take a fufficient quantity of this medicine to 
anfwer the defired purpofe—for the belt form to which they will 
adhere the lougeft, (See No. 74.) 
But they have been cured by baths, in which half their body 
has been immerfed, of bark decodion, rubbing the fpine with e- 
qual parts of foap liniment and tindure of opium—or wearing a 
waifleoat made of callico doubled, within which bark has been 
quilted. 
With refped to our prognoftics in thisdifeafe, when eruptions 
appear upon the lips, they afford a good omen ; and the more 
regularly the fever pafles through its ftages, fo much the better. 
Epidemic fevers of this kind are worfe than thofc which occur 
accidentally to a few—quartans than quotidians or tertians— 
autumnal, than vernal—Inflammation of the tonfils is confidered 
as mortal—fometimes it carries off thofe who are very infirm in 
the firfl ftage—they frequently leave the conftitution extremely 
weak, fo that it requires a long time for the re-eftablifhment of 
perfed health j which muff; be affifted by proper regimen, ancl intermittent fever. 
<exercife, as has before been fpecified, after the termination of 
other ievere fevers—fome times they terminate in jaundice, con- 
fumptions, and dropfies, which, if they arife from feirrhofities, or 
hard irreloluble tumours of the vifcera, are fatal. 
Eat, notwithftanding what may be thought, with refpe£t to 
the necefiity ol an early cure, it is not always proper to take oif 
this fever immediately—lor by their continuance, they have been 
known to cure epilepfy, fevere coughs from affections of the li- 
ver ; alto hypochondriac and gouty affe&ions have difappeared, 
by this fever bringing about, from its continuance, fome faluta- 
ry conditutional changes—the bleeding piles, fmall-pox, and 
other acute fevers, as well as ftrong mental affe&ions, have bsea 
known, on the other hand, to fubdue the ague. 
SECTION XL 
HECTIC FEVER, or 
Chronic remittent Fever without Crisis. 
HTHUS would T W101 to denominate this fever, becaufe the word 
**- HrGTiC, except from long continued culiom alone, gives us 
no determinate idea relpe£nng it; and where any complaint is 
peculiarly marked by any known caufe or fymptoms, by which 
it deviates tiora all others of the fame clafs, and by which from 
them it may be diftingmihed, can be confined in a very (bort 
compals, by terms expteffive of that peculiarity would I have it 
marked down. As, therefore, heftic fever is of longer duration 
than any other remittent fever, goes off, when curable, by no 
known crifis, and, during the whole courfe, has various exa- 
cerbations and remiffions, I have ventured to alter its appella- 
tion. 
Authors have been much divided with refpeft to this fever, 
fome confidering it always fymptomatic, deriving its fource from 
fome local complaint, and depending entirely on that—others, 
that it may alio be a primary difeafe, neither arifing from, nor 
dependent on any -other—for the latter opinion I confefs myfelf 
an advocate; for, though heftic fymptoms certainly do derive 
their fource from fcitrhous obftruetions and ulcerations of all 
the vifcera, more particularly of the lungs (28.) and mefentery, 
(46.) becaufe it is faid the former are expofed to injuries from 
the external air, and the force of the blood circulating through 262 
HECTIC FEVER, OR CHRONIC 
their fubftance ; the latter is fubjedf to the fame from compref- 
fkm of the aliments in the firft pafiages, from vifeid chyle, (43.) 
and the flower circulation of the blood through the inteftines ; 
ftill may they arife immediately from fome acrimony of the blood, 
becaufe they have occurred certainly where no one vifeus, 
through the whole courfe of the difeafe, was affedbed more than 
the reft ; nor do the vifceral obftrudtions, which are always found 
on diiledtion, deftroy the validity of this opinion ; for they are 
the effedbs, as well as caufes, of hedbic fevers—of which we fhall 
be convinced, if we will only examine the remote or inducing 
caufes, which w?e fhall fhortly fpecify. 
DESCRIPTION. The fymptorns are very fimilar to what 
appear in confumption of the lungs—the patients labouring un- 
der this complaint have a continued, dry, unnatural heat; they 
lofe their appetite, and their pulfe is fmall, weak, and frequent, 
though fuller and dronger after eating ; they have no fenfatior* 
of licknefs ; after meals a fluffiing of the cheeks comes on ; and 
their urine is in general red, and covered with an oily pellicle ; 
their deep by no means refrefnes them ; they become hollow-ey- 
ed ; their Ik in grows harfli, the belly links inwards ; a colliqua- 
tive loofenefs comes on, the body grows tabid, and death makes 
its approach by flow degrees. 
On this fever the fagacious Dr. Heberden has made feveraj 
itfeful remarks in the London Medical Tranfa&ions, Vol. II. page 
i, &c. amongft which he fays, “ the molt certain mark of this 
“ fever is, when the fweat, which ufually attends this fever, is 
“ over ; the fever will fometimes continue, and in the middle 
,s the chillnefs will return.” 
This is very readily diftinguiflied from all other fevers by the 
fiownefs of its progrefs—but from the full llage of the watery 
head, with great difficulty, and not without the moft affiduous 
attention to the fymptorns peculiar to each. 
CAUSES. Remote or inducing are, immoderate and long 
continued mental alFeflions—long watchings—too great evacua- 
tions, whether of blood, milk, femen, faliva, pus, fweat, or the 
alvine fluids—too acrid medicines, as mercurial preparations, 
flrong purges, too often repeated—debility of the firft paflages, 
by which the chyle, either crude or corrupted, is conveyed into 
the circulating mafs of fluids—preceding difeafes, as intermit- 
tents, fmall-pox, meafles, dropfy, feurvy, king’s evil fo called— 
fuppreffed evacuations—frequent intoxication—old people and 
infants are alio fubjed to if, from their age alone, dependent up- 
on conflitutional debility. 
The proximate or immediate, both from the preceding caufes, 
and the modes of cure, are faid to be, a laiine and alealefeent REMITTENT FEVER WITHOUT CRISIS. 
263 
ftate of the fluids—whether this may be the precife cafe, per- 
haps it may be difficult to determine—though mucilaginous ma- 
terials and acids are faid to be beneficial, yet it is highly proba- 
ble fome fpecies of acrimony takes place in the habit, as the fun- 
damental principle of this difeafe. 
CHARACTERISTIC SIGNS. Febrile affedions long con- 
tinued, having frequent increafe of violence, no perceptible in- 
termiffion, and not terminating in crifis, attended with irregular 
vai'cular aition increafing often in the day, move fo in the even- 
ing and generally at the beginning with tenacity, towards the 
termination, with putrefcency of the blood. 
CURE. The indications are, to mitigate febrile affe&ions, 
and corre£l the acrimony of the fluids. 
If care is taken of this complaint at an early period, and pro- 
per advice adminiftered, a cure may he effected—but, under 
thefe circumflarices, patients often delay too long, and confide 
either in their own imaginary knowledge, or the family receipts 
of fome humane old woman, till little chance remains for the Ikili 
of the more judicious ; for when the powers of the conflitution 
become to be greatly debilitated-—the hair falls cfr—a colliqua- 
tive diffolving loofenefs, night fweats, and fwellings of the legs 
come on—the urine begins to have an oily appearance, and the 
countenance aflumes a cadaverous afpect, becoming thin andghaft- 
ly, all prol'pe£t of warding off the fatal blow is irrecoverably gone, 
the patient is got bey'ond the reach of our art, and death quick- 
ly clofes the fatal feene. 
In the beginning, where we can be of fervice, we muft firfl of 
all clear theJiomnch and bowels by gentle emetics, (No. Si, 12.) 
and mild aperients, chiefly rhubarb—abate the febrile heat by fmall 
doles of Polychrell fait, (171.) and nitre, (177 ) and giving fucli 
doles of oil of caflor, manna, or fome fuch like cooling and gent- 
ly opening medicines, as will keep the body free from coftive- 
nefs, (171, 172.) —in order to Jheath the acrimony of the fluids, 
we muft have recourfe to demulcents, (1S7.) emollients, (137.) 
and particularly, which will be more effectual, to a well-regulat- 
ed diet and regimen. 
The food fhould confift of chicken broth, jellies, and if the fto- 
mach will bear them, oyfters—-milk, particularly women’s or 
afs’—goat’s whey—buttermilk, with Briftol or beltzer water. The 
patient fhould live in a clear country air, on a dry foil ; keep 
cheerful company ; ride conftantly on horfeback, or travel from 
place to place—or he fhould take a voyage to fea, or fail every 
day, for that has been known to fave numbers in the beginning 
of this difeafe, and fome who were rather advanced ; but to all 
it affords great relief. And at the fasne time, with intent to keep 264 
ERUPTIVE FEVERS. 
np the tone of the fyflem, mild aflringents, flight infufions of 
bark, one ounce and an half, with ten drops of dilute vitriolic 
acid may be. given twice a day, or two or three ounces of tinc- 
ture of rofes alfo ; three or four drams of the conferve may be 
mixed with fix or eight ounces of milk, and taken two or three 
times, or oftener, in the day ;—as for common drink, they ihotfd 
life bailey water, deco&ion of marfh-mallows, linfeed-tea, or that 
of colts foot. Briflol water has been elleemed highly fervicea- 
ble ; but it is often deferred too late. In the earlielt ftages of 
this difeafe it fbould be applied to, tor in them it promifes to be 
of the ruoft effential fervice, little, as we have before remarked, 
being capable oi being done in the more advanced or latter pe- 
liods. 
SECTION XII. 
ERUPTIVE FEVERS. 
GO called from the Latin word erumpo, to break out, and alfo 
in medical language EXANTHEMATOUS, from the Greek word 
exanthema, puftula, a puflule, becaufe thefe eruptions make 
their appearance on the furface of the fkin—and this is done by 
the effort of natare to throw out fome matter olfenfive to the 
coniiitution, which was creative of difeafe. 
Now though thefe partake of the nature of fome of thofe we have 
mentioned in Se&ion 8th, Hill they derive their names from the 
eruptions with which they are conflantly accompanied, and of 
thefe there are feveral fpecies and varieties—of which we fhall 
treat feparately, becaufe they require different modes of manage- 
ment, according to the different effects they produce upon the 
conftitution. 
And thefe effe&s will be affifted or alleviated, by attending 
more to the habit of the patient than to the Ipecific nature of the 
morbid particles which produce them ; for we know nothing of 
the materials* or tire parts of which thev are formed, confequent- 
ly cannot be able to find out any fpecific remedy which can cor- 
rect them, fo that the difeafe, of which they are the fource, may 
be fubdued, by weakening or deftroying the power inherent in 
themfelves. 
Therefore, in all our medical exertions, we attempt only to 
prevent the ill confequences they are likely to produce, by fo 
guarding the conftitution, that nature may be empowered to fe- ERUPTIVE FEVERS. 
265 
ji&rate and throw out what would, if fuffered to remain, prove 
fatal to the human machine, either producing immediate death, 
or bringing on other maladies which would in time have a iimi- 
lar termination. 
Now all thefe fevers of which we are going to treat are efteem- 
cd infectious, confequently contagious ; for thefe two terms are 
ufed fynonymoufly by the moll learned authorities. Notwith- 
itanding which, I would endeavour to make fome difcrimination 
between them, and am warranted in the attempt, if anv the leall 
benefit can be derived to l'ociety by the obfervance of fuch a dif- 
tindtion ; to prove which, I afi'ert, that there are fome difeafes 
which are acquired by the particles of morbid matter floating in 
the circumambient atmofphere, either from that matter being in- 
haled by the lungs, impregnating what we eat or drink ; or ab- 
forbed by the inhaling Veflfels of the Ikin, nofe, or fauces, whiltl 
others are communicated from contadl alone—hence the former 
of thefe I would term infettious, the latter contagious; and for 
this reafon the modes of prevention would be different—for in 
a country or town where the firil was rife, quitting thole places 
is abfolutely necefiary ; but where the lall, cautious refideuce in 
tiie fame is fufficient, avoiding commerce wdth perfons fo contami- 
nated ; or touching any materials, which are capable of retaining 
the contagious matter, that have by them been ufed or handled. 
Belides, in this county, it ihew's, in cafes of the plague, the fe- 
curity in drawing lines of circumvallation to prevent its pro- 
grefs ; indeed other modes, from this idea, might be found out 
of great utility under thefe unhappy circumilances. Support- 
ed by thefe reafons, I ihall beg leave to preferve the difference 
between the two terms, and proceed to treat on eruptive fevers 
from infe&ion ; and, firil, on the 
$ i* Small-Pox, or Pocks. 
Becaufe we call a lingle puftule pock—this feems to be derived 
from the Saxon word poccai pocket, or the French pocbe, a i’mall 
bag. The Latins gave the difeafe the term variohe, becaufe 
from the eruptions it altered the appearance of the ikin. 
This complaint is occafioned by morbid matter ol a peculiar 
nature abforbed into the habit from the external air, from con- 
tact of a perfon infedled, or from inoculation, either by the in- 
haling veflfels of the ikin, lungs, membranes of the nofe and 
mouth, or firil pailages—and has been divided agreeable to the 
cuticular appearances, into diftindt, confluent, coherent—or into 
common, cryjlalline eruptions full of thin ferous matter—verru- 266 
SMALL- POX# 
roua, rcfembling warts—or bloody, filled with red fluid, or blood 
in a broken ft ate. 
However generally now we adhere to the terms diflincl and 
confluent ; but tills leems of little ufe in pradtice ; for they may 
be diflincl, yet of a very bad kind ; and confluent, yet very 
good; therefore the more eligible divifion appears to be into fitn- 
plt'and malignant—the firft comprehending thofe which are the 
leaft, the laft, thofe which are the moll dangerous. 
This difeafe ha:s four ftages : the firft, the flebrile, which con- 
tinues three days—2d, the eruptive, two days—3d, the fuppura- 
tive, five or feven—4th, the exflccative, or ftage in which the 
puftules dry, two or four days—or fometimes another fever 
comes on, called the Jccondary. 
DESCRIPTION. It generally commences with fymptoms 
of an inflammatory fever, from whence the particles of the mor- 
bid virus are confidered not only highly fubtilized, but inflam- 
matory and ftimulant, attended with naufea or vomiting--pain iti 
the head and back—tightnefs about the pit of the ftomach—the 
patients are very drowfy, fometimes delirious—in grown people 
often fweats break out on the firft days, and infants are apt to be 
feized with convulfions—the flein though, in general, is rather 
moift and foft—the upper orifice of the ftomach fometimes 
acutely painful, and alfo the Ikies. 
Thefe fymptoms continue three or four days, on which appear 
fmall red fpecks like flea-bites ; which, when prefled with the 
finger, may be felt hard in the flein, and thus may be diilinguifh- 
ed from other eruptions, particularly the meafles, which, on their 
firft appearance, are very feldom fo hard, or can be felt in this 
manner, as not elevating the cuticle fo much ; firft on the face, 
and fcattered on the hands, neck, and breaft ; and with thefe 
commences the fecondflage; from which period the puftules keep 
continually increafing, and diffufing themfelves over every part 
of the body ; at which time the fever goes oft when the 
tion is completed ; after this they inflame, begin to be prominent 
above the fkin, are painful, hot, and fill about the fifth day ; 
and have round their bafts a circular florid rednefs—the throat 
alfo is painful, and inflamed commonly—the face begins to fweji 
and puff up, for the moft part, on the feventh day, fo much, that 
they generally clofe the eyes, and occafion blindnefs. 
At this period, the commencement of the third flage, as if from 
external irritation, foliciting the perfedl and complete difeharge 
of morbid matter, frefli febrile fymptoms arife, which continue 
to the ninth, tenth, or eleventh day, according to the feverity of 
the difeafe, or quantity of the eruption. The puftules having 
acquired their full ftze, moft of them as big as peafe, are filled SMALL-POX. 
267 
with a whitifti or yellowilh matter ; this concludes the third ftage ; 
and then the matter oozes out at the top of the eruptions, dries, 
turns of a dark colour, and forms hard fcabs, and this is in the 
fame order in which they made their appearance—and, as the 
face fnbiides, the feet and hands fwell, and fubfide not totally till 
the fourteenth day, at which period the difeafe is confidered to 
have completely finifhed its courfe, which forms the conclulion 
of the fourth ft age. 
This is in general the progrefs of the Ample or mild fpecies— 
though l'ometimes another fever, called secondary, will come 
on, when the eruptions have run fo together, that they form one 
uniform cruft, and by that means, obftrudi perfpiration ; fo that, 
inftead of the quantity of variolous matter palling out of the ha- 
bit, it is again re-abforbed, and the inteftines are loaded with an 
often five collection of acrid materials, which create a fever of the 
remittent clafs that often proves fatal. 
But in the confluent fort there are fome peculiarities which ought 
to be fpecified ; and, therefore, we mall obferve, that in thefe 
the puflules break out fooner, on the fecond or third day -, the 
febrile fymptoms run on with a greater degree of violence—and 
on the appearance of the eruptions, or a day or two after, which 
happens now and then in the diftinft fort a fpitting will come on, 
gradually increafing to a falivation in grown people—in infants 
a loofenefs fuppiies the place—though in common the attendant 
fever of the fmall-pox is of the inflammatory kind, yet, in the 
more complicated fort, the fever affumes a different type, and 
puts on the appearance either of—iff, an inflammatory remittent 
—2dly , nervous— 3dly, putrid fever—or is affociated, qthly, with 
fymptoms of dyfentery. 
In the first, the febrile afteftions run very high, with ex- 
ceffive heat, and great proftration of ftrength—the fkin is dry 
and hot—the arteries, called carotids, running through the neck 
into the fuperior parts, throb—the tendons, (22.) grow ftiif—the 
eyes are bright, vivid, and full of blood—the head and loins are 
painful, often without any delirium or drowfy dilpofltion—when 
the eruption is finifhed, if the patient dies not before the com- 
pletion, which, from the violence of the fever, is l'ometimes the 
cafe, the head-ach, pain in the loins, vomiting, and other fymp- 
toms, are relieved ; but the fever revives its former force, or 
continues, and has increafe of febrile affeclions every thirty-fix 
hours— hence termed tertian ;—at this period there arife want of 
deep, delirium, anxiety—there alfo come on bleeding of the nofe.; 
copious fweats—then heat, and drynefs of the fkin—very often 
miliary eruptions break out in fpaces between the puflules, or 
fmall purple fpots like flea-bit—fometimes an eryfipelatous in- 268 
SMALL-POX. 
flammation will occupy the head and face, and occafion a large 
inflammatory fwelling—the febrile and other fymptoms increafe 
in the fuppuvating ftate, with tolling and delirium—the puftules 
fubdue not, nor ieem to be of a very bad fort—fometimes though 
they grow black and mortify—then the patients lie in a ftate of 
aparent deep, and convulfious dole the lcene. 
In the second, at the commencment, there is great proftra- 
tion of ifrength, lownefs of fpirits, obfeure febrile fymptoms, ex- 
treme naufea, ficknels, and oppreffion. 
Ihe puftules never puili forth perfectly, nor maturate kindly, 
but many lurk in the fkin ; and thofe which elevate themfelves 
a little above it, are flat and depreflfed, containing a thin aqueous 
fluid, and have a fmall black fpot in the middle—the face, when 
the eruption is copious and runs together, never fwells, but looks 
as il covered with a yellowiih fkin, fomething like a macerated 
bladder of that colour. 
A thin ferous loofenefs generally comes on—if not, convulfi- 
ons put a period to the unfortunate patient’s exiftence. 
In the third, the fymptoms preceding the eruptions are 
nearly hmilar to the former; but the puftules are black ; the 
bottoms of which are in a mortified ftate ; indeed, the texture 
of the blood is fo broken by the putrefeent acrimony, that it 
runs oft’ by urine, and various other haemorrhages ; the fpaces 
between the puilules are black, and large broad lpots, called vi- 
bices, or fmall ones, like flea-bites, are formed on the lkin ; be- 
tides, the red portion of the blood not only mixes with the 
ierum, and tills the eruption, but it raifes large blifters elfe- 
where. 
Thefe puftules, 'which are only a little elevated, beginning to 
appear upon the fecond day, are black ; the urine, for the molt 
part, is bloody; as are alfo the ftoofe, fpittings, vomitings, and 
in fome even the tears ; the fever is violent, and the febrile fits 
almoft infuppoi table. 
In the i ourth, which was called dysenteric, becaufe it 
happened in the year 167c, at the time of the epidemic dyfente- 
ry, and partook, in fome degree, of its nature ; or, bccaufe the 
matte! ot the fmall-pox was often thrown out of the conilitution by 
inteftinal evacuation, when treated by the warm regimen, not un- 
common in thofe days, 
In this the eruption does not occur, as in the mild fort, on the 
fourth, but on the third day; the puftules are of a lefs fize al- 
ways, and are fharper, or more pointed at the top, and grow 
blackilh towards the conclufion—beudes, a copious difeharge of 
ialiva, as in the confluent kind, is often a concomitant. Should 
the acrimony of the putrid, which produces the alvine flux, that SMALL-POX* 
forms the charaCteriftic fign of this fpecies of fmall-pox, be ve- 
ry copious and active, occaiioning the dilcharge to be violent, it 
almolt always proves mortal. 
CAUSEb. The remote or inducing of this, as well as of eve- 
ry other ipecies of infectious or contagious fever, is a predilpo- 
fition, or peculiarity of the conftitution to feel the impreffions 
made by the morbid matter, productive of diltrefs in the mov- 
ing folids, and alteration of the fluids of the machine. 
jf he proximate or immediate, contaminating particles, peculiar 
to the imall-pox, abforbed into the habits, and thefe producing 
febrile effects, which vary according to the nature, or particular 
Hate of rhe conilitution at that time. 
CHARACTERISTIC SIGNb. The only certain ones are 
the eruptions themlelves, with their progreflive concomitant 
iymptoms, the appearance of which may be lufpeCted in the fivft 
ftagc, it the attack, ihould be fudden—if the fmall-pox lhould be 
the reigning epidemic, or the patient fo fituated, that he has been 
thrown'in tne way of this fpecihc infection—if pain fhouid affeCt 
the back part ot the head, fauces, loins, particularly the pit of 
the ftomaeh, attended with vomiting, and that pain increafed on 
preffure. 
CURE. The indications are, to dimini fit the aflimilating or 
contaminating power of the morbid matter, and keep the fever 
within fuch bounds, nature [hall be enabled to leparate from 
and throw out of the habit the ofFenfive materials that caufe the 
dillrefs, which is done by fo regulating the motions of the ner- 
vous and vafcular fyftems, that the conilitution may be put into 
a Hate to mitigate and fupport the fucceeding conieit with the 
greatell eafe, and freedom horn danger. 
• And this knowledge we fhall acquire, by confidering the fitua- 
tion of the habit, the mode of living, and feaion ot the year, 
with refpect to the weather or conftitution of the air, as thefe 
will dilpofe more or lefs to the production of inflammatory, ner- 
vous, or putrelcent febrile affections ; for I am certain, that, ac- 
cording to the nature of the fever, fo are we to regulate our con- 
duct, and hence obferve tliofe rules which have been previoufly 
laid down in the management ot thofe different fevers fpecified 
in oar eighth and ninth ie£tions. 
Sometimes thedifeafe is(fo extremely mild, that there is no need 
of medical ailiftance, though at the dole, in order to clear the 
firft paflages from any fouinefs or ofFenfive matter which may 
have been collected there during the progrefs of the complaint, 
it would be right to give two or three purges. (No. 3. 19 to 
24O 
At others, it is of a very dangerous nature, and requires the 270 
5 MALL-POX. 
advance and fagacity of no fmall fhare of medical knowledge, 
as it is accompanied with fuch a variety of threatening fyinj - 
toms. 
Should the fmall-pox attack flrong, hale, robtift habits, where 
inflammatory fymptoms run high, which they fometimes do to 
iuch a degree, as to affedt the brain, throat, or lungs, fo as to pro- 
duce delirium, fuflocation, and extreme difficulty of breathing; 
according to the violence of the fymptoms we muff have recourfe 
to bleeding, and that repeated, if they give not way to the firft 
operation—indeed, if the pulfe is hard and full; the heat confi- 
derably above the natural ftandard ; the urine high-coloured ; 
the pain iu the head, back, and loins acute ; the bleeding at the 
beginning Ihould be copious—and, under thefe circumflances, 
blood may be taken even at the height, or any intermediate flage 
•—we may alfo give antimonials, nitrous and cooling medicines, 
and fuch other things as have been advifed in cure of inflamma- 
tory fevers, (210, &c.) for the fame reafons, 
If the, head fhould be violently affected, the feet may be bath- 
ed in warm water, and warm fomentations, or poultices, appli-, 
cd to them; for thefe will folicit a freer circulation downwards, 
a more copious eruption into the extremities, and diminifh the 
quantity of variolous matter, which otherwife would appear in the 
more fuperior parts. 
After once or twice bleeding, a gentle emetic, (No. 11, 12. 
38.) would be ufeful, and clearing the firll paffages with fomc 
mild aperient, (No. 3. 22 to 24.) or at leaii repeated glyfters 
every, or every other day, (No. 25, 26.) 
By the means above directed, we reduce the adtive power of 
the fyftem, that it may not be hindered from throwing off the 
matter of the fmall-pox, by the too great disturbance and 
diftrefs occafioned by the rapidity and violence of febrile ac- 
tion. 
But fhould the train of fymptoms be fuch as indicate the pre- 
fence of a nervous fever, (225.) we muft endeavour to roufe the 
vafcular motions, and increafe the activity of the nervous fyftem, 
in the manner we have directed in nervous fever, (216.) for, 
without this, there will only be a partial feparation of the vari- 
olous matter thrown out upon the furface of the body; and the 
internal parts, i'uc.h as the brain, flomach, lungs, and bowels, be 
more loaded, and the fluids not perfedtly free from morbid par- 
ticles. To obviate thefe inconveniencies, we muft not do any 
thing that is likely to turn the humours upon the bowels, nor 
take away any blood ; for thefe would weaken the fyftem, alrea- 
dy in too debilitated a date, and render the fluids too acrimoni- 
ous ; we muft try to invigorate the conftitution, in order that SMALL-POX. 
271 
the blood may circulate with proper freedom externally, by wine, 
wine-whey, volatiles, and cordials, (218.) 
The load, naufea, anxiety, and oppreffion, which are almod 
always condant concomitants in this fpecies of febrile affe&ion, 
might be relieved by an emetic. (247.) for the fhock would tend 
in i'ome degree to roufe the fyllem, and promote the eruption by 
that means. 
Should the fever attendant be of the putrid hind, and betray 
fymptoms of prevalent putrefeency in the humours, we mull not 
have recourfe to the lancet ; for bleeding would hurry the con- 
dilution rapidly into all thole mifehiefs which arife from ex- 
treme debilitated nervous action, and broken texture of the blood, 
as before explained when treating on putrid fever. (223.)—here 
we mud depend upon bark, and fuch things as were fpecified when 
treating on that malady. 
In order to promote fuccefs in treating this complaint, in the 
bed manner we can, by procuring a feparation and expulfion of 
the morbid matter, we mud, indifputably, pay attention to the 
precife nature of the fever ; for it is by properly regulating that 
trom whence we can hope for perfect and lading relief. 
Particular occurrences prefent themfelves frequently, which 
call for our attention in an efpecial manner, added to the general 
plans we have fpecifically pointed out, in which we mud at- 
tempt to imitate nature in her operations. 
When infenfible perfpiration is too much impeded by the puf- 
tules crowding fo clofe together, and obdructing the pores of the 
Ikin, Ihe produces either a copious fpitting, free difeharge of u- 
rine, or loofenefs, to make up that defeft, or lodges the aqueous 
fluid in fome part of the cellular membrane (26.) of the hands 
and feet, which at that time put on dropfical appearances—hence 
is pointed oat to us the neceility of ferous evacuations. 
It is therefore incumbent upon us to endeavour to promote 
the flow of urine from the completion of the eruption to the 
turn, by the ufe of diuretics ; the fafed of which is aethereal 
fpirits of nitre, (176.) and taking the patients now and then out 
ot bed, and expofing them to the cool air. 
Small doles of calomel, under thefe circumftances, have been 
attended with fome fuccefs, as they often promote a fpitting, or 
increafe the difeharge of urine ; or, fhould we be afraid of deter- 
mining the humours too much to the bowels, it may be thrown 
into the habit in form of ointment, rubbed in above the knee, or 
on the infide of the thighs. 
But if thefe difeharges are defective, or ceafe altogether, and 
there is no fwelling in the extremities fufficient to counterbalance 
the decreafed or obdructed evacuations, the ankles or wrids mud 272 
SMALL-POX. 
be ffliflered, by infinuating fomc bliftering ointment into tfte 
ipaces between the puftules—and if this fucceeds, by creating a 
free difcharge, the danger which before threatened may be hap- 
pily prevented—if not, we Ihall have reafon to fear a fatal con- 
clufion. 
Sometimes reftleffnels will be occasioned, and the febrile fymp- 
toms increafcd, by irritation on the furface of the body, creating 
pain, as the puftules proceed to perfed maturation and drynefs—• 
here opiates (151.) (No. 4, 5.) procure etue and fteep, forward 
ill ppu rat ion, expedite leparation and expuliion, by preventing 
internal difturbance in the fyftem from the caufes above fpecili- 
ed. But, perhaps, by their ufe the body may be rendered cof- 
tive ; or if fo, at this period, from any other caufe, gentle aperi- 
ent medicines have been recommended ; but glyfters, (No. 2,5, 
26.) every day rill the drynefs of the pocks takes place, are more 
eligible, as from them there can be no danger of creating the 
fmaileft difturbance in the habit, nor of determining the fluids 
too much to the inteftines, fo as to run the lead rifque of induc- 
ing a loofenefs ; and they will alio effectually aflift in preventing 
an increale of febrile diftrefs, which might arife from collections 
of acrimonious matters in the flt.lt pall’ages. 
Sometimes after the incruftation is perfectly formed, front 
the reforption of pus, offenfive acrid matters in the firft paf- 
fages, or the ahforption of acrimonious or foetid particles 
from foul linen, the fecondary fever is apt to arife. In or- 
der to prevent which, the patient fhould have his linen changed, 
be put into frefh iheets well aired, every thing be removed from 
hint which can be fuppofed to harbour offenfive matter, and a 
purge, (169, See-) (No. 19 to 22.) given as foon as the cruft is 
actually formed. 
Though fome conjectured, with equal if not with more pro- 
bability, that this fever arifes from the imperfect leparation or 
expuliion of the variolous matter, and that it becomes the inftru- 
ment of nature to free the habit from what remains. 
However, be the cafe which it may, if it runs high, and is at- 
tended with violent head-aoh, great opprefiion, and difficulty of 
breathing, bleeding may be neceffary, and lo long as the pulfe 
can fupport the operation well, it may be repeated—blitters ffiould 
afterwards be applied—and purgatives adminiflered, if the pulfe 
does not flag—and vegetable acids ffiould be mixed with common 
drinks—but lliould the itrength fail, we mult have reeouife to 
cordials. 
Jf it goes not off by thefe means, it will, in all probability,, 
put on the appearance ot a remittent fever, and as fuch rnuft be 
soniideied—for the iubd action of which, we mult, as in cafes of SMALL-POX. 
273 
thofe fevers before fpecifled, (252.) apply to the bark, (253 ) and 
with refpe£t to the quantity to be applied, the age of the patient, 
and violence of the difeafe, mull regulate our judgment. 
Some, in order to mitigate or prevent this fever, have advifed 
the puftules, as foon as they are fuliy matured, where they are 
of the confluent kind, to be opened as they ripen, in the order 
they make their appeal ance. I am, however, far at prefent from 
recommending the adoption of fuch a plan, as I fhould be fearful 
of the moll dangerous confequences enfuing from fuch a practice, 
particularly where the fever, after the eruption, kill continued 
with anv degree of force ; for it is very probable that, from 
thence, there is not a due reparation of the morbid materials, and 
that the feconJary fever is very often, at leak, an effort of nature 
to throw what remains out of the habit—and that by the irrita- 
tion on the Ikin this purpofe might better be effetled, than by its 
being taken off ; for from fuch attempts, there has been reafon to 
believe death the confequence. Much mifchief has accrued from 
applications made to gouty limbs, from the impetuofity of the 
fufferers to take off the pain arifing from that caufe, before the 
W'hole of the gouty matter had been depofited ; and in thefe two 
cafes the veafoning is nearly fimilar, as well as fome others ; and 
it is well known, that nature frequently makes pain arifing from 
fome initatiag power the foie caufe of conkitutional relief. I 
would therefore advife great circumfpeftion on the prefent point, 
which only can be warranted by practical certainty, not whimfi- 
cal, though ingenious, conjefture. 
Sometimes the fmall-pox will be attended with a remittent fe- 
ver, (250, &c.) verging to the inflammatory clafs ; then the dif- 
eafe mull be treated in the fame manner as we have delivered 
when treating on that fever. (210.) (See 2^2.] 
Sometimes the eruptions will put on different appearances,(263.) 
which from thence are called crystalline, and be attended with, 
a nervous fever ; in this cafe therefore, we chiefly depend on blifters 
and vinous cordials, with fuch other aids as we have fpecified in 
the treatment of the flow nervous fever. (216.) Or sanguine- 
ous or bloody, and have for their concomitant a putrid fever ; 
in which cafe, without fome fervice can be done in the begin- 
ning, not one ray of hope remains for our fuccefs—for which pur- 
pofe we mull depend upon bark, and fuch other antil’eptics, (102.) 
as are fuppoled to have the moll powerful and immediate aflion, 
the principal of which is alum, (137, &.c.) (No. ) and purfue 
the mode of management throughout, as recommended in the 
putrid fever. (223.) 
Or, they are attended with extreme pain, and violent flux 
from the bowels, putting on the appearance of dy fernery, (2O8.) SMALL-POX. 
—in this cafe we muft endeavour to retard the flux, by fome gen- 
tle cordial antacids, of the {hell or earthy kind, (iyi.) called ab- 
forbents, (No. 42, 43.) or the white decodtion, with red port or 
claret, or aftringent draughts. (No. 75, 76.) 
But in this complaint much nicety is required—for alvine 
fluxes are net always to be confidered morbid, they are fometimes 
critical, and the means of which nature makes ufe to carry mor- 
bid virus out of the habit—if, therefore, the pulfe does not fink, 
but continues to move with ftrength and greater freedom, and 
the opprefiive fymptoms are all alleviated, the ufe of aflringeqts 
fhould be cautioufly adminiftered. it would be more advifable, 
to fupport the patient by mild cordials, and exhibit fuch medi- 
cines as would {heath the bowels, and fuffer the matter to pal’s 
throuoh them with the leaf! uneafinefs—fmall dofes of ipecacu- 
anha (No. ,57.) will be beneficial, and preparations from the clafs 
of the demulcents, ds mixtures of gum tragacanth, Arabic, flarch, 
and fuch like ; and, towards the conclufion, opiates, joined with 
fome of the mild aftringents, might be ufed. (No. 77, 78.) 
With regard to the diet, it is always to be adapted to the na- 
ture of the {ever, during its continuance, which may be collect- 
ed from what has been faid on this head, when treating of the 
inflammatory, nervous, and putrid fevers. The apartments muft 
be kept cool, and the patients fit up fome hours every day, if 
the circumftances of their cafe will permit—and after the com- 
plaint has finilbed its courfe, purgatives ftiould, at proper inter- 
vals, be repeated, to clear tbe habit of any remains of morbid 
particles ; and the fame courfe purfued for the recovery of the 
itrength, as after the conclufion of other fevers, where the con- 
flitution has been much harraffed. 
Long experience have enabled praftitioners to make the fol- 
lowing obfervations refpe&ing the good and bad omens in this 
difeafe : 
The later the fmall-pox make their appearance in winter tbe lefs 
dangerous they will be—they are alfo more mild in the youngfub- 
jeci than the Jlrong adult—the longer the JirJl, or febrile )lage, 
continues before the eruption, fo much more mild ; the Jhorter, 
fio much the more violent may we expert the dileafe to be— 
fhould there be an acute pain in the fide, or in the upper orifice of 
t je jtomach, they are bad figus—the more the pujtules crowd toge- 
ther , the more numerous they are in the face and trunk of the body * 
the more fiat or depreffed, the /lighter the remijjion in the fecond, or 
eruptive ftage, fo much greater will be the danger—a delirium 
Jucceeding the eruption imports no little mifehief—deficiency ofi 
the falivary difcharge, in the deprefied or confluent fort, is one 
of the worft fymptoms—the more florid the /paces between the pif- SMALL-POX. 
ttiles are, the greater may he our hope ; palenefs there affords us 
no flattering profpeCt. 
If the matter in tbe pufiules he white, vifeid, and full, it is a 
fortunate appearance ; but if, on the contrary, it (hould be brown 
and thin, and the pufiules grow yellow, or have their tops indented, 
it is the reverfe—if the /paces between the pujfteles, and they them- 
Jelves, are livid, death is at hand. 
It is alfo a bad omen if the fecondary fever appears before the 
retrocejjion of the pufiules—if the face fubjides, and the falivation or 
/pitting cea/es, and the hands and arms fwell not in the fame propor- 
tion, in the confluent fort, it is a fign of death. 
If, on account of being too heated, the patient cannot bear the 
bed-cloaths upon him, it portends a delirium—great inflammation 
of the fauces, quickne/s in breathing, clear urine, with little cloud- 
ine/s fioatmg in it, grinding of the teeth, picking of the fiocks from 
the bed cloaths, threaten diiTolution—nor are we to build any hopes 
on the remifiion of delirium, if the fever continues in the fame 
flute. 
Before vve clofe this part of our fubjeCt, we muff beg leave to 
make one general obfervation refpeCting all eruptive fevers, as 
well as the fmall-pox—that as many, though their eruptions a- 
rife from the confequence of their peculiar aftion on the confti- 
tution, and produce fpecific cuticular appearances, are ufhered in 
by fome fever, either of the inflammatory, nervous, or putrid 
kmd, in general ; yet, fliould they he attended, as fometimes 
they are, with thofe of the mixed clafs, where we cannot perfect- 
ly diftingnifh to which of the more fimple fort they belong, we 
mufl treat them according to the ideas given in the mixed fe- 
vers. (240, &c.) 
§ 2. Inoculated Small-pox. 
It is rather lingular, that after fo many years experience of 
the advantages accruing from inoculation, that there remain any 
fo blinded to their own intereft and happineis, as to be delirous 
ftill of abrogating the praCtice—which is the preferver of life, 
beauty, and health, fo perfectly clear to common obfervation. 
The mere recital of the benefits annexed to it are fo confpicu- 
ous, that reafoning is unneceffary. 
It fupplies us with the opportunity of having the body pro- 
perly prepared for the reception of the morbid matter; fo that 
it may be freed from fuch materials as would fupply an aftive 
caufe to incrcafe and prolong febrile affedtions ; and thus prevent 
the fever, which always attends in the fmall-pox, from running 
too high, or producing other wife dangerous effects, according 
It.T INOCULATED SMALL-POX. 
to the nature of the conflitution—it occafions a fmaller quantity 
ol eruptions, and the puftules to be more fupeificial—hence not 
leaving thole deep pit.:, and often unfeetnly fears as in the natu- 
ral fmall-pox—it fupplies us with a knowledge of the dileale at 
the fuft onfiet, and enables us to provide againfl its confequences 
-—it empowers us throw in the matter into the conUiiution 
from places far diftant from the vital parts, and prevents the 
lungs being primarily affected—and, what is of great confequenee, 
it enables patients to t- fcape the fecondary fever, j'o fatal to num- 
bers ; for in this artificial fort it rarely attends—add to this, the 
operation is fo extremely trilling, that it is performed almofl. 
without the flighted pain, in the following manner : 
The fcarf-fkin, of one or both arms, is elevated by a lancet, 
upon which fome of the infectious matter, taken from a patient 
labouring under the fmall-pox, remains, then prefiing the fcarf- 
fkin upon the k licet, and withdrawing it from under that prel- 
furc, the variolous matter is left upon the true fkin, and taken 
into the habit by the abforbent inhaling veilels, which open up- 
on its fur face. 
Subjects of every age may be inoculated, even fuch as are at 
the bread ; by fome efteemed the bed time of life ; but it ihould 
he before they begin to cut their teeth—certainly their conftitu- 
tions are at that time in the mod proper ftate—and, could we be 
allured that no accident would occur that might need the aid of 
medicine, there could not be a moment’s hefitation refpecting the 
preference ; but, on this account, 1 fhall rather recommend ino- 
culating at two years old, when complaints could not arife from 
teething when the conflitution was not in fo irritable a Hate as 
to be inconvenienced by flight cauies—and, in cafes of necefiity, 
Ihould they arife, the application of medicines would be lefs re- 
filled. 
With regard to the feafon, pra&itioners have differed in that 
point—the hot months in dimmer 1 confider as the moil excep- 
tionable, and give the preference to thofe which are the moil 
temperate—the fpring, or latter part of autumn, taking care, dur- 
ing thefe periods, to avoid performing the operation when in- 
flammatory or putrid fevers or other acute complaints were epi- 
demic, for very obvious reafons. 
The modes of preparation fhould be adapted to the conflitution 
cf tite patient. 
Generally living cool and temperate for three weeks, feeding 
on acefcent food, with now and then a gentle mercurial purga- 
tive, for thole of healthful habits, will in common be fuflicient 
—but thofe of puny conftitutions, whofe fyfiem is relaxed, Ihould 
live more freely, and be allowed animal food once every day, of INOCULATED SMALL-POX. 
the light and eafily digeflible kind, and in moderate quantity, 
mixed with acelcent vegetables. 
In fine, prefervjjig the conftitntion in a moderate degree of 
flrength, clearing the fir ft paffages, removing glandular oh tt ruc- 
tions, making that fyftem act with freedom, and loading the ma- 
chine, as much as may be, with acefcent fluids, feems the moft 
rational mode of putting the body into the belt (late. 
By thefe means, the nervous and vale alar fyftem will be ena- 
bled to perform their functions properly, and .the humours not 
become prone to run into an acrimonious or putrefeent it ate— 
hence nature will not meet with any impediment to prevent her 
from feparating and throwing out the offendve matter, after it has 
produced its effects on the mafs of circulating fluids. 
It has been thought, and I am of opinion, rightly, that it is 
immaterial from what fort of fmall-pox the inoculating matter 
is taken, as the different kinds produced depend not upon the 
nature of the morbid particles, but the conftitution into which it 
is thrown—for there will be a bad fort arife from matter that 
lias every mark of mildnefs, and a good fort from fuch as ap- 
pears more of a malignant nature ; nay, indeed, different people 
inoculated with the fame matter taken from the fame pultule, 
have been known, and that commonly, to have different lorts of 
the fmall-pox. 
However, I would always advife it to be taken from fuchfub- 
je&s as labour under the difeafe in its mildell Rate, and have the 
mofl favourable appearing pus—for it is our bufinefs to take mat- 
ter from thofe constitutions which, by’ the appearance of the 
pocks, befpeak the greatefl purity, and freedom from any mor- 
bid taint—for all people are not agreed upon what the maligni- 
ty of this complaint depends ; and many conclude that other dif- 
orders may be inoculated with the fmall-pox—thefe, there- 
fore, furnifh arguments fufficient for great cautions in our elec- 
tion. 
• DESCRIPTION. After the pun&ures are made in the arms, 
on the fecond day, if the parts are examined by a good magnify<t 
ing glafs, there appears commonly about the puncture an orange- 
coloured ftain, whilft the fkin around it feems to contract ; but 
fometimes an inflammation takes place on the fecond day, then 
difappears totally—this, though, may arife from irritation from 
the puncture, trifling as it is ; we remain, therefore, doubtful 
whether or not infection has taken place—but if it has fucceed- 
ed, on the fourth or fifth day from the operation, a hardnefs and 
itching, with an apparent inflammation of the part, is percepti- 
ble ; and a kind of blifter, filled with a transparent liquid, is ob- 
i’ecvable. INOCULATED SMALL-POX. 
Oa the filth day, a pain and ftlffnefs nfleCts the arm-pits. 
On the feventh, but more frequently upon the eighth, fymp- 
toms which precede the eruption make their appearance; and 
thefe are commonly filch as {hew themfedves in general at the 
commencement of fevers—cold chills and heat alternate with each 
other, a flight degree of languor, heaviness of the eyes, and flight 
pains in the head and back, are, now and then, perceptible ; and 
thefe remain pretty conllant tiil the fmall-pox manifeft them- 
fclves. 
The inflammation now begins to fpread very faft. and, round 
the punctured part, a great number of fmall eruptions may be 
ieen crowding together, which increafe during the courfe ot the 
dileafe. 
Surrounding the iricifion, and extending itfelf half way rpund 
the arm, but more commonly deferibingthe breadth ofafhilling, 
a circular, or oval, efilnrefcence is obfervable. The larger this 
inflammatory appearance is, which is fmooth to the touch, and 
not painful, the fewer are the general puftular eruptions—and, 
indeed, I have obferved, when the thread was made ufe of, this 
vras the cafe, if the difeharge from the incifion was very copious 
now all the fymptoms ceafe, and the bufinefs feems to be per- 
fectly finiflied. 
UNFAVOURABLE SYMPTOMS. Though this is the pro- 
grels of thedifeafe in genera], vet it fometimes happens that there 
are deviations, and that we have not inflammatory appearances 
cn the wounded arm till the eighth dav. then it w7ill fuddenly 
ihew itfdf, with the other concomitant fymptoms—this is not 
recorded as a favourable omen—(till it lometimes is in this point 
deceptive. 
But if the colour around the puncture continues pale, though 
it is barely perceptible that inoculation has fucceeded, inftead of 
becoming red or inflamed—if the edges of the wound fpread 
but little, and remain flat, unattended with itching, or any kind 
of uneaOflefs—if, inftead of a red inflammation about the incifion, 
it fhouid have a purplifh caft ; if red, and the circle round the 
pun£ture mould be narrow and deep, and the incruftation around 
it fhouid be deprefled and concave in the center, they are confi- 
der<»d os unfavourable figns. 
FAVOURABLE SIGNi. Oa the other hand, if on the fe- 
cond day there fiiould be an orange-coloured ftain round the in- 
nfion —an itching there in two or three days—a kind of eleva- 
tion of the fcarf-fkin, refembling a blifler, without much inflam- 
mation, on the third or fourih day—a pain or fliffnefs in the pit 
of the arm, a large efllorefcence round the puncture, on the tenth 
or eleventh day, or fooner—a hardnefs fpreading circularly from INOCULATED SMALL-POX. 
279 
the puncture, the inflamed part of the arm elevating itfelf, and 
forming a point, terminating in a dry feab ; thefe are laid to 
form very pleafine prcgnc flics, and flatter ns with the molt 
agreeable expectations of a happy concluflon. 
CAUSES. Thefe are fimilar to what we have before recited 
in the fmall-pox—for if the conftitution is not poflfefied of the 
predifpoflng caufe, no eifeift will be produced, though the vario- 
lous matter fhould be thrown into the habit. 
CURE. In the evening after the pun&ure is made, it hath 
been thought advifeable to give a few grains of the calomel pow- 
der, as much as will procure two or three evacuation's, purg- 
ing it off in the morning with fome gentle cathartic. (No. - q, 
8- ) 
Or, inftead of the laft, a dofe of Glauber’s or Polychreft fait, 
proportioned to the age and conftiution of the patient—thefe ate 
advifed to be given every fecond morning and evening, till the 
appearance of the eruption. This is fuperfluous, two doles will 
be in all common cafes fuflicient, immediately after the operation, 
and a day or two before the attack. If the inflammation 
is flight at the puncture,the dofe of calomel xnuft be increafed. 
Afterwards we have nothing to do hut to guard againft the 
febrile fymptoms, which are in general to mild, that there is lit- 
tle occafion for medicine. 
At the commencement, if neceflary, what,has been juft above 
preferibed are advifed ; and repeated two or three times, if the 
difeafe appears to be of a late or unfavourable fort. 
In the intermediate days, ftiould the fever run high, Clnt- 
ton’s febrifuge fpirit, or the tetbereal fpirit of vitriol dropt into 
any aqueous fluid, fo as to make it agreeable, ui2y be taken of- 
ten in the day. 
As foon as the fymptoms of the eruptive fever come on, the 
patients ftiould continue to be expofed to the cool air as much 
as poflible ; for it is the beft cordial and corre&or of febrile af- 
fection in this cafe, as I have repeatedly experienced. 
Indeed, when the iebrile fymptoms appear to be violent at the 
onfet, great good has oceured from the adminiftration of an an- 
timonial emetic and purgative. 
Where the fever appears to be languid, and the patients are of 
weak and delicate conductions, lonie caution is here'neceflary ; 
for thefe, perhaps, it will be fufficient to be kept in a large well 
ventilated room, efpecially if the weather fhould be very cold; 
and they fhould be lupported on fomethingof a more cordial and 
flimulating, nature, than if things were othervvife, and the pati- 
ents more robuft, who fhould be kept, during' the eruption, oil 
a mere ace-fcent diet. 280 
INOCULATED SMALL-POX. 
After the eruptive State is over, and the pnSlules begin to ma* 
turate, fmall broths, jellies, white wine whey, or fuch like ma- 
terials, may be allowed. 
In this State of the difeafe, the weakly and more delicate may 
require to be kept in bed, and fupplied with mote cordial appli- 
cations, in order to perfect the fuppuration of the puitul ■*, and to- 
tally free the constitution from any remains of the variolous mat- 
ter. 
if we proceed in this prudent manner, adapting our mode to 
the particular constitution of our patient, wc Shall very feldom 
have much trouble ; hut Should there arife uncommon complaints 
now and then in the inoculated fmall-pox, it will be neceffary 
for us to proceed as directed in the natural difeafe, (265, &c.) 
obferving whether it verges to the nature of inflammatory ner- 
vous, putrid, or mixed fever, and coodudt ourSelves confident 
with what the Symptoms point out to our judgement. 
§ 3* Meazles. 
Called by the Lntins morbilli, as being a difeafe of lefs confe- 
quence than the fmall-pox ; as by morb Hus, we underftand mor- 
bus parvus, a trifling difeafe—they have alio been named rubeo- 
las and rofeohe, from the rednefs attending the eruption, or put- 
ting on a colour Similar to rcfea—like the fmall-pox, this difeafe 
appears to be a native of the Eaft, and has certainly a great affi- 
nity with that complaint, as they are both generally of an in- 
flammatory nature, equally infectious, and never affect the con- 
stitution twice—tome authors fay, except very rarely indeed—be- 
caufe the habit cannot be brought a Second time into fuch a date, 
as to feel the effefts of either of thefe infectious particles, fo as 
to reproduce the difeafe, Ihould they circulate ever io plentifully 
in the fluids a Second time. 
They generally make their appearance in the month of Janu- 
ary, rage moil violently about the vernaTequinox, and disappear 
in July- , 
They commonly attack children ; but allbconflitutions, which 
have never before felt their influence, are theN*gbje£ls of this in- 
fection—hence, in the more advanced Stages of life, many with 
them are afflicted—they are propagated by the particular consti- 
tution of the air, and become highly epidemic. 
Some have considered the attendant Sever of the Simple inflam- 
matory fort •, others as a catarrhal, or inflammatory remittent ; 
fome Say it is of the peripneumooic kind, and conceive the erup- 
tion, not as critical, but Symptomatic, as the cough and aflfedtions 
of the lungs will remain after that is over. MEAZLES. 
281 
According to my conception, it is in general a febrile difeafe 
of the inflammatory kind, always infectious, eledtively affecting 
that membrane, called fcheiderian, which lines the infide of the 
nofe, throat, and lungs, and, in its progreflion, the Ikin—though 
1 have feen the affection of the lungs io extremely flight, as not 
to call forth the lead attention, where there was a diarrhoea at- 
tended through the whole courfe of the dileafe. 
DESCRIPTION. Its progrefs is divided into three flages—< 
the firjl precedes, the fecond attends, and the laji fucceeds the 
completion of the eruption. 
At the commencement there are chillnefs and heat alternately 
fucceeding each other—foon after, on the fecond day, the fever 
increafes, attended with confiderable ficknefs, great heat, third, 
languor, and lofs of appetite—the tongue is white—there is a 
heavinefs of the head, and drowfinefs—fneezirfg—brightnefs of 
the eyes, from whence flow a thin humour---the eye-lids fwell, 
and, mojl commonly, there is a dry and very troublefome cough 
---fometimes vomiting and loofenefs are ailbciates with thefe, 
the lad of a green colour, when children are getting their teeth 
—-and all thefe fymptoms gradually inercafe till the erupti ve, 
or secondary stage begins, which occurs generallv on the 
fourth day ; about which time fmall red fpots, like flea-bites, 
make their appearance in the face, which run into clufters, form- 
ing larger fpots, riling above the fkin, perceptible only to the 
touch, not the fight ; afterwards broad fpots fpread over the body 
dowmwards, not quite fo prominent, though of a higher colour 
than thofe of the face—-when the eruption is finifhed, the vomit- 
ing ceafes, but the fever increafes ; and the cough, with the dif- 
ficulty of breathing, become more violent—-a fvveat and diar- 
rhoea now and then fnpervene. 
On the fixth day, or thereabout, the third stage commenc- 
es, on which the fpots on the face grow dry, and give it a rough 
appearance ; and in three days more they totally difappear from 
the whole body ; for on the ninth day nothing is to be feen, ex- 
cept a dark coloured fine farina, or appearance like bran all over 
the furface of the fkin—at this period, the fever and cough aie 
fometimes alleviated ; fometimes increafed, and teiminate in a 
dangerous peripneumony— and not uufrequently a loofenefs fuc- 
ceeds the difeafe. 
After this we are not to conclude the patient free from dan- 
ger, unlefs, during its courfe, fome confiderable evacuation has 
taken place, either by fweating, vomiting, urine, or loofenefs ; 
for without fomething of this kind occurs, the cough will conti- 
nue, the fever will return with additional violence, and the MEAZLES. 
llrcngth not be recovered except with great commotion in the 
fyftem, and, confequently, extreme danger. 
Though what we have deferibed is the mod frequent mode of 
the tneazles appearance and progrefs to their termination, yet 
fometimes they differ fo much, that authors have denominated 
them anomalous, or irregular, as deviating from the com- 
mon courfe, or as in the eruption putting on the appearance oF 
the fmall-pox—both which we fnall deferibe before we proceed 
to the cure. 
The anomalous differ from the mild fort, becanfe the eruption 
happens not on the fourth day, but fometimes before, and fome- 
times after—the fymptoms preceding, as well as accompanying 
the eruption, are more fevere—the eruption dees not begin fo 
much on the face as on the fhoulders and trunk of the body— 
and becaufe it is attended by more dangerous confequences. 
Befides the fymptoms which are common in fevere fevers, 
there are fome which are more peculiar to eruptive ones of this 
fort ; for here1 the pulfe is fmall and frequent—refpiration is fhort 
and quick—there is an oppreffion of the hypochondres--(33> 38.) 
—the urine pale—a great drowfinefs—twitching of the tendons— 
fpafms—delirium, with rednefs and watery appearance of the 
eyes—load on the eye-lids—and pricking pain in the flein—a 
ferenefs of the throat comes on, with a fhrill hoarfenefs, and vi- 
olent cough, in which children appear almoff fuffocated, vomit 
up their food, and grow black in the face—when, after fo fevere 
a ftruggle, the eruption appears, the fever in part depofits its ma- 
lignity, the difeafe is at its height ; and the fever perflfts in the 
fame manner to the drying of the fpots, which yet, according to 
Sydenham, did not feem to put on that branny appearance as 
before deferibed. 
The event of this fever is often dreadful and deadly ; for, on 
the eruption receding, the fever and difficulty of breathing are 
augmented—a peripneumony and diarrhoea, occafioned by the 
linking in of meazly particles, comes on ; which laft is not with- 
out danger, as happens often in the milder fort, becaufe here it 
is acrid, dyfenteric, and excruciating—fometimes a cough, diffi- 
culty of breathing, and hedtic fever fucceed—at other times, a 
general dropfy, but oftener obftinate inflammatory affedtions of 
the eyes. 
The other is faid to be common at Paris, wherein the erup- 
tion is different from that of the common regular meazles ; for 
they are more prominent, fuppurate perceptibly like the fmall- 
pox, and occafion the face to fvvell conflderably ; but then they 
are attended with the cough, watery eye, and other affedtions, 2VIEAZLES. 
283 
arifing from defluxions, which chiefly diflinguifh them from the 
fmall-pox. 
CAUSES, whether inducing or proximate, are fimilar to thofe 
of the fmall-pox, (269.) the peculiar particles only creative of 
the difeafe being altered. 
CHARACTERISTIC SIGNS. An infedious inflammatory 
fever for the mofl part, with which are affociated, a defluxion of 
a thin watery humour from the eyes, tickling in the nofe, fneez- 
ing, diy cough, more or lefs violent—on the fourth day, forne- 
times fooner, fometimes later though rarely, fmall fpots running 
together, perceptible to the touch on the face, but broader on the 
body not perceptibly elevated above the fkin, break forth, which 
in three days after are converted into branny feales in part, and 
totally difappear upon the ninth day. 
CURE. In fo mild a manner will the mealies fometimes af- 
fect patients, that little is neceflary to be done, except abftinence 
from all animal food, or heating applications ; and drinking free- 
ly of thin watery acefcent liquids, fuch as common fig drink, 
made agreeably acid with lemon-juice, apple water, or fome fuch 
like fluids. 
But Ihould the febrile fymptoms run high, we mull proceed 
as directed in the fmall-pox, (26.)—but great attention mull 
be paid to the affedion of the lungs—oily emulfions and iindures, 
(No. 81 to 83.) may therefore be prefetihed occafionally, in con- 
junction with the other remedies, calculated to keep the febrile 
affedions within proper limits. 
Should ©ily medicines difagree with the ftomach, as is fome- 
times the cafe, we mult have recourfe to the clafs of demulcents, 
(187.) (No. 84 ) ufing the pedcral decodion, or that of linfeed 
as common drink. 
After the eruption is completed, flight opiates are ferviceable 
—but as nature generally performs her crifis either by fweats, 
loofenefs, or urine, we mult obferve what way fbe direcls her ef- 
forts, and proceed as we have beforedireded in cures of this kind, 
where they occur in fevers not eruptive. 
As foon as the rednefs of the fkin goes off, and the fpots begin 
to die away, gentle purgatives mull be adminiftered, at proper 
intervals, and the patient return to his ufual inode of life gra- 
dually, (209.)—care alfo fhould betaken, that patients expofe not 
themfelves too early to the cold air, for thefe are apt to bring on 
a very difagreeable cough, afthma, and confurnption, from affec- 
tions of the lungs, or of fome other parts. 
Some perplexing fymptoms, notwithftanding all our attention, 
will now and then prefent themfelves, which alk for our utmofl 
exertions. 284 
MEAZLES. 
Should a delirium come on the fourth day, wherein the 
pulfe is (mall, it is an unfavourable omen ; (till by the ap- 
plication of leeches to the temples, it may be mitigated or fub- 
duea. 
It is alfo a bad lign if the fever Jhould increafe and become vio- 
lent, accompanied with intenl'e third, about the termination of the 
difeafe—and ihould there appear great danger offujfocation, as 
will fometimes happen from too great an afflux of ferous humours 
on the lungs on the ninth day, we mud fly to bleeding, accord- 
ing to the Urength of the patient, and apply blifters, to prevent 
an inflammation coming on from that caufe—which, if it cannot 
be done, fuffocation may be the immediate confequence—or, el- 
caping that abicefs will probably fucceed, a hectic fever and con- 
fumption. 
A diarrhoea, or dyfentery, is apt to come after vomitings of 
green materials ; and continue, though the meazles have flnifhed 
their courfe—thefc cdlnplaints yield only to bleeding. 
The meazles which put on the appearance of the fmall-pox, re- 
quite the fame mode of treatment as the mild fort. 
But in cafes of the anamolous fpecies, we mutt be directed by 
the nature of the fever, and proceed in our modes of cure, as 
pointed cut in our treatment of the different kinds of the fmall- 
pox, 
A moderate loofenefs, with a foftnefs and gentle moiflure of 
the (kin, alleviate all the febrile fymptoms—but the (lower the 
eruption, fo much greater will be the danger—of which alfo we 
may have itrong fuipicion if they make their appearance on the 
fecond, or the fifth and fixth day from the attack—if they (hould 
retrocede, and be alfociated with delirium, or become livid, the 
worit is to be dreaded—too high a degree of redriefs or palenefs 
of the puftules, great orofiration of (trength, vomiting, great refi- 
lefl'ncfs, difficulty of ("wallowing; or other fpots, purple-colour- 
ed, like flea-bites, are alfo dangerous appearances—the con- 
trary of all which will flatter us with mod pleafing expecta- 
tions. 
Few people have thought the meazles to be a difeafe of fuffi- 
cient confequence, to avail themfelves of thofe affiflances which, 
as in the fmall-pox, might be derived from inoculation in this 
complaint. As for my own part, pi'aCtically I cannot fay any 
thing on the fubjeCt; but if we may believe the authority of 
Come who have made the experiment, or be allowed to depend 
on reasoning from analogy, our labours might be happily re- 
warded—for it is afferted, and appears probable, that from ino- 
culation from infefted blood, on the fixth day a (light (ever nia- 
mfefts itfelf mod commonly, though it is very moderate, unat* MEAZLE5. 
tended with lofs of fleep and inflammatory fymptoms ; and it is 
neither fucceeded by a heclic fever, cough, nor inflamed eyes ; 
fo that we find we fhould be freed from a train of the moil dan- 
gerous fymptoms, and confequently relieved, in many cafes, from 
the moil diilreffing apprehensions. 
§ 3. Water-Fox. 
This ob vioufly takes its name from the fluid with which the 
puflules are filled. 
DESCRIPTION, This is a difeafe which attacks children 
about two or three years old, without any remarkable febrile 
fymptom or indifpolition ; it chiefly appears on the face, in fmall 
red puflules full of a clear or whitifh watery fluid, about the fize 
of a lentile ; fome of which dry off in two clays, whilft others 
increafe ; and all fall off in a dry ftate within the fpace of four, 
generally leaving no pits in the fkin, as they are commonly at- 
tended with no inconvenience. 
There is another variety which frequently affects infants a 
week old, and puih forth fimtlar watery puflules, about the na- 
vel, arm-pits, and fingers, which grow dry within three or four 
days, and fall off in a lcab. 
The cure left totally to nature is always fuflicient ; and no- 
thing more neceffary, than, if it is cold weather, keeping in bed, 
living upon gruels, weak broths, and warm liquids. 
§ 4. Chicken, or ‘Swine-Pox. 
Having had in the courfa of praclice fo little opportunity of 
attending, the complaint throughout, and when called, there be- 
ing fo little to be done, I confefs it fcarce ever awakened my ob- 
fervation, a? nature, after the itomach and bowels were cleared, 
if fuch attempts appeared neceffary, always performed the cure. 
I a:n happy to have it in my power to fupply my readers with 
an account drawn by the pen of fo accurate an obferver as Dr. 
HtBERDEN, who fay's, in enumerating the 
SYMPTOMS, that the pocks in many break out without 
any previous figus or illnefs ; in others they are preceded by a 
flight degree of chillnefs, lailitude, cough, broken fleep, wander- 
ing pains, lofs of appetite, and feveriftPfor three days—the puf- 
tuies in moll of them are the common ii/.e of fmall-pox ; but 
fume arc lefs—they are never confluent or numerous. 
On the iirlt day of the eruption they are reddifh—on the fe- 
cond there is at the top of moll of the puflules a very fmall 
bladder, about the fize of a millet-ieed j this is fometimes full 286 
CHICKEN, OR SWINE-POX. 
of a watery and colourlefs liquor, fometimes it is yellowifn, con- 
tained between the cuticle and fkin—on the fecond, or at the far- 
theft, on the third day from the beginning of the eruption, as 
many of thefe pocks as are not ruptured feem arrived at their 
full maturity, and thofe which are fulleft of that yellow li- 
quor very much referable what the genuine i’mall-pox are on the 
fifth day. 
A thin fcab is formed at the top of the puftule from the cuti- 
cle being burft, on the firlt or fecond day, which contains this 
thin fluid, by accident, or, perhaps, from rubbing to allay the 
itching; the fwelling of the other parts abates without its being 
ever turned into pus—thofe which efcape being burft, have the 
little liquor turn yellow and thick, and dries into a fcab—on the 
fifth day of the eruption they are almuft all dried and covered 
with a cruft. 
'1 he patients fulFer little, except fome languor of fpirits, ftrength, 
and appetite. 
This difeafe wants no remedies. 
It is diftinguifhable from the fmall-pox by the appearance on 
the fecond or third day, from the eruption full of ferum upon 
She top of the pock. 
From the cruft alfo, which covers the pock upon the fifth day, 
atwhichtime the fmall-pox is not at the height of its fuppuration. 
But of this diforaer there appears a more malignant fort. 
For three or four days all the fymptoms which precede the 
eruption run much higher—on the fourth or fifth day the erup- 
tion appears, with very little abatement of the fever—the pains, 
likewile, of the limbs and hack continue—to which are joined 
pains of the gums—the pocks are redder than the common chick- 
enpox, fpreaa wider, and hardly rifefo high, at leaft not in pro- 
portion to their lize—inftead of one little head, or veefile of a 
ierous matter, there have been from four to twelve—they gooff 
juft like the chicken-pox, and are diftinguifhable from the fmall- 
pox by the fame marks. 
Befides, the continuance of the pains and fever after the erup- 
tion, and the degree of both thefe, though there be not above 
twenty pocks, are not obfervable in the fmall-pox. 
From the fimilarity of the chicken, or fwine, and fmall-pox, 
■we may be able to account for the tales we have bad of people 
being affected with the *fmall-pox twice, or having them after 
being inoculated, and fucceeding—for fome may have been ino- 
culated from the chicken, inftead of the fmall-pox—and this is 
one of the ftrongeft reafons that has induced me to infert this ac- 
count, that the error may be avoided—as very little is nccefiary 
in this cafe to be done by medicine more than what has been be- SCARLET-FEVER. 
fore recited—taking care, that if the febrile fymptoms run high, 
to treat it in the fame manner as the fmall-pox under fimilar cir- 
cumftarices. 
It is alfo worthy of obfervation, that thofe who have bad the 
fmall-pox may have the chicken-pox ; hut thofe who have had 
the chicken-pox cannot be infefted again bj' it; though, to fncli 
as never had the diftemper, it is as infectious as the fmall-pox. 
§ 5. Scarlet Fever. 
This takes its name from the fcarlet coloured efncrefcence up- 
on the fkin. 
This fever is iiiftammatofy, and attended with different kinds 
of eruptions ; whence it has been divided into two fpecies—one 
called SIMPLE SCARLET FEVER the Other, SCARLET NETTLE 
rash fever, from its eruptions being fimilar in appearance to 
thofe marks left by the flinging of nettles. 
DESCRIPTION. At the commencement the fymp- 
toms attend which we find in continued fevers, among which 
there is no great degree of ficknefs ; but on the fourth 
day the face fwells, the eruption manifefts itfelf externally, 
which are red, more copious, broader, and of a much more florid 
colour, but not at the fame time fo uniform as thofe which at- 
tend the meazles ; but they arife without any cough or watery 
eye, which diftinguifhes them from the meazles ; they appear 
and recede two or three times during the difeafe ; befides, the 
rednefs fhews itfelf to be uniform, as if the fkin was fuffufed 
with red wine, not breaking in clufters of puftules upon the 
bread as the meazles do—in three or four days it entirely ceafes 
—the fcarf-fkin foon after peels off', and there continues on the 
furface of the body fine bran-like (cales, which are fucceffively 
fupplied for two or three times. 
Sometimes eruptions break out on the face and reft of the bo- 
dy like the flinging of nettles, with much itching, which are ele- 
vated above the fkin, foon increafe, of a pale rofe colour ; fame- 
times with protuberances almofl eryfipelatou5,and roughnefs like 
tetters-—fometimes, on the fever remitting, they difappear ; but 
about the evening fhew themfelves, with fever, and a trouble- 
forne hot itching—and, in three or four days, like the former, 
entirely ceafe, when extremely fmall feales feparate from the 
fkin. 
CAUSES. The fame may be advanced here as in the mea- 
zles. (z8y) 
CHARACTERISTIC SIGNS. This is an infe&ious inflam- 
matory or remittent fever, of fhort duration, with a fuelling of 
the face on the fourth day, attended with a florid rednefs all over 288 
SCARLET FEVER. 
the fkin, with broad fpots, running at lafl together, not elevated 
above the Ikin • or with fpots like the flinging of nettles, which 
in three, four, or five days difappear, occafioning the fcarf-lkirr 
to peel off, and covering the furface of the body with fine bran- 
ny feales. 
CURE, This is of the molt fimple nature—abfiinence from 
animal food, keeping out of the cold air, free ufe of watery li- 
quids, thin gruels, and moderate warmth whillt in bed ; but 
fhould the fymptoms run very high, and the pulfe be very 
quick, full, and ftroug, bleeding may be neceflary, once, perhaps, 
and the ufe of faline mixture, (No. i.) or fmall dofes of ancirno- 
nials, (183.) or nitrous powders, (No. 2.) keeping the body gent- 
ly open, by the ufe of the rnildefl aperients, if coltive, (171, 172.) 
(No. 3. 22 to 24.) and, after the whole is over, and the fcarf- 
ikin begins to peel off, two or three doles of gentle phyfic fhould 
be given. (*72.) (No. 19 to 22.) 
But fometimes convulfions, or great drownnefs may come on 
in the beginning, particularly with infants, a large blifter may 
be applied between the fhonlders, and a quieting draught, limi- 
lar to No. 4, given every night, agreeable to the age and confti- 
tution of the patient—ufing, for common drink, milk and water, 
balm tea, in which may be ciifiblved fame gum arabic, and fmall 
portions of nitre. 
Doubts have arifen about the exigence of this fever, Dr. Cul- 
len having never feen it in its fimple it ate—however, 
ly does exiit, and as defci ibed by Syd lnii am, of whicn repeated 
experience has convinced me ; nay, indeed, 1 have known it feize 
feveral children in the fame family, and molt generally at the 
end of fu earner. 
There is another fpecies arranged here by fonie authors, Ailed 
the maiignant scarlet fevek — but of that wer fhall take 
the opportunity of fpeaking under the head of Sore Throat, as 
that is one of its peculiar and diflinguiftiing fymptoms, and may 
probably be derived from that fuurce. 
§ 6. Miliary Fever. 
This receives its name from being attended with 
hze and appearance like millet je-ed, which are fometimes red, at 
others white—the firil filled with a coloured f rum ; the 
a tranfparent fluid, called lymph, accompanied with fcarce any 
rednefs at all. 
'1 hough the e;xiftcnce of this feve-r has been doubted by many, 
fiill, it is generally now allowed, that there is a lever of this pe- 
culiar kind, originating from fpecifx infectious particles getting 
into MILIARY FEVER. 
289 
into the blood, and producing its effefts upon the machine—yet 
it may, and often does arife from the injudicious management of 
other fevers, by treating them with too heating a regimen—hence 
it is considered alfo Symptomatic, and often joined with the Small- 
pox, meazks, and other fevers. 
Like Some other of the eruptive clafs, this is Ample and com- 
plicated. 
DESCRIPTION. At the commencement there is a chillnefs 
Succeeded by no extraordinary heat—the fever is mild, attended 
by an uneafy and copious Sweating—there is no general pain, but 
the head appears Slightly affected—no third—the appetite conti- 
nues—the pulfe depreffed, and rather hard—and the urine appears 
healthful. 
The patient Soon after, on the Second day, begins to be fearful 
and apprehenfive, confluntly fighitig, from a fenfe of weight and 
tightnefs at the pit of the flomach—has uneafy dreams—dejeEtion 
of foir its—the head confufed■—his Sweats perpetually Smell Sour—. 
there are a variety of Sudden and involuntary motions, and con- 
Jiant refleffnefs—the pulfe is J mailer, and increafed in quichnep 
—and there is a certain fenfation of tingling numbnefs in the 
fingers—and the urine pale and limpid. 
On the third or fourth day, Seldom later, red or white erup- 
, tions break out on the neck, bread, and back, Seldom on the face, 
preceded by pricking pains, Sometimes itching—at this period 
chillnefs and heat Succeed each other repeatedly, and the Sweat- 
ing becomes profufe—from thence, for about the Space of thirty 
hours, eruptions continue to cornu out, which are filled with a 
thin Serous fluid, having round their bate an inflammatory ap- 
pearance. The Symptoms now begin to be alleviated —the Sweat- 
ing continues, though not So protufely—the mind begins to be 
lefs opprefled—the urine puts on a higher colour—the pulfe be- 
comes more Soft and regular—and about th# Seventh day tha puf- 
tides for the mod part grow dry, the Scarf-Skin peeling off in 
Scales. 
This is a pretty accurate defeription of the'mild Species of this 
fever, in which we may expeid the eruptions will very Soon 
make their appearance, when there are an uncommon dejection 
of Spirits, watchings, confufion of the head, much opprellion on 
the bread, with a weak quick pulfe ; for thefe are conficlered as 
the certain Symptoms of their near approach. 
CAUSES. Both the inducing and immediate are Similar to 
v/hat we have delivered when Speaking of the meazles. (283.) 
CHARACTERISTIC SIGNS. A mixed fever, attended 
with anxiety—dejection of Spirits—frequent involuntary Sighing 
—drong Smelling Sweats—-and pricking of the Skin—Small didinft MILIARY FEVER. 
fpots, for the moil part of a red colour, breaking out mod fre- 
quently on the third or fourth day on the neck, bread, and back, 
feldom on tlic face, cvhofe tops referable, after one or two days, 
very minute pufiulcs, which continue only for a fhort fpace of 
time. 
CURE. The indications of cure are the fame as in other erup- 
tive fevers. 
Now this fever mult in this place be confidered of a mixed 
nature, (240 ) verging rather more to the nervous than inflam- 
matory clafs—however, if they attack thofe of flrong, robuft, full 
habits, and there fhould be a great degree of valcular action, 
bleeding may, perhaps, be neceffary, but that rarely—we fhould 
rather proceed as we have direded when fpeaking of the iimple 
continued fever, to the life of faline mixtures, with fmall doles 
of anrimonials, (181.) (No. 6 to 9.) from whence, if the ftomach 
fhould he foul, a vomiting will enfue ; this will abate the fick- 
nefs, take off the opprtfiion, produce a gentle perfpiration, deter- 
mine the morbid matter to the fkin, moderate the febrile fymp- 
toms, and cceaflOn, though not a lefs copious, a more expediti- 
ous eruption—and before that, cooling purgatives are beneficial, 
though not afterwards. (171, 172.) (No. 3. 22 to 24.) 
Bleeding, it mud be obferved, is only admiffiblc in the jirjl 
Jlage of this difeale—afterwards it is fo far from being of any 
ufe, that convulfions and death itfelf are often the fatal conie- 
quences. 
Cooling acids may be alfo allowed in the beginning ; but when 
the eruption has appeared they are prejudicial—diluting, emol- 
lient, and acefcent liquids may be ufed—and from fomenting the 
feet and legs with tepid fomentations, great advantages have been 
derived. 
But fhould the conflitution be different from what we have 
fpecitied, that is, rather debilitated than languid, and the ner- 
vous fyitem appear to be in too inactive a (late, we muff apply 
to fuch things as are of more cordial nature, to fupport and in- 
vigorate the conflitution ; but out of them we muff feiett thofe 
of the milder fpecies ; for, by Simulating the habit too violent- 
ly, we fhould prevent the reparation and expulfion of the morbid 
matter, and be infl rumental in occafioning it to fail upon fomt- of 
the nobler parts internally. 
Hence, then, fuch cordial volatile medicines as we have def- 
cribed in the nervous fever, or fome things fimilar, fhould be 
adminifiered—and wine and water, or white wine whey may be 
allowed to be drank occafionally. 
Bliflers fhould alfo be applied ; and as foon as one has ceafed 
to difeh.trge, another muft be laid on, becaui'e it is obfervabi-e MILIARY FEVER. 
291 
that the evacuation produced by them, as well as keeping up 
the ftimnlus, affords great relief; for, on the evacuation ceaf- 
ing, all things wear a more favourable afpeft, which are al- 
ways altered for the better, on the reproduction of the dif- 
charge. 
But fometimes, inflead of the convulfive fymptoms being 
mitigated after the eruption, they iucreafe, attended with luch 
a tiain of fymptoms as are indicative of greater degiee of dan- 
ger. 
For the febrile affections grow more violent, increafing about 
raid-day and at night—the deep is difturbed ivith dreadful dreams 
--the f wearing decreafes—the fkin is hot and inflamed—the head 
is affe&ed with pain, producing the fenfation ol inward aiftenfion 
—the face appears fuller—the tongue is dry and white—the 
pulfe fmali and quick—and the urine copious, thin, and wate- 
ry- 
On the third day of the eruption there appears a great aug- 
mentation of violence throughout—the heat is burning—the puf- 
tules fublide—the fweat ceafes—the fkin becomes rough—the 
tendons ftart—the patients are extremely reftlefs, froward, and 
loquacious—they grow delirious, and are convulfed—they be- 
come thirfty—the pulfe is hard and quick—and the urine copi- 
ous, and like water. 
The belly, which before was coflive, is now the reverfe, eva- 
cuating foetid bilious (tools—Ibould any fweat return, this vio- 
lence on the puftules breaking out again is mitigated—and on 
the fucceeding day the eruptions become more copious and lar- 
ger, the former beginning now to dry—notwithftanding which, 
about the third day the fecond crop creates new and fimilar dif- 
trefs, though in a milder degree than the former—a third and 
fourth crop will fucceed, until the lalt ftage of decienfion, fimi- 
lar to what occurs in the milder fpecies.—Still in this llate of 
the difeafe there is a bilious foetid loofenefs, with rolling of wind 
in the bowels, which continues—the urine lometimes feels hot, 
and appears like milk whey without any fediment. 
Patients afflicted with this fever feldorn recover before the fif- 
teenth or twenty-fit ft day. 
This fever has been by fome confidered of the inflammatory 
clafs ; by others it has been called the acute malignant—but it 
appears to be truly of the mixed kind, and might properly be 
looked upon as a malignant miliary mixed fever. 
Sometimes the progrefs of this fever is flower, and longer con- 
tinued, the puftules not ftriking out with a proper rednefs, but 
finking down in the fkin or retroceding inwardly, liable to return 
at fome other time, and cccafioning a flow recovery ; and fome- 292 
Mt LI ARY FEVER. 
times death ; but its progrefs is different in fome degree. 
This fever is apt to fei/.e the delicate and relaxed, who have 
a thin and acrimonious flate of fluids. 
In addition to the puftular appearance above fpecified, the ten- 
dons ftart continually—a dplirium and convulfions come on—the 
head-ach, though confiderable, is not very acute—the tongue 
trembles—-the velocity of the pulfe is not fo great in the erup- 
tive flage ; but the freedom and quicknefs are irregular ; fome- 
times it almolt intermits—the urine is various, fometimes thin 
or higher coloured, but oftener turbid and fmall in quantity 
—but a vifcid fweat breaking out which is foetid, having for its 
affociate fome larger vefieular eruptions, and puftules offize more 
confiderable, putting on an appearance almolt iimilar to the fmallv 
pox, alleviate thefe fymptoms. 
After this flage, now and then the patients become extreme- 
ly drowfy, and have continual twitchings of the tendons, and 
convulfive erudations, then become ltupid, forgetful, and fall 
into a flate of lethargy ; to which fucceed convulfions, which 
are followed flovvly by fnoring and death. 
This fever, fliould the patient recover, is apt to return about 
the fame time in the fucceeding year, and often fcizes women 
during their lying-in—whence there is a fupprefliou both of 
their milk and thofe difcharges alter child-birth, called lo- 
chia. ' 
The mildeft fort of the miliary fever generally terminates in. 
feven, the malignant mixed in fourteen, and this in about twen- 
ty-one days. 
There can be little doubt of the nature of this fever, if we 
j:ay attention to the fymptoms, for they befpeakit truly nervous 
■—hence, for the cure, we mull refer to what we have faid on 
the nervous fever, (216.) making, perhaps, a freer ufe of blifters, 
and obferving a quicker fucceliion, for the reafons advanced. 
(29°-) . // • v :i ' 1 
Sometimes, added to the miliary' eruptions, fuch a train of 
fymptoms will attend, as clearly to Ihew its dilpofition to be of 
the putrid kind ; little deviating from what we have recited 
when lpeaking of putrid fever, (22!, &c.) and conlequently will 
require firnilar applications—but Hill, though much cannot be 
expeded from bliflers in fymptoms limply putrefeent yet fuch 
is the alleviation they bring in miliary eruption, that to neglect 
them would be an error of no trifling confequence—and, il to 
thefe we add the ufe of bark, mineral acids, and wine, little more 
can be expeded to be done in this fever, as thefe are the prin- 
cipal materials from whence wc can exped any confiderable fuc- 
cefs. ' * - ,1 MILIARY FEVER.' 
293 
Should a loofenefs come on under any of the circnmftances of 
this fever, we mtifi proceed in the iame manner as we have be- 
fore dire&ed, taking care not to be too bufy in putting a total 
Hop to it by the ufe of aflringents ; for if that happens, we may 
expect a great increafe of febrile affections, which is invariably 
the cafe ; we fhould rather attempt to folicit a flow of humours 
to the fkin, by fmail doles of ipecacuanha, (i8t.) (No. 57.) and 
fupport the Urtngth of the patieat by wine, and other generous 
antiputrefcent cordials. 
Thofe figns which portend a favourable conelufion are, 
If convulfions begin with, or precede the eruption, and, upon 
ceaftng, the pulfe becomes left and full, the puflulesfilled with 
Jerum grow large—if they are of the red kind, and manifeft 
themfelves ' with a gentle perfpiration, free and eafy refpirati- 
on, and the pulfe as above fpecified, the fever having remiC- 
lions. 
But if the fweat fhould be violent and premature, particular- 
ly if the pulfe at the fame time mould be fmail, they indicate 
iriifchief. 
A tingling flupor or numbnefs in many places, fhews that the 
morbid matter is copious ; but if it is flight, attended with wa- 
tery urine, fweats, and a l’mall pulfe, it hot only indicates the 
fame, but fhews the virus not eafily determined to the fkin ; hence 
dangerous. 
Should there be great dejection of [pints, the patient become ve- 
ry fsarfu4 I'fe all hope, rife up terrified, thefe are bad omens— 
nor is it a promising appearance if the fkin does not [well ironx 
the eruption, nor be aifefted from the application of bliiters or 
pupping-glafles. 
' It the head-ach goes ofF before the fourth day, in thofe of full 
habits particularly, it is an unfavourable fign ; and a fmail pulfe, 
growing more Jo after the eruption, with tenfiori, and quicknets 
increafing, denotes convulfions, and diffolution, or extreme dan- 
ger. / ! _ 
If the urine is conflantly watery, or changes to that from a 
reddiih colour ; this affords no good fign ; but it beipeaks along 
continuation of the difeafe if it is like milk-whey. 
Drops of blood from the nfe at any time beipeak great danger ; 
and, when drawn, if it mould be of a fcarlet colour continually 
without ierum, it is a bad fign. 
If, at the conelufion of the difeafe, th z fearf-fkin peels not off at 
all, or only [paringly, the convulfive fymptoms [till continuing, 
we may expect a relapfe. 
With regard to the eruption, the red are more favour- 
able than- the white ; and the fooner they make their appearance, 
r 294 
MILIARY FEVER. 
fo much the worfe ; for thofe which appear upon the third or 
fourth day often prove mortal on the feventh or eighth ; they 
are lefs dangerous if they break, out on the dxth ; the later the 
fafer ; for the fooner they appear, the difeafe proportionally of 
longer continuance, and more apt to return. 
After the eruption all oppreffive convul/ive fymptoms are omin- 
ous, and thofe which follow the fubfiding debruclive. 
If the pujluies are fmatl, and very numerous, they befpeak dan- 
ger—nor is it a favourable fort which do not prick, hut itch when 
they are pvjlsing out of the fkin—but if they recede, and afterwards 
the patient vomits, fees badly, has a rattling noife in fwallow- 
ing, hiccoughs, and ltaimners in talking, thefe import extreme 
danger. 
By how much more copious and prominent are the puflules, 
by fo much fooner will death make its approach, if they fubfide 
-—and thofe which fometimes fubfide, and fometimes appear, in. 
dicate a long continuance of the difeafe. 
| 7. Erysipelas, or Serous inflammatory Fever, com- 
monly called Saint Anthony’s Fire. 
This is confidered as an inflammation of the (kin, and fubja- 
cent fat, attended with an inflammatory fever, originating from 
an acrimonious humour and inflamed date of the thinner part of 
the blood, from which nature endeavours to free herfelf by ex- 
pelling the morbid portion from the habit, and depofiting it on 
forne external part, chiefly the (kin, in broad red fpots, .which 
creep from place to place—hence its name, from the Greek words 
*ruo, to draw, and pdas, into the vicinity. 
DESCRIP 1ION. It generally commences with chillnefs and 
fhivering, which in a day or two are fucceeded by a violent fud- 
den rednefs, and pain, attacking fome part or other, chiefly the 
face; and has for its affociates an acrid heat, rofy-coloured efflu- 
refcences, with great tightriefs of the (kin, llightly fwelitd, which 
is broad and diflfufed, not circumfcribed---the febsile affections 
increafe, with heat, anxiety, third, often alfo awhile Longue and 
drong breath. 
But it is often attended with greater degrees of violence—then 
it begins with great (hiverings, fucceeded by a burning heat, a- 
cute head-ach, retching and vomiting, till the eryfipelas appears, 
which is fometimes deferred to the fecond or third day ; when 
the febrile fymptoms are alleviated, and the ficknefs ceafes, tho’, 
not unfrequently, they continue in a (lighter degree to the height 
—fometimes, when the difeafe runs high, the fever continues, SEROUS INFLAMMATORY FEVER. 
the brain is oppreffed, delirium comes on, and matters wear an 
unpromifing afpeft. 
Upon the tumid part veficles arife, and run along the forehead 
hairy fcalp, eye-lids, neck, forming a circle round them, which, 
it injudicioufly treated, become gangrenous, and creates delirium 
—fometinies the humour filling the puftules, and iiTuing from 
thence, in dead of being thin and ferous, is thick and gluey, and 
forms a thick fcurf or cruft, continuing fixed before they tall off, 
for many days. 
The difeafe frequently terminates in feven days ; bnt fome- 
times it will proceed in a fimilar manner for eight, ten, or twelve 
days, and at laid: go ofFby a copious fweat, of which reft'leffnefs, 
with concomitant (hivering, and feme anxiety, though not much, 
for a fmall fpace of time, will be fometimes the forerunners ; and 
from thence may the critical effort be prognofticated. During 
the progrefs of tiiis complaint, the whole tkin and inffde of the 
mouth is very dry. 
CAUSES. The remote or inducing are faid to be, violent men- 
tal affection, particularly anger and fear---a fudden cooling of the 
body, heated before by the ftrong powder of the fun-—drinking 
of, or bathing in, too cold water—-a fuppreffion of the natural or 
artificial evacuations—moift and rainy feafons—and, in fine, 
whatever occalions the obllrudtion of perfpiration. 
The proximate or immediate, acrimonious and heating particles 
derived from humours that are contaminated and retained, which 
ought to be thrown out of the habit. 
CHARACTERISTIC SIGNS. An inflammatory fever, for 
the mold part, of a few days continuance, with a fuperfieial, foli- 
tary, diffufive fwelling, of a red rofe colour, going off upon prel- 
fure, and returning ; of an uniform fmoothnefs, unlefs made rough 
by eruptions ; and is attended with an acrid burning, or itching 
heat. 
CURE. As this difeafe, though neither infectious nor conta- 
gious, evidently arifes from fome acrid humours cfeCled out of 
the mats of fluids, and collected in the cuticular veffieis, through 
which it onj»ht to efcape out of the habit, we muff be very cau- 
tious not to lower the fever too much by excelTive evacuations ; 
nor hinder the exit, or caufe the retrocefiion when difeharged up- 
on the tkin by the injudicious adminiftration of cold or affriugent 
applications ; tor the indications of cure are, fo to regulate the 
moving powers, as to enable them to throw the offenfive matter 
out of the conftitution, and prevent any retrocefiion on the inter- 
nal and vital parts. 
Hence, therefore, mutt we proceed, as in other cafes, confid- 
ently with the llrength of the habit. If it attacks thole of itrong 296 
saint antkony’s fire, or 
full conftitutions, we Weed in proportion to the ftrength, and 
give the cooling cathartics, fnch as purge off the ferous humours 
in the moll certain and eafieft mode, as vitriolated natron, ace- 
tated tartar, Polychrefl fait, Epfom fait, manna, tamarinds, cry- 
ftals of tartar, jalap, &c. (171, *72.) (No. 1. 22 to 2a.) and, on 
the intermediate days, we fhould give at intervals antimonials 
joined with nitre, acetated tartar, or the faline mixture } to which 
gentle aperients may be added, if neceffary. 
Emetics in this cafe have been found efficacious—muflard 
poultices applied to the feety and bathing the legs and feet in 
warm water are very beneficial, where the head and face are af- 
fected—and, under this circumftance, bleeding and purging may- 
be repeated, till an alleviation of the fymptoms are produced. 
In all our endeavous we fhould attempt to promote gentle e- 
vacuation by the fkin with cooling diaphoretics. 
There have been different opinions with vefpeft to local appli- 
cations to the part affe&ed ; fome advife mild and foftening ap- 
plications to the part affeCtcd, a3 frefh cream, the ointment of 
elder leaves, tepid watery fomentations, or the ufe of the water 
of acetated litharge—however, the fine powder of fenugreek, or 
wheat flour, fprinkled upon the part, and lying in bed—or, if a 
fluid begins to oo?e out of the veficles, chalk or (larch may be 
fprinkled on a foft cloth, and thus applied ; for all repellents, 
whether of an aqueous or oily nature, are hurtful. 
Should the fuelling be fuddenly depreffed, from a retroceffion 
of the offenfive matter, attended with internal oppreffion and anx- 
iety, and at the fame time the pulfe becomes weak and finks, we 
raufl immediately apply bliflers, and have recourfe to vinous 
arid other cordials ; wine may be exhibited freely, volatile and 
other ftirmvlants, which have more permanent aid ion, fuch as the 
nature of the eircumftances require. 
Sometimes this difeafe attacks the trunk, chert, ffioulder-blades-, 
or fides, and frequently makes its appearance lower, encircling 
the middle of the body, like a belt—hence called by the Greeks 
zoster and zona, a belt} and by the Englilh shingles, from 
the Latin word cingulum, a girdle. 
In this complaint little yellowifh pimples, hut more frequent- 
ly of a livid hue, arife which are wont to corrode, like a tetter, 
which fpecies they refemble. 
The fever which is the affociate of this eruption is only flight; 
but, ffiouid the pimples be puflicd back, fymptoms of greater con- 
fequence prefent themfelves. 
There have been inflances where the eryfipelas has begun with 
fhivering, heat, delirium, violent pain of the back, head, and o- 
ther parts of the body, where there was no inflammation; but SEROUS INFLAMMATORY FEVER. 
upon the third or fourth day, the hot burning humour was de- 
pofited in the glands under the arms, or in the and there 
formed abfcefl'es ; or defcended into the feet, and Drought on mor- 
tification ; and from a retroceffion of the morbid matter, life was 
in the mod extreme danger. 
For if this matter cannot be made to re-appear, the peccant 
humour is depofited upon the brain or bread, and death is fhort- 
ly the confequence—if the depofition happens upon the brain, 
delirium immediately fuceeeds, the vifage is fiulhed, the eyes 
fparkle very quick, then follows madnefs, terminating fatally in 
lethargy ; but (hould it be upon the lungs, the heat and anxiety 
is intolerable, of which no words are adequate to convey a per- 
fect idea. 
Notwithfianding thefe appearances, our modes of cure vary 
hot from that which we have before defcribed. 
Though, in general, the eryfipelas very feldom comes to 
fuppuration, Hill, when that is the cafe, it does not maturate 
kindle, and frequently forms difagreeable and ill-conditioned ul- 
cers. 
bometimes a mortification will threaten, then mud we apply 
fuch things as are calculated to dop its progrefs, as decodVion of 
bark, lime-water mixed with camphor and fpirits of wine, or 
camphorated fpirits of wine, with tin&ure of rhyrrh. 
In the flighter kinds of eryfipelas there is no great danger ; 
but if a violent inflammation, attended with dupor, drowfinefs, 
or delirium, fhould feize patients with an acrimonious date of 
fluids, much are the confequences to be dreaded. 
Should the inflammation recede or be repelled, it brings on 
delirium, internal inflammations, adhma, convulfions and morti- 
fication ; or fhould the tumid part grow livid, we may conclude 
the latter of thefe affections at hand. With refpetb to the puf- 
tules, the thicker and whiter the matter, the lefs will be the de- 
gree of danger ; but fhould it be thin and pale, fo much more in 
proportion will it be increafed. 
The Plagu!■, and that fever called Pemphigus, from the 
Greek word pemphix, bulla, a bubble or veficle, or bullous or 
VEsiculary fever, fhould be next treated on ; but as' 1 have 
had no experience in the former, 1 fhall proceed to Ipeak on the 
latter only as far as it has fallen under my obfervation, as the 
difeafe itfeif ieems nbt to be perfectly fettled by authors. 
xj 8. Pemphigus, bullous or vesiculary Fever. 
This takes its name from the bliiters with which it is accom- BULLOUS OR VESICULARY FEVER. 
panied on the furface of the body, of the fize of 
hazle nuts. 
In three inftances they were attended with a fever of the con- 
tinued kind, purely inflammatory ; and in.one it appeared to be 
contagious, attacking the wife of one man labouring under the 
difeafe a few' days after the eruption, who would not deep from 
him during his illnefs. It was in thefe cates treated as an inflam- 
matory fever, free ufe being made of the faline diuretic s, parti- 
cularly the acetated kali. 
The other two had fcaree any febrile fymptoms, but copious e- 
ruptions filled with yellow ferum, which went off, and returned at 
different periods.—diuretics in thefe two cafes were ufed in the 
\tegimiing, and, at the conclufion, l ark was joined along with 
fhejafe&pcl cordials, there appearing obvious remiffions of thefe- 
which were flight, and feemed to point out the 
nervfttst- fyftem to be the feat of the difeafe, from the languor 
and' lbwtfrels witli which the complaint was attended, and the 
pulfe at the fame time being weak, fmall, irregular, and 
quick. 
SECTION XIII. 
INFLAMMATORY DISEASES. 
C II A P. I. 
ON INFLAMMATION* 
|N a former feclion we have fpoken of inflammatory fever, 
'(20 F.) which we have find depended upon'a pecufar date of 
the *valculur fyftem and blood, the movifig powmi'sHpr part of 
them, put into too ftrong motion, ancMvipporied in tne violence 
of their action hy the ffeculiarity of that ftate : here the%afFeflions 
were general, produced not by,' or dependent upon, Any other 
diieafi-. ' 
But in this place we are to treat of local aftcciions, having a 
fever for their afibciate ; hence it is to be confidered, -not as a 
primary, but as a fecondary difeafe, produced by, or dependent 
on, fome other ; confcquently only a fign that feme other mala- ( 
dy reigns ip the habit—the firft of thefe fevers is culled idiopa- ] 
►’Tiiic, the fecond symptomatic. 
' j ON INFLAMMATION.- 
299 
Now, in inflammation there are fome particulars obfervable, 
which, on examination, will lead us to the caufe, and enable us 
to lay down certain rules for the cure. w<- 
In a part under a ftate of inflammation there are more than na- 
tural heat, tednefs, tenjion, pain, an A /welling. 
The first is produced by the blood circulating to the part 
with more than ufual force, and being there collected in too great 
quantity ; and wherever that is the cafe, there is a proportionate 
increafe of warmth—the second is owing to the blood being 
pulhecl into thofe veflfels, which, in an healthful ftate, are only 
permitted to carry the ferous or thinner fluids drained from the 
fanguinary mafs—the third arifes from a too great quantity of 
fluids crowding into the containing veflfels, by which they are 
dillended, and their fibres diftracted, which produces the fourth, 
or pain—and the FIFTH deduces its origin from the-difteniion, 
and the fluids being too freely puflied into the cellular membrane ; 
or exuding through the coats of the veflel, by their natural parts 
being too permeable, from the fqperabundant quantity of liquids 
they contain. 
Now all thefe effe&s may be produced by.Jlimulus of fome 
nature applied to the parts affected, increafing the action of the 
vellels, w'hich folicits the fluids to thefe parts too rapidly, and 
produces dijl&njion. 
Hence it appears obvious, that thefe two caufes are adequate 
to create thefe effects -one of which acting will occafion only a 
flight degree of inflammation, of no long continuance—but if 
they both are conjoined, then arifes an inflammatory difeafe of 
greater violence and duration ; inaftnuch as, from thefe fwp 
caufes co-operatmg, the effects produced will be more vehement. 
But in the parts which a.e molt folid, or in which the veftels 
continue their courfe in a flraight diiedtion, fliould any inflam- 
mation arife, there will confequently be greater degree of pain, 
than if it happens in the foster vifeera, or glandular parts be- 
caufe th*re is always a higher degree of tenfion in the 
hence in firm membranous parts, the fki'n, ligaments, tendons, 
cartilages, and bones, (21, 22. 24.) inflammations are found' 
more acutely painful, whilft in the fofter parts before-mentioned, 
the pain is fometimes flight, and always inferior to that of the 
other. « 
But external accidents will, by producing the two capfes af- 
figned,- (298.) create local ’.nflammatory fymptoms, whilft the • 
vaicular fyftem in general fhall perceive no difturbance, which 
will not at all be indicated by the pulie, or*other febrile afFefti- 
ons ; fo that if a fever fliould arife, as it generally does in all 
ccnfiderable inflammations, it is to be confidered as owing its ori- on inflammation: 
gin to this caufe, and is a confequence, therefore only efteemed 
a lymptom ; fof*exceffive heat, third, and reftleflnefs, are conco- 
mitants of vafcular aff’eCtion, and generally attend inflammatory 
difeafes, independent of any fever, except what they themfelves 
create; whilil weaknefs and lofs of appetite, eflential fymptoms 
attendant on primary or idiopathic (29S.) fevers of any continu- 
ance, are wanting, and l'eem to belong to affections of the ner- 
vous fyilem. 
But fome inflammations owe their origin to fever, and may 
be or rationed by peculiar caufes ; either from the elective power 
of moibid matter thrown into the habit, that is, a predeli&ion 
for fixing on fome peculiar part or parts in preference to others, 
as in the i’mall-pox, meazles, gout, rheumatifm, &c. or from lo- 
cal conffitutional imperfection—hence we find, different parts 
may become the feat of inflammation from general caufes alio ; 
fo. if the refinance of any part is fupernaturally increafed, and 
a ftimulus fhoukl be applied to them from acrid humours circu- 
lating in the mafs of fluids, and fixing there, an inflammation will 
be the unavoidably confequence—and thefe very often terminate 
fatally, fhould it in fevers fix in fome of the nobler parts ; and 
ro theie is often to be attributed in many fevers the death of the 
patient. 
If we reflcCt on the caufe of inflammation, we (hall find, that 
every part of the human machine; which is plentifully fupplicd 
with blood vefiels interwoven in their texture, is fubjeCt to this 
aff'eCtion—and mojily fo are thofe parts which are liable to be ex- 
pofed to external injuries ; or to llimulating materials, which 
circulate and are buoyed up in the atmofphere ; though fome of 
the very thin membranes, the fcarf-lkin, hair, and nails, may fie 
confidered as exceptions, • ■ 
Hence, according to the confequence of the part affeCted, will 
be the dillurbance of the conffitution, and the degree of danger ; 
and thefe will manifeft themfelves according as the ufe of thofe 
parts is moil imynediately conaeCted with thofe of the 
conffitution on which life is immediately dependent, by which 
the machine is nourifhed, and its parts kept in proper order, and 
from whence it has its power of motion, diffinguiffced by the 
terms vitql, natural, and animal—upon all which, aCling in uni- 
fon, is eonffituted the welfare of that machine. 
With rel'pect to the termination of inflammation, there are five 
modes, RESOLUTION, EXUDATION, SUPPURATION, MORTIFICA- 
TION, and scirrhus. 
Inflammation is confidered to terminate in resolution when, 
in the firff: inftance, the flow of blood is diverted from the part 
affeCted, the violence of vafcular aCtion allayed, and ff length giv- on inflammation: 
301 
en to the coats of the veffels, fo that they may he properly fup- 
ported, and the diflipntion of the load ot fluids which have been 
collected be procured ; or they may be rei'orbed into the habit—• 
by exudation, which occurs only in fuperficial inflammations 
on the Ikin, and membranes lining internal cavities or paflages, 
or covering the different vifcera, when diilenfion of the arteries, 
and an enlargement of the pores of their fides takes place, by 
the rapidity of motion producing more than ufual torce on the 
veffels in an inflammatory llate, occafioning great increafe of heat, 
and expanlion of the contained fluids. 
In this manner frequently ends eryfipelas, by pufhing forth 
little puftules or blitters, and freeing the veffels which are in- 
flamed—fo alio in burns and wounds matter exudes, which is 
termed digeftion ; and as this comes on and continues, fo arc the 
parts affected alleviated, and totally cured. Nature alfo makes 
life of this expedient in catarrhal and other flightly inflammatory 
complaints of the lungs, as well as in the gonorrhoea virulenta, or 
clap ; for all thele are fuperficial inflammations—by abscess, or 
suppuration, when neither of thefe prccefles takes place, but 
the violence of motion continues or increases, and the v/eaknefs 
of the veffels flill remains ; then the fluids which have been col- 
lected in the cellular membrane are either too copious, or become 
fo thick and vifeid, that they cannot be aSforbed and received 
back into the circulating fluids, nor puffed out, and thus evacu- 
ated through the pores of the Ikin—amongft thele another pro- 
cefs takes place, termed fertm entaTION, wherein the veffels, 
cellular membrane, and mufcular fibres are melted down, and a 
white thick matter is formed, called pus but this happens 
chiefly in more deep feated inflammations in feme vifeous, flethy, 
or glandular parts—by MORTIFICATION, when the force of cir- 
culation is fo violent againft the fides of the inflamed veffels, that 
the coats are ruptured ; or when the arterial coats are fo very 
weak, that the blood burfting into the cavities of the cellulaf 
membrane there flagnates, and quickly corrupts, forming what 
is called in medical language gangrene, or sphacelus ; the 
fir ft confidered by fome as mortification in its incipient ftate, the 
laft when it is perfectly formed ; but others, when the fkin and 
cellular membranes are the parts affeCted, give it the former name; 
when the mufcular, the latter; when the bones, it is called ca- 
ries ; fo, in fact, they are all truly mortifications, though only 
of different parts. 
When mortification takes place, there is a ceffation in the part 
of all pain, from the deftruCtion of the living folids ; hence the 
protrufion of blood, which becomes of a darker colour than be- 
fore, or has a livid appearance ; hence its ftagnation and corrup- ON INFLAMMATION, 
tion, and deprivation of its natural colour—after this, a fponta-j 
rieous feparadon of the parts which compofe it takes place, tliel 
thinner part is driven forwards towards the furface, and elevates 
the cuticle into blifters. 
From what has been faid, we may form a judgment why mor- 
tifications are moll likely to occur in thofe whofe fluids are in an 
acrid Hate, old people, and thofe of dropfical habit ; becaufe the 
folids are foon broken down, and many fli Jit accidents are fufti- 
cient to produce thete dangerous, and olten fatal effects, which , 
we at firil obferve with an unfulpicious eye, when they are at- ] 
tacked by inflammations of fome force ; for, indeed, in conftitu- ; 
tions not labouring under thefe defeCts they rarely happen. 
The lull termination we fhail mention here con- 
fidered as a hard indolent tumour only, and chiefly piefents itfelf 
in the fpongy vifcera, as the lungs, mcfentery, womb, and par- 
ticularly the glands in various parts of the machine. 
And this generally arifes from the circulation in the glands, 
generally being too languid—hence are obflruCtions formed from 
the fluids infpiflating within the fmall capillary, or hair like 
tubes, and only producing vafcular difler.flon fo gradually, that 
there is no great excefs ot pain, nor any violent increafe of heaf, 
fo that proper power is wanting to create that procefs which in- ; 
duces luppuration? and alfo force fuflicient to break down the 
veflels, and produce mortification, which in thefe parts are faid 
feldom to take place, except from acrimony of the fharpeft na- 
ture pouring down on the veflels of any particular gland, and 
being there depofited. 
Inflammation then may be confidered only as one caufe of 
fcirrhus, which induce thefe tumours by imperceptible degrees, 
and very flow beginnings, which are attributed to fome peculiar 
indefcribable defeat of the humours, terminating frequently in 
cancerous affections. 
They are, befides, productive of great mifehief from the com. 
predion of the neighbouring pars, as palfy, impeded deglutition, 
barrennefs, and many other complaints. 
From what4bas been faid on this fubjefl of inflammation, we 
fliall be resd.ily and forcibly Itruck with the moft eligible modes 
of termination. 
The firft is by refolution, the fecond by exudation, if the mat- 
ter exuded can have a free exit out of the habit ; but in thofe 
inflammatory afieCtions which make the membrane that lines the 
cavity of the bread, and abdomen, or belly ; or vchich cover the 
different vifcera contained in them—the objects of their attack ; 
and if the matter which from that caufe exudes from their fur- 
iace iliouid remain there, a heCtic fever will be the coniequence, though the original pain chafes, and a frefh concourfe of fymp- 
Wbrns will then fucceed. But fitppofe neither of thefe termina- 
tions can be brought about, we then wiih for abscess, becaufe 
only the inert folids fuffer chiefly, and feldom have any perma- 
nent bad effeCts, if they can only be permitted to clear themfelves; 
for then the parts heal up ; nor have the nerves or blood-vefiels 
fuftefed any material deftruetion, though the laft may have been 
diftended, and fullered greatly from i’uch dillenfion ; yet, once 
freed from the impelling caufe, foon recover their tone, fuflici- 
ently to perform properly their conititutional action ; and as for 
the inert folids, they are again i'oon fupplied, by the di'geftive 
powers of the machine forming frelh materials from nutriment, 
in order to renew the fubftance loft, by the application of homo- 
geneous particles poured into the interftices of the celullar mem- 
brane. 
In all our attempts to cure inflammatory complaints, our 
firft aim is refolution, whether the part affected be exter- 
nal or internal ; the former of which is obvious to ocular demon- 
ftration ; the latter, by heat and pain affecting fome inward 
part, accompanied with general febrile affections ; of which wre 
fhall fpeak more particularly when we come to treat on‘parts 
labouring under this complaint; at prefent we fhall fhew how 
we attempt to bring about refolution, when any conliderable in- 
flammation calls for our affiftance. 
If it occurs in habits which are plethoric and ftrong, the pulfe 
full and quick, and much increafe ot heat, we purfue the lame 
courle as was delivered when treating on inflammatory fever, § z. 
SeCtion VIII. attempting to allay the intenfenefs of motion in 
the vafcular fyilem, and abating the exeefs of heat, which is the 
natural concomitant. 
But here fometimes the complaint yields not to general bleed- 
ing, we then fhould have recourfe to local, by the application of 
leeches or cupping-glafies near the part affeCted, which will ve- 
ry often fucceed ; and as there is too great a flow of fluids to 
the part, we endeacour to leffen that by fmart cooling purges, 
(No. 3. 22 to 2q.J giving freely in the intermediate times be- 
tween the purges, nitrous powder, (No. 2.) mixed with fmall 
doles of antimonials, (180.) gentle aperients, (171, 172.) and o- 
ther cooling faline diuretics, (176-) applying to the parts them- 
felves fomentations, (No. 85.) with which let the part affected he 
fomented three or four times a day, and continued at each time 
for half an hour, or longer, taking care not to apply it too hot, 
but only moderately1- warm. 
Afterwards the inflamed part fhould be covered with a white 
bread poultice, in which a fufHcient quantity of ointment of marih- 
on inflammation. 304 
ON INFLAMMATION. 
mallows has been ufed—fome advife a poultice of bread boiled 
in litharge water, called vegeto-mineral water ; others of wine- 
lees thickened with bran; and feveral prefer that of bean-meal 
and Ample oxymel, foftened with oil of rofes—and fhould the tu- 
mor and inflammation be by thefe means diffipated, the poultices 
fhould be changed lor dupes moiftcned with the camphorated lo- 
tion, (No. 8h.j and occafionallv applied to the parts. 
By thefe means commonly refolution will take place, the hu- 
mours collected in the part being diffipated, and the remainder 
abfovbed back into the habit, by the lymphatic fyftern being 
freed fufficiently, and ilimulated to a reproduction of its a£tion 
in the part affeCted. 
But, notwithflanding our efforts, if the common fymptoms 
mould gradually increafe, fuch as great heat, throbbing in the 
part afi’eCted, fuppuration will take place, and an abfeefs be form- 
ed—here, then, our mode of cure mult be altered, and we mud 
aim at foliciting the matter externally, and freeing the habit in 
a proper time, by the application of thole things which promote 
fuppuration, thin the external lkin, and determine the contained 
matter towards the furface. 
Hence poultices made of mallow leaves, boiled in milk with 
linfeed, orlinfeed itfelf—boiled lily roots, or onions—the matu- 
rating cataplafm—or the gum plailler, will anfwer the purpofe; 
for thefe, by clogging the pores of the Jkiri, prevent the diffipa- 
tion of the humours, increafe the heat of the contained fluids, 
promote the procefs of fermentation, and render the humours 
more aCtive in diiTolving, or melting down the folid parts, as well 
as foften the inte uments, and, by their llimulus, folicit the fluids 
to pufb outwards. 
From thefe applications, then, the abfeefs wlllfoon be in a pro- 
per ilate for opening ; which mud be performed in the mod de- 
pendent part, if the fwelling is equally foft throughout, and the 
fkin of a fimilar thirinefs ; if not, where the part is fofted, and 
the fluctuation of the matter mod perceptible ; and the aper- 
ture fhould be made of fuflicient width, in pioportion to the fize 
of the tumor, that a free egrets may be allowed for the mat- 
ter. 
After this, the healing of the wound in good coriftitutions is 
feldom attended with any difficrity—dry lint placed gently in the 
part, and that covered with tl\e ointment of yellow refin, fpreacl 
thin upon lint or tow, are the general dreffings atiird ; and from 
thefe frefh granulations will appear ; and in time fill up the ca- 
vity occafioned by the lofs of fubflance ; but fliould the fore ap- 
pear foul, covered at the bottom with a white or brown appear- 
ance, indead of red granulated flefii, we mud apply fome of thofe 
. 1 * on inflammation. 
305 
things conhdered detergent, or cleaning; as the ointment of 
gum elemi, of yellow refin, mixed with a proper proportion of 
red precipitate, or green bafilicon ; thefe will cleanfe the ulcer; 
and then dry lint as before, and proper bandages, will in common 
perform a perfect cure. 
But fometimes, inflead of a thick well-coloured laudable mat- 
ter, there will be a thin ichorous dil'charge, occafioned by an acri- 
monious Hate of humours, while, at the fame time, there will 
be febrile heftic fymptoms. 
Under thefe circumflances, in order to produce a laudable fup- 
puration, and take off the heftic affeftions, in relaxed habits, 
joined with an acrid Hate of the fluids, bark is the moll effica- 
cious remedy ; but where the difcharge depends more upon the 
Hate of the fluids, in order to correct or evacuate the acrimony, 
a courfe of mercurial medicines, as the alternative mercurial pills, 
two of which may be taken twice a day, with one or two pints of 
the decoftion of the woods, (No. 87, 88.) bid faired for luccefs. 
There is a fpecies of complaint very common belonging to 
this place, which here calls for our attention, ancl that is, a 
Boil, or Bile, though this feldotn terminates by refolution, 
but commonly maturates—it is a hard circuml'cribed tumour, 
riling to a point, hot, red, and very painful, which, maturating, 
may be let out, or left to burft, from whence a ftnall portion of 
matter only will illiie forth, in proportion to the fwelling, leav- 
ing a Hough behind, which is called a core, and mult be cad 
off before the wound can be healed. 
In its hard and painful Hate, we can have no expeftations of 
difcuflions ; our endeavours, therefore, are to be confined to haf- 
tening the fuppuration, as we have before direfted, (304.) or ap- 
ply bean-meal and honey, which is a favourite remedy with 
fome—when it is opened or burH, we mull proceed as before 
under the fame circumHances in abfcefs (304.) 
But thefe eruptions very often originate from a depraved Hate 
of the fluids, which occaiion their frequent returns, and are ex- 
tremely tronblefome—here we mud have reference to the altera- 
tive courfe before recommended, (305.) which mult beperfifled in 
for feme time, now and then interpofing gentle cooling purgatives. 
Thus far we have fpoken of thole inflammations which lie fu- 
perficially, and are alleviated by appeaftng applications ; but 
fometimes the feat of the complaint will be too internal for them 
to become effeftual, we then apply over the part Himulants, 
which have been found highly efficacious in producing refolu- 
tion—indeed, where complaints have been flight, applications 
of hot land or fait, flimnlating cataplafms, as of muftard, pelli- 
fory, horfe-radiih, Burgundy pitch, volatile liniments rubbed 
well upon tile pait, have been found fervicesbie auxiliaries y but ON INFLAMMATION. 
when the fymptoms have been more fevere, bliflers applied over 
the part contribute the molt readily to promote refolution. 
Thefe remedies, and the fedatives and emollients we have be- 
fore fpoken oF, where the caufe has been excefs of the vibratory 
motion of the veflels dependent on fome ftimulus, and external 
.remedies can be applied, have been thought neceflary—or when 
inflammation proceeds from fra&ures, wounds, contufions, or Inch 
like caufes, difcutient fomentations, (No. are mod of all to 
be relied on—when it depends on local relaxation, or a decreafe 
of vafcular rejijtance, as it fometimes does, particularly in inflam- 
mations of long Handing—bleeding and purging fhould be cau- 
tioufly advifed, and all emollient poultices and fomentations omit- 
ted ; for thefe, by their relaxing properties, will add to the caufe--a 
contrary plan mult be adopted, calculated to give ftrength and acti- 
vity to the veiTeh, that the ofFending caufe may be repelled. 
For local applications, alum, white vitriol, acetated litharge* 
lapis calaminaris, and turty prepared, mixed with rofe-water, 
are occaflonally ufed ; as are alio tincture of rofes, and flight 
decoctions ot bark, and eye-waters ; gargles made of thefe well 
adapted to relieve inflammatory complaints arifing from a debi- 
litated and relaxed fiate of the veflels—and where the general 
llate of the habit is fo relaxed, as to demand the ufe of tonics, or 
fuch things as invigorate the fyftem, bark and cold bathing are 
highly ufeful. 
By the modes we have laid down, we (hall almoft always be 
able to conquer any common inflammation ; or conduct our patient 
through with the greatefl eafe and l'afety, if abfeefs fhould take 
place—but there aie fome niceties to be obferved, which we fhall 
particularize. 
Fomentations fliould never be pufhed too far ; for, after tak- 
ing off the violence of vafcular motion, if continued, they induce 
a Itate of relaxation in the fibres, from which fucceed debility 
and obflinate tumours—inflead, therefore, in perfevering in their 
ufe, when excefs of vibratory motion is fubdued totally, and in 
many cafes when it is allayed, corroborants then become necefla- 
rv, (No. 86.) or fome thing of a fimilar nature. 
With regard to abfccfi’es, we mult obferve, that they all point, 
and the contained matter endeavours to make its way to the 
parts where it finds the lealt refifiance—hence thofe formed in 
the lungs rupture internally ; thofe in the vifeera of the belly 
move externally—thofe which are deep ieated, and formed under 
itrong tendinous expanfions, run along the l'paces between the 
mufcles, and appear at a confiderable diftance from whence they 
full originated. 
Befides, they do not all originate from inflammation preferr- 
ing its regular courfe ; they are lometimes critical, the effeft of ON INFLAMMATION# 
307 
k nature freeing the conftitution from fome morbid matter, by 
"throwing it out of the circulation, and depofiting it in fome lo~ 
pal fituation, which is attended with the moft happy confequenc- 
es, admit the vital organs, or the parts of high importance in 
the habit efcape, from its being depofited in them. Abfcefles of 
this kind are generally preceded by fome fever ; and this depo- 
tion of matter is called metaftafis, or tranflation, which occurs 
chiefly in parts where the veffels labour under fome uncommon 
weaknefs, from fome caufe which has left them in that ftate. 
Under this circumflance, as foon as ever the ikin is in a proper 
Hate of thinnefs, the matter muff be let out by incifion, if it can 
be come at, elfe would it, by too long continuance, diflblve too 
much of the folid parts, deftroy the texture of the nerves and 
blood-veflels, produce a caries, or mortification of the bones, by 
penetrating through the membrane which covers them, and lay 
the foundation for a he&ic fever, from the matter being taken 
up by the abforbent veflels, and carried into the habit. 
In cafes of exudation, (300.) where the furface appears on- 
ly excoriated, not ulcerated, we can give the happieft affiftance, 
when it (Lews itfelf externally by internally exhibiting fuch things 
as tend to promote refolution ; and having recourfe externally to 
fuch as are calculated to cleanle, heal up, and ftrengthen. 
And when fuch is the circumflance on the membranes of the 
breafl, of the belly, or the external furface of the vil'cera, as it 
fometime? is, we are allured, from the appearances on difle&ion, 
where there has been no perceptible ulcerations or deftrudbon 
of the folids, though matter has been found in thefe cavities ; by 
early advice judicioully given, many might be faved from fome 
of our moft fatal complaints, pulmonary, and fome other con- 
fumptions ; for many of thefe arile not, in the Jirjl injlance, from 
ulcerations or little glandular tumors in the lungs, called tuber- 
cles, but from matter exuded from membranous furfaces, which 
acquire a degree of acrimony, and then, by melting down the fo- 
lids, caufe ulcerations : and 1 have no doubt but by a very early 
application tofuch modes as we have fpecified for refolution, thefe 
mifchiefs might be often prevented—but here the great misfor- 
tune is delay ; patients, in the infancy of this complaint, by dabs, 
noftrums, and old family prefcriptions, lofing the favourable op- 
portunity which ought to be given to the well-informed phyfi- 
cian, applying for fuch aid only when fome of the internal parts 
have fullered irrecoverable injury. 
Though we have before fpoken of the eryfipelas, or Saint An- 
thony’s fire, which arifes from a febrile caufe, there is another 
fort which fometimes fucceeds external injury ; and in this, it 
the inflammation runs high, bleeding and purging are Kfghly-ef- 
ficacious j and in. the intermediate times, betwixt the adraiuiftra- 308 
ON INFLAMMATION. 
ting of purgatives, I depend upon faline diuretics, (176.) and evenij 
thofe purgatives which I prefer, are fuch as mod powerfully 
cuate the ferous humours, luch as vitr iolated natron, Rochelle fait, 
regenerated tartar, jalap, fyrup of buckthorn, &c. 
The external applications in thefe cafes fhould be fuch as will 
expel the obltru&ed fluids through the pores of the fkin ; hence 
diluent fomentations are recommended, decodtion of linfeed, and ; 
white poppy heads, with elder and chamomile flowers, and a pro- 
per proportion of foap liniment, one ounce and a half to two 
ounces to a quart, whilfl there is no break upon the fkin—chalk, 
or fine flour, fpread upon the part, and confined with a fine rag—• 
and lotions of the vegeto-mineral w'ater are thought by fome 
highly ferviceable, where refolution is the aim. 
But when pimples or painful blifters make their appearance,4 
equal parts of lime-water, oil, vinegar, and comphorated fpirit of 
wine, form an efficacious compofition to lay on the inflamed 
part, by means of a rag dipped into, and well loaded with it— 
or the ointment called unguentum tripharmacum, or that of a- 
cetated cerufs, have been confidered as proper applications. 
We muff now proceed to fpeak on mortification, another 
termination of inflammation, which generally proceeds in 
the following manner. At firfl the fwelied part begins at the 
point to grow yellow, the pain is mitigated, and a dingy colour 
comes on ; the ikin is flabby and foft, retaining the imptefflon 
made by a finger upon it, it lofes almoft all fenfation, and grows 
livid—a tumid elevation of the part is perceived, which diffufes 
itfelf around—there appears puffules of a thin yellowifh acri- 
monious liquid, which are black at their bafis—then the ikin 
and parts underneath corrupt, become dead, black, lofing all fen- 
fation, and diffolve into a foetid (linking fanies—the mortification 
creeps onwards, and feizes the neighbouring parts-—at length 
Havering, fever, cold fweats, fmall and weak pulfe, and faint- 
ing, befpeak the approach of death* 
In the beginning, when the fource of this mifchief has been 
external injury, and there is much ftrength of conflitution, in-, 
dieated by a full, hard, quick pulfe, high degrees of heat, pain, 
and drynefs, the cooling method is to be purfued, as if retolu- 
tion was to be brought about; and though in this we cannot 
hope to fucceed, we are warranted in this mode of procedure, by 
the extreme violeucp of the fymptoms, with intent to bring on a 
Irate of fuppuration, by checking the vehemence of the circula- 
tion, and preventing the veffels from being ruptured—betides, 
exudaiioh would be favoured from the continuance of relaxing 
and emollient fomentations. 
But mortifications arife from very different fources, and affe£l 
conflitutions—fhould they happen to patients, there- ON INFLAMMATION. 
kfore, whofe blood is in a thin, acrid, putrefcent date, which will 
Pbe indicated by debilitv of the pulfe, lofs of ftrength, lownefs of 
fpirits, fcetid thin acrimonious difcharges, and, fhould blood be 
taken, by its texture being very weak, we mud have recourfe 
to invigorating and cordial remedies ; as bark, wine, mineral 
acids, and fuch like, in order to prevent the accefs of gangrene, 
and produce a reparation of the part affected ; and, in cales of 
great pain, opiates have been advifed with very fortunate ef- 
fedfs ; indeed, whether the caufe is internal or external, the free 
ufe of opium is directed, and conlidered as the greateft internal 
cordial known—-as an external application, the antiputrefeent lo- 
tion, (No. 90.) is recommended to be applied frequently, warm, 
as it is alfo ftimulant and digedive—cataplafms of cummin-feed, 
and the carrot poultice, are much approved ; but if emollients 
are mixed with antil'eptics, (192,) they are faid to affid in the 
feparation of the putrid parts, and dopping mortification. 
The lad termination of inflammation is scirrhus, (302.) or 
indolent tumor, which >arifes from obdrudlions forming in fome 
of the glandular parts,-as before deferibed, where either no fup- 
puration takes place, or if it does, it is in no fmall a degree, that 
it has not power to melt down the folids fufnciently to remove 
the induration—or it may be brought on by the too long ufe of 
warm fomentations, foliciting too free and long continued flux 
of humours, relaxing the veflels of the parts, hence occafloning 
hard fwellings, which are not eaflly removed. 
. Now thete fwellings which we here ccnfider are totally free 
from all acrimony of any peculiar nature, and, as the fluids arc 
in a found date., it is often the mod eligible pradfice not to in- 
terfere by any applications—becaufe in young fubjects they will 
very often gradually wear away ; in older ones continue gene- 
rally without creating any uneafinefs or inconvenience— but 
fhould the hardnefs be io confiderable as to require particular at- 
tention, warm vapour or fleam directed to, and confined to aft 
upon the part affedted, is one of the mod efficacious applications 
in this cafe. 
i Sometimes thefe tumors are foft and flabby, then fridtions, and 
well adapted bandages, where they can be applied, are ufeful 
• or letting cold water fall from fome height upon the o.r 
pumping upon it, feems bed calculated to fucceed. 
Thus far has it been neceffary to premife, before we enter on 
the inflammation of the different parts, wherein the treatment 
of the inflammatory fymptonis will be nearly fimilar ; but there 
will be fome deviation neceffary on account ol the parts affedted 
— for the INFLAMMATION OF the BRAIN will require a differ- 
* enc treatment from that,pf the eye—of the eye from that of 310 
INFLAMMATIONS OF THE HEAD AND NECK. 
the lungs—of the lungs from that of the intejlines, &c. t© 
which we lhail now proceed. 
C Id A P. II. 
INFLAMMATIONS OF THE HEAD AND NECK. 
§ 1, Phrenitis, inflammation of the Brain. 
‘-"PHIS is fo called from the Greek worAphren, mens the mind ; 
becaufe the brain is fuppofed to be its feat. 
DESCRIPTION. The fymptoms at the onfet are, with re- 
fpeft to the general affe&ions, fimilar to what occur in the be- 
ginning of the inflammatory fever, only the head feems to be 
more violently affe&ed ; for in this there is pain and puliation 
of the head, with a founding noife, a ringing in the ears, and 
dillurbed fleep—the eyes are painful and inflamed, almoft always 
ihunning the light—the countenance is puffed, the hearing acute, 
and the patient is irritated from the flighteft noife—the pulfe, 
for the moll part, is weak, fometimes hard, always low and de- 
preffed—the urine looks pale like water—and continued watch- 
ings are protracted to the eighth day—the pulfation of the ca- 
rotid arteries is perceptible—fometimes blood flows from the 
nofe—there is great debility, anxiety, and frequent fighing—the 
tongue is fometimes white and moilt, fometimes black and dry— 
the patients are uncommonly iralcible, labouring under a feroci- 
ous delirium and convullions. 
CAUSES. The remote or inducing, fevere drinking of ine- 
briating liquids, particularly ardent fpirits—watchings, long ex- 
pofure to the fcorching rays of the fun, particularly if the head 
is uncovered—violent rage—too deep and long continued think- 
ing—exceffive grief—violent love—a fuppreffion of the piles, and 
thofe difeharges in women after child-birth, called lochia. 
Th c proximate or immediate CAUSES, a true inflammation of 
the membranes of the brain, or a congeftion of blood in the bo- 
dy of the brain, or both conjointly. v 
CHARACTERISTIC SIGNS. An acute febrile affe£tion, 
attended with pain of the head—rednefs of the face and eyes— 
incapability of bearing the light or found—perpetual watching 
—a violent delirium, or delirium attended with fome degree of 
apparent drovvfinefs. INFLAMMATION OF THE BRAIN. 
This difeafe terminates between the feventh and fourteenth 
day, by rel'olution—htemorrhage from the nofe; in women, by 
a flow of the menfes—loofenefs, or depofition of a copious fecii- 
ment in the urine ;—but fliould not fome of thefe occur, fuppu- 
ration or mortification is the confequence : it often, though, de- 
generates into other difeafes, as mania, i. e. delirium or madnefs 
without fever, lethargy, melancholy, or idiotifm—when people 
recover, they will be affe&ed a long time with giddinefs, weak- 
nefs and pain of the eyes, quicknefs of hearing, and a heavinefs 
of the head. 
We Ihould be particularly careful in diftinguifhing this dif- 
eafe from the delirium, that common attendant in many fevers : 
and this knowledge may be acquired by obferving, that in this 
fpectes the delirium comes on firfl, and is perceptible and violent be- 
fore there is any great degree of fever—in other cafes it is confe- 
quent to fever which has continued for fome days before the de- 
lirium is manifeft ; and the degree of ghrenzy is correfpondent 
to the degree of fever; but in the true inflammation of the brain 
the degree of fever is nearly adequate to the delirium, which is 
equal to what we meet with in real from which the 
inflammation of the brain is fcarcely to be didinguilhed, but by 
the fnortnefs of the continuance ; as in the fpace of a few days 
it mutt either inevitably terminate in.recovery or death. 
This difeafe is either idiopathic, (299.) or lymptoianatic, (299.) 
—the frjl, wherein the head is primarily afle£ted, rarely appears 
in temperate climates—but the fecond very often occurs, and 
moll frequently about the crilis of fevers; and is generally at- 
tended with chillnefs, tremor of the joints, difienfion about the 
pit of the domach, coldnefs of the extremities, thin urine dif- 
charged too copioufly, or too fparingly ; and mod commonly, if 
violent, proves mortal, from the conflitution being reduced to a 
date of great weaknefs from the preceding difeafe. 
From the great confequence of which the brain is to the life 
of man, this becomes a mod dangerous difeafe, from that part 
being affected—men experience greater degrees of violence in this 
difeafe, and recover with more difficulty than women—the more 
the patients are, and the more they recede, from their natural date 
and difpofition, the greater is the danger—bleeding at the nofe is 
a good omen ; but if the phrenzy changes into a lethargy, it is 
bad ; and total lofs of, or a trembling voice, convulfions, hiccough, 
may be looked on as extremely unfavourable fymptoms. 
CURE. In a cafe fo defperate as this, without we can dimi- 
nifh the violent force of the circulating fluids againd the fides of 
the veffels, remove the obdruttion, and take off the congedion, 
and that foon, from the delicate texture of the brain, it mud end 312 
INFLAMMATION OF THE BRAIN. 
fatally—our applications, therefore, muft not only be powerful j 
in themfelves, but moil expedijpoufly adminiftered, with intent 
to divert the flow of blood from the head, at the fame time at- 
tempting to allay the violence of vafcular adlion, and flrengthen 
the veffels of the part affedted. 
For thefe purpofes, therefore, we fhould have recourfe to bleed- 
ing—fome advife in an eredt pofture, copioufly, and from a large 
orifice, till the patient faints, giving preference to the large vein 
of the neck, called jugular, or the temporal artery ; or, where 
the menfes are obftrudted, to the veins of the feet; and this muft 
be repeated according as the ftrength of the patient will permit 
—if the pulfe, as fometimes happens, will not allow this, parti- 
cularly after the third day, then cupping-glaffes or leeches inuft 
be applied to the temples, or the internal part of the noftnls muft 
be fcarified, and blood taken away in one of thefe modes—and 
immediately after fmart purges of the cooling kind, (171, 172.) 
muft be adminiltered, or glyflers—the lower extremities fhould 
be bathed in warm water, or the feet and legs wrapped up in 
warm moiit cloths or flannels—the head fhould be fcaved, and 
waflied with cold vinegar, or cold water poured upon it ; nay, 
fome advife even the application of ice ; and after proper evacu- 
ations, when there appears a reduction of ftrength, a blifter may 
be applied to the head—large dofes of nitre, mixed with a little 
camphor, may be given every four or five hours, or fixed fal am- 
moniac, (176.) or Clutton’s febrifuge fpivit, fo called, may be 
mixed freely with the | atient’s drink, which fhould be of the 
diluting and watery kind—milliard poultices may be applied to 
the foies of the feet ; and, in fine, every thing which can folicit 
the blood from the head, and abate the violent motion of the 
fluids. 
The bedchambers fhould be large, dark, and cool—every thing 
fhould be kept extremely quiet ; the pofture fhould be as eredf 
as poftible, or, at leaft, the patient fhould lie with his head ele- 
vated. 
If matters, by the means here made ufe of, take net a favour- 
able turn within the firft four or feven days, there comes on a 
drowfinefs, and propenfity to fleep, which i'oon puts a period to 
the unhappy patient’s exiftence. 
Sometimes we find it goes off by the efforts of nature produc- 
ing fome evacuation, (gn.) which, fhould they come on before 
the veffels of the brain buffer much from being orer diftendedr 
the termination of the difeafe may be very fortunate—if not tilL 
the veffels have been much injured, the fenfes feldom return per- 
fectly to their original ftandaid —nav, fome affirm, it ends in ftu- 
pidity, and madnefs, which are rarely curable* INFLAMMATION OF THE EAR. 
§ 2. Otitis, or Otalgia—from the Greek words, oust au« 
tis, the ear ; and algos, dolor, pain ;— 
Inflammation of the Ear. 
By this is meant an inflammatory (late of the internal parts of 
the ear, whofe membranes, from their being well fliored with 
nerves, are extremely fenfible ; and from being attached to bones, 
leel pain very acutely. 
DEbCiUP TION. An inflammation of the more internal parts, 
attended in common with great pain, and that pulfatile, or throb- 
bing head-ach, and fome flight feverilhnefs ■, l'ometimes when i? 
afll-cl s in a more fevere degree, the fever is flronger—the head 
more painful, accompanied with delirium. 
CAUSES, remote and inducing. Arty extraneous body infi- 
huating itfelf into the ear, that has the power of exerting any 
HimuLus—acrid humours falling upon the membranes of the ear 
—ob(trusted perfpiration—currents of cold air pouring forcibly 
Into the car, through narrow crevices, or cracks in doors or win- 
dows. 
The proximate, or immediate, are flmilar to what we have be- 
fore fpecilied, and which occurs in ail inflammation, where the 
parts are in a hate of prediipofition, fufficient to feel the effects 
of thole acting ciul'cs which are more remote—indeed the proxi- 
mate and immediate caufes of thefe complaints are fo exactly fl- 
milar, that we (hall have no occaflon to i'pecify them. 
CURE. When the affections are flight, a little warm oil, with 
a few drops of the tincture of opium, may be dropped into the 
ear—or a decoction of poppy beads may be injected—thefe will 
fometimes take off the complaint when trifling :—but fliauld it 
be more fevere, bleeding and purging may be requifite—apply- 
ing alfo cupping- piaffes, or leeches behind the ears, and bliiters 
—bathing the feet alfo in warm water—and when the pain is vi- 
olent, an opiate, No. 4, may be adminiflered at bed-time. 
But fliould the throbbing pain, notvvithitandiag our efforts, 
ftill continue, fuppuration will be the corffequence ; Which we 
muff endeavour to promote by warm poultices applied external- 
ly ; and wait for the burlting of the abicefs—which, when it 
happens, we muff endeavour to keep the ulcerated pait clean, by 
injections of warm Water in which is diii’olved a little foap—or 
of barley water, to four ounces of which add—one ounce and a 
half of honey of rofes, and half an ounce of tirnfture of myrrh— 
this will aflilt the diicharge of matter, keep the ulcerated parts 
clean, and expedite theii Healing. INFLAMMATION OF THE EYE. 
§ 3. Ophthalmia—from the Greek, word ophthulmos, ocu- 
lus, the eye ;— 
INFLAMMATION OF THE EyE. 
This difeafe is fo very obvious to every common obferver, that 
there feems fcarce a neceiliry lor putting down the 
in order to d-iUmgnilh it ; however, ..o preferve the regularity 
v;e have adopted in other complaints, we (hall give of it a con- 
cife view. 
DESCRIPTION. This complaint at the beginnins?' is attend- 
ed with heat, rednefs, and lwelling, or fulnefs of the eye—and 
often ieels as if a particle of land, or a imall fly, had got into it, 
and there fixed—the eye is painful, tears flow, which appear hot 
and Raiding—the angles of the eye are often filled with a vifeid 
ydlowifh matter, particularly after fleeping—the fight is weak* 
and all light is ofFenlive—in the more fev.re facies, the pain is 
very acute—the pulfe quick and rather hard—the light intolera- 
ble—there is a perceptible pulfation of the arteries—and the eye- 
lids, with the circumjacent parts, fwell ; but when it is Jlillmore 
fevere, the membrane covering the white of the eye elevates it- 
felf above the darker coloured part, called cornea, from its horny 
appearance—and the patients complain of flies flying beiore them, 
and feel other unplealant fenfations of this kind, the eiTeft of ima- 
gination.—Afterwards fucceed fuppurations, fpiffitude, of the hu- 
mours—fpots upon, and thicknefs of tne cornea itfelf. 
From this account there appears to arife three material con- 
fiierations : First, whether it is flight, affecting only the vefFels 
of the outward membrane of the eye ;—second, whether it is 
very fevere, extending itl'clf to the eyelids, and their edges, call- 
ed tarfi ;—THIRD, whether it is extremely violent, fixing its feat 
in the internal veffels of the eye itfelf, and in thofe of the mem- 
brane called retina, at the bottom of the eye, which is confider- 
ed the feat of vifion ; in which cafe it is attended v.-ith high de- 
gree of fever, intolerable pain, and often delirium. For thefe 
diffinfi ions w ill make fome alterations in our modes of cure. 
CAUSE'S. The remote, or inducing, are—external injuries 
Occafioned by blows—dull getting into the eye, or other itimu- 
latirtg bodies—a free admiffion ol cold wind—fweats fuddenly 
fuppreffed—looking frequently or long at the fire, the fun, or 
other ftrong glaring colours—expofure to the" cold air of the 
morning and evening, which lucceeds hot and fun-fliiny weather 
—acrid and metalline fumes—-couching, or extracting a cataract. 
It alfo may proceed from internal caufes—fuch as the iuppreflion 
of ialutary evacuations—-humors repelled—drying up of iflues— INFLAMMATION OF THE EYE. 
fetnns—ffftulas—or ulcers—indigetlion—-too lung watchings— 
night ftudies---other difeafes of the eyes—fmall-pox—and mea- 
zles. 
CHARACTERISTIC SIGNS. Rednefs, and pain in the 
eye—with incapability of bearing the light. 
CURE. With regard to this we are to take into our account 
the immediate caute—whether it is an increafed irritability in 
the vellels ; or a want of proper veliftance in their coats ; or 
they both co-operate together—tor, according to rhe acting caufe, 
fo fhould our applications differ ; as what would in one cafe 
produce a good effeffc, would in the other be attended with dan- 
gerous, or at leaft difagreeable effe&s. 
In the (lighter degrees of this complaint, the cure is perfectly 
«“afy, as little more is requilite than external applications—walk- 
ing the eyes.with warm milk and water, mixed with a little 
brandy—conferve of rofes—roqfted apples, and fome fuch reme- 
dies. 
But in more fevere affections, if the habit is full, general 
bleeding and purgatives are neceffary, with a cooling regimen 
—to which, if the diforder does not foon give way, not lei's than 
three leeches Pnould be applied, as near each other as poffible, 
in the hollow of the temple neared the eye affected-—opening 
the jugular vein is often ferv ccable bleeding in the eye itfelf 
has by fome been ftrongly recommended ; but the operation is 
apt to irritate, and is only neceffary when the inflammation is 
kept up by a foeck in the eye, which is fed by one or more 
blood veffels, then they may be divided. 
In obftinate cates, keeping the head lhaved is highly proper, 
and applying blitters about the ii/.e of half a crown over the 
orifices made bv the leeches,' is ufeful;—bathing the feet in 
warm water fbould not be negledted. 
With relpecl to the local applications, the chief, and mod ufe- 
ful, is the tinlira Thebaica of t’;e London Pharmacopteia as an 
opiate, joined with fome llimulant, tor without, it will not an- 
fwer ;—at ffrff the anodyne eye-water (No. 91.) may be applied 
to the eye two or three times a day. In flight cafes, this is 
often fufficient; and, indeed, in the more obftinate, two or three 
drops of the tin&ure may be diopt into the eye two or three 
limes a day.—The body thould be kept cool by proper diet and 
medicines, and the eyes free Irorn any thing that can irritate 
them. 
In fome cafes, though, where the inflammation has been long 
continued, its duration will be apparently owing to want of pro- 
per retiffance in the veffels—hence muff recourse be had to fuch 
medicines as give ftrength and activity to them ; (till fome can- INFLAMMATION OF THE EYE. 
tion is here nc'ceffary—they fhoultf orly be applied when the 
eye is in the weakelt date of inflammation, which generally 
happens in the morning, after the eye has been kept fome time 
free from an3' irritating caufe.—-In thefe cafes the coagulum 
aluminofum of the old London Difpenfatory may be mixed 
with a common poultice, and applied t.o the eye affected for 
three or four hours in a morning—and in the remainder of the 
dajr, tincture of opium—-afterwards as the eye gets ftrength the 
vitriolic folution, No. 92, may be ufed. 
By this method I have feen inflammations of the eyes of long 
Handing, cured, v. Inch had refilled every other mode-—the 
quantity of the vitriol may be gradually increafed to 10 or 12 
grains. 
In all inflammations of the eves arifing from common caufes, 
one of the modes above fpecified will generally fucceed—-only 
we fhould be careful not to ufe any of the more ftimulant ap- 
plications, till the inflammation begins to relax of its violence, 
for it they are ufed too Toon, they will rather increafe, than fub- 
due the makdy. 
But fometinies this difeafe will be occafioned, and fupported 
by fome morbid humour in the habit-—as that called ferophu- 
lous---venereal—-or fome other which we are incapable of dif- 
covering.—-In the two former cafes, we mult make ufe of thole 
remedies pointed out in tile treatment of thofe complaints—in 
the latter, a courfe of alteratives in which mercury has the 
greateft iliare, will be moll efficacious. Under thefe circum- 
ilances I have known ftnall dofes of calomel, with antimonial 
powder and rhubarb, or jalap, given twice a day, and walhed 
down with the deception of the woods, interpofing proper pur- 
gatives once in a week or ten days, be very fuccefsful—and 
greatly afii.fi the application of external remedies. 
In obftinate cafes, where blifiers have been ineffectual—iffues, 
and fetons in the neck, have been recommended ;—or having 
the lobes of the ears pierced, and exciting a difeharge by Ikains 
of filk being palled through them in the manner of letons. 
The gluing of the eyelids together, fhould be prevented by 
inunuating a little mild unctuous medicine between them, be- 
fore the patient goes to reft. 
Notwitbftandihg what has been faid refpecting inflammation 
of the eyes refulting from a relaxation, or attended by that 
ftate of the vefiels, it is fometimes owing to intenfenefs of mo- 
tion—which is difcoverable from the orent heat,—drynejs, and 
•very fevere pain,—which are concomitants -then bathing the 
eye with warm milk and water, in which poppy heads have 
been boiled, a{t'en#$trds applying a poultice of this decoction QUINSY. 
thickened with crumbs of bread, inclofed in thin cambrick, will 
be neceffary. But in order to prevent the acceffion of thefe 
complaints in thofe who are fubje£t to the returns, hefides 
guarding againft the remote caufes (315.) iffues have been re- 
commended—taking away blood about the equinoxes—-purging 
occalionally—-a cooling diet—avoiding reading in the night, 
particularly l'mall print—or, in line, doing any thing, that can 
too much fatigue the eyes. 
§ 4- Quinsy. 
An abbreviation of the word from the French fqvinancie, fore 
throat—-the Greeks term it, cynanche, from kuon, cam's, a dog, 
and ankoy flrangulo, llrangulate—-becaufe patients affh&ed with 
this complaint were fuppol'ed, in the difficulty of perfpiration, 
to ufe their tongues like a dog—-and by the Latins angina, 
from the Greek word ariko. 
This is an acute affection of the throat, divided into two fpe- 
cies—the inflammatory, and malignant—of the fir ft of thsie 
fome authors form varieties, according to the different parts 
they affe£t. 
1. Tonsillary Quinsy. 
Becaufe it affefts the membrane on the fuperior parts of the 
throat, particularly the toxfils, with tumor and rednefs. 
2. Tracheal. 
In Scotland called croup, becaufe it affefts the mufcles of the 
trachea, or membrane covering its upper part, the windpipe; in 
xvhich difeafe in infpiration the voice is rattling and hoarfe, 
there is a ffirill cough, with no apparent tumor, and a little dif- 
ficulty of iwallowing. 
3. Pharyngeal. 
Becaufe the pharynx, in the lower part particularly of the 
fauces, is affected with rednefs, the iwallowing is very difficult 
and painful, though perfpiration is fufficiently eafy. 
4- Parotodeal. 
In England called mumps, in Scotland, Branks, becaufe QTfJNST, OR 
there is a canflderable fwelling of the parotid and maxillary 
glands, refpiration and deglutition flightly difturbed. 
All thefe are attended with an inflammatory! fever, though 
the lait, or the parotidaeal, is of a very mild fort. 
Tne fecond fpecies is called the tonsillary malignant, 
or ulcerous quinsy, becaufe it affe&s the fame parts as the 
inflammatory tonflllary, (fee above.) with tumor, rednefs, and 
with white or grey coloured {loughs, fpreading and covering ul- 
cers. attended with a nervous or putrid lever, and red effloref- 
cences—-hence (filed by fome the malignant fcarlet fever. (288.) 
Of all-thefe we {nail proceed to treat in the order they are fet 
down—and, firft. 
THE TONSILLARY INFLAMMATORY QUINSY, OR COMMON 
SORE THROAT. 
DESCRIPTION. In this the tonfils and fuperior part of the 
fauces are affefled—in general the inflammation begins in one 
tor.lil, then fpreads acrqfs the palate, feizes the uvula, and other 
tonfil. 
Though confiderable pain attends the affion of fwallowing if 
only one fide of the fauces is affe&c-d, yet can that aftion be per- 
formed tolerably well ; but the pain becomes intolerably levere 
when both fides are affe£ted, and fwallowing is performed with 
extreme difficulty ; indeed, the pain is fometimes fo great as, in 
delicate and irritable habits, to occaflon convulfions. 
It may, however, appear Angular, that more pain Ihould be 
felt in fwallowing liquids than folids ; but this is the facf, be- 1 
caufe a greater portion of mulcular Abies are employed in the 
deglutition of the former than the latter. 
So long as the inflammation confines itfelf to the parts above 
defcribed there is little danger, mere particularly if the neck, 
appears puffed up, for this feems to indicate lei's danger of fuf- 
focation, and is therefore confidered a favourable omen. 
But if the inflammation extends itfelf to the mufcles of the 
larynx, in that degree as to impede the opening of the glottis, or 
fuperior part of the windpipe, the complaint becomes extremely 
precarious, becaufe then there will be great apprehenflon of fuf- 
iocation. 
Or fhould the brain or lungs be affected by a tranflation of the 
morbid matter, from the one occafloning violent head-ach and 
llrong delirium ; and from the other oppreffion of the cheft and 
difficulty of breathing. If to what we have here faid we add the 
febrile fymptoms which commonly attend inflammation, and the COMMON SORE THROAT. 
apppearances in the throat, (315.) we cannot avoid diflinguiiking 
the complaints. 
CAUSES. The remote or inducing are, perfpiration obftruft- 
ed, particularly in the neck—the admiffion of cold air into the 
fauces, efpecially if it rnfhes rapidly into the mouth, and ilrikss 
them forcibly—violent and long continued finging--*-fhoucing., or 
; too fevere exercife of the part—any acrid (limnlating particles, 
or hard pungent bodies adhering to the parts—-drinking too cold 
| water— fu.pprefled or impeded evacuations---or a peculiar flate 
: of the air rendering this complaint epidemical. 
The proximate or immediate, limilar to thole of other inflamma- 
tory complaints. 
CHARACTERISTIC SIGNS. Rednefs, tumor, heat, of 
the tonlils, rendering deglutition painful, attended with febrile 
inflammatory fytnptoms. 
I' CURE. The lame rules are to be obferved as in other inflam- 
mations, refpecting the general treatment, fuch as bleeding, purg- 
ing, cooling, diluting medicines, and regimen. With regard to 
local application, it is of ufe to apply dupes of flannel dipped in 
jfpirits of fal ammoniac, or hartfliorn, mixed with a little oil, and 
applied to the throat in the (lighter cafes—in the more fevere, 
I Tolilters ; for thefe folicit the matter from the internal to the ex- 
ternal parts. 
Gargles alfo of fage tea and vinegar, or infufions of elder and 
chamomile flow7ers, in equal parts of water and vinegar* apply- 
ing the fleams of this to the throat ; they are of infinite ufe, and 
give great relief, favouring the exudation and diffipation of the 
obitru£!ing fluids. 
After ths imflammation is abated, gargles more afiringent 
[lhould be ufed, made of tincture of rofes, or red port, with the 
vitriolic or muriatic acid, fvveetened with honey-—alfo to them 
may be added a l'mall portion of alum, or weak decotlions of 
bark, with the acids above-mentioned, or alum ; for thefe will 
give ftrength to the fibres, which, from over dittenfion, have 
been weakened and relaxed-—and, for gargling the throat, per- 
haps, fyringes had better be made ufe of, both on account of eafe 
and certainty in reaching the part affected. 
By this mode the cure in common will be completed within 
the courfe of four or five days ; but if within this time the in- 
flammatory fymptoms fliould not become milder, and the inflam- 
mation itfelf l'ubfide, then will little doubt remain of fuppuration 
taking place ; difcoverahle by the following symptoms of ab- 
scess forming : the febrile fymptoms continue, though 111 a fighter 
degree, the pulfe groves Jofter, the florid colour of the infiamcd part 320 
(5UINSY, ok 
abates, the pain becomes more hearable, and flight Jhivc rings come 
on frequently. 
Here we mull endeavour to promote fuppuration as fall as 
poifible, by applying maturating po litic e to the throat exter- 
nally; and internally, deception of figs; or infufion of linfeed 
(hculd be drank very warm, and fwallowed gradually ; careful- 
ly, at the fame time; watching for the appearance of abfcefs, 
which generally difcovers itfelf in a few days, by a whitifh tu- 
mor, and iiudination of a fluid to the touch-—{hould not this burll 
of itfelf in a few days, which, though, is generally the cafe, it 
fhould be opened as early as may be, and detergent gargles of 
barley-water; honey of roles, vinegar, and tiuddure of myrrh, 
may be had recdurfe to. (No. 93 ) 
When the abfcefs is perceptible to the fight, and within the 
reach of external remedies, this method mult be pjurfued ; but 
fometimcs it forms itfelf fo low down as not to be within the 
reach of infiruments ; vVe mull therefore wait for its burfling ; 
and lliould, before this happens, the tumor be fo large as to pre- 
vent l'wallowing, the patient mull befupuorted by broth or milk 
glyfters ; and blifilers and ftimulant poultices lliould be applied 
to the throat externally, in order to folicit the morbid matter 
outwardly. , - 
The confequences in thefe cafes is very rarely fatal, when 
there is a fuppuration ; however alarming may be the appear- 
ances, or tedious the procels. 
But, now and then, this complaint arifes from the want of 
proper refi (lance in the velfiels of thofe parts, difcoverable bv the 
relaxed liate of the folids, manifelled by weaker degrees of heat 
and pain, and more flight inflammatory appearances refpecling the 
colour of the parts as they are lefs red, than in the former. 
In thefe cafes copious. bleeding is rarely neceffary; purgatives 
are more to be depended upon, and the application of (linaulants 
and bliHers locally and externally---gargles (hould be of the pun-J 
gent kind, made of the infufion of horfe-radifh, or mufiard feed,* 
or fome other of the pungent flimulants, (145, 146.) for thefe at- 
tenuate the vilcid mucus which'clogs the follicles or cells of the 
tonfiis, and other contiguous glandular parts, that Crowd the fau- 
ces, by ftimulating the vefiels to an increafe of proper action on 
their ftaonatins mucus ; for thete fore throats are confidered as 
puuitous. 
In habits like thefe of the phlegmatic kind, (60,) fcbfcefles fel- 
dom arife ; but fhould that be the cafe, they require the fame 
mode of treatment as above lpecified ; to which mull be added 
tonic and corroborant medicines internally, as well as externally, 
in order to give tone and fnmnefs to the veflels after proper de- j COMMON SORE THROAT. 
321 
tergents, and add ftrength to the conftitution, as hark, fieel, with 
a generous and nutritious diet. 
The Tame mode mull he purfued in the second and third 
species in their inflammatory ftate ; to which if the difeafe does 
not yield, and there is reafon to he afraid of fuffiocation, from the 
high degree of inflammation of the mufiles of the larynx, pre- 
venting proper refpiration, recourle tnuft be had to bronchotomy, 
or opening the windpipe, though not without extreme neceflity, 
and then it muff be performed by the hands of the mod fkilful 
furgeon, for it is attended with the utmoft danger. 
But fometimes the inflammation not only attacks the membrane 
lining the upper part of the tiachea, but extends itfelf down on 
the interior iurface into the lungs, which furface is found,' oil 
diikcTon, to be covered over, and the paflfage for the air aim oft 
filled up with a thicK. Hough, having a fibrous membrane-like 
appearance, which is concluded to be the vifcicl remains of mu- 
cus thrown off by exudation from the inflamed furfaces—and ig 
difc verahle by a peculiar Jhrillnefs of the voice, like tie crowing 
of tie cock, with a cough, but no fickneis, norat firll much diffi- 
culty of breathing. 
This difeafe is at certain times epidemic, and feizes chiefly 
children, and runs to its fatal termination fo extremely ra; id, 
that little chance is given to uny medical applications, from the 
want of time—immediate vomiting, and bliiferirig the throat, are 
the whole vve can, perhaps, depend upon for any the leaf! prof- 
pedt of fuccefs. This variety of the trachel quinfy is called the 
croup, and is more frequent in Scotland than elfewhere. 
The fourth species, or the parotideal quinsy, or mumps, 
called alfo maxillary, from its affedting the maxijkry as well 
as the parotid glands, and alio the mufcles and ligaments which 
raife up and connect the upper with the lower jaw, from which 
is necelfarily felt fevere pain in opening tiie mouth. 
In this the fwelling is generally external, increatlng fo much 
in a few days, particularly in the lower part of the face, and un- 
der the chin, as almoft to obliterate the features, though the at- 
tendant fever is but flight. 
Saline purgatives, with nitrous medicines, moderate bleeding, 
and external llimulants, chiefly volatile liniments, are all that are 
required, keeping at the fame time the head and face warm, and 
free from external cold. 
But there is a lingular peculiarity now and then attending this 
complaint; for fometimes on the fwelling of the glands fubfiding, 
a fimilar affection of the tellicies of men takes place, and of the 
breads in women—however, no alteration in the cure is required j for it has been ohferved, that to the fame it yielded, nor were 
the parts, particularly the tefl.es, ever knowm to fuppurate. 
Sometimes a hardnefs will remain in the parotid and maxilla- 
ry glands ; thefe yield to fmall dofes of calomel, and gentle purg- 
ing ; fometimes the application of the quickiilver ointment hath 
been neceffary. 
MUMPS. 
5. Tonsillary malignant ulcerous Sore Throat, 
(318.) OR MALIGNANT SCARLET FEVER. 
This has often raged in England, and appears to be a quinfy, 
or fore throat, of a more malignant nature, attended with a re- 
mittent fever, verging more to the putrefcent than inflammatory 
fort ; or running very rapidly from the former into the latter. 
This difeafe oftener attacks, and with a greater degree of vio- 
lence, infants and young children than adults ; gills than boys ; 
the infirm than thole in the vigour of health ; thofe of a pale, 
wan complexion, and relaxed habit, with an acrimonious Rate 
of fluids, than the robuft and fanguineous ; and appears particu- 
larly in autumn, preceded by a hot fummer. 
DESCRIPTION. In its commencement, it firft feizes the pa- 
tient with chillnefs, languor, fcknef, and extreme opprcfjion at the 
pit of the fotnach—great dejcBion offpirits—very fudden weukncfs 
--great heavinefs on the hrcaji—and faint nefs—thefe are fucceed- 
ed by extreme heat, naufea, vomiting, with forenefs of the throat—- 
fometimes the affection of the throat makes the firft appearance 
—in general the pulfe is frequent, fmall, and fluttering, though 
fometimes deprefled, and undulating—the tongue mcill, efpecial- 
ly towards the root—the eyes heavy, reddilh, and watery—the 
countenance frequently full, flulhed, and bloated, though now and 
then pale and lurik—the breathing quick and laborious—the fkin, 
though extremely hot, not perfectly dry—the urine commonly 
pale, thin, and crude ; in many adults, however, it will be made 
in fmall quantities, high coloured, or turbid like whey—the throat 
fore and inflamed, exhibiting a fnining rednefs, of a deeper colour 
than in common inflammatory fore throats, and having a puffy 
appearance which covered the tonfils, and fpread over the fau- 
ces, the tonfls at the fame time ulcerated, and in fome degree, 
though not greatly, enlarged—a delirium fometimes comes on in 
the day-time, the fymptoms appearing flight; yet is there in the 
night a confiderable increafe of violence, and that through the 
whole courfe of the difeafe—the fwallowing is difficult, and more 
fo on fwallowing the faliva only, than of any fiquid or folt diet. 
On the third day, or thereabouts, an effiofeleence on the fkin 
generally appears, but without any alleviation of the diffreffing MALIGNANT SCARLET FEVER. 
fymptoms ; indeed, they frequently inereafe, and, added to them 
there is often a purging — at this time the patient begins to throw 
about his arms and legs, lying in a Hate of great inquietude ; or 
he becomes drowfy—there now comes on great pr oft ration of 
Jlrength—the con(litutional powers fail—[wallowing grows more 
difficult—the breathing more laborious—and before thefixthday 
the patient expires in a Hate of fuffocation. 
CAUSES, The remote and inducing, as in all difeafes arifing 
from any fpecific infection, or contagion, is a predifpohtion in 
the habit to receive and feel the effe&s of the morbid matter, 
v/hich we conceive to be of a peculiar nature capable of creating 
the difeafe, communicated from the air, or bodies before affect- 
ed, which conftitutes the proximate or immediate caufe ; for fre- 
quently the difeafe, either from the breath, or contaminated mat- 
ter fpit up, will attack the attendants, and a whole family—a 
ftron:; proof that the difeafe is infeCtious and contagious. 
CHARACTERISTIC SIGNS. (See page 319.) And here 
it is of the utmoft confequence to diflinguilh this from the limp- 
ly inflammatory fore throat, which may be done by the loofenefs 
and vomiting—the puffy and dark-coloured rednefs attending 
the fwelling—from the foetid ulcers of the throat, covered with 
a white flough—from the haarfenefs of the voice—the flight de- 
lirium coming on fo foon— and from the fudden and great prof- 
tracion of llrength—becaufe much depends upon the mode of 
cure firft adopted—for what will be the means of laying a foun- 
dation of a cure in the Ample inflammatory, would be the caufe 
ot death in the malignant quinfy. 
The rednefs of the tumefied parts, brightnefs of the eyes, no great 
degrees of debility and fainting, the flough being white, and the 
florid appearance of the eruption on thelkin, are favourable omens. 
But if the debility Inould be violent ; if the ulcers are alh-co- 
loured, black, or livid ; if there ffiould be a diarrhoea, rigor, 
weak and fmall pulfe ; the body put on a cadaverous appear- 
ance ; the eyes lofe their fplendour ; the eruptions difappear, 
or become livid; and particularly if the nofe bleeds—the worit 
mull be expected. 
CURE. The indications of cure are fimilar to thofe of pu- 
trid fever, (223, &c.) to which we mult add, the healing of the 
ulcers. 
in the moil malignant kind, little can be expe£ted from our 
endeavours, the progrefs to diffolution is fo rapid. 
In the more mild lort, whatever may have been faid by men 
whofe medical characters entitle them to attention, with refpeCt 
to bleeding, nothing except the moft diffreffing inflammatory 
fymptoms, which rarely occur but at the commencement, can INFLAMMATION OF THE BREAST. 
authorife the practice : for I have generally obfervetl, that thofe 
who have undergone the operation in chrs fpecies of fever, ran 
very quickly into extreme danger, or died. 
If, then, at the onfet, there appea. , to be flrong vafcular ac- 
tion, faline mixtures, with flight antimonials, and acid gargles, 
flightly aifringept, with occafional gentle aperients, or emollient 
glyfiers, if neceffary, after the adminiflration of a vomit, may 
be perfifted, in, till fymptoms of putrefcency make their appear- 
ance, which will foon be the cafe—then we muff rely on bhf- 
tering under the throat, and antifeptics, as bark, mineral acids, 
acefcent drinks, and vinous cordials, for relief. See Putrid 
Fever, (223.J where we have treated on thefe remedies, except 
gargles, which may be made as direfled No. 94. 
Or the vehicle to the other ingredients may be pectoral de- 
co&ion ; the more antifeptic ones mhy be made of deceptions of 
bark, with tin&ure of rnyrrh, red port, and the mineral acid— 
fome advife a gargle made of honey, barley-water, and fpirit of 
fea fait—and after the fever has remitted, drying the ulcer with 
quick-lime ley mixed with honey. 
CHAP. II. 
INFLAMMATIONS OF THE BREAST. 
§ i. Pleurisy, or inflammation of the Pleura. 
r! 'HIS is an affeflion of that membrane called Pleura, from j 
the Greek word pleas, plenus, full, which lines the ii iide of 
the cheft, covering the ribs internally, and intercoilal mulcles 
(.33.) and lungs, (28.) and forming the mediaftinum and perica"- j 
dinm, (28.) attended with an acute fever, great pain, and diffi- 
culty of breathing. 
It is divided into the true pleurisy, when the membrane 
itfelf is affected—into the spurious, when the intercoftal muf- 
c:es ; and alfo into moist, when ex perforation is an alTociate ; 
and DRY, when there it no fuch appearance—indeed, at the onfet 
it puts on generally the appearance of the latter, and of the form- 
er in its prog refs, if not conquered by refolution ; for then inott 
commonly expc£foration takes place. 
DESCRIPTION. At the commencement, the patientis ge- 
nerally attacked with chillnefs and fhivering, which are fuc- 
cceded by heat, reftleiTnefs, pain in the head and Iide, the lail INFLAMMATION OF THE PLEURA. 
325 
very acute and pungent, running to the back and collar-bone— 
d nlty of lying-on the fide affe&ed, with a dry cough, in- 
•c -iif the pain, which, after the third day,- is attended with 
a 'flotation of a thin? famous, and fometimes bloody inat- 
tt breathing is alfo very difficult and painful—the pulfe 
h enfe—the blood, when drawn, firm in its texture, and 
c l a coriaceous, or fubitance like buff-leather—the 
i Vh coloured—and all the fymptoms of a peripoeu- 
u , ve fiictll hereafter deicribe. 
CA he remote or inducing are, obftructed or imped- 
e . hrong exercife, cold, thick, heavy air admitted 
inr cold northerly winds—drinking of ardent ipirits 
-■-c '.ink when the body is over-heated. Sometimes 
ir linfy, colic, and fpafmodic pains—fupprefled eva- 
ci -uprions repelled, as the meazles and fmall-pox, &c. 
injuries of the cheft—and, in fine, whatever will cre- 
. as on the i gs poffeffed of an inflammatory difpo- 
oximnte or imm din' , an inflammation of the pleura run- 
ng the exteuor fur race of the lungs, or that part cover- 
ribs j bur moil frequently of loth affe&td at the fame 
RACTKRISTIC SIGNS. A pungent pain of the 
i c, ‘ended with febrile affections, *oain alfo in infpiradon 
particularly increafed ; a difficulty of lying down, for the moil 
part on the fide affected; and very painful cough—in the begin- 
ning dry, afterwards moiit, and often bloody. 
CURE. The indications are fimilar to thofe of inflammation 
of other parts—at the onfet, we mufi have recourfe to copious 
bleeding, and that repeated, if the fymptoms continue urgent, 
according to the ftrength of the patient—the blood ffioukl be 
taken from a large orifice ; and in ftrong full habits, and yourg 
up-grown fubjefts, not lefs than fourteen or fix teen ounces — 
above the part n pain cupping-glafles may be applied, and blood 
taken away by thofe means—if the pain fhould be relieved br 
the fir ft bleeding for fome hours; and, notwithflanding that, the 
pain and opprellion return, the operation mult be repeated, and 
about twelve ounces more blood taken awray; and, indeed, 
fliould the fymptoms prove obftinate ; and return in the courfe 
of ten or twelve hours, we mult have recourfe to the operation 
again, and apply a biifterover the part affected, efpeciallyfif the 
inflammation appears to extend itfelf outwardly, or the pain has 
any great degree of feverity ; for, indeed, our chief dependence 
refls on bleeding and local bliftering, to weaken the tone of the 
vafcular fyitem, and fubdue the violence of the action of the 326 
INFLAMMATION OF THE PLEURA# 
■veftels—after the firft bleeding, and in the intermediate times, 
fuch things fhould be adminiflered as will co-operate to promote 
thefc intentions—we mud, therefore, have recourfe to fuch 
things as are diluting, relaxing, and emollient, with cooling and 
aperient diuretics—hence may the patient drink copioufly of 
pe FI oral decoction, hr art or linfeed tea, almond milk, apple-water, 
lemonade ; in all which portions of nitre may be cfiffolved ; and 
the body fhould be kept open w ith cooling and relaxing glyjlers, 
(No. 25, 26.)—ci large fpunge dipped in warm vinegar applied to 
the mouth and nollrils is ufeful, as well as diluting drinks, that 
the vapors may be received with the air into the lungs, relax 
the pores of the pulmonary veficles, promote exudation, and 
bring on expectoration, by unloading the diftended blood-vefi’els, 
and making them permeable—or, for this purpofe, the Jleann of 
warm water, or fovje emollient decoFlion, might be received into 
the lungs by innaling them from the fpout of a large tea-pot ; 
or by Mudge’s inhaler, contrived for that purpofe. 
Emollient fomentations, or bags filled with boiled herbs, might 
be applied over the parts —oily medicines, forming emulfions or 
linctus’s, (No. 81 to 84.) might be taken infernally occafionally 
---and nitre, mixed with a little camphor, or antimon:als—a.nd fa- 
line mixtures given every two, three, or four hours. 
In the beginning of this difeafe, there is little doubt but this, 
like other inflammations, may be carried off by refolution ; but 
if the power and itrength of the vefl'els have been io weakened,] 
or there has been a plentiful depofition of morbid matter upon 
the lungs, which has changed the nature of the pulmonary fluids,1 
.we muil then endeavour to promote, by all means, expectoration,' 
as the only remaining means of faving the patient from extreme 
diftrefs, or death. 
For this purpofe, added to what we have above delivered, as 
an attenuant, ieneka, or rattlelnake-root, (159-) is eifeemed a 
powerful one, and lias in thele cales been attended with fuccefs, 
given three or four times a day ; it promotes perfpiration and 
expectoration ; but when tve find the latter is remifs, expecto- 
rants mult he had recourfe to, (No. 95.} four fpoontuls oi which 
mult be taken every third or fourth hour. 
When people begin to expeCtorate, fome authors forbid any 
farther ufe of the lancet ; but fo long as the violence of the fymp- 
torns go on to inertafe, we may purfue it to a fourth or fifth time ; 
nay, indeed, farther, according to the Itrength, till we find them 
alleviated, and the patient perceives himfelt conliderably re-! 
lieved. 
This alleviation will be perceptible on the fourth or fifth clay, 
by the head being freer from uneafinefs, the tongue more moift; INFLAMMATION OF THE PLEURA. 
327 
the cough will be lefs troublefome ; the breathing not fo difficult; 
the expedoration more eafy ; the matter lets tinged with blood ; 
and by fome alleviation and freedom in the pulfe, which will beat 
more regularly, and with more quietude. 
Under thel'e circumflances, we lhoukl perfift in the ufe of di- 
luents and expectorants, keeping the body open with gentle ca- 
thartics, fuch as the eleCtarium e caffia, oil of caftor, manna, 
Rochelle fait, &c. (169 to 171) or by the ufe of emollient gly- 
Hers—debiting now from farther bleeding. 
Though ifi’e difeafe in a few days generally terminates favour- 
ably, if the expedoration continues free and copious, yet fome- 
times it Hops fuddenly, and no other clii'charge fucceeding, the 
breathing becomes difficult and laborious ; we mult then endea- 
vour to renew the difeharge, left the patient lhoukl die fuffocated, 
by bleeding, inhaling warm fleams into the lungs, the application of 
blflers, and antimonials, l'uflicient to promote gentle vomiting. 
As the mode of treatment mull be flmilar in the Ample inflam- 
mation of the lungs, heart, medial!inum, pericardium, and dia- 
phragm, (28, 29. 33.) we ffiall now only defcribe them, to ikew 
how they may be difcovered---and, firlt, 
§ 2. Peripneumony, fo called from the Greek words peri, 
circum, about, aud pneurno, pulmo, the lungs. 
INFLAMMATION OF THE LUNGS. 
DESCRIPTION. This begins with Ihivering or chillnefs, 
fucceeded by heat—after which there comes on anxiety, debili- 
ty, and reftieffnefs, watchings, and delirium—the blood drawn is 
lirnilar to that in a pleurify—befides, there is a rednefs of the 
countenance and in the eyes—the tongue is white and dry—the 
refpiration laborious, quick, and hot, attended with a dull, not an 
acute pain—the patient cannot lie on the fide affected—there is a 
pain in the moulder—dry cough at firfl, afterwards moift, 
and vomiting — the pulfe is full and foft—tlie urine high, 
coloured, which, after Handing, fometimes becomes turbid—at 
length the mind is difordered—the light fails—a kind of hilling 
node attends the breathing—the pulfe rather creeps than beats— 
the extremities grow cold—partial iweats breaks out in the i'u- 
perior parts—and deaJi clofes the lcene. 
Now this complaint is obvioutly diltinguilhed from a pleurify, 
by the breath being hot, the pain dull, not acute, and the pulfe alfo 
full and foft. 
CAUSES. The remote or inducing, (fee page 325.) Proxi~ 
mat» or immediate, inflammatory obftruCtions of the terminations 
of thofe arteries of lungs, (30.) called pulmonary and bronchial, 
either feparately or conjointly. 328 
CHARACTERISTIC SIGNS. Febrile affections, attended 
with an obtufe pain under the breaflbone, o betwixt the ;boul- 
ders—anxiety, and difficulty of breathing—a cough, gener. , 
though not always, moill—the face fwelled, and of a purpl a 
colour. 
CURE. (See Plcurify, page 326.) But here it may not be® 
ufelefs to obferve, that there feems to be a material alteration be-* 
tween the termination of an inflammation of the pleura and that j 
of the lungs—the foiution of the fir ft often happens by a pk-oti-j 
fell fweat, or a copious difcharge of loaded uri ne—of the lafi, 1 
more frequently by expectoration— -and in both cafes, when thcfe j 
evacuations of fweat, urine, or expeftoratioo have been peifedtJl 
a full and falutary crifls is formed, all the oppreffive fytnptornsl 
vanilli gradually, and the re-eftabliftmient of health happily! 
fucceetls. 
The inflammation of the mediaftinum, which is only a dtipli- 1 
cature of the pleura, manifefts itielf by an acute pain in the 
middle of the bread, between the breaft-bone and the fpine, or f 
clavicles or collar-bones, attended with frequent and quick 1 
breathing, and the reft; of the pleuritic fymptoms. 
The inflammation of the heart, and the membrane furrounding j 
the heart, is accompanied-with a deep-feated pain—weight, anx-1 
iety—very quick, and frequent refpiration—great thirll—a heat 
in the cheft—palpitation of the heart—with a hard and unequal 
pulfc, and frequent fainting. 
jIhejame affeBion making the diaphragm, or that part of the 
pleura which covers it, (27.) the feat, has for its attendant fymp-j 
toms, an acute fever—reilleffnefs—anxiety—arid delirium—an 
acute pain between the fpurious or ffiort ribs, and the vertebrae 
of the back places oppofite to them, agreeable to its fituation— 
the breathing is quick and ffiort, accompanied with convulfive :j 
catchings in infpiration—a dry cough and hiccough—the hy- | 
pochondrium, or part below the fhort ribs is drawn in towards 
the back, and the abdomen, or lower belly, has little or no mo- , 
tion during the action of breathing. 
The three complaints we have now mentioned are called by 
fyftematic writers, carditis, from cardia, cor, the heart—pe- . 
RiCARDlTis, from peri, circum, about, and cardia,—and para- j 
phrenitis, in contradiftin£tion to phrenitis,. or the inflamma- 
tion of the brain, becaufe, though a delirium always attends it, ' 
the brain is only fympathetically affected in this cafe, whilft in 
the phrenitis it is the feat of the difeafe. 
With refpect to the cure, we mull purfue the fame plan as ad- 
vifed in pleurify, exerting our llrongeft efforts to produce refo- 
lution, the only falutary termination ; for all the other either 
INFLAMMATION OF THE LUNGS'. MALIGNANT PERIPNEUMONY. * 
329 
bring on immediate death, or lay the foundation for fome irre- 
mediable complaint, of which we fliall treat, as foon as we have 
taken notice of another fpecies of the peripneumony; for in 
this place w’e have confined ourfelves to fuch as were purely in- 
flammatory. 
Malignant Peripneumony. 
This complaint is by far more dangerous than that we have 
before defcribed—as it generally attacks thofe where humors 
are in an highly acrimonious Hate, icorbutic habits, and failors 
alter long voyages. 
DESCRIPTION. In this complaint, the blood is in a dif- 
folved llate, livid, and when drawn has no coriaceous, or leather- 
like appearance upon its furfacepas in the inflammatory fpecies 
— there is alfo great reflleflhefs with extreme debility ;—pains 
all Over the body ;—profufe fweats, and red, or livid eruptions, 
like flea-bites ;—the patients are apt to faint on the lealf mo- 
tion, have a difficulty of bieathing, and cough or fpit up a thin, 
lanious, bloody matter, which fmells uffenlively—the pulie is 
loft, and deprtflfcd, and the urine very high coloured. 
CUKE. The fever attendant on this feerns clearly fo be of 
the putrid kind, and a3 fuqh mult be treated—Bleeding, there- 
fore, mult be avoided, without at the beginning the pulfe fliould 
be llrorig, for otherwife it does great injury, particularly if it 
flrould be repeated. Blilters alfo are mif< hievous Our chief 
dependence reits upon vegetable or mineral acids— camphorated 
vinegar, (No. 55.) with a nourijhing and acefcerJ diet—vinous li- 
quids, particularly fuch as are allringent, the belt of which are 
rhenilh, claret, and red port—Opiates alfo have been found fer- 
viceabie in thickening and rendering more mild the thin, acri- 
monious humours depofited upon the lungs ; but then they 
iiiould be given with great caution, taking care not to increafe 
the difficulty of breathing by their ufe. 
Of the jpurious peripneumony we (ball take notice, when we 
come to treat on afthma ; and now proceed to treat on fome of 
the confequences of pleuritic and other inflammatory afie£fions 
of the bread, forming different difeales. 
For when the pleurify, or peripneumony is not cured by re- 
folution, or expectoration, matter is generally formed within 
the chelt, which, according to it* fituation, has received differ- 
ent appellations ; when in the body of the lungs, though no 
more than an abfcefs, it is called vomica—from vomc, to vo- 
mit, becaufe they vomit forth, as it were, matter—when be- 
tween the pleura, EMTXEMA, from en and puont pus, matter. VOMICA* 
DESCRIPTION. Upon the formation of matter, which* 
occurs, if the inflammation goes not off w'ithin fourteen days, 
there is an abatement of the feverity of the fymptoms—the 
pain ceafes—-and the pulle, ilill quick, is weaker and fofter ; 
yet the cough, difficulty of breathing, and oppreffion ft ill conti- 
nue—-and if in this fituation the patient feels a flight ihivering, 
fucceeded by heat, little doubt remains of an abfeefs taking 
place -add. to this, if the cough increafes upon the leaf!; mo- 
tion, the patient cannot lie but on the fide affeCtcd, and the 
fymptoms grow daily more fevere, accompanied with debility', 
and emaciation, thefe appearances make it more certain.—And 
ihould the vomica fcurft fuddenly, a fuffocatiou may be dreaded 
•—or Ihould the matter not find its way into the branches ol the 
windpipe, fo that it may be coughed up, and make its exit out 
of the habit, all hopes of fueceU are at an end., 
1. Vomica. 
2. Empyema. 
DESCRIPTION. An increafed difficulty of breathing up- 
on the reclenlion of the bread, preceded by an unrefolved in- 
flammation-—inability to lie on the fide unaffebded ; a fenfe of 
weight above the diaphragm, and many fymptoms common to 
a dropfy of the cheft—becaufe the immediate caufe is a quanti- 
ty of matter lodged in the cavity of the thorax, or the matter 
may form a fac in any of the membranes of the bread ; though 
they commonly built, pour out their contents into the cavity 
of the cheft, and by preffing upon the diaphragm, or other parts, 
according to the pofition of the body, occafion the fymptoms be- 
fore fpecified. 
CURE. In both thefe cafes every profpect of fuccefs de- 
pends upon freeing the habit from the ofFenfive matter, which, 
fhould we not be able to aecomplifh, either the patient will die 
fuffocated—or confumptive. In an empyema there are no 
hopes, except making an aperture between the ribs into the 
cheft, as low as poffible, to avoid wounding the diaphragm. 
In a vomica, if from the expebdoration of matter we have 
reafon to believe that it has burft into the branches of the wind- 
pipe, and the matter be white, fmooth, and free from any offen- 
five fmeli, and continue to be freely difcharged; if all the op- 
preflive fymptoms from day to day abate, particularly the cough 
and laborious breathing, w?e mu ft not defpair of a recovery, 
which we rnuft endeavour to promote by the ufe of expectorant 
balfamics conveying the fteams of the Eetherial fpirit of vitriol 
—or Sterne’s aether dropt into hot water, and inhaled into the 
lungs, in order to.cleanfe and heal the ulcer. PULMONARY CONSUMPTION. 
331 
Ground ivy, hyflop, chervil tea, whey, fweetened with honey, 
are proper drinks—all animal food and broths fhbuld be avoid- 
ed, and their place fupplied with milk—rice, fpinage, turnips, 
or any other diluent, cooling vegetables, properly prepared : 
thefe will keep the body cool, and difpofe the humours to be 
mild and loft—and proceed farther in the manner we have laid 
down in pulmonary confumption. 
Sometimes matter will be fo fituated by being locked up in a 
fac, whofe fides are formed fo thick, that the matter cannot be 
abforbed into the habit, but communicating with the branches 
of the windpipe, be from time to time expectorated—under 
this circumftance men will live a long time, as I have in two 
inftances known, where nothing was ever attempted but putting 
the patients on a milk diet. 
Sometimes an adhefion will be formed between the mem- 
brane covering the outer furface of the lungs and the pleura 
which covers the inflde of the ribs, forming a cavity, and points 
itfelf outwardly ; or inanifefls itfelf by a conftant fixed pain in 
fome particular part—under thefe circumftances, when all 
hopes of a cure by expectoration are paft the vomicce and ulcers 
have been conquered effectually by an aperture being made into 
the cyft in which the matter was lodged. Cafes attending the 
fuccels of this practice, with the mode of management, may be 
found in Dr. Barry’s treatife on the three different digeftions, 
and difcharges of the human body, to which our reader is re- 
ferred. 
§ 3. Pulmonary Consumption, 
called Phthisis pulmonal ls, from the Greek wordpthino or 
ptbuo, corrumpo, to corrupt. 
This difeafe is a wafting away of the whole body, attended 
with a heCtic fever, cough, and fpitting up of matter, from an 
ulcer on the lungs. 
Authors have divided them into different fpecies ; the dry, 
or TUBERCULOUS CONSUMPTION -THE MOIST, OT CATARR- 
HAL—and the sanguinary, from their attendant fyniptoms 
and caufes; but by dividing this difeafe into two ftages, and ad- 
verting to the caufe, we (hall, by a concife view, render it leis 
perplexing ; the first, compriftng its ftate of inflammation ; 
the second, of fuppuration. 
DESCRIPTION. The inflammatory ftage begins with chill- 
nefs, fucceeded by heat, low fpiritednefs, and pain-fhrillnefs of 
the voice, fait tafte in the mouth, and dry cough—there is gene- 
rally an oppreffion in the breaft, efpecially after motion—thirft— PULMONARY CONSUMPTION, 
a weight in that part of the lungs affe&ed—lofs of appetite, and 
vomiting up fometimes of the food loon after taking it--the pulfe 
is quick, foft, and ftnall ; fometimes full, and rather hard—and 
frequently a fpitting and coughing up of frothy and florid blood 
—this forms the firlt fpecies—and when blood is coughed up, the 
third, or fanguinary ; and this by iome is confidered as a con- 
fumption in its incipient date. 
After fome time, matter is expeftorated of different colours, 
white, yellow, green, bloody, either without fmell, or offenfive— 
the body begins to fall away, and grows cold even in fummer— 
the hebtic fever increafes in the evening, and in the morning a- 
bates by diffolving fweats—there is a burning heat frequently in 
the palms of the hands—and in the day ioofeneffes come on, or 
the patient makes a larger quantity of water—fometimee the 
tongue wili be befet with finall ulcers—and, after earing, the pa- 
tient will have a fixed red colour in his cheeks—the fingers grow 
thin, though the ends are bulbous, and nails curve inwardly-- 
the feet fwell--the hair falls off—and pit of the ftomach feems to 
be pulled inwards and upwards- all the functions grow languid— 
the body dry-and the eyes fink deep within their cavities-at 
length, from debility, the patient pays the debt of nature, at the 
time when he is flattering himfelf with the hopes of a recovery. 
CAUSES. The remote or inducing are, acrid matters feparat- 
ed by tite lungs, and, by t!\eir ftitnulus, exciting a cougb—imall 
glandular tumors, called tubercles—fumes of arfenic, or other 
noxious materials, getting upon the lungs—moilt air—fpitting of 
blood- a diminution or fuppreffion cf evacuations to which the 
conllitution is accultomed—inordinate paffion--fedentary mode of 
life—too luxurious living—extraneous bodies getting into the 
lungs--wounds—retropulfion of acrimonious humours—befides, 
it is occafioned very often by a variety of other difeafes ; as fcro- 
phula, pox, fmall-pox, meazles, fcurvy, afthma, pleurify, and pe- 
ripneumonic difeafes ; fcarlet fever, and other continued and re- 
mittent fevers ; befides, it may by contagion be acquired; and is 
alfo hereditary. 
The proximate or immediate is, in the Jir/t Jiao e, an inflamma- 
tory Hate of fome portions of the lungs, particularly the glandu- 
lar ; in the feco'nd, almoll always ulcerations, which the opening 
of dead bodies who have died of this complaint verify ; though 
fometimes the caufe has been found to be, an induration and 
fvvelling of the bionchial glands, which are difperfed through the 
lungs, hard and black, not fuppurated in the center, but running 
together, and firm, of the fize of hazle-r.uts or nutmegs, and ooz- 
ing out a purulent mucus into the terminations and branches of 
the windpipe, not obfervable in the fpits—iome of them form PULMONARY CONSUMPTION. 
333 
earthy concretions, do not fuppurate kindly, but remain in a Hate 
of hardnefs, and, when cut, ooze out a thick purulent mucus, 
and thick black blood. 
CUj&E. Now, whether we confider them as different fpecies, 
or as different ftages of the fame complaint, we inuft adapt our 
mode of cure accordingly—hence, then, in the first stage, 
we mull endeavour to conquer the inflammation, by gentle bleed- 
ing, renewed at proper intervals, and the applications of blifters 
to the back and lides, frequently repeated; we ihould alfo give 
oleaginous and iucrafiatiug demulcents, to {heath the humours, 
and prevent the coughing—gentle vomits Ihould be, after proper 
evacuations, repeatedly had recourfe to, at leaii every morning, 
by giving a few grains of ipecacuanha, white or blue vitriol ; 
though the nrft is preferable—a courfe of goat’s whey would be 
ufeful—living upon vegetable diet, and being extremely tempe- 
rate—when the inflammation abates, gentle dofes of fome deob- 
flruents ; fucb as ammoniacum, millipedes, myrrh, ammoniacal 
iron, &c. would he ierviceable to fome ; to others Seltzer water ; 
thofe of Moffat, Harrowgate, Kilburn, Iflington, to others ; ufmg 
at the fame time riding exercife. 
Small dofes of mercury have been thought efficacious in refolv- 
ing the tubercles after the inflammatory llage is over, of which 
quickfilver with chalk, by fome, has been preferred to every o- 
ther compofition of that clafs ; but, whatever of them are admi- 
niftcred, Ihould be given in fmall dofes, in proportion to their 
activity. 
In the second stage, the indications are, to difcharge the offen- 
five matter from the conllitution by expectoration, or any other 
mode agreeable to nature, permitting her always to point the wav; 
heal the ulcerations, ftrengthen the lungs, and give tone and firm- 
nefs to the habit in general; for which purpafes chalybeate waters, 
mineral acids, particularly elixir of vitriol, have been recommend- 
ed ; gentle exercife, efpecially riding on horfeback ; a clear, dry, 
warm air, and fuch amufements and company as will moderate- 
ly exhilirate, not fatigue the fpirits—venery, all painful mental 
affections, or too great folicitude about bufinefs, ihould be a- 
voided. 
In order to clear the lungs, and produce freedom of expe&o- 
ration, we advife gentle emetics, (fee above.) and failing, for thefe 
are greatly conducive towards giving iirength to the part affect- 
ed—the myrrh mixture, (No. 96.) has been in many cafes high- 
ly ferviceable—and, in order to prevent the abforption of matter 
from having any bad effeCt upon the blood, antijeptics, not of the 
{Emulating kiud; and demulcents, with vegetable and mineral a- 
cids, ihould be ufed, if the patient has no loofenefs to forbid their 334 
PULMONARY CONSUMPTION. 
adminiftration—hark alfo in this point is beneficial—at the fame 
time the patient ftiould be kept on all fuch things as are cooling 
and nutritious, and what we comprehend under the term milk 
diet—-and if neither riding exercile or failing can be procured, 
fwinging in the open air muft be fubftitnted in their places. 
Nothing is more necefFary than an exa£l obfervance of regi- 
men in point of diet in thefe confumptive cafes ; but of this, 
and other particulars, we have before fpoken when on heclic fe- 
ver, to the cure of which we fhall refer our reader, (261, &c.) 
and proceed to treat on forne other fpecies of confumptions, which 
sirjfe not from affeftions of the lungs, but from matter formed 
in fome other of the vifeera, and thefe are called 
Tabes, 
from the Latin word tabeo, to pine away. 
DESCRIPTION. Emaciation of the whole body, attended 
with an heclic fever, lois of ftrength, without much cough or 
fpitting of matter ; and thefe are generally owing to formation 
of matter in fome of the interior parts of the machine. 
If it happens in the liver, it is known by pain extending it-, 
felf up to the fhoulders—a fwelling, and pain on touching the 
region of the part affected—naufea, vomiting, and loofenefs— 
there is frequently a cough—the fkin has a fallow or yellowiffi 
look—and the fediment in the urine is either brown or yellow. 
If in the stomach, it manifefts itfelf by foetid oftenfive belch- 
ings—a cough without expectoration—a vomiting of purulent 
matter—fainting frequently—fweats—and pain, either during 
the time of fwallowing, or juft after. 
If in the intestines, it is difcoverable from the fituation of 
the parts, and the ieparation or matter by ftool. 
If in the mesentery, the figns are nearly fimilar to thofe 
which occur when in the liver, (fee above) though a heCtic fever, 
joitwa to a tenfe fwelling of the belly, and a frequent diarrhoea, 
are diftinguilhing marks of this difeafe. 
If in the kidneys, there is a weight in the part afFeCled, the 
patient lies on his belly, the urine has matter mixed with it, and 
there is a difficulty and pain in making water. 
If of the womb, it is known bv a pain of the loins, and a flow 
of matter externally through the vagina. (51.) 
A tabes may alfo be occafioned by matter being lodged in fome 
parts more external, where an evacuation of pus may be procur- 
ed by opening the abfeefs ; which done, and the ulcer healed, 
the cure will be completed ; but where this cannot be accorn- 
pliftied, as is generally the cafe in aim oft all of the import huma- TABES DORSALIS. 
lions we have fpecifled, we mull attempt to correft the acrimo- 
nious ftate of fluids brought on by the abforption of matter, and 
guard the conftitution againft its effects, by the ufe of Peruvian 
bark, and fuch a regimen as we have before laid down in cafes 
of confumptions from ulcers of the lungs. 
Sometimes, though there will be a fcirrhofity, or nardnefs of 
the parts, particularly the liver and mefentery, ariling from the 
vellels being obftru&ed ; to the latter of which children about 
feven years old, without any figns of a fcrophulous taint in the 
habit, born of common proftitutes, are faid to be the molt fub- 
je<ft—they grow pale, fpiritlefs ; have a voracious appetite, fome- 
times a depraved one, longing for things uncommon and impro- 
per to eat ; with a relaxed ftate of the intellines, and a loofenefs, 
in which the food taken pafles away almott in an unaltered 
flate, foon after eating ; they fall away, are confumed by a low 
lurking fever, and often fall into a dropfy of the belly, or a lo- 
cal inflammatory affedlion comes on, and clofes the fcene in 
death. 
CURE ; This, in all cafes of their kind, is to be attempted, 
by Heel medicines, or waters, goat’s whey, foffile alkali, or fo- 
|da, (Page 185.) or fuch of the mineral waters as abound with 
them, joined to afs’ milk—deobllruent gums, particularly 
myrrh, ammoniacum, with foap, and preparations of fleet, rhu- 
barb, and tartarized kali, may, when opening medicines are ne- 
ceflary, be given ; and, with the ufe of thefe, a miik diet ffiould 
be perfifted in, with great regularity. 
Though we have faid that raofi of thefe confumptions, not of 
ithe pulmonary kind, arife from formation of matter, or obftruc- 
tions, there is one which deduces its origin from another caufe ; 
and this is called 
Tabes dorsalis, or the dorsal Consumption. 
from the Latin word dorfum, the back ; which, befides the com- 
mon fymptoms of a tabes, is to be diftinguiffied by others, as a 
conftant difcharge of mucus, or feed fo called, through the ure- 
thra, with frequent no&urnal emiffions—-difficulty of making 
? water—coftivenefs—pain and weakuefs in the fmall of the 
back—violent and acute head-ach—with an uneafy creeping 
fenfation down the fpine from the neck to the loins—difficulty 
of breathing, and wearinefs, with an heavinefs of the head, and 
ringing of the ears. 
: The general cause of this complaint is, excefs in libidinous 
indulgences, wdiich often ends fatally, as the unhappy victims 
are generally fo weak as to perftft in them ; and, without total 
abftinence, the molt judicious advice will be inefficacious. INFLAMMATION OF THE STOMACH. 
CURE. This depends upon onr attempts to invigorate the 
fyftem, and increafe the ftrength and activity ot the folids, by a 
courfe of afs’ milk, fteel waters, the cold bath, with bark, and 
elixir of vitriol—the patient living in a pure air, ufing gentle 
exercife, light, and moderately cordial diet, given in fmall quan- 
tities, fucli as will not be too great for the ftrength of the digeft- 
ive powers—tliefe applied in time—and no difeale requires 
more early application—-before the he&ic fever, and violent 
night fweats cdme on, may give relief ; but, after that period, 
there is little hope for fuccefs. 
§ 4. Inflammation of the Stomach, or Gastritis. 
from the Greek word gafler, ventriculus, the ftomach ; in 
which cafe the ltdmach is laid to be inflamed wholly, or only 
in part. 
DESCRIPTION. In this complaint the general symp- 
toms are, extreme anxiety—watchings—-reflleflnefs—tolling 
about of the body—fainting—with a tttofl acute fever, foon ac- 
companied with nervous and putrid febrile affections—the lo- 
cal ; great thirft—difficulty of breathing—pain in the region of 
the Jlomach—ex cejfive heat, and a Jenfe of burning---continued 
painful vomiting—hiccough, and extreme pain from throwing up 
of wind, and particularly after taking any fiarp acrid medicines 
—fullnefs and tenfion of the Jlcmacb—-ihe pu fe rather hard, con- 
tracted, and frequent—with coldnefs of the extremities. 
CAUSES. The remote or inducing are, a prevalent predifpo- 
fition in the ftomach being prefent—bruifes on the region of 
that organ, or wounds in the ftomach itfelf—drinking of cold 
water, fermented liquors, ftrong acrid emetics or purgatives, or 
other acrid medicines thrown into the ftomach—corrofive poi- 
fons—acrimonious humours generated in the blood, or repelled 
from the exterior parts of the machine, and thrown upon the 
coats of the ftomach, fuch as that of the fmall-pox, miliary 
eruptions, gout, acrid bile, or any hard fubilances fwallowed, 
and lodging in the ftomach ; or, in fine, any thing fixed there 
capable of producing ftrong irritation—which naturally bring on 
the proximate or immediate cauje, inflammation. 
CHARACTERISTIC SIGNS. Thefe may be known from 
the Italics in the defeription. 
CURE. This will in many cafes depend upon adverting to 
•the caufes afting upon the ftomach, and taking off that aftion ; 
but if it arifes only from thoie which commonly induce in- 
flammation, our chief dependence mult be upon copious bleed- 
ing, fomentations, cupping upon the parts, and local bliltering, 
and keeping the body open with emollient glyfters—very little INFLAMMATION OF THE STOMACH. 
337 
can be expeded from internal remedies, from the propenfity the 
llomach has to rejed whatever is taken down—hence all we 
dare venture upon are demulcents, only moderately warm, fuch 
as folutions of gum arable, tragacanth, or fpermaceti, with ni- 
tre; to which may be added, a very fmall portion of camphor, 
and three or four drops, now and then, of the tindure of opium 
—nitre may alfo be added to the glyflers, and thrown up freely 
into the bowels—flannels alfo, foaked in warm folution of nitre, 
may be applied as a fomentation. 
But what we rauil mod infill upon mud he bleeding—nor 
mud we be diredecl by the pulfe, as in this cafe it is apt to de- 
ceive us, for it is generally fmall, quick, and irregular ; fome- 
times intermittent ; the operation ihould therefore he repeated 
till the pulle rifes, and beats with fome degree of freedom. 
Indeed, if refolution is not accomplished in the very begin- 
ning, mortification will very rapidly fuccecd. 
Suppofe poison JJjould he the caufe, at a very early period a 
quickly ading emetic Ihould be given, fuch as white or blue 
vitriol, indantaneoufly, and afterwards large draughts of new 
milk, or Ireih butter melted, and oil ; thefe are extremely falu- 
tary ; or any* other fheathing liquids, drank in fuch quantity as 
to fill the whole alimentary canal, in order to guard the coats of 
the domach and inteflines from receiving any injury from the 
acrimony of the poifonous ftimulus—when even arfenic has 
been taken, thefe have been found efficacious. 
Should the poijons be compounded of any metalline fuhflance 
joined with an acid, fuppofe corrofive fublimate, before the in- 
flammation comes on, alkaline fait diffolved in water ihould be 
freely adminiflered ; this will difunite the compound, and ren- 
der it inadive. 
Admit it Ihould be occafioned by any eruptions receding 
from, and thrown back into the habit from the furface, and fix- 
ing on the flomacb, we Ihould apply bliders, in order to recal 
to the ffiin the offending matter, by foliciting a more copious 
flow of humours there. 
§ 5. Inflammation of the Intestines. 
called enteritis, from the Greek enteron, inteftinum, intefline. 
Perhaps there is not any complaint lb commonly talked of as this j 
yet it certainly does not occur any thing like fo often as is ima- 
gined—fome fpecies of the colic is frequently, I am perfuaded, 
miflaken for it—practice warrants me in faying thus much. 
DESCRIPT/ON. It generally proceeds in the following 
manner : after the body has been coltive, there comes on acute INFLAMMATION OF THE INTESTINES. 
pain, and diftenfion of the body, particularly near the navel; 
the coftivenefs then becomes more obllinate—the patient com- 
plains of ficknefs, and throws wind upwards—then fucceeds vo- 
miting of the contents of the flomach, afterwards of vifcid 
phlegm and bile—fhould this continue, the fames corne up, nay, 
even the glyfters, by the mouth—there is much difficulty of 
breathing—an obftru&ion of urine—the pulfe quick and fmall 
—third—-and great debility—the pain at length ceafing, faint- 
ings, hiccough, delirium, and couvulfions, dole the fcene in 
death, occafioned by a mortification having taken place. 
CAUSES. Thofe which ate remote or inducing are faid to 
be, ruptures in the groin—worms—(Emulating medicines—poi- 
fons—or too acrimonious bile—too long retention of fteces—un- 
ripe fruit—or any hard fubftances lodged in the intellines—an 
introfufccption, or running in of one of the bowels into the 
other, land there confined by feme ftri&ure—tumors or hard 
dwellings in the ir.teftines or neighbouring parts. 
The proximate or immediate, what occurs in ether local inflam- 
mations, attended with the natural motion of the bowels, called 
periftaltic, inverted and turned upwards, arifing from the bowels 
being obflrudled. 
CHARACTERISTIC SIGNS. Great internal pain, and 
forenefs about the navel, fo that it can fcarcely bear the (ouch, 
with a diflenfion of the belly, accompanied with third, heat, 
great proflration of ftrength, and a quick fmall pulfe. 
CURE. Whatever may be the caufe, we mull labour to 
bring .bout, as quick as poflible, refolution, left mortification 
Ihould be the confequence, which may in a very fhort fpace of 
time fucceed. 
The treatment recommended in the inflammation of the fto- 
mach will be here proper; though more reliance may be placed 
on internal remedies, which muff be calculated to gain a pafl'age 
through the bowels, check the vomiting, and fubdue the in- 
flammation. 
To anfwer the flrft purpofe, the mildeft aperients fhould be 
tried ; if they avail not, thofe which are ftronger ; and fhould 
they be rejected, we may couple them with opiates ; the dofes 
ihould be fmall, and often repeated. (See No. 97 to 99.)—If li- 
quids .will not fucceed, folids may fupply their place, (No. ico, 
lot.)—or fhould thefe not anfwer, in conjun£lion with them,Jup- 
pojitories, (No. 102.) and irritating glyfters, (No. 103.) or the ufc 
of tobacco, (155.) may be tried; or crude mercury may be ta- 
ken, an ounce at a time, three or four times a day. 
Should fome acrimony be fufpe£ted to be the caufc, the purg- 
ing antimonial mixture is recommended, (No. 104.) of which INFLAMMATION OF THE LIVER. 
339 
let three or four fpoonfuls be taken every fecond hour, till the 
patient vomits, and has a free paflage downwards. Indeed, when 
every thing has been tried in vain, cold water thrown fudden- 
ly upon the feet, legs, thighs, and belly, laid bare, has fuc- 
ceeded. 
If thefe remedies, added to the applications we have advifed 
in inflammations of the flomach, do not anfwer our purpofe, mor- 
tification will take place—and here we mull be careful that we 
are not deceived ; for people, for ten or twelve hours before 
their death, being freed from pain, flatter themfelves with the 
hopes of recovery, even when the fatal feene has commenced, 
and they die in a few hours—but if the pulfe Jhould he low, the 
countenance become pale and gh a fly, and cold clammy fw eats come 
on, we may be certain of the dreadful event. 
But, fhould our efforts prove fuccefsful, great care fhould be 
taken to avoid a relapfe ; for, unlefs the bowels have acquired 
proper flrength, the malady is apt to return. 
The diet therefore fhould be, for fome time, of the lightefl 
kind, and not flatulent—the patients fhould be kept quiet, free 
from cold, and unruffled by mental inquietude—nothing crude 
and difficult of digeifion fhould be taken ; nor fhould they ufe 
puich walking exercife, or any fevere motion of the body. 
§ 6. Inflammation of the Lives, 
sailed hepatitis, from the Greek hepar, jecur, the liver. 
The liver itfelf may be inflamed, Hill rnanifeft itfelf by differ- 
ent fymptoms, which authors have thought neceffary to fpecify, 
in order to avoid any errors which might occur for want cf fucli 
proper diftindlion. 
DESCRIPTION. If the inflammation happens on the interi- 
or concave part of the liver, it is difcoverable by a fixed obtufe 
pain, and weight in the right fide under the fhort ribs, attended 
•with heat, unealinefs about the pit of the flomach—the pulfe on' 
the attack being almofl in the natural ftate ; though afterwards 
much quickened—there i3 in the right fide alfo a difienfion— 
the patients lole their appetite, are tick, and troubled with vo- 
miting—the tongue becomes rough and black—they complain of 
pain in the flomach, have a very troublefome hiccough, and their 
countenance is either pale, of a citron colour, or yellow like 
thofe in the jaundice. 
If it is on the fuperior or convex part, they feel an acute pain 
in breathing, extending either towaids the throat or fnoulder— 
the pulfe is quicker—they have a dry cough—lie down with dif- 340 
INFLAMMATION CF THE LIVER. 
ficulty on the left fule—are troubled with hiccough and vomit- 
ing, and grow extremely weak. 
CAUSES. The remote or inducing are, too violent and re- 
peated blocks from vomits—hard tumors of the liver—extreme- 
ly tenacious blood—too great a load of fat in the omentum or 
caul, (37 )—cold air, or cold liquids fnddenly affecting the liver, 
at a time when it experience* too great a degree of heat. 
Though iome do not confider the complaint as originating in 
the liver itfelt, but communicated from the parts which lie con- 
tiguous to it, being thus primarily alleged—to all which we may 
add, among!! the numbeiof inducing caufes, all inch as are com- 
mon to other fevers of this kind. 
CHARACTERISTIC SIGNS. A tenfion and pain in the 
right fide under the fpurious ribs, fometimes pungent, like that 
of a pleurify ; fometimes more obtufe, with a fenfe of heat and 
weight—a pain at the collar-bone and top of the right fhoulder 
•—an uneafinefs on lying down on the left fide—a difficulty of 
breathing—dry cough—vomiting aud hiccough—the face of a 
yellowifh colour, accompanied with thiift and a loathing of 
food. 
CURE. This difeafe in our climate is confidered a3 rather 
uncommon, though, if properly treated, it rarely becomes dan- 
gerous. 
In this, as in other cafes of vifceral inflammation, we mud have 
rccourfe fil'd to copious bleeding, nor wait to be led till it is in- 
dicated by the pulfe ; after this, a blifter fhould be immediately 
applied over the part affiecled, where the pain is felt ;■ the belly 
ill oil Id be fomented, the legs bathed in warm water, and emolli- 
ent and attenuating glyders frequently adminidered, (No. 25, 26.) 
—faline neutral mixtures, with antimonials, fhould he given, to 
which fhould be added as much rhubarb as will keep the body 
condantly foluble, (No. 8.) and when the pain and other inflam- 
matory fymptoms are perceptibly abated, mercurial purgatives, 
joined with antimonials, will be of the greatefl advantage. (See 
No. 105, 106.) 
Thefe means, if early and judicioufly applied, will generally 
conquer the inflammation—if not, an abfeefs of feirrhus is form- 
ed— the confequences of which are very frequently incurable 
tabes, jaundice, and dropfy—though there are fometimes pecu- 
liar circumflances by which the patient in cafes of abfeefs is pre- 
ierved—fhould the inflamed pare of the liver form an adheiioti 
with the membrane covering the infide of the right hypochon- 
drium, or part under the fpurious ribs, fo that the. matter con- 
fined in a fac is prevented from falling within the cavity,of the 
belly, and pulhes outwardly, occafiouing a fuelling which'points INFLAMMATION OF THE SPLEEN. 
341 
to the feat of the abfcefs, an incifion made into it, fufficiently 
large to evacuate the whole matter, may fave the life of the pa- 
tient, (fee page 331, &c.)—lometimes the matter formed will be 
thrown out of the habit by the kidneys, lometimes by the inter- 
lines ; but from whatever caufe matter is formed in that organ, 
we mufl wait for the operation of nature, and have recourse to 
fuch remedies as the circumilances of the cafe will admit, la- 
bouring chiefly to fupport the constitution in the manner we 
have before Specified, when treating of confumptions from inter- 
nal abfceffes. 
§ 7* Inflammation of the Spleen. 
called splenitis, from the Latin word Jplen, the fpleen. 
This, though a cafe which very rarely occurs, Hill, in confe- 
quence of certain fevers of the remittent and intermittent ciafs, 
the fpleen will frequently be loaded, and remain in a hardened 
and indolent Hate—however, when it does'make its attack, it 
puts on the following appearances : 
DESCRIPTION. There is a pain, generally dull, and fixed 
in the left hypochondrium—alio a weight attended with a remit- 
tent fever—there is generally a.protuberance on that fide exter- 
nally, attended with a throbbing pulfatde pain—the fever, for 
the molt part, increafes every fourth day—the feet and knees 
grow red—the nofe and ears iometimes pale, attended with a dif- 
ficulty of breathing. 
CAUSES. Thefe are fimilar to thofe which induce the fame 
afredion of the liver, if we except the morbid defed of the o- 
fnentum or caul. 
CHARACTERISTIC SIGNS. DiHenfion and pain cf the 
left hypochondrium, increafed on preflures, without any Amp- 
toms ot an inflammatory Hate of the kidneys, attended with a re- 
mittent fever. 
CURE. Similar to what we have delivered in cafes of in- 
flammation of the liver. 
But, without much previous diHrefs or diforder, an abfeefs 
will here iometimes be formed ; which, buriling fuddenly, pours 
its contents amongit the vifeera of the belly, and in a few days 
deiiioys the unhappy patient. 
§ 8. Inflammation of the Kidneys, or Nephritis. 
fo called from the Greek nephron, ren, the kidneys. 
DESCRIPTION. Thole who arc ieized with this complaint 
feel a heat and pain, and iometimes have a rednela in the region 342 
INFLAMMATION OF THE KIDNEYS. 
of the kidneys, attended with febrile affe&ions—they complain 
of a numbnefs of the thigh and leg of that fide in which the af- 
fedled kidney is fituated ; they make water with difficulty, 
■which is at firft pale, afterwards high coloured—and complain of 
a painful uneafinefs in fitting down or Handing—they lie down 
■with molt eafe on the fide affe£ied--they complain of coldnefs of 
the extremities—are lick, and vomit, and breathe with difficulty ; 
at length, if refolution takes not place, a fuppuration or morti- 
fication fucceeds. 
This lias not unfrequently been miltaken for in inflammatory 
lumbago, or pain of the loins ; but from which it is diftinguiffi- 
able; firlt, from the patient’s being able to raife himfelt into an 
eredt pofture ; from being bent forwards without any remaika- 
able pain, which in the lumbago is very fevcre ; from the pain 
following the courfe of the ureters (50.) ; from the difficulty of 
making water, and the urine being more changed, which is not 
the cafe in the lumbago. 
CAUSES. The remote or inducing are, whatever canfes an 
irritation in the kidneys, fo that the blood is determined too 
freely and obftru&ed there, fuch as wounds and bruifes—-calcu- 
lous concretions—food which generate flatulencies in the bowel, 
called colon, (43.)—heating diuretics—fhaking in a carriage, or 
on horfeback—fupprefled evacuations—fullnefs of blood, or any 
ltrong fpafmodic contractions of the kidneys themfelves. 
The proximate or immediate are fim dar to what induce other 
local inflammations. 
CHARACTERISTIC SIGNS. Pain in the region of the 
kidney, often purfuing the courfe of the ureters—frequently 
making water—the urine being either pale, thin, or of a very- 
red colour—numbnefs of the thigh—retraction or pain of the 
tefticle of the fame fide, and vomiting. 
CURE. If it proceeds from common caufes, fuch as induce 
other local inflammations, the fame mode mu ft. be purfued as 
has been repeatedly advifed in the foregoing part of this work. 
But fuppurations are often formed here, which are difeover- 
able, notwithstanding the abatement of the pain, by a fenle of 
weight perceptible about the region of the loins, with hot and 
cold fits fucceeding each other, and the urine, from being high 
coloured, without fediment, becoming whitifh and turbid—un- 
der this circumftance people will live many years, from there 
being fo free an exit for the matter out of the machine by the 
ureters—however, in ulcerated kidneys, goat’s whey, balfam of 
copaiva, (P. 165.) Canada balfam, (P. 175.) and alfo foflile al- 
kaline waters are recommended—folutions of kali impregnated 
with fixable air, (P. 199,)—demulcents, (P. 187.}—-the leaves { INFLAMMATION OF THE KIDNEYS. 
343 
of the bear’s wortle berry, (P. 139.) in powder, have been high- 
ly recommended in tbefe cafes ; and, from experience I lpeak, 
much may be done by its ufe. 
But thofe calculous concretions, called done, or gravel, are 
the mod frequent fource of inflammation in the kidneys—this 
caufe is difcoyerable by the pain increaling, and being more a- 
cnte from exercife, or riding in a carriage—being more violent 
at intervals—from the urine being fometimes gravelly, bloody, 
or mucous—-the numbne'fs of the the thigh—-retraciion of the 
teflicle on the fide affe<Eted—pain following the courfe of the u- 
refers—-as -well as naufea and vomiting being more violent.--- 
The indication of cure in this cafe is, not only to take off the 
inflammation, but to procure a paffage for the offending materi- 
als, whether gravel or calculus, by relaxing the parts, that it 
may flip away, and be evacuated. 
Here then, befides bleeding, warm bathing is effentially ne- 
Ceffary ; fomentations copious ufe of demulcents, (P. 187.) par- 
ticularly the internal emollients, (P. 142.) oily emulfions and 
draughts, (No. 81, 98, 99.) emollient glyfters, with turpentine 
and opium, (No. 116. 121.) diluent mucilaginous liquids fweet- 
ened with honey, as bran tea, linfeed tea, decoflion of raarfli- 
mallows, or that of barley, in which lall is dififolved gum ara- 
ble, or gum tragacanth. 
Nitrous medicines joined with the fame gums may be admi- 
niflered, and opiates in fmall dofes. 
By thefe means the ureters will be relaxed, and fheathed, for 
the eafy and quick paffage of the calculus, or gravel, into the 
bladder—befides, the irritation on the parts will be ieffened, as 
they will become lefs fufceptible of the ftimulus. 
Should the Hone be fmall enough to pafs into the bladder, and 
be evacuated, the complaint ceafes—if not, a different one com- 
mences, which we ftiall treat of hereafter. 
§ 9. Inflammation of the Bladder, or Cystitis. 
from the Greek word kujlis, vefica, the bladder. 
DESCRIPTION. In this complaint, the patient experiences 
a pain and tumor of the lower part of the belly--a frequent defre, 
and difficulty in making water— fometimes a fupprejjion of urine 
—and frequent efforts to go to Jloof attended with febrile ajfeblions 
—to which we may add, the pain on touching is intolerable— 
watchings, third, and delirium, with coldnefs of the extremities 
come on—and, by retention of the urine, an increafed hardnefs 
®f the tumor. 
CAUSES. The remote and inducing are, urinous acrimony inflammation of the bladder. 
concurripg.witb fullnefs of blood—an acridflate of fluids-inflamma- 
tion of the urethra, from venereal ulcers or acrid injeftions-inflam- 
tnation qf the re cl um—fupp relied piles—taking Spaniih flies in too 
'large quantities—in which, befides the difficulty of making wa- 
ter, or ievere flrangury, bloody urine will be voided, and a pri- 
apifm occafloned,' fometimes bringing on convulflons—or it may 
originate from blows, bruifes, compreffion, hard riding, or, in- 
deed, from the ftimulus of a ftone in the bladder. 
GUP*E. From whatever caufe it proceeds, it muft be cured, 
eonfiflehtly with the plan laid down iu inflammation of the kid- 
neys ; only, in this cafe, greater benefit may be derived from 
fomentations and vapour applied to the parts affected. 
There are alfo inflammations of feme other parts of the lower 
belly as the peritoneum, that membrane lining the lower belly 
as the'pleura dobs the chefl—omentum, or caul, (P. 37.) mefen- 
tery, (p, 46.) which, as they all' of them require the fame mode 
of treatment, we fhall particularize only thole fymptoms by.fvhich 
they are faid to be diitinguifhable. 
The Inflammation of the Peritoneum, or .Peri- 
tonitis, 
Jo called from peritoneum—is dife over able py a pain of the low- 
er belly, which is increal'ed by the body being in an ere£t pof- 
ture, attended with fever ; though not accompanied with figns- 
peculiar to other abdominal inflammations. 
Inflammation of the Omentum, or Caul, namei> 
Ometitis. 
This is diftinguiflied by an acute darting pain, perceptible, 
through the fuperior and mkrdle part of the lower belly, below 
the fkin, mufcles, and membrane of the abdomen, increased up- 
on preiuire, with fwelling and ten lion, accompanied by an in- 
flammatory fever. 
Iflamm'ation of the Mesentery, or Mesenteritis, 
In this there is a tumor and deep-feated pairs in the region of 
the nave], or thereabouts—the habit is altogether coftiye, or 
nearly fo—from the adminiltration of glyfters, after the ftrlt, 
not any thing is evacuated—the fever is fometimes flight, feme- 
times remittent, at others violent—the urine high coloured— 
there is a bitter talle in the mouth—iofs of appetite, third, and INFLAMMATION' OF THE MESENTERY. 
345 
watchings come on—-afterwards a thin, red, fcetid, or v;hite mat- 
ter paffes off by (tool. 
The muscles of the lower belly will be sometimes 
Inflamed, and from thence theliver comprefled—which phyfici- 
ans have fometimes miftaken for an inflammation o*f the liver—• 
but which is eafily difcoverable, from touching the {kin, pulfati- 
on of the tumor, and circumfcrihed figure, extending itfelf beyond 
the limits of the liver, and above the ribs-—from the abfence of 
cough, difficulty of breathiug, vomiting, and hiccough—matter 
he t forming between the mufcle of the abdomen and the membrane 
which lines the in tide of that cavity, has been mifiaken for an 
affection of the liver itfelf-—therefore neceffary to be fpecified. 
CURE. In all thefe cafes we mult have recourfe to the 
fame methods as have been repeatedly pointed out in local in- 
flammations, to prevent fuppuration—-which, if we cannot effect, 
a tabes will be the confequence, particularly in the three firft 
mentioned—but wc muff here obferve, that in cafes of in- 
flaIWdj-ation of the peritoneum, or that of the mus- 
cles of the abdomen, we muff depend much on fomenta- 
tions—applying after each operation, volatile liniment, with 
tinfture of opium, (No. 107.)—and ffiould not thefe fucceed, 
blifters—-which in the others may be ufeful—and/rztf//, repeated* 
glyfters ; for thefe aft alfo as fomentations, and in moil apply 
clofer to the part affefted. 
SECTION XIV. 
ON DISEASES WHERE PAIN IS THE CHARAC- 
TERISTIC SYMPTOM. 
‘tTT'E confider pain as arifing from four different caufes, either 
* * from nervous i'ncitability, (P. 27.) vafcular or mufcular ir- 
ritability, (P. 27.) diftenfion, or fpafm, creating ftimulus ; and 
when it is fo oppreffive as to become the moll violent fymptom, 
being of long duration, or frequently returning, it conft'Uutes 
difeal'es of this clafs—which take their names either from the 
caufe known, or l'uppofed to be the agent, or from the feat of 
the affection.—Yet we mean not here to include all difeafes 
which have pain for their affociate, becaufe it is attendant on 
all inflammations, fettled fevers, remarkable evacuations, and 
evident fpaiins ; but confine onrfelves to thofe difeafes where HEAD- AC II. 
pain is the predominant fymptom, unaccompanied primarily 
with any of the above-mentioned disorders. 
CHAP. T. 
§ I. He AD-ACHi 
TM this complaint, it will be fufficient to enumerate the caufes • 
hecaufe it requires not any particular defeription ; and, ac- 
cording to the caufe, to that is the cure adapted—but fxrft we 
mufl obferve, that it has been divided into three fpecies, the 
two fir it agreeable to the nature o: the afFedlion : the lad to its 
O , 
feat. 
If there is a heaviness and uneafy dull fenfation, occafioning a 
pain in the head, as if it was too full, internally diflended, and 
overloaded, it is denominated cephalalgia, from kephalos, ca- 
put, the head, and algos, dolor, pain ;—and, by way of diflinc- 
t.ion, cepiial.’EA, if the whole head fliould not only be alre&ed, 
but the pain be acute and violent, having fevere exactrbations* 
or increafe of feverity on flight occafions, with fpafmodic ten- 
fion, and forenefs of the integuments. 
And fhould the pain attack, either fide of the head, chiefly at 
the temples, forehead near the eyes, and that fliould be violent, 
and often periodical, it is called hemicrania, from emifus, di- 
midium, half, and hr anon, caput the head. 
CAUSES, ill, A too great fullnefs of blood—2d, fuppref- 
ficn or retrocefilon of the menfes or piles—3d, morbid particles 
occafioning intermittent:;—4th, from a load on the ftomach, and 
indigeftion—'th, different fpecies of acrimony ; as that of the 
pox, gout, rheumatifm—6th, hyfleric fpafms—an4, 7th, from 
latent caufes undifcoverable, or irremediable when known—to 
each of which in our mode of cure we muft particularly advert. 
If it deduces its origin from the FIRST—a full flow puHe-— 
florid countenance ; pale—load and heavjnefs. of 
the head, particularly of the fove part, immediately after riling 
in the morning, or {looping to the ground—a difficulty of 
thinking, of diflin£Uy reafoning, and detedd of memory, diftin- 
guifli this. 
Bleeding and purgatives will generally afford relief ; if rot, 
cupping at the nape of the neck, or back part of the head, may 
be had recourfe to. HEAD-ACH. 
347 
If fram the seco.nd, bleeding during the fit will be nece.flary, 
and a tempting to reproduce the periodic difcharge, and fo licit 
the renewal of the piles-—bleeding in the feet in the former, 
and at the anus .with leeches in the latter, may be attended with1 
agreeable confequences. 
If from the third, and it puts on intermittent appearances, 
bark alone, or coupled with valerian, (150. 193, 194.) (No. 32.) 
becomes efficacious, and giving emetics, (No. n. 12,38.) at 
proper intervals. 
If from the fourth, it will be attended with throwing up of 
wind-—naufea—-load and pain in the llomach—-a bad tafie in 
the mouth—and vomiting ; though this laid will alfo attend 
both cephalalgia and hemicrania, (346.) without the origin of 
thefe diieafes being in the fto.nach, but in the head only ; hence 
we fhould be careful in making this proper Cridindtion. 
Therefore, if it is owing to the ilornach, we mull apply to e. 
metics, (No, 11, 12. 38.) lhould not any thing in the conftitutiou 
prohibit their ufe ; and afterwards to purgatives; taking- care 
previoufly, if neceffary, to empty the veffels of the head by bleed- 
ing ; afterwards bitters and chalybeates, (No. 6i to 65.) to 
ftrengthen the llomach—we mud alfo affiduouily prevent coltive- 
nefs, with proper aperients taken occasionally. (No. 66, 108-, 
109.) 
If from the fifth, we mud proceed to attack the difeafes 
from whence they originate*, as under thefe circumilances they 
are only confidered fymptomatic. 
It from the .sixth, or thofe called nervous headachs, pene- 
trating, volatile, antifpafmodic fubdances externally and locally 
applied, fuch as Ward’s eiffince, sether, compound fpirit of am- 
monia, camphor,, will l'ometimes give immediate relief—plainer* 
.alfo made of opium, applied fa the part affedted, in periodical 
partial arFedtions of the head, 1 have known efficacious. 
If from the seventh, we Ihall be convinced how impoffiblc 
the caufes are to be difeovered, and how little is to be done, if 
we only mention what has appeared on di Heft ion. of thofe who 
have laboured under this complaint. 
In forrie the futures of the J'cull were fo clofely and. firmly con- 
joined, that no traces of the jun&ion of the bones of the cranium 
were to be fouhd:—in fome the dura.muter (26.) was thickened 
and indurated, and in others it held earthy concretions—the Jcull■ 
in fome, fetit out little proceffis, like thorns, running through the 
membranes into the brain—and, in others, crude quichfilver was 
found in the ventricles of the brain, (27.) at the balis ol th$ 
feu 11. 
.Some periodic headachs, from fuch latent caufes, will continue 348 
EAR-AC H. 
for a long feries of years, without any fatal effects whilfr others* 
if they are conftant and violent, terminate in apoplexies,’ fortve •' 
kinds of bad fevers, or fpafmodic difeafes. 
Some general rules, however, are necefTary to be obferved, 
whatever may be the precife nature of the affe&ion. 
Patients l'ubjedt to thefe complaints fiiould always keep their 
hands, arms, legs, and feet *arm, particularly their legs, and 
have them well rubbed at bed-time—avoid coftivenefa—eat very 
light {’uppers—lie with their heads high, and in thin night-caps 
-—their food Ihould he always light, and ealy of digeftion—their 
exercife moderate—and their minds kept in a hate of cheerful 
cafe. 
2. Ear-agh, or Otalgia. 
from otts, auris, the ear, and algos, dolor, pain. 
We have before fpoken of the inflammation of the ear, § 2. in, 
inflammatory complaints ; but there are other caufes which induce 
this complaint ; as, ill, worms, fuppofed to arife from the eygs 
of the fiefh-fty depofked in the wa:;, which form (or them a neit 
— 2d, a defluxion of humours—3d, from hard bodies pufired into 
the ear. 
In theory? in-flance, fmoke of tobacco poured into the car, and 
afterwards warm oil, prove efficacious. 
In thefecond, the fymptoms are not violent—fthere are pain 
and (welling in the vicinity of the ear—running at the hole— 
cough—but ottener a foreneli. of the throat—frequent founds 
and ringing of the cars—with painful i’enlations from thcic which 
come externally. 
This complaint is apt to be occauoncd by cold itfclf, or moill 
cold winds linking the ears and head, expofed to them without 
covering. 
Local bleeding behind the ears with, leeches, and blidering 
there, or the back part of the head, and, at the lame time, the 
linieqent, (No. 110.) may he dropt into the car ; fedative foment- 
ations, (.No- in.) are ufeful, with iedatives and diaphoretics, 
(Nq. 4 tp 10.) given internally. 
In the third, the bodies mull be extradled in the gcntlcll 
manner. We have an account of acute pains, attended with o- 
ther melancholy circumftances, by Fadiucius . Hii.danus, oc- 
calioned by a ball of glafs falling into the ear, and continuing 
for eight years, cured by extra£tion. 
And we are alfo told, .that i'ome furgeons, mitiuking a fweii- 
Ing of the bony part of the ear for l'orne extraneous body, deftroy- 
the patient, by the violence exerted for it* .extraction. TOOTH-ACH. 
Theft cafes fhew the necefiity of caution and circumfpeclion, 
even iu cafes confidered in theini'elves as trivial. 
§. 3* Toqth-ach, or Odontalgia, 
from odous, clens, a tooth, and algos, dolor, pain. 
This complaint is known by a throbbing, gnawing, darting, 
or fome other fpecies of pain in the teeth, attended with watch- 
ings ; fometimes with a fvvelling uf the cheek, great dil’cliarges 
of faliva from' the mouth, See. 
Its feat is fuppofed ta be the nerve creeping over the inter- 
nal, fometimes the external, membranous covering of the tooth. 
CAUSES, ill, Caiies, or decay of the tooth or teeth affect- 
ed—2d, an acrid deflation, or flux of acrimonious humours, as 
of the feurvy, rheumatifm, gout, from the ohftruaed perfpira- 
tion—3d, nervous cr hytteric affections—and, 4th, pregnancy. 
If it arifes from the first ca'ufe, it is generally perceptible to 
the fight—the caries though fometimes lurks between the teeth 
— fometimes begins internally, fometimes externally—however, 
it is not perceptible to the eye, it may be difeovered by-the 
tooth being almotl pellucid like pearl—or by the fhock of fome 
metallic indrument, which increafes, or renews the pain—by a 
feetid breath—affharp darting pain from cold water, or cold air 
received into the mouth—from a gnawing pain—from the oblli- 
nacy of the difeale, without any confiderable tumor of the gums 
—from fillulo.us ulcerous sums, havins a fmall circular tumour 
round the orifice, and a purulent difeharge—from rotten teeth, 
ulcerations have been formed, and fwelling on the chin, and a- 
bout the cheeks, which are never cured without drawing the 
tooth. 
CURE. Drawing is the firft remedy—though, if at the be- 
ginning a fmall fpeck or portion Ihould be perceived difeolpured, 
that Ihould be immediately taken off, by which its prog refs wonlll 
be flopped—applying oil of vitriol to the part affected, or muriatic 
acid, and neutralizing it with kali prepared, and then filling the 
hollow tooth with lead, or gum maftich, has been fuccefsful—a 
pill of opium and camphor, or of opium and calcined 
—burning the part afledted with a hot iron-— caTiterizing the ear 
—applying oil of cloves or cinnamon with lint to the rotten ca- 
vity, have been recommended ; if this difeafe returns from fi-fglrt 
caufes, and many of the teeth are in a (late of decay, experience 
approves of wrafhing the mouth every morning with warm urine-- 
though indelicate, this remedy lias it advocates—perhaps tiling; 
in the fame manner lavender-water, fpirits of wine, or brandy, 
properly diluted, may be confidered as good a prefeevative. *• TOOTH-AC It. 
If from the second, it may be difcovered by the teeth being 
in a found ftate---by the pain not confined to one or two teeth,, 
but the whole jatv of that fide being affected ; and by the fwell- 
ing of the gums, attended moil commonly with a copious dif- 
charge of faliva. 
. CURE. The gums in. the beginning fhould be fcarified, or 
leeches applied ; alfo murtard plailters behind the ears, long c- 
notlgh to occafion a rednefs—-or, in more obftinate cafes, blifters 
--the mouth fliould be walked with warm milk and water—and 
internally, diaphoretics, coupled with fedatives, (No. 4 to 10.) 
fhould be given ; f19.0ak.ing tobacco, chewing pellitory of Spain, 
ginger, fwcet reed, pepper, &e. to caufe a flux of faliva ; appli-, 
cations of warm refinous plailters, (No. 112.) with opium to the 
temples fliould be adminirtered ; fl.annels impregnated with the 
fumes of frankincenfe, amber, fiigar, Sic. applied warm to the 
cheek, and the mouth waffled with fpirits of wine and camphor. 
If by thefe means the difeafe is not conquered, which general- 
ly happens to be the cafe, but the pains perfiit, and the gums in- 
creafe to fwell, an abfeefs will be molt likely the. confequence • 
under thefe circurnftances a roalled fig fliould be kept upon the 
part to promote fuppuration, which once accomplilhed, muft at 
a proper time be opened, cleanfed, and healed, by the applications 
of pledgets, dipped in a mixture of honey of rofes and tinCture 
of myrrh. 
If from a defluxion of any fpecific humour, we muft proceed 
as in the car-ach (348) from flmilar caufes, making ufe of thole 
applications calculated to alleviate the local affections. 
If from the third, it generally yields to a courfe of antifpaf- 
modic and fedativc medicines, fuch as we find advifed in hyfte- 
ric affeCtions. 
If from the fourth, there is no remedy, particularly in ha- 
bits full of blood, foTfficacious as bleeding. 
§ 4- Pains in the Side, or Pleurodynes, 
from the Greek words pleuron, pleura, and odune, dolor, pain. 
DESCRIPTION. This difeafe coafifts of pungent pain af- 
fecting the cheil on one fide, attended with difficulty of breath- 
ing, but without any acute fever, by which it is diftinguifhcd 
from pleurify. 
CAUSES, lfi, Too great fullnefs—2d, worms—3d, fpafrus 
-—4th, adhefions—and 5th, flatulence \ to the cure of which 
mull our remedies be adapted. 
If it ariles from the first, it may be difcovered by the pain 
not being deeply feated, but afteCting only the intercoftal muf- FAINS IN TflE SIDE. 
ties, (P. 33.) the difficulty of breathing unattended with opprefiion ; 
though accompanied with a cough, flill the pulfe is unaltered, 
nor is there any febrile heat; it generally originates from catch- 
ins cold, or an obilru&ion of the rnenfes. 
O 7 
CURE. This Nature often performs by a return of the 
menfes, and indeed it will in healthful habits precede their ap- 
pearance. 
If from the FIRST, thin fpare diet, gentle diaphoretics, (No. 
1. 6 to 10.) and bleeding, are highly ferviceable ; volatile lini- 
ments, (No. 107.) muftard plaifters ; warm flannels impregnated 
with aromatics, or warm water ; bags of hot lair, or bladders, 
applied to the fide, will expedite the cure—but Ihould they fail, 
local bleeding, by cupping, and blillers to the part affedted, we 
mad call in aid. 
If from the second, there generally attends an erratic fever, 
but not of the inflammatory clafs—with a dry cough, pleuritic 
pain of the fide ; and worms are fometimes evacuated—in the 
breath there is a particular offenfive fmell—but thefe happen 
chiefly in infants. 
CURE. Though one bleeding may be fometimes neceffary, 
if the fever runs high, to abate its violence, yet the chief de- 
pendence is on cathartics, (P. 171, 172, 173.) emetics, (No. it, 
12, 38.j and vermifuges, (197,)—-tile purgatives though ihould 
be of the milder clafs. 
If from the third, it generally proceeds from fevere exer- 
cife, or Itrains ; and is mufcular— for pains in the bread from 
fuch caufes are attended with fuch fenfrbility of the part affect- 
ed, that it cannot bear the touch/ and feels as if the part had 
been bruifed.-—This though is feldom attended with a cough. 
CURE. Bleeding—with emollient fomentations, (No. 11 r.) 
oily liniments, (No. to7.) and gentle purging, (No. 3. 19 to 2a.) 
If from the FOURTH, as it proceeds from the lungs adhering 
to the pleura, occafioned by preceding inflammation, it is often 
attended with a dry cough ; fometimes with bloody lpits ; fe- 
brile affections coming on after eating, without iweating ; but 
with difficulty and fhortnefs of breathing ; great uneafinefs in 
lying on the fide affected, and pleuritic blood. 
CURE. The caufe is irremediable, alleviation of the oppref- 
five fymptoms is all for which we can hope,—and this mull be 
attended by bleeding, diluentjdrinks, oily emulfions, or linfl id- 
es, (No. bi to 84.) emollient decociions, (142.) gentle fedatives 
and diaphoretics, (No. 4 to 10J nitrous medicines, (No. 2.) and 
a thin, fpare diet—and all fuch remedies as take off lulnefs from 
the veffels, and render the circulating fluids thin. 
Jf from the fifth, the pain in the fide is ludden, and acute, 352 
PATHS OF THE ■ STOMACH. 
foon yapi flies, and refenibies the cramp ; though fometimes it 
will be fo violent for fome minutes as to become intolerable ; 
the pulfe is fmall and flow ; there is no cough ; but the pain is 
fo troublefome that it impedes the breathing. This mofl com- 
monly arifes from cold, and chiefly affects the melancholy, hy- 
pochondriacal, and thole who devote themfdves to lludv. 
CURE. Warm flannels, bladders filled with warm water, or 
bags of hot fait generally remove the complaint ; and it will 
now and then be neceffary to give fome nervous tincture, (149, 
45°*) 
Rut thefe pains, or flitches, have generally indigeflion for 
their caufe; therefore, to prevent their return, we mull proceed 
in the fame manner as we advife for affilling the digeltive or- 
gans in preferving their functions, fee DylpepCy, and increasing 
their power; in, order to prevent an accumulation of offenfive 
matter in the firfl pailages ; or crude chyle from being thrown, 
into the mafs of circulating fluids. 
If pains of the fide ihould a rife from the a£lion of any fpecific 
aciimony—we mufl proceed as before directed, (5^6.) 
§ 5* Paths of the Stomach, called Gasthodynia. 
from gajler, ventriculus, the flomach, and onunc, dolor, pain. 
Thefe, according to the peculiarity of the affections, have been 
differently denominated. 
When there is an acute and conflant pain in the region of the 
flomach, unattended with fainting,-as in the Cardialgia, or 
fever as in the Gastritis, (ct$6.) often attended with a fweliing 
in the flomach, it is called Gastaodynia. 
"When there is an uneafy fenfation belonging to the flomach, 
or epigaftric region, attended with a degree of faintnefs, as il a 
fwooning would come on, Cardialgia, from cqrdia, os ven- 
triculi, the mouth of the flomach, and «4r°h dolor, pain—for this 
is flip poled to be an a§c£tion of the upper orifice o.f the flomach. 
When the principal'fyraptom is a feufe of heat in the flomach 
and gullet, w.hicn fometimes arifes into the fauces, unattended 
with any acute fever, Pyrosis, heart-burn, from pur, ignis, fire, 
or its effe<St, heat. 
However, we think in a praflical view, they may all come 
tinder one head, particularly as the modes of treatment depend 
tipon the fpecific caufes from whence they proceed—we ihould 
fay therefore, 
Pain of the Stomach, or Gastrodymia, is difeovera- 
ble by an acute and conftant pain, unattended with any febrile 
affections—fometimes affociated with a propenfity to iaimings, PAINS OF THE STOMACH. 
at others with a fetife of heat there, and in the gullet arising now 
and then to the fauces—then called heart-burn, and not un.fre- 
quently’ with a considerable difcharge of faliva froth the mouth 
—then fly led Water Brash, or Black Water. 
CAUSES, tft, Foulnefs from indigestion—sd, flatulence—■ 
3d. bile—4th, poil'ons—5th, hard lubftances taken into the io- 
xnnch—6th, inflexion of the lower part of the breafl-bone, 
(called xyphoid, or enliform cartilage, from its being point- 
ed like a fword)—7th, gout, worms—8th, debility, ulcers, 
or excoiiations. 
CURE. From considering the caufes in the firft five, the in- 
dications are ver)7 neatly Similar, except in the flatulent, to eva- 
cuate the contents, and fo to invigorate the ftomach and inteftines, 
that digeftion not only may be properly promoted, but the re- 
mains, or what is indigeflible, may be carried out of the machine 
regularly by the i He rented power of the inteftines. 
If, therefore, it arifes from foiilfiefi of the Jlomach occafonecl by 
ihdigefiion, which pnffes not oft' Soon by vomiting, ©r purging, 
but continues, the orifices of the ftomach will be contracted, and 
prefliiig upon its contents, occaiion Severe pain, with a fenfe of 
weight, restraining free refpiration ; Sometimes the pnlfe will be 
hard and quick ; at others deuce [fed, and Slow—this will be the 
cafe where the complaint is recent, and proceeds merely from 
indigeition, and matter which the Stomach contains being in a 
crude Slate only ; but if it is vifcid, acrid, bilious, putrid, or ran- 
cid, there will be a difagreeable tafte on the palate—foul tongue 
—unpleafant eructations, added to the Uneafinefs at the ftomach, 
naufea, and load in the region above the navel, with a lofs of 
appetite; beftdes, if the matter is acrid, thefe will be a heat in 
the ftomach, the nature of wdiich will be denoted by a tafte in 
the mouth if any thing is thrown up, whether acid, fale, bitter, 
rancid, or oily ;—in cafes where the matter is merely vifcid, there 
is a kind of watery inSipid tafte in the mouth only. 
Which ever of thefe caufes are prevalent, if the habit is cof- 
tive, I clear the firft paiTages with (ome opening medicine, (No. 
108, 109.) 
Afterwards wafh the ftomach well with warm waiter and oil— 
chamomile flower tea drank, plentifully—or Stimulate the top of 
the gullet with a feather, or preferibe an emetic, (No. iz, 12. 38.) 
— if great expedition is requisite, a few grains of white or bine 
vitriol, (No. 259.) Should thecaufe be mere load from iudigeftion; 
thefe will be fufticient, giving for a lit le time a few drops of e- 
lixir of vitriol in cinnamon tea twice a day ; but Should this cir- 
cumftance often occur, Srorn the debility of the coats of the Sto- 
mach, I have reconrfe to bitter Stimulants and chalybeates, (No, 354 
PAINS OF TII£ STOMACHS 
61 to 6,7.) and recommend riding exercife, or failing—alfo the 
nfe of fome chalybeate water, particularly thofe of Bath, which 
contribute much to invigorate the tone of the ftomach—but 
fhould the offending caufe coni;ft in the quality of the offending 
matter, fuch things mull be prefenbed as counteract their pro- 
If it is of an acid nature, magnefia, abforbent earths, alkalines, 
or thofe medicines termed antacids, may be -applied to (191)— 
if acrid, the ftomach fhould be well wathed with weak chicken 
broth, or warm water alone ; then gentle aperients' fhould be giv- 
en, (No. 3. 22 to 24.) and occafioually perfifted in. 
If merely vij'cid, faponaceous medicines, (No. icgj.),are ufe- 
ful. 
If rancid, or putrid, the antalkalines, particularly the mineral 
acids, (190.) 
And in all thefe cafes the ftomach fhould be invigorated with 
ftlmulant bitters, &c. advifed (333.) and fuch mode of living 
preferibed as will prevent the generation of thefe offenlive ma- 
terials; avoiding fuch viands as are apt to turn acid, alkaline, 
vifeid, or rancid ; and perhaps the only thing we can depend 
upon for completing the cure, is a courfe of fuch mineral wa- 
ters as upoiy., trial beft fuit the conftitution, which can only 
from experiment be afeertained. 
If the complaints arife from flatulence, it is caufed by wind dif- 
tending the ltomach, and throwing its orifices into a contracted 
liate, hence there is a violent ten live pain at the pit of the fto- 
mach, with difficulty of breathing ;—the pulie grows fmall and 
depreffed—the extremities are cold, ■with great anxiety—and the 
body is often folicited to bend forwards, to promote the emiffion 
cf wind ; which always brings fome alleviation—in this cafe the 
region above the navel can hear prejffure with the hand, which it 
cannot do in inflammation of the ftomach, nor pain from fome 
other caufes. 
CURE. In full fanguinary habits bleeding is advifeable ;— 
and to remove coftivenefs glyfters, (No. 25, 26.) which is very 
often an attendant; notwithltanding which, fhould it continue, 
opiates (No. 113.) are requifite ; though, in flight cafes, pepper- 
mint water will be lufficient—till the pain has totally ceafed for 
a day or two, cathartics, even the milder ones, fhould be avoid- 
ed. In order to prevent its return, the patient fhould abftain 
from all food difficult of digeftion ; all crude, flatulent, or legu- 
minous vegetables ;—the body fhould be kept open, and a courfe 
of bitters and chalybeates be perfifted in for fome time. 
Iffrom acrid bile the pain is extremely acute, accompanied 
with vomiting of green materials like a leak, cr verdigreafe— PAINS OF THE STOMACH. 
fbmetimes yellow, with fuch tendernefs above the navel, that 
the part cannot bear the leal! prelfiire—there is extreme debili- 
ty, with great deje&ion of lpirits ; indeed the pain is fometirnes 
fo acute as to bring on convulsions. 
We rnuft proceed as recommended (353 ) where acrid mate- 
rials were the caufe ; afterwards, when the ftomach is perfectly 
cleanfed, opiates mufbbe taken internally, (lgc ) or by way of 
glytter ; and perhaps it may firft be rfeceffary to premife'bleed- 
ing, if the pain is extremely acute, to prevent inflammation.—- 
The bilious colic feems to have the fame origin, the feat of the 
affection onlv differing—to that, therefore, we muft refer. 
In cafe of poifon being the caufe, we muft proceed in the fame 
manner as in inflammation of the flomach from the fame fourc- 
es—in gout or worms—fuch remedies are ierviceable as are ad- 
vifed in thofe particular difeafes. 
If from debility, we muft proceed as directed (353 :) 
If from*extraneous bodies, which are fmall, and blunt, we muft 
have recourfe to emetics—if long and pointed, the ftomach 
fhould be kept diftended with materials of the demulcent clafs, 
f'o that an opportunity may be given for them to pals through 
the lower orifice of the ftomach, and along the courfe of the in- 
teftines ; for if emetics are hati recourfe to, there is great danger 
of their getting acrofs the upper orifice, or flicking in the paf- 
lage, and moil probably terminating fatally. 
If from the inflexion of the lower part of the breaf-bene, there 
is a conllant pain of the ftomach, attended with vomiting, lofs 
of appetite ; and from a continuance of the difeafe, a coniump- 
tivon, called ATRQpriy—the food and liquids are immediately re- 
jected as foon as taken, and the pain continues to torment the 
unhappy patient for years. 
Cupping-glaflfes applied to the region above the navel, and 
afterwards an aftringent plaifter, have been advifed. 
A reduction of it, by the manual operation of a fkilful furge- 
on, has been afterted by Uonetus—as for my own part, pallia- 
tive remedies I think the only things to be depended upon—the 
utility of which I have experienced. Keeping the ftomach as 
empty as poflible, eating fmall portions of the moil eafily digert- 
ible food, of.en in the day—refraining from all which are flatu- 
lent—taking very moderate exercife—avoiding coftivenefs, and, 
in fine, fo conducting the patient, that the ftomach fhall be but 
{lightly diftended, is all that can he done in this cafe. 
If from excoriations, or ulcerations of the flomach, or its lower 
orifice, it is the moft obftinate and dreadful, for this may conti- 
nue for many years—this is known by extreme increafe of heat 
and pain on taking any thing acrid or hot—vomits here may be- COLIC. 
come detrimental, and dangerous in the extreme—in this cafe 
nothing can be done but giving all thofe things which are foft, 
mild, and iheatfling ; and wftiat bids faireft lor relief is living 
folely upon a milk diet. 
Befides what we have here enumerated, the heart-burn will 
be attended fornetimes with an effiux of clear lymph like faliva, 
fornetimes taftelefs, fornetimes acrid like the tafte of lime, and 
pomes up at intervals in confiderable quantity. This arifes from 
a fpafmodic contraction of the ftomach, and increafed aft ion of 
vefl’eis which fecrete the thin fluids of the ftomach and falivary 
glands, (20.) 
In this cafe, the rough acerb fruits and warming vegetables 
may fie ufeful, as horfe-radiih, muftard, quince, floes, medlars, 
&c.—watery fruits and vegetables fhould be particularly avoid- 
ed, as cherries, cucumbers, melons, and fuch like ; and aftring- 
ents (lightly cordial, (No. 61 to 63.) exhibited. 
§ 6. Colic—Cplica, 
fo called from the colon, (43.) one of the inteftines, being confi- 
dered as the feat of this complaint. 
DESCRIPTION IN GENERAL. ThR is a painful com- 
plaint of the inteftines, originating from a CQnftriftion, or oft- 
ftrudlion in fome part, or parts of them, brought on by iome in- 
ternal ft Lm ulus, attended with, an acute burning pain of the ab- 
domen, particularly running round the navel, difficulty of breath- 
ing, heart-burn, naufea, or vomiting of a bilious or viicid mat- 
ter, coftivenefs, the appetite and digeftion weakened-.—a diften- 
iion and inflation of the lower belly—fhirft--high-cojoured, hr 
yellow urine, often an obftruction in making water—hiccough, 
—fainting—delirium—convuiuons, a rupture of the inteftines, 
or mortification. 
CAUSES. The remote or inducing are, fpafmodic affeftions, 
or biliary concretions, Hopping the ductus communis choledo- 
chus, (36 )—acrid, bile—different kinds of foul offenfive materi- 
als in the bowels—-hardened. fasces—worms—ruptures—-re- 
mains of, folid food—earthy or ftony concretions lodged in the 
inteftines—compreffion of them formed in. any of the contigu- 
ous vifcera-k-intiolufception, or the running of one inteftine into 
another, and there confined by fome ftrift.ure—a thickening of 
the coats by fcirrhus, cancer, See particles of lead—-unripe a- 
cid wines—-or drinking too freely of things acerbly acid—or, in 
fine, whatever is poffefi'ed of the power of inducing the 
CAUSE, proximate or immediate ;. which is a conftriftion or 
Qbftruftion in fome part or parts of the alimentary canal, com- COLIC* 
357 
suonly the upper or lower orifice of the ftomach, the lower por- 
tion of the duodenum, (42.) at the valve of the colon, (43A and 
at its flexure which it turns up under the Ihort ribs on the left 
fide, (43.) 
CHARACTERISTIC SIGNS. Pain of the abdomen, or 
lower belly, running round the navel, attended with vomiting 
and coftivenefs. 
CURE. The indications are, a removal of the conftridting 
or obftrucling caufe, by taking off the fpafms, and evacuating 
the irritating matter, from whence they deduce their origin. 
We have before treated ot' the inflammation of the bowels, be- 
tween which, and the colic attended with local inflammatory 
fymptoms, fome make a diilindtion ; this may be fyflematically 
right, but cannot be of any practical utility ; for the mode of 
cure mull obvioully be the fame—though we muft obferve, that 
the colic with any acute fever, or quick pulfe, heat of the 
whole body, fweat, &c. appears only to be a flight inflammation 
of the inteitines from fome local caufe, not producing general 
inflammatory fymptoms. 
Rut the colic pain will fometimes be attended with great de- 
gree of flatulence, from the air in the bowels being rarefied, and 
expanding itfe'lf— hence pain,*diltenfton, coftivenefs, and rolling 
of wind in the lower belly—if the coniiriilion of the bowels 
continue long, their motion downwards, called periftaldc, will 
be inverted, and vomiting the confequence. 
That it is from wind which occalions the ftrongeft fymptom, 
is very obvious, by the alleviation from pain by the dilcharge of 
it downwards ; from the pain purfumg the whole tradt of the 
colon, (43.) or running round the lower belly, appearing alfo to 
affedt the llomach ; but that alFedtion fubfiding by the palling 
down ot wind, or its change of fituation ; on prelFure by being 
mitigated rather than increafed ; and by not being attended by 
any remarkable thirft, or alteration of the pulfe. 
At other times, it will have for its all'ociate bilious vomiting, 
which is difficult to reft rain the patient will alfo have fome- 
times a number of bilious ftools—when vomiting of green-colour- 
ed matter is the leading lymptom, thefe attend heart-burn,, 
loathing of food, hoar fen els-, hiccough, heat, thirft, and bitter- 
tiefs of the mouth— the urine is high-coloured, and made in 
fmall quantity. 
When bilious Jlools, the pain attendant generally affedts the 
■whole inteitines, particularly the duodenum, (42.J-—the lower 
belly is neither tenl'e nor hot, as in inflammation of the bowels 
»—the patient is affedted .with giddinsfs—the pulfe is quick, 358 
COLIC. 
though neither hard nor tenfe—and this difeafe is often fuccecd- 
ed by the jaundice. 
In all thefe com plaints, where the pain is very acute, bleed- 
ing fhould be had recourfe to, though no inflammation fhould 
actually exift, in full habits particularly, very early to prevent 
that lymptoTi fupervening.—Emollient oily glyfters, (No. 25, 
26.) ■warm fomentations, friction, and chamomile tea, in flight 
and common cafes, will fubdue the complaint—but when more 
obstinate, chicken water fhould be drank plentifully ; then glyf- 
ters thrown up occaflor.ally, and lepeated—if the fir(1 does not 
anfvver, a feccr.d Stronger, (No. 114.)—Ihould thefe be ineffica- 
cious, oily purgatives may be tried alone, (No. 66, 99.) or mix- 
ed with Rochelle fait, and continued till a free evacuation is 
produced—caftor oil is the molt efficacious, as it often alleviates 
pain before it procures any evacuation, which it alfo does very 
quickly. 
Sometimes liquids will be reje&ed, purgatives then in a folid 
form mult be tried, (No. 1 15 ) and continued every hour till the 
wilhed-for effe£t occurs—bat ihould the attendant pain be ex- 
tremely fevere, with cathartics we may couple opiates ; or feda- 
tive medicines may be given full, and a fmall time afterwards, 
purgatives—by thefe means fometimes the gentler purgatives 
will anfwer every purpofe—bags filled with fait, cats, boiled 
bran, or water made hot, may be applied to the belly. 
But Ihould there be any fufpicion of inflammation, the ftrong- 
er ilitnulant cathartics mult be avoided—the Epfom fait folu- 
tion, (No. 97.) is preferable to other purgatives ; for, dilfufed 
in that way, it is always pleafant, and gentle in its operation. 
We Ihould always inquire in thefe cafes, whether there be any 
rupture ; for, from the it 1 angulation or the inteilines pufhed out 
into the lac externally, this complaint fometimes arifes. 
In order to flop the vomiting, the laline draught in a ftate of 
fermentation (No. 59.) fhould be tried—fedative glyfters, (No. 
116.) and philters of mithridate, may be applied to the flomach 
—leaves of common garden mint, boiled in port, and laid on the 
pit of the ftomach and wrifts, have been found fometimes fupe- 
rior to every other application. 
Should there be any appearance of bile copionfly difeharged, 
foftening glyllers, fuch as decoction of linfeed and marfh-mal- 
lows, with oil, fhould be had recourfe to—acidulated drinks alfo, 
with lemon or orange juice, vinegar, apple-water, &c. chicken- 
water, fedative emulfions, (No. Bj. 83.) to which may be added 
thirty or forty drops of the tincture of opium, if the pain is vio- 
lent—and the patient fhould be put into a warm bath, and re- 
main in it fo long as he can bear it without diltrefs. NERVOUS COLIC. 
359 
If this complaint, from a bilious caufe, fliould return, which 
it is apt to do, a courfe of faponaceous and deohdruent medi- 
cines, (No. 11 7.) with Seltzer waters, or the water of Bath, or 
Aix la Chapelle, fihould be had recourfe to, in hopes of perform- 
ing a radical cure. 
So difficult is it fometimes to procure a paffage through the 
inteflines, that when the gentler cathartics fail, the mod power- 
ful ought to be tried, (No. 108. 115.) to which may be added 
from half a grain to a grain of opium ; or opiates may be given 
with liquid purges, No. 97. to 99 ) tobacco girders, two drams 
of the leaves in decoclion, or fmoke, or tilings which a£l by 
their weight, have been recommended, quickfilver, two or three 
ounces, fwallowed in a little broth every turn or three hours, or 
leaden bullets ; or taking the patient out of bed, and dafhing 
cold water on his legs and feet, while he dands barefooted on a 
cold flag, has been attended with fuccefs. 
A purging once procured, it fliould be continued fome days 
by the ufe of cathartics, giving opiates at night, until the fore- 
nefs and diflenfion of the belly go off, and no hardened faxes ap- 
pear in the llools. 
§ 7. Nervous Colic. 
In this complaint, contrary to the other, the vafcular fyftem 
feems but (lightly, if at all affe&ed : for the pain will continue 
extremely fevere for five or fix days; fometimes for fourteen or 
fifteen; yet the pulfe will not be quicker, or more didurbed. 
than in health; nay, indeed, it has been fometimes flower. 
It is called rachialgja, from the Greek words taxis, fpina 
dorfi, the fpine of the back, and algos, dolor, pain ; becaufe the 
origin of the complaint.has been attributed to an afFeclion of the 
fpmal marrow—alfo the colic or Poictiers, becaufe there it 
is endemial, or peculiar to the country—Devonshire and 
West Indian colic, from its being common in tliofe coun- 
tries— PAINTERS, PLUMBERS, POTTERS, MINERS, from their 
being mod fubject to it, and saturnine colic, from its fre- 
quently affecting the makers of white lead, or the icception of 
the particles of lead into the habi\ 
DESCRIPTION. This complaint is attended with very fe- 
vere pains in the back and loins, as if it was in the center of 
the mefentery, (46.) whicii do not increale on prefiure—the,na- 
vel is very often drawn inwards, and the inteflines fometimes 
alfo to the fpine; fo much fo, indeed, that the forcing up of gly- 
fiers has been impracticable—the body is coftiye, and the com- 
plaint extremely obdurate ; fometimes terminating in torpor, or 360 
NERVOUS COLIC. 
numbnefs of the hands, and palfy; at others, in chronical fixed 
contractions of the limbs. 
CAUSES. The remote or inducing are, particles of lead re- 
ceived into the habit—or the fmoke from lead—or drinking wa- 
ter which runs over its ore—unripe acid wine—cyder—punch— 
and white wine not fufficiently fermented—eating or drinking j 
too freely, or too frequently of things acerbly acid. Theproxi- j 
mats or immediate, fimilar to that of the colic, ('356.) and the i 
characterijlic Jig ns alfo, if we add, the pain creeping more par- • 
ticularly to the loins and back, with a retra&ion of the navel, j 
and fometimes of the inteftines, inwards. 
CURE. Before the complaint is confirmed, in the beginning, 1 
fuccefs may be expe&ed from the application of fuch glyfters as 1 
were before prescribed, (N®. 25. 26.) adding to them caltor oil, 1 
and keeping the body open with emulfions of the fame oil, (No. ] 
66.) with which two or three ounces of tin&ure of fenna may 
be mixed. 
Cold mnft be avoided, and a very light eafily digeflible diet 
ftri£tly adhered to. 
But in the more advanced Rage, where there is generally a 
vomiting of green bile, the difeharge is to he encouraged by drink- 
ing freely of thin weak broth—the hardened excrements evacuated 
by repeated glyflers—an alleviation of pam procured by more than 
common dofes of opium, (152.) and thefe repeated—the belly 
muft be fomented with warm fomentations, (No. 85. 111.)— : 
wrarm bathing partially ufed—and the umbilical region blifter- 
ed. 
I have fometimes found great benefit by opiated emulfions, 
(No. 118.) given till ftools were procured freely \ afterwards o- 
piated antimonials, (No. 119.) occafionally giving the emulfion. 
In Charleftowu they adopt the following fchetne : 
Fir ft, they bleed, then give the gtyfter, (No. 114.) and re- , 
peat it two or three times, till a ftool or more are procured—if 
this does not alleviate the pain, then an opiated glyfler, (No. 
116.) and the following morning exhibit the vitriolic mixture, 
(No. 120.)—the effects produced are generally a difeharge of a j 
great quantity of acrid bile, for the firft four or five days, up- 
wards and downwards, which by degrees grorvs lefs, leaving, 
gradually only a flight naulea, a few yellow ltools daily, and 
iometimes not any. 
Broth, gruel, and panada, are allowed as diet—if fuch food 
is loathed, about the eighth day, bread and boiled chicken are 
allowed, with rum plentifully diluted as beverage—all ferment- 
ed liquids and acids are prohibited, and fo is four punch, for PAIN OF THE LIVER. 
fome months ; ana the patients return to their common mode of 
living by flow degrees. 
If a pain in the flomach continues, which is fometimes the 
cafe, rhubarb is advifed, and a plaifter of galbanum applied to 
the flomach. 
Though death by thefe means fhould be avoided, not nnfre- 
quently a palfy fucceeds. This complaint has been relieved, 
fometimes cured, by rubbing the limbs arid doxvn the back a- 
long the fpine, with Barbadoes tar and rum, or rock oil, (75c.j 
—the Barbadoes tar, or balfam of Peru, taken internally, has 
been thought ferviceable. (No. 121.) 
But fhould thefe not fncceed, change of climate, fea voyage, 
or the natural hot baths, are the only remedies fiom whence 
fuccefs is to be expected. 
§ 8. Pain of the Liver, or Hefatalgia. 
from epar, jecnr, the liver, and algos, dolor, pain. 
When pain affects the liver, as well as fpleen, it is very often 
impofiible to diltinguifh them from fome of the fpecies of colic, 
during the lire of the patient ; nay, ind- ed, fome practitioners 
think it unrieceffary, fm.ce they require the lame mode of cure 
as the colic from a bilious caufe, (358, &c ) 
But as thefe a rife. frGm different caufes, it may not be ufelefs 
to delcribe fome of them; viz. thofe which arife from fthirrhoji- 
ty, or hard tumefaBion of the liver, (33.)—ohfiruciions of the 
gall duBs, (33.) from very vifcid bile—the all bladder (33.) be- 
ing alfo full of bile—and gall fonts, to called. 
When pain of the liver owes its origin to SCHIRRHOSITY, it 
is. attended with the following fymptoms : 
DESCPvi PTIOiS. There is a tumor and hardnefs on the 
right fide below the (Port ribs— fenfe of weight, with a dull 
and ten live pain, which is conftant—the patient breathes with 
' difficulty, and has a dry cough- and, after eating moderately, 
there comes on a loathing, and fenfe of preflure on the llcmach, 
with an increafe of the difdcu’ty of breathing—befides, he can- 
not lie with eafe on his left fide—the countenance is yellow ill), 
pale, and fallow—the urine o'ten of an orange colour, and de- 
posits a thick mucus fediment—rhefe are generally the fir It ap- 
pearances, which, if the complaint continues, as is too frequent- 
ly the cafe, the feet are feized with a lo:t party fweiling — the 
fuperior parts fall away—and the conclufion is, a dtopfy of the 
belly, with a remittent fever. 
When the caufe is obstruction of the gall ducts, from 
biliary or vifcid obilructions, the fymptoms of a fchirrhous liv- 362 
t* AIN OF THE LIVER; 
er, which come on in the beginning, attend but in a much' 
{lighter degree—bcfides, there is a flulliing heat of the face, with 
rednels and heat coming on noW and then in the palms of the 
hands—an irregular third—drynefs, and bitter taite in the 
mouth—a dry cough —vifcid faliva—lofs of appetite—heart-burn 
>*—wearinel's and heavinefs of the limbs—increafe of pain on 
touching and p re ding the left fide—and the habit mod common- 
ly codive—in this cafe the hardnefs on the light fide is not fo 
firm as in the former, nor are there any pafty lwellings, or hec- 
tic fymptoril3. 
When it arifes from gall stones, there is a deep-feated and 
excruciating pain on the right fide of the ftomach, extending tot 
the back, about the place where the ductus communis choledo- 
Chus, or duel of the gall-bladder, (36.) is infeited into the duo- 
denum, (42.I which remits and increafes ; the patient complains 
6f ficknefs, and vomits much—the right fide is didended with 
flatulence — the belly coflive — the excrements pale-coloured* 
fometimes white—the pulfe is weaker, but 1'carce at all quick-; 
cned, U'defs the pains are very violent, and continue long—in- 
deed, the violence of the pain heitig unattended with fever, and 
quicknefs of the pulfe, is confidered as the certain fymptom of 
this difeafe— the patient, either in an erect poflure, or lying on 
the left fide, feds much uneafinefs—hence becomes reftlefs—- 
there attend alfo difficulty of breathing—heart-burn, and fome- 
times convulfions—at fird the urine is pale, afterwards yellow 
•c-and the lkin and white of the eyes have a jaundice-like ap- 
pearance— the pain at lad vaniflies luddenly, which is fometimes 
fucceeded by a loofenefs, by which the gall dories are thrown 
out of the habit—and the yellownefs weais graduallv away. 
CURE. Pain in the liver from fchirrhofity, (361-) is apt to 
attack gluttons—hard drinkers—thofe who lead indolent fluggidx 
lives—and alfo arifes from fupprefiion of lbme hsemorrhages— 
trnifes upon the right fide --and very often in thole airlifted with 
long-continued intermittent fevers—and generally proves fatal, 
when once completely formed-—though, it attacked in the be- 
ginning, it may be fometimes prevented. 
Decoctions of vegetable ap-rients, with the more powerful at- 
tenuating gums, (No. 1 174) joined with mercurials and cathar- 
tics, (160. 172 to I 73 ) are ferviceable ; alfo grafs-roots, dande- 
lion, endive, ammoniacum, myrrh, rhubarb, aloes, calomel, 
final! doles, not to l’alivate; hemlock, (152. ) in all curable 
cafes is very ufeful. 
In constitutions confidcrcd as dry and bilious, (60.) decoc- 
tions of the mild opening loots, goat’s whey, and tartarizid i- 
TOIl. PAIN OF THE SPLEEN, 
Tn the cold and phlegmatic (6o.) the mode here recommended 
will be proper when the complaint arifes from qbftrudlions of 
the biliary pores; but, in delicate and irritable habits, lpafmo- 
dic affections will fometimes be the caufe, fedatives and antifpaf- 
modics may then be joined with the apeiients, afafoetida, cam- 
phor, (149. 15c.) or with opium, (152.)—and when, by thel® 
means, the bile has palled into the bowels, a courl'e of bitters 
and if eel may be neceffary to complete the cure, (No. 61 to 64.) 
—taking care always to keep the body open with fuch medi- 
cines as are bed adapted to move the bile. (No. 108. 117.) 
Bath water, and chalybeate fprings in general, are beneficial 
and proper to prevent a relapfe. 
When it arifes from GALL STONES, we mull endeavour to 
promote the expulfion byr long perfeverance in the ufe of emol- 
lients, (142.) and gentle cathartics, (170, 171, 172.) (No. 66. 98, 
99O—warm baths afterwards, oceafionally repeated, in which 
a cathartic may be given—this mode has proved fuccefsful—-vo- 
mits, and flrong expiration, with glyllers of frefh urine, and 
fage infufion, have fortunately fucceeded—opiates fhould be ad- 
miniflered to alleviate the pain, joined with aperients ; becaufe 
they promote at the fame time a relaxation of the dutt—setheri- 
al fpirit of turpentine, (No. 122.) has been recommended as a 
folvent. 
In habits full of blood, in any of thefe complaints, bleeding 
may be had recourfe to, left inflammation fhould be the confe- 
quence of the violence or long continuance of the pain. 
Old people and women are molt fubjedt to this complaint— 
thofe who lead fedentary lives, drink much of flrong ardent fpi- 
rits, feed on vifeid, coarfe, and diy aliment, or are fubjedt to 
the ftone and gout. 
In order to prevent a return of thefe complaints, gentle exer- 
cife, particularly riding on horfeback, fhould be perl'evered in j 
light eafily digellible food taken, avoiding all that is vifeid. 
§ 9. Pain of the Spleen, or Splenalgia. 
from ffile/i, the fpleen, and afoot, dolor, pain. 
Here, as in the liver, the difeafe arifes from fchirrhoflty and 
obftruclion. 
DESCRIPTION. When from the first, it is difcoverable 
by a hard tumor occupying the feat of the fpleen, (58 ) and re- 
fembling its figure, attended with a fenfe of weight—the tumor 
is fometimes wonderfully large—fucceeds a quartan intermit- 
tent, and often runs into a dropfy'of the belly—-the complexion 
of thcfe labouring under this complaint is of a lead colour— 364 
PAIN OF THE SPLEEN. 
they grow v'erv thin—are oppreffed with difficulty of breathing 
■—and have a fenle of weight, drawing the throat downwards 
towards the left fide—they complain of oppreliion at the do- 
mac!) after eating—at lad their lect become pally, and they lome- 
times have ulcers of the legs. 
When from the second, it does by no mean« refemble the 
figure of the fpleen, neither is it hard or circumlcribed—the 
pain is more acute ; which, on the fcirrlius being foimed, be- 
comes dull—attended with a fenfe of greater weight. 
In this there is perceived a load on the left iide, afterwards 
feme acute pain, particularly raifed in running and walking— 
the colour of the face changes to one more livid—there is an 
univerfal laflitude—difficulty of breathing from exerciie—fome- 
times a dry cough—now and then a palpitation of the heart—■ 
eruptions break out—the patients become hypochondriac— 
have ravenous appetites, &c.—and the difeafe is extremely ch- 
ili nare. 
CURE. The mode is fimilar to what has been delivered on 
the pain of the liver from obdru&ion. (361.) 
CHARACTERISTIC GENERAL SIGNS. Thofe of the 
fpecific caufes mud be recolle&ed from the particular deferip- 
tions—the general ones are, an uneafy, dull, tenfive fenfation, on 
the right or left, according whether the liver or fpleen is af- 
fe<5led ; being free from that fpecies of fever which attends in- 
flammations of thofe organs. 
§ ic. Pain in the Kidneys and Ureters, or Nephral- 
gia. 
ft'btn nephron, ren, kidneys, and algos, dolor, pain. 
This difeafe proceeds either from iinall fand-like appearances, 
or from a ftony fubfiance a dealing the kidneys-or ureters,(48. 
—in the firft cafe it is called gravel, in the half stone in 
THE KIDNEYS ; both which \vc flia]] treat under one head, as the 
mode of treatment of the former is linailar to the more gentle 
method ufed in the latter. 
DESCRIPTION. The gravel, is mod common to old men, 
the ftudious and fedentary, and thofe whofe trades oblige them 
to lit long confined in one pofture, as coblers, weavers, watch- 
makers, &c.—feldorn affedls the kidneys, but much more com- 
monlv the ureters and,urethra, (54.) occafioning oftentimes ve- 
ry great pain Which abating, fmall Hones like lentil-feed, but 
rough, red, and very hard, are paffed at that time with the u- 
,yine—thcfe leldom flick in their pafl'age, and are fcarcely dif- 
folvablc by any known lithontriptic. (198-) PAINS IN THE KIDNEYS AND URETERS. 
When there is a ftone in the kidney, there is genernllr an ex- 
cruciating pain in the loins, fixed and permanent, on that fide 
where the ftone lodges—the patients complain of heat—the bo- 
dy is coftive—and the fymptoms are aggravated alter eating— 
when it falls into the ureters, the pain is increai'ed, and extends 
along their courfe obliquely in the belly over the hip towards 
the bladder—men have at this time a painful affeifticn, or draw- 
ing up of tefticle, women a numbnefs of the thigh and leg—ha li- 
fe a and vomiting frequently occur—the urine is in part iuppreff- 
ed, and puts on various appearances ; at firft it is watery, after- 
wards more copious and turpid ; frequently hot, and often bloo- 
dy, or purulent—a difficulty of making water, or rather a total 
fuppreffion, comes on—great drowftnefs—inflammation—ulcera- 
tion—and confumption. 
But it mu it *be obferved, that a ftone may be lodged in the 
kidney without producing any uneafy fenfation, unlefs moved 
by a hot regimen, or mode of living, violent paffions, ftrong 
exercife, or jolting in a carriage over rough ftony pavements. 
CAUSES. The remote or inducing are, luxurious living, with 
weak digeltive powers—gout and rheumatifm—old age—feden- 
tary life—keeping much in bed, or in an horizontal pofition— 
drinking wine loaded with tartar, or water full of earthy or fan- 
dy matter—peculiarity in the conftitution to form this ftony fub- 
llance—or an hereditary taint. The proximate or immediate need 
no fpecification 
CHARACTERISTIC SIGNS. A fixed pain in the region 
pf the-kidneys a.id ureters, unattended with any acute fever, fuch 
as accompanies the inflammation of thefe parts. 
CURE. the indications are, to abate the uneafy fymptoms, 
by taking off the fpafmodic aft’edlion of, fneathing and relaxing 
the parts, and facilitating the progrefs of the offending caufe, 
that it may be evacuated—which purpofes will be promoted by 
bleeding, emelliefit and demulcent decoctions drank plentifully, 
fedatives, chiefly opiates, oily emullions, and mild aperients, &c. 
(See Inflammation of the Kidneys. 943.) 
All heating or llimulating diuretics are to be avoided, parti- 
culaily .' here calculi are fixed o-r very obftinate to remove ;- for 
they are apt to aggravate the painful l’enfations, and bring on in- 
flammation--infufion of wild carrot-feed, (No. 123.) has beep 
kno ivn to give confiderable eafe—a folution of kali impregnated 
with fixed air, (199.) given two or thiee times a day, and cabrie'd 
as far as the ftomach will bear it, is in this cafe peculiarly appli- 
cable—the leaves of the bear’s w'ottle berry, (139-) is here alfo 
beneficial—from decoftion of raw coffee, twelve berries boiled 
ja a quart of water till it becomes of a deep greeailh colour, to 366 
PAIN tN TI-IE KIDNEYS AND URETERS. 
eight or ten ounces, with twent}T drop” of aethereal fpirit of ni- 
tre, twice a day for two months, great relief has been derivr 
cd. 
Still, foap leys, (199 . taken in milk or veal broth, or foap and 
lime water, (199.) are confidered either as perfect folvents, or 
rendering the rugged furfaces and fliarp points lefs capable of in- 
juring the fenftble membranes, where thefe hard bodies pafs 
through or lodge. 
But foitietimes a fmall ftone will pafs through the ureters in- 
to the bladder, and from thence makes its exit: here then the 
difeafe terminates in the molt favourable manner; hut if it 
fhould be too large, it remains theie, forming a balls, called Nu- 
cleus, for a larger ftone—indeed, any hard tubflance lying in the 
bladder will give rife to this complaint in confutations repletq 
with flony matter—in this cafe it is termed, 
Stone in the Bladder, or Litiiiasis, 
from Ihhon, lapis, (lone, 
DESCRIPTION. In this difeafe, there is generally a pain in 
the bladder, efpecially about its neck, and oftentimes bloody u- 
rine after riding on horfeback, on being jolted much in a carri- 
age, a fenfe of weight, in the perineum, or part immediately be- 
fore the anus, with an itching of the glans penis, (5.5-) a ftimy 
fediment in the urine, and frequent lloppages in making wa- 
ter. 
But if the ftone fhould he fmooth, of a round form, it mav lie 
a conliderable time before it is perceptible to the patient, till by 
its increafe of weight, acquired by acceflion of frefh matter, it 
creates uneafv fenfations—but fhould it be angular, or have a 
rugged furface, yet lmall in fize, it generally occalrons pain and 
bloody urine, or a difcharge of llimy fluid, with a fruitlefs 
effort to go to fiool, called tenejmus, and difficulty of making 
■water. 
All thcfe fymptoms though are fallacious—examining there- 
fore with the inftrument called a bTAFF, ufed by furgeons for 
difeoveving the ftone in the bladder, is chiefly to be depended up- 
on ; and 1 believe, when one is found too large to pafs, cutting 
is the only remedy, which muff be committed to the hands of a 
fkilful and judicious operator. 
Of the cure by internal remedies, we mull refer to what has 
been faid above in the cure for pain in the kidney and ureters, 
proceeding from calculi there. 
In this place may be inferred tkofe complaints where the uri- STONE IN THE BLADDER. 
367 
rtary paiTages aveafle&ed, and properly divided into three, accord- 
ing to the nature of the alfecdion—as 
1. A Suppression or Retention of Urine, 
named Ischuria, from ijko, cohibeo, to reflrain, and ourort, uri- 
na, urine. 
2. Strangury—Stranguria, 
from Jtrartx, gutta, drop, and aureo, to make waters—when wa- 
ter is made by drops as it were, and there is a perpetual propea- 
fuy to make it; 
3. Dysury—Dysuri A, 
from dus, infeliciter, painfully, and oweo, tvhen the ftrangury is 
attended with heat, or a fenfe of fcalding. 
The FIRST may arils from inflammation of the kidneys, or a 
flone, and becomes a fymptom, and then mult be cured as ad- 
vifed in cafes of nephritis, (342.) and nephralgia, (364.) but forne- 
times it derives its‘origin from mucus thrown into the vefiels 
of the kidneys, (48.) in fuch a degree as to hinder almoil the to- 
tal fecretion of urine. 
DESCRIPTION’. In this cafe there is generally a fmall 
[quantity of turbid urine made, without any pain ot the region 
[below the navel, or iwelling over the bone at the lower part of 
[the belly, called os pubis, or any figns of the (lone or gravel 
bat a dull, heavy pain over the loins ; and this happens in con- 
flit utions which are generally phlegmatic, (60.) mucous dif- 
eafes having preceded, and mine before made loaded with mu- 
cus. • 1 ifjj 
CURE. Stimulating diuretics, (175, 176.) fitch as mallard, 
horfe radiih, with fcjuills ; alfo foap, (177.J in order to clear a- 
way the mucus, free the urinary vefiels, leave at liberty qnd'fo- 
licit the lecretory vefiels of the kidneys to perform their office ; 
for in thefe cafes we find little or no urine comes into the blad- 
der. We mult obferve,.fh-at when the fupprejjim is total, there 
lean be little or no hope of giving relief; it is only in cafes where 
lit is partial, that our eipiedtsftions with fuccefs can be flat- 
tered. ' - 
1 When the urine is retained in the bladder, we obferve a fwell- 
jing of the loweft part of the belly above the bone {kuated at the 
■bottom, attended with pain, and often a ieufe of fulnefs, and 
jpukurc at the neck of the bladder. 368 
Dysury, 
CURE. Whatever the caufe, the mode of relief is fimiiar ; 
if the pain is great, blood fhould be taken away, and teribintlii- 
nate glyflers, (No. 124.) thrown up ; fomentations 11 x.) 
Ihould be ufed to the belly; the patient fhould be kept perfect- 
ly quiet; the Catheter, or an inftrument to draw oft the u- 
rine, be as foon as poflible made ufe of ; and fhould the reten- 
tion return in eight or twelve hours, the operation mult be re- 
pca.cd, and this occaflonally till the caufe creating it be removed, 
which may be various, and depend on other difeafes of the ma- 
chine—as paralytic affeElion of the bladder—-/welling of the piles 
~T—indurated excrements—- fungus /swellings in the urethra, (p. 94.) 
---tumor of the profir ate gland, (p. 54.) hyjlcncs, ulcers, feirrbus, 
or cancer of the bladder-—pregnancy ; for the cure of which we 
mult apply to thefe things which are advifed in fuch of thefe 
complaints as appear to be the adding caufe. 
In the second and third Division we find water palfes 
from tire bladder but with painful fenfations. 
DESCRIPTION. Befides the effort to unload the bladder by 
palling urine by drops, and with great pain, and fometimes fcald- 
ing, the liimulus, after a fmall quantity of water has been 
made, goes off, and foon returns; the feverifh affedtions 
are increafed, the fkin grows hot, the belly fwells, at the lower 
part, particularly the penis, and the part running to the anus, 
appear full; the body is in general coftive ; and tuere are fre- 
quent efforts to go to ftool; there is alfo a perceptible pain in 
the back and lower part of the belly, an uneafinefs at the pit of 
the ftomach, and vomiting femetimes attend. 
CAUSES. Thofe which are confidered the remote or induc- 
ing are laid to be—an acrimonious difpofition of the humours; 
cantharides internally taken; the application of bliflers ; and 
matter carried from the kidneys, or tranflated from any other 
of the ulcerated vifeera; flrongly ftimulating injedtions, or 
venereal ulcers of the urethra, (54.) inducing inflammation, ex- 
pofiug the anus to the cold air, particularly during the opera- 
tion of fmart cathartics ; an inflammation of the redtum, (45.) 
or fnppreflion of the piles. 
The proximate, or imme diate, an inflammation of the fphindter 
{51.) of the bladder, or a deprivation of the mucus which de- 
fends it from feeling the irritating power of the urine, as it pafT- 
es through it. 
This difeafe is bv no means dangerous, and terminates in the, 
fame manner as do other local inflammations, though extremely 
rarely in mortification. 
CURE. This requires no mode of treatment different from, 
•ther local inflammations, particularly that of the bladder, .(344.) dysury: 
369 
s&rdy we fhould ohferve great caution is nec-effary in attempting 
to p-Ts the catheter, left we fhould increafe the irritation ; and 
indeed fhould that operation be impracticable, a punCture may 
be made into the bladder in cafe of great emergency, through 
the perineum, the part which lays forwards before the anus ; 
fome recommend it over the pubis ; bat the former is much 
the more eligible; in thefe cafes glyfters of warm oil, and tinc- 
ture of opium, are highly beneficial. 
§. Rheumatism—Rheumatismus, 
from rso, fluo, to flow down, or upon, as the ancients confidered 
it to aiife from a defluxion of fome humour on the particular 
■part affe&ed. There are two other complaints properly come 
tinder this head, called 
Hip Gout, Ischiatica, or Sciatica, and the Lumbago, 
■deriving their names from the parts they affect; the former at- 
tacking the hip, Ischium, and the latter the loins, Lumbi*—• 
hence their derivations—hence the rheumatifm is confidered as 
general and local ; and it is all’o attended with febrile affec- 
tions, frequently—fometimes not—hence fly led acute and chro- 
nic. 
DESCRIPTION. When it affeCts the habit generally, it 
begins with a coldnefs and fuivering, which are fucceeded by 
heat, reftleffnefs, coldnefs, and heavinefs of the limbs ; the bo- 
dy is commonly coiiive, the patient complains of third, and the 
pulfe is quick and hard. 
To thefe fucceed in a little time acute pain, attacking parti- 
cularly the large joints, tendons, and their expanfions running 
along the courfe or the mufcles; which pain is increafed on mo- 
tion, often changing its fituation, and where infixes there comes 
on fwelling and inflammation ; it fometimes attacks the head 
and itomach, and very often all the febrile lymptoms will go off, 
and leave the pain remaining. The blood taken away has the 
appearance of that of pleuritic patients ; this is called the acute 
Rheumatism ; bat when it is not attended with febrile affec- 
tions, the pain flies from one part to another, giving a fenfe of 
ltiffnefs to the mufcular or ligamentous parts, and is feldom at- 
tended with any fwelling. 
When the pain recedes internally, there arifes much uneafi- 
■nefs and inward ltiffnefs, which on re-appearing go off. 
When it attacks the Hip, it impedes the free motion of 
the leg, occafioning pain and an halting in walking, or drag- 
ging of the leg ; the pain often defcends fiom the hip along the 
thigh and leg to the feet; and it is fometimes attended with a RHEUMATISM. ' 
violent fever ; in this cafe the feat of the affection is fometimes 
in the joint of the hip, and at others in the nerve called feia- 
tic. 
When it seizes the Loins—In them there is a very acute 
pain, with great difficulty in raffing tilt body into an eredt pof- 
ture ; fometimes the pain defeends to the lower part of the back, 
to the thigh-joint, or through the fides towards the bladder—• 
here the mufcles of the loins, or the ligaments of the vertebrae* 
are the feat. 
CAUSES. I’be remote, or inducing, are, an expofure to cold 
fuddenly whilfi hot, too great lots of blood, or feveie purging, 
hard drinking, immoderate venery, indigeflion, a vitiated date 
of the fluids from other difeafes, a too great fullnefs from evacu- 
ations fuppreffed, and often from quick changes of the weather* 
The lumbago will alfo be brought on by lifting too heavy 
weights, in habits difpofei to rheumatic affedtions. 
The proximate, or immediate, have been fuppofed to be a vif- 
cid acnmoniousTerum oblirudting the ferous and lymphatic vef- 
fels of the mufcles, but particularly of the membranes, or li- 
gaments ; or rather a peculiar acrimony, eledtiveiy affedting 
the larger joints, membranes, and tendons of the mufcles. 
CHARACTERISTIC SIGNS. This difeafe arifes from an 
external, and, lor the mod: part, from an evident caufe, attended 
with pain about the joints, following the courie or the mufcles* 
stffedting the knees and the larger joints rather than thofe of the 
bands and feet ; lometimes the hip, mufcles, and vertebrae of the 
loins : frequently hav ing febrile all'edtions for its afiociate, fome- 
times not. 
CURE. When it is attended with febrile fymptoms, we muft 
have recourfe to bleeding, and that repeated according to the 
llrength of the patient, and violence of the inflammatory affec- 
tion ; and two drams of nitre diiTolved in a quart of water-gru- 
el fweetened with honey, and acidulated with lemon juice, forms 
not an inefficacious remedy, giving a tea cupful every fecond 
hour, throwing up cccafionally glyflers, or giving occafionally 
cooling purges, to keep the body open, (P. 171, 172. or No. 3. 
24.)—to the nitre may be added one-eighth of a grain of 
tartarifed antimony in each dofe, or to the purgatives. 
Or the antimonial nitrated powder, (No. n,5.) with the vola- 
tile faline mixture, may be given every five or fix hours, (No. 
126.) adding two or three grains of the powder to the night 
dole. 
Should thefe not keep the body open, glyflers may be given, 
or aperients added to the powder or mixture. 
Thefe generally abate the febrile fymproms, mitigate the pain, RHEUMATISM. 
371 
and evacuate the acrimony, by keeping up a continued, gentle 
perfpiration. 
When the difeafe is on the decline, the rapidity of the fever 
and the violence of the pain are abated, not before—fleams of 
warm water may be conveyed to the parts affected, or friction if 
the parts can bear it, or liniment of water of acetated ammonia, 
and oil may be rubbed warm into, and a flannel worn over the 
part. 
After fufficient bleeding, and emptying the inteftines, partial 
or general warm baths have been found to give great relief; and 
our patients Ihould ule the fame fort of diet as recommended in 
inflammatory fever, (212. to 214.) but when all the febrile fymp- 
toms begin to abate, muftard whey, (No. 127.) will be aif ufeful 
drink. 
Now from experience we find, though the crifis of this com- 
plaint happens either by fiveat, or urine dropping a yellow fedi- 
rnent, looftnefs, ordepofiting an humor upon the exterior furface, 
particularly the legs—ftill it is belt conveyed out of the ma- 
chine by the pores of the fkin—hence a courfe of diaphoretics 
are advil'ed, and the patient ordered to lie in blankets in prefer- 
ence to linen, in order to add to their efficacy. 
When the pain goes off, and the fever fubfides, the diet fhould 
be more fubftantial ; and with intent to clear the conftitution 
as perfectly as poflible from the remains of the offending caufe, 
a decoftion fhould be taken of diaphoretic woods, (No. 88.) or 
the compound deco&ion of farfaparilla—fhould ulcers happen 
upon the legs; they Ihould not be dried up too foon, for fear of 
imprudently repelling the humour to fome internal part, which 
might prove more dangerous. 
But fometimes, after the febrile affe£lions are totally gone off, 
the pain ftill continues, and here we mufl labour to attenuate 
and throw out the acrimony which creates the painful affedlions, 
by a courfe of gentle diaphoretics—fuch as compound powder 
of ipecacuanha—or antimonials (230.) joined with opiates, in 
order that reft may be procured, and the patient’s flrength flip- 
ported. 
Stimulants are here alfo required, as tincture of guaiac, 30 or 
40 drops upon l'ugar, and mixed with peppermint water, three 
or four times a day, or gum guaiac, made into a draught, with 
30 or 40 drops of fome volatile fpirir, (No. 128.) or gum guaiac, 
and quick lime, equal quantities, well rubbed together—then 
lime water poured on, and when it has flood feme time, decant 
the limpid part—to this add a few drops of any volatile fpirit 
and it will mix with water without feparation—fometimes there 
will appear an intermiffion in the pains ; and where, at the on- 372 
RHEUMATISM. 
fet of the difeafe, there have been prof ufe difeharges by the lkin, 
with a copious depofition in the urine;—bark 193,(194.) is 
highly ferviceable, united with volatile tindure of guaiaclim, 
(180 ) and has been knowm to relieve very obllinate cafes, par- 
ticularly in debilitated habits. 
The Chronic Rheumatism chiefly affeds old men, or thofe 
who by indifcretions have fo weakened their conftitutions, that 
they are reduced to that ftandard. The attack of this is not fo 
general, feldom affeding fo many places at once; nor do the parts 
appear fo red or fwelled—it returns at intervals, without any fe- 
brile afledions almoft, or fweat—and there are fometimes tu- 
mors of the colour of the ikia, or very (lightly red, riflng in dif- 
ferent parts, rather round, of the fize of a nut, afledini!; chief- 
ly thofe of lull habits, and women who have nor their men- 
fes. 
In full habits bleeding may be had recourfe to once—bliflers 
and fudorifics are more ufeful—repeated purging expedites the 
cure. 
Mercurials, joined with diophorets (No. 87.) are extremely 
efficacious—and alfo the addition of gum guaiacum to purga- 
tives, (No. 19, 20.)—guaiacum given from day to day, fo as to 
procure two or three Itools every day, has been often attended 
with fuccefs; or on the nights previous to giving a puige (No. 
19, 20 21.) in the morning, calomel joined with guaiacum has 
been of great ufe, (No. 129.)—w’hen the pain is excruciating, 
opiates (151.) may be given at night. 
Volatiles, and opiates externally applied, are often attended 
with falutary efleds, (No. 107.) or itimulating plailler, (No, 
130.) fufficient to create proper irritation over the part affed- 
ed. i'y 
Oil of turpentine has been fpoken of as an internal as well as 
external remedy, (No. 122.) , 
Eledricity has been recommended for 15 days, a quarter of 
an hour each day, drawing the fparks through the parts affededj 
and giving a few- general lhocks. 
D O O # 
In order to.prevent relapfes, a flannel mirt Ibould be worn next 
to the Ikin ; compound decodion oi fari'aparilla w ith milk taken 
for a month ; now and then the warm bath Ihould be had recourfe 
to, and at the prbper'feafon fea-bathing. 
Some of thel'e modes; will be fufficient in common cafes ; but 
in fuch as are more obftinate, change of climate is very often 
requiiite, and alfo the natural hot baths—or in perfons whole 
vafcular iyftern ads with freedom, nothing is more conducive 
to prevent itsr return'tban cold bathing. 
la tbofe rhenmatie-xjomplaints called Sciatica, or Hip Gout*- GOUT. 
and Lumbago, as they are of acute or chronic kind, fo muft 
they be treated in the fame manner as we have fpecified in gene- 
ral rheumatifm—only in the hip-gout, when the diieafe has been 
obtlinate, an iflue cut above, or below the knee, has been of 
great fervice, as alfo bliltering the thigh. 
§ 13. Gout, 
fo called from the French word goutte, an acrid defluxion in 
medical language it is called Arthritis by many, from an- 
fbron, articulus, a joint, becaufe it affedls the joints—by feme 
Podagra, from pous, pes, the feet, and agra, captura, feizure, 
becuife they coniider the feet as its natural feat—and though it 
is thought, that there is truly only one fpecies, yet, according to 
the different appearances it puts on, it has been diftinguilhed— 
all which may very properly come under two heads—the regu- 
lar, or fixed—the irregular, or uncertain, Gout, ref- 
pe£ling the feat it occupies—both thefe fpecies, which we (hall 
proceed to defcribe, appear to depend upon the ftrength or 
weaknefs of the whole, or fome part or parts of the conftitu- 
tion. 
DESCRIPTION. Before the fit comes on, the patients rood 
commonly experience a general laflitude and wearinefs—are low- 
fpirited—complain of a load and fullnefs of the ftomach after 
eating-are fqueamiih very often, and throw up wind—the belly 
is diltended with flatulence—the habit coftive, the fweating 
or moiflure of the feet goes off, and the veins there appear 
full. 
After thefe an acute pain for the moft part feizes the joint of 
the great toe, accompanied with a fenfe of coldnefs, as if cold 
water was poured down—flight fhiverings, and other febrile af- 
fedions—a (hooting, gnawing, pungent, or burning pain, feizes 
the fmall bones of the foot, or they feel as if fqueezed ftrongly 
with the hand—in about twenty four hours, the part begins to 
look red, and fvvell—a gentle breathing fweat comes on, 
and then the pain begins to decreafe, and the fever difappears. 
In the morning patients find themfelves better, in the evening 
worfe, becaufe at that time the fit comes on—during the fit men 
become irafcible, and are eafily irritated—they have little or no 
aopetite—the body is coftive ; and a painful fenfation of the part 
accompanies the whole fit—on the fiift days the urine is high- 
coloured, and difeovers a brick-coloured or red fandy fedi- 
ment. 
In proportion as the conftitution is Wronger or weaker, fo 
does the fit go off quicker or flower; at which time an intoler- GOUT. 
able itching is perceived between the toes, and the fcarf fkin 
falls off in fcales like bran,—the joints feel ftiff as if they were 
covered with plaiflers and dry, and a period is put to the difeafe 
for fome time—which again returns. 
This is the cafe of the gout in its firfl. attacks, fo long as the 
confutation preserves a proper degree of power; but in proctfs 
of time, as the habit becomes weaker, the complaint takes deep- 
er root, the difeafe feizes the hands, wrifls, elbows, knees, and 
' other parts—hard chalky tumours are formed, and the dillorted 
limbs lofe all motion. At this period the fits continue almoll 
the whole year, and the afflicted make large quantities of pale u- 
rine ; they are alfo tormented with piles, putrid eructations, 
fpafmodic affections, flony concretions in the kidneys, gravelly 
complaints, and lofe all appetite. 
The ftrength of the conflitution (till failing more and more, 
till it becomes almo.ft exhaufted, the gouty matter, incapable of 
being thrown out upon the extremities, at7e£t3 the internal parts 
of the fyftem, and produces complaints peculiar to thofe parts 
from the ftimulus it there occafions—fometimes upon the head, 
producing apoplexy, lethargy, palfy, delirium, tremors, and u- 
niverfal convulfions—fometimes upon the membranes of the che/t 
occafioning pleurify—or on the fiomach and intejlines, whence in- 
ternal uneahnefs and opprefiion, ficknefs, vomiting, loofenefs— 
during the continuance of thefe affections, there is no pain in a- 
ny part, otherwife it generally exerts itfelf—at length, the con- 
liitution being worn out, and having loft all its power, the vital 
parts, as the brain, lungs, and heart, begin to be deprefled, and 
the machine falls a facrifice to its own weaknefs, and the vio- 
lence of the morbid affection. 
This defcription comprehends the gout in both its forms of 
regularity or irregularity-—it being conlidered the regular 
gout, when it Axes upon the feet, and is attended with a fuffici- 
ent ftrong inflammation, continuing for fome days, and gradual- 
ly going off, with fwelling, itching, and peeling of the fcarf-fkin, 
in form of fcalcs, like bran. 
The irregular, when it attacks'other places, and is attend- 
ed with interna! debility of the ftomach, or* other parts ; or 
has flightly affected the joints, and receded ; or has not at- 
tacked them, but produces inflammation on fome internal 
part. 
CAUSES. The remote or inducing are, full, free, luxurious 
living—hard drinking, particularly acid and rough wines—in- 
dolence, or the omiffion of accuftomaiy exercife— relaxed, fort, 
and full habit—-immoderate venery in youth—too fudden chang- . 
ing from diltilled liquors 01 fpirits, to thofe which are thin gout. 
375 
and watery—fuppreffed evacuations—and an hereditary taint. 
It feldom attacks boys, caftratas, or women, except viragos, 
or fuch as have pafled the time of having the rnenles ; but mod 
commonly men in the decline of life, thofe of lively invagina- 
tions, the fludious living a fedentary life, and fitting up late at 
night. 
The proximate or immediate cause is, a peculiar humour elec- 
tively fixing in common upon the fmall joints, or rather thin 
ligaments; or, perhaps, upon the membranous coverings of the 
nerves, there fituated ; or fometimes in other parts of the ma- 
chine, particularly thofe which are the mod irritable. 
CHARACTERISTIC SIGNS. A difeafe accruing without 
any evident external caufe ; but having, for the moft part, an 
unaccaltomary afFedion of the ftomach preceding the attack, and 
alio febrile fymptoms—-a pain in the joints, and that moll fre- 
quently of the great toe, but certainly attacking chiefly the joints 
of the hands and feet- —this pain returns at intervals, and of- 
ten alternates with aire&ions of the flomach and other internal 
parts. 
Though we allow of two fpecies of the gout, yet it is pretty- 
obvious, that they depend only upon the different proportions 
of ftrength in the conffitution and this will regulate our con- 
dud in the mode of 
CURE ; and here are indicated a feparation and expulfion of 
the morbid matter, and a prevention of its return, or capability 
of reproducing its morbid effects—in all which we muft be go- 
verned by the conflitution. When the gout proceeds regularly, 
and fixes in the feet, patience and warm flannels are recommend- 
ed—-and the free ufe of wine allowed, under the idea of making 
the depofxtion of the gouty matter more complete, and afiiiling 
the local expulfion. 
However, in the rr.oft Ample and regular cafes, I do not re- 
commend a total prohibition of all medical afliflance ; nor can I 
think that large draughts of wine, and loads of flannel, can com- 
penfatc for the lofs of judicious advice ; for to me, who frequent- 
ly have experienced the gout, it is dear, that forne things may 
fie done without any rifque cf pvefent danger, or future mis- 
chief, which render the fit oftentimes lefs violent, lhorten its 
continuance, and obviate the confequent debility ; for I am per- 
fuaded, we fuffer more from constitutional defeats,--the effects 
of fymptoms,- and mifmanagement, than from the nature of the 
difeafe ilfelf, particularly in thofe who labour under recent at- 
tacks—flmilar inftances we have feen in the treatment of other 
difeafes ; as in the fmall pox, where warmth and cordials were 
iniiituted for the lame purpofe, of throwing off the morbid mat- 376 
GOUT. 
ter by which the fever was too highly inc-aafed, and deflru&ioi* 
too often, and danger always the confequence. 
Let us fee who are the men mod fubjeft to this malady—hard 
drinkers, particularly wine-bibbers—men of voracious appetites, 
who feed on high-feafoned diilies-—venereal devotees—men of* 
lively imaginations, and thofe addicted to fevere liudy, late 
hours, and good living ; and, in fliort, moll of thofe w ho, by va- 
rious means,-weaken their digeftive powers—if* thefe have the i 
gout in their habit, they feldom efcape; if not, commonly ac- 
quire it from their own indifcretion. 
In men, before they fall into the gout, it generally happens, 1 
that their flomach and bowels are loaded with crude materials* 
vifeid humours creeping through the mefentery and other vif- 
cera—local fullnefs in the liver—fpleen or fweetbread ;—impeded, 
or irregular evacuations by ftool, urine, or perfpiration—hence 
often an acrid flate of fluids. 
Now, in fuch conftitudons, previous to the attack of the 
gout, we find a number of fymptoms announcing its approach, 
iuch as flatulence,, load at the Itomach, and naufea, or fick- 
nefs. 
Here it would be proper to admifler an emetic, (No, n, 12, 
380 which fome gentle purgative ihould fucceed, particularly 
ol the aloetic clafs, ('No. :.fcS.) and this laft given two or three 
times, at proper intervals; after which, llomachic bitters, join- 
ed with mild chalybeates, (No. 63'to 65.) or w ith fome of the 
warm diuretics, (175, 176*) will be tifeful--thefe will luffice tor 
the firft tlage ; tor I confider the affection of the ftotnafch as that 
flate of tiie difeafe ; befides, if t!ie patient be of a full habit, and 
ltrong, has a good puife, bleeding may very properly precede 
this caufe. r 
The mode of living fhould he moderate, with refpecl to eat- 
ing, drinking, and exercile—the flelh of young animals allowed 
only once a day—vegetables Hewed in their own liquid, or 
with very fmall portions of water—the beverage, fmail rum, 
brandy, or geneva and water—and the exercile chiefly on horle- 
-back. 
By thefe means the flomach and bowels are unloaded, and kept 
free from accumulations of crude and offenlive faeces; vifcerai 
obflrmSlions are opened; the fluids made to circulate through 
the different viicera ; the mal's of blood puihed forwards to the. 
extreme parts, and furface of the body ; the liver, flomach, kid- 
neys, and bowels evacuate theiv contents in proper proportion ; 
from the lungs, and through pores of the fkin, is thrown out a 
clue quantity of perfpirable matter, and noxious exhalations ; 
the powers of digeftion are increafed ; and, in fine, the whole GOUT. 
machine put into as healthful a ftate as the nature of the cafe 
will permit. 
Prepared, therefore, for the fecond or painful ftage; if the me- 
thod above purfued fhould not prevent its acceflion, it will come 
on lefs violently, continue a fhorter time, and leave behind it 
lefs debility, from the conftitution being freed from any luper- 
fliious load, the vafcular and nervous fyftem rendered flronger, 
and the fluids being put in a mild flute—however, even here 
fomething may be done to mitigate any degree of violence which 
may occur from conftitutionaTpeculiarity, with relbeCt to pain 
and febrile fymptoms, which laft are now to be confidered only 
fymptomatic. 
Diluent cordials, wine and water, fage, balm or mint tetf, may- 
be freely drank, and antifpafmodics, diaphoretics, and antifflo- 
nials, joined with camphor and volatile?, (No. 131.) may be ta- 
ken—if the pain fhould be exceflive, not otherwife,-gentle opiates 
may be added—aetliereal fpirit of vitriol, water of acetated am- 
monia, with aromatic confection, and asthereal fpirit of nitre ; 
thefe vvill promote perfpiration, and increafe the urinary dif- 
eharge, 
The body fhould alfo be kept open with fmall dofes of rhu- 
barb, caftor oil, manna, lenitive electuary, and glyflers occafi- 
onally, if neceflary. 
The diet fhould be broths—gruels with a little wine, fago, fa- 
lop, arrow-root, tapioca, in which may be put wine, or a little 
brandy—trgfli water fifh, eels and falmon excepted—chicken, rab- 
bit, veal, Iamb, fraall birds, and fuch like may be allowed, but 
fparingly ; they hall better be deferred, at lead a free ufe of them,, 
till the decline of the fit; 
As for external applications, during the fit, by whatever au- 
thority they have been recommended, I am averi’e to their ad- 
mi niftration, becaufe the pain feems rather an inllrument of na- 
ture for the full completion of depofiting the' whole of the gou- 
ty matter, creative of the fit, in the extremities--it fhould be 
mitigated, if violent, by the means above deicribed. 
Indeed, if the pain is moderate, as well as the febrile fymp- 
toms, and the bowels as well as kidneys perform their func- 
tions fully and regularly, little is neceflary to be done, till 
the decline of the fit, and then diaphoretics at night are ufe- 
ful. 
After the fit is over, a gentle dofe or two of phyfic may be 
takenl'ind a little flomachic draught once a day for a week or 
ten days ; and fhould the joints affedled remaiu weak, we may- 
early ufe the fiefn brufh, or flannels impregnated with franken- 
cenfe, amber, or myrrh, by way of friction—however painful it 378 
GOUT. 
may be, T would advife ufing the joint aife&ed during the fit 
repeatedly ; for that prevents the too great relaxation of the li- 
gaments from the flux and ftagnation of fluids in thefe vefiels. 
By thefe means may this painful difeafe be mitigated, or the 
painful confequences often fubdued, and always made lefs fe- 
vere ; but if we would attempt the cure, we mud try that in 
the periods where there is fome long intermiflions ; and this by 
the preventive plan, (62. 97.) to which regimen there point- 
ed out, domachic and aromatic bitters ihouid be occadonally 
taken, fuch as quaffia wood, (175.) or bark mixed with deel, 
(No- 61 to 65.) chalybeate waters, particularly thofe of Bath— 
the ikin ihouid be kept clean, and a flannel fliirt worn next to 
it—a <lofe of tin&ure of rhubarb, (173.) ihouid be taken twice 
a day and, in fine, fuch things occadonally applied to, as will 
contribute to drengthen the domach and digedive powers, keep 
up a free date of perfpiration, and prevent the body from being 
coilive. 
Should thefe things fail, our lad: refort mud be a milk diet, 
and that condantly perfided in ; though this will only fuit fuch 
as have a pretty llrong Itamina : the weak and very debilitated 
would probably fall a facrifice to the change. 
When the gout affumes its irregular form, we conclude 
it is owing to the weakened Hate ot the moving powers, not 
being able to throw the offending matter to the extremities, or, 
when there depofited, of not keeping it in that fituation—and 
hence the head, lungs, ftomach, kidneys, bladder, come to be 
aiFe&ed, becaufe they polfefs more fenfibility, and are more ir- 
ritable than other of the internal parts—however, when it fixes 
on thefe parts, it is extremely hazardous, in proportion to its 
degree of violence-—we, therefore, as expeditiouily as we can, 
Ihouid labour to throw it out of the habit into the extremities, 
particularly into the feet. 
Now, if the head and lungs are affc£led, and the habit full 
of blood, we mult bleed in proportion to the ftrength and full- 
nefs—afterwards apply blilters to the infide of the thighs and 
legs—bathe the feet in decoftions of horfe-raddilh and bruifed 
multard-feed---fome advile wine, or fome other fpirituous men- 
flruum— finapifms (No. 30.) may alfo be applied to the feet— 
and we fhould give -volatile camphorated medicines, (No. 33. 
35 to 37 ) a,)d with cordials, (No. 13 to 18. 28 to 30.) to in- 
creale the motion of the blood, at the fame time that it is foli- 
cited to the extreme parts. * 
Bat ihouid the stomach be the feat, vomiting will often be 
fo violent, as to reje£t almoft every thing which is taken ; in or- 
der to allay this, we mult depend upon cordials, as above, uni- GOUT. 
379 
ted with opiates ; and occasionally give opiates fhemfelves, as 
twenty or thirty drops, or more, of tinifure of opium, at pro- 
per intervals—and hot wine, or rather brandy, with lpices and 
garlic, fhould be copioufly adminiflered—and firong aromatic 
diaphoretics, as fnake-root, camphor, volatile falts, &.c. (17b, 
179, 180.) 
Which remedies may he applied if the bowels fhould be at- 
tacked, and in conl'equence a loofenefs lupervene, then to them 
we muff add fome aftringents, as extraft of logwood, (140.) 
tinifure of catechu, (139.) columbo root, in powder, ten grains, 
in tinfture, two drams—a drop or two of the compound water 
of acitated litharge, or ley of iron, called lixivium martis, giv- 
en at proper intervals, have been efficacious, when other appli- 
cations have failed. 
Indeed, in every fpecies of the irregular gout, whatever in- 
ternal parts it attacks, the fame modes of proceeding are necef- 
fary, as pointed out here in general, increafing the force of the 
circulating powers, and foliciting a free flow of them to the ex- 
tremities, endeavouring, at the fame time, to alleviate the op- 
preffive fymptoms peculiar to the affeited part ; as when it at- 
tacks the kidneys, we have recouife to emollient decoitions and 
glytters, with warm baths, &c. 
With regard to the mode of living to be obferved by gouty 
patients, or thofe in whofe conftitutions there is much of that 
matter creative of the difeafe, temperance has always been 
advifed—on which I ffiall beg leave to obferve, that by this 
term is meant fuch a mode of living as is beft adapted to the 
conflitution ; for there may be as much intemperate mifchief 
to fome habit by drinking too large a quantity of water as of 
xvine; and, indeed, in every fpecies of abftinence, were purfued 
to fuch extremities, as weaken rather than properly fupport the 
powers of nature. MORBID EVACUATIONS, 
SECTION XV. 
MORBID EVACUATIONS. 
WE muff now proceed to treat of thofe diforders whofe 
mofl: Unking l'ymptom is fome evacuation, which is ei- 
ther not natural, exceeds the limits, or returns at more frequent 
periods, than what is ufual in a flate of health. 
Thefe may be properly divided into fuch evacuations as flow 
from the bowels, called Alvine, from cihus, the belly—san- 
GUiNARYjfrom fangui?, the blood-—called hamorrhages, from 
awia, l'anguis, and reo, fluo, to flow—and serous, from fe- 
rnm, or the thinner fluids, as lymph, urine, mucus, fweat, and 
fimilar fluids. 
Now ail thefe evacuations are either active or passive, 
fimilar to what we have faid on inflammation, (29H. 
when they are active, they are folicitcd by fome morbid fli- 
mulus, or medicines by which the excretory veflels of the parts 
affecled are put into ftronger a£lion, and throw out their con- 
tents too copioufly, or the vefllls burfl, and from thence is the 
evacuation produced—-when passive, the proper powers of the 
living machine do not excite, but become defective in refiflance, 
as in cafea of a conftant flux of urine from the relaxation of 
the fphin&er of the bladder. (51.) 
Of thefe truths we fliall be convinced, if we confider, that all 
the fluids of the human machine are contained in different re- 
ceptacles, as bile, urine, &c. and alfo that part of them are 
kept in perpetual motion, as the blood, &c. part of them fecre- 
ted and excreted ; fome of which fecretions flow out of the body 
in regular fucceffion, as the matter of porfpkation ; lome are re- 
tained for a time, till nature calls them into motion for particu- 
lar purpofes, as milk, femen, &c. 
It will therefore appear obvious, that whenever the force of 
the impelled fluid, or the weight of it, when collefted, is too 
powerful for the natural ftrength of the veflels or cavities, the 
veflels which burft, or the fphinclers by which they are guarded, 
and prevented from pouring out their contents, be opened; 
hence, when either the expuifive force of the contained liquid is 
too great, and the iides of the veflels too much weakened ; or 
when the fluids are in too great quantity, and the fphindters in 
too relaxed a Hate, the rupture of the one, the want of contract- 
ile power of the other, will neceflarily lay the foundation for 
the difeafe ; fo that it may arife either from an increafe of the 
cxpulflve and decreafe of two refilling power, or from them both MORBID EVACUATIONS. 
happening conjointly in the fame habit, and at the fame time. 
The indications of cure will then be, in active evacuati- 
ons, to attempt to remove the morbid itimulus, and weaken the 
powers oi the veflfels or cavities—in the passive, to ftrengthen 
the veifcls or cavities, and give power to the fphin&ers, that 
they may act with proper force. 
CHAP. I. 
ALVINE EVACUATIONS. 
THESE may all come under the term looseness—-diar- 
rhoea from dia, per, and rheo, to flow, though they are 
by authors divided into different fpecies, either from the nature 
of die alfeftion, or from the appearance of matters which flow 
through the bowels in too large quantity—the firft of which is 
ftiled diarrhoea, or common looseness, when there is a 
conftant a'nd remarkable evacuation by ftool of liquid matters 
without much pain or uneaflnefs; but when there is an evacua- 
tion of ftimy matter, fometimes bloody, attended with febrile 
affections, fevere gripings, naufea, or ficknefs, and frequent pro- 
penftty to go to ftool, with very fmall evacuation’s from fuch ef- 
forts, it is called DYSENTERY, DYSENTERIA, from dus, male, 
and e/iteron, inteftinum, inteftine. - 
When the difeafe is very acute, attended with a continual vo- 
miting of bilious matter, and at the fame time a violent loofe- 
nefs, or at leal! a naufea, and llrong propenfity to go to llool, 
with lofs of ftrength, and very often cramps of the thighs and 
legs, it is called cholera morbus, ftorn hole, bilis, bile. 
When there is a frequent purging of bloody fernm, as if raw 
flelli had been waChed in fome liquid, fuppofed to flow from the 
liver, it is called indolent, becaufe unattended with any fe-v 
vere pain, great ficknefs, or remarkable lofs of ftrength-—this 
evacuation is therefore named iiepaitrrhoea, from epar, je- 
cur, the liver, and reo, fluo, to flow. 
If there is a frequent purging, in which the aliments appear 
fcarcely to be changed by the digeftive powers, and comes on 
immediately, or foon after eating, it is termed leienteria, 
from leios, laevis, fmooih or flippery, and enteron, inteftinum, 
inteftine 
Should there be a frequent evacuation of white matter, flip- 
pofed to be chyle, it is termed coeliaca, from koilia, venter, CHOLERA MORBUS, OR 
the ftomach, or firfl bowels, where the firfl digeflion takes place, 
and fprms chyle, which chyle is fuppofed to give the appearance 
from whence this difeafe js nominated. 
if of black matter, or of a deep red colour, is then called ME- 
LJENA, from melas, niger, black, unattended with any putrid 
fmell, fudden deprivation of flrength, or remarkable degrees of 
pain, or naufea. 
However, it will be fufficient to take notice only of two of 
thefe, as the reft may be cured by the fame means made ufe of 
in fome of the llages. 
§ 1. Cholera Morbus, or bilious, vomiting and intes- 
tinal Flux. 
The feat of this complaint feems to be the whole inteflinal 
canal, particularly the ftomach, head of the duodenum, (42.) 
and dotftus communis choledochus, the common du£t of the 
gall bladder. (36.) 
And it is apt chiefly to attack fuch as are of bilious, dry, 
choleric habits, or whofe conftitulions are loaded with fcorbutic 
acrimony, or the firfl paftages with acid humours, or are of 
irafcible difpofitions. 
DESCRIPTION. Though this difeafe will fometimes come 
on very fuddenly, it is often preceded by heart-burn, a gnawing, 
painful fenfation of the llomach and bowels, and rancid eructa- 
tions—after which fucceed enormous vomitings, and inteftinal 
diicharges of vitiated humours, bilious, green, yellow, and 
fometimes black, with great difficulty and pain—there is alfo 
a violent pain and diftention of the belly and inteftines, accom- 
panied with thirft—a pulfe at firfl full, flrong, and frequent, 
afterwards weak and irregular—heat, and anxiety—moreover, 
there attends a naufea extremely troublefome—fometimes a 
contraction of the legs and arms—an acute pain above the navel 
•—retention of the urine—fainting—coldnefs of the extremities 
.—the body becomes weak, and the fpirits low—with other 
fymptoms of a fimilar nature, which greatly terrify the atten- 
dants, and will deftroy the patient in forty-eight hours. 
This difeafe generally makes its appearance in autumn, more 
efpecially after a hot and dry fummer. 
IF the diieafe is more than commonly violent, the evacuations 
downwards are very numerous, amounting in the fpace of a 
few hours to ninety or a hundred—the patients foon become e- 
maciated and reduced—and the fymptoms above fpecified arc 
quickly followed by hiccough—univerfal convulsions—cold BILIOUS, VOMITING, AND INTESTINAL FLUX. 
383 
fweats—frequent fwoonings—and either in one of thefe fits, or 
in a convulfed ftafe, when the difeafe proves fatal, they expire. 
CAUSES. The remote or inducing are, eating of pork, ba- 
con, fat meat fried in oil or butter—or fvveets, grapes, cherries, 
cucumbers, melons, or all fuch viands as become readily rancid 
or acid—poifons—llrong purgatives—violent .rage—and acrimo- 
nious bile. 
The proximate or immediate, conrtriftions of the ftomach and 
fmall inteftines, particularly the duodenum, by bilious or acri- 
monious humours irritating and vellicating the fenfible nervous 
coats, which caufa an increafe of aftion in thefe organs, produc- 
ing different fymptQms, according to the parts locally or fym-> 
pathetically affecled. 
CHARACTERISTIC SIGNS. An acute difeafe, attended 
with the vomiting of fome humour, mortly bilious or acrid mat- 
ter, at the fame time a frequent inteftinal evacuation, or at leaft 
a naufea and tenefmus, or frequent defire to go toftool, accom- 
panied with anxiety, abdominal pains or gripings, and very of- 
ten fpafmodic contra&ions of the legs. 
CURE. The indications are, to (heath, dilute, and expel the 
acrimonious humours, take off‘the convulfive affefition; after- 
wards to reftorc ftrength and activity to the ftomach and intef- 
tines ; and thefe are done, fitft, by drinking freely of weak chick- 
en water, made by boiling a chicken in three gallons of water, 
fo that the decodlion juft takes of the fleih—large draughts of 
which Ihould be taken, and given in glyfters till the whole is 
confumed—about three or four hours alter which an opiate, (No- 
A-) maybe given ; and this mode, if at fir ft made ufe of, will gene- 
rally complete the cure. 
Or, very weak beef or mutton broth, diverted of fat—or millc 
and water—freffi butter—milk—decodlions of rice or barley— 
or infufions of oaten bread, toafted and made brown like coffee 
—or wheat-bread, or oat-meal toafted may do, where chicken- 
broth cannot be had—indeed the infufion of the oaten bread has 
been preferred by fome, as it lias been obferved to lit ealieit on 
the ftomach, and never vomited up. 
But fhoukl the patient have been purged for ten or twelve 
hours before affiftance has been given, an opiate lliould be adrni- 
niftered during the urgency of the fymptoms, and. the doles 
large and repeated, approportioned to the violence of the dileafe. 
—Sydenham gave twenty-five drops in an ounce of cinnamon- 
water, and that proving inefficacious, in half an hour thcfidofe 
was increafed, and repeated at fuch intervals as gave room to 
fuppofe the effect of the former dofe had ceafed, before the fuc- 
ceeding one was adrainiftered—and after the feverity of the dif- CHOLERA, MORBUS, OR 
eafe abates, the opiate fhould be repeated and morning, 
till the drength and fpirits return. 
In common cafes this will be fufiicient 5 blit if the patient is 
of a full, fanguinary habit, bleeding is immediately necedary — 
fhould the pains of the llomach and iriteftines be extremely vio- 
lent, partial warm bafhs, or local fomentations of the fpirituous 
kind, may be had recourfe to, arid camphorated and volatile lini- 
ments, (No. 107. 132.) 
Should, after copioully walking the domach with fome of the 
diluting liquids, the affeCtion of the domach dill continue, the 
fermentative faline draught, (No. 39.) may be exhibited ; or the 
infulion or powder of columbo-root, ten or fifteen g ains to a 
dole, at proper intervals, which is often an effeftual retriedr— 
cataplafms of mithridate,* Venice trecle,* or opiated confection, 
or the leaves of common mint bruifed, boiled in port, may be 
applied to the pit of the domach and wrifts—and mint tea, or 
weak infufio'ns of cloves or cinnamon, may be taken occaliori- 
ally. 
In Cafes of great heat and internal tineafinefs, nitre is recom- 
mended— from thirty grains to lixty of powdered columbo-root, 
from the lird, taken every three or four hours, have been faicl 
in three or four days to have completed a cure—indeed, in hot 
climates, it has been edeemed almolt a fpec.ific. 
After wathing the llomach extremely well, in ten or twelve 
hours that organ fettles, opiates then given in a liquid, or folid 
form, as bed agrees, are requifite to allay the didurbance which 
has been created in both the nervous and vafdular fyftems ; which 
mud be continued at .bed-time; and, in about three or four 
days, a dole of rhubarb may be proper, and, at night, an ano- 
dyne. 
Should the appetite be left weak, a draught of the infufion of 
quadia wood, with a few drops of dilute vitriolic acid, may be 
given twice a day, or feme other bitter infufion, (No. 63 to 65.) 
—and the paient fliould return gradually to the common mode 
of living. 
O # 
The mode of treatment here recommended is proper m this 
complaint arifing fporitaneoufly, or from an epidemic caufe. 
But when it originates from food got into a Hate of fermen- 
tation and corruption, bolides plentiful dilution, with watery and 
mucilaginous liquids, we mud have recourfe to emetics and ape- 
rients, (165. 172, &c.) (as ipecacuanha, emetic tartar, cador 
oil, rhubarb, &c.) and afterwards warm bitters and tonics, and 
corroborants, with aromatics. (No. 61 to 65.) 
' y - * i y 
If it is brought on by Jlrong emetics and purgatives, warm fe- 
datives are necelTary, to allay the agitation of the bowels arid do- 
Edinburgh New Dilyeniitsry. 1789, BILIOUS, VOMITING, AND INTESTINAL FLUX. 
385 
mach, (No. 113-) fpirituous fomentations ar.-d volatile campho- 
rated liniments, (No. 107. 132.) afterwards, to alleviate the un- 
eafinefs occafioned by the violent aftion of the emetics and 
purgatives. 
If violent anger ftiould be the caufe, emetics and piirgat ves 
are to be avoided ; nor mail cold water be given immediately 
afterwards, as wt ftiould run the rilque of bringing on an in- 
flammation of the ftomach—the acrimony of the bile we mutt 
endeavour to correct, by proper abforbents, (iqi.) united with 
nitre, (No. 2.) diluting and fheathing it with mucilaginous and 
watery liquids, as barley-water, thin gruel, bran tea, decoctions 
of hartfhorn fhavings, and fuch like lubricating and emollient 
drinks—afterwards, when the hurry is over, it may be carried 
off by emetics and aperients, 
If it deduces its origin from acrimonious irritating pci fans ta- 
ken internally, we muft depend upon tilling the llomach and in- 
teftmes with oily and mucilaginous liquids, to guard them from 
the effects of their (tumulus—ahfotfaents added to thefe liquids 
are fakl to render them more efficacious—or alcalefcent fubltari- 
ces, (192.) well diluted, might be ferviceable, if the poifons had 
been of the faline kind, for reafons advanced in inflammations of 
the llomach from the fame caufe. (337.} 
§. 2. DYSENTERY, OR TenESMODAL, DYSENTERIC, INTESTI- 
NAL Flex. 
When this difeafe is epidemic, it feizes indiCcriminately all 
clatTes of people—but tbofe in general are*moft fn’ojeiff to it. who 
are of bilious conftitutidns, (bo, 61.)—who feed on corrupted 
diet, unripe fruit*and drink fermenting liquids—and who expofe 
themfelves to the moift night air, afrer being in the day-time 
much heated by the fun. It is moft rife in fummer and autumn, 
when damp cold nights fucceed hot weather. 
It is not only infectious but contagious ; becaufe it has been 
known to be occafioned by the frnell of d'Tenteric faeces, and 
from having lecourfe to the fame clofe-flool after people labour- 
ing under dyfentery, and alfo from the nurfe’s milk, under fi- 
milar circumftances. 
DESCRIPTION. This difeafe is generally ufhered in by a 
general laffitude and chillnefs, with a lofs of appetite for Come 
days, which are fucceeded by great degrees of heat—reftlelfnefs 
—naufea—vomiting—heart-burn—and uneafinefs at the nit of 
the ftomach—thirft—and a quick pulle—excruciating pains then 
feize the belly, which occalion a frequent evacuation from the 
intcltincs, but fmali in quantity—the matter evacuated is cither DYSENTERY, OR. 
mucous, thin, and ferous, bloody, frothy, and often mixed with 
thin fkin-like, or filamentous fubftances—the bowels are loaded 
with wind, which rolls about, and makes a conliderable noife— 
and the patients are perpetually defirous of going to ftool—have 
a ftrangury, and often a flipping down, or protrufion of the low- 
er parr of the re£h»m, (43.)—the lofs of flrength becomes ex- 
treme—and whilft the extremities are cold, they perceive in the 
interior parts great heat—then foon come on a hiccough, and cold 
fvveats. 
At length the pain fudilenly ceafes—the farces, extremely of- 
fenfive, pals away involuntarily—--the pulfe becomes weak—the 
tbirft goes oft—and, whilft the unhappy patient is flattering him- 
feif with the hopes of recovery, from the apparent alleviation of 
the fymptoms, he fuddenly expires. 
This difeafe, notwithstanding it is often fatal to adults, but 
molt of all to fuch as are much advanced in life, ft ill in in- 
fants it is very mild ; for they will be affected with the fame 
difeafe for fome months without any inconvenience, if it is left 
tc the direction of nature. 
Though the general progrefs of the difeafe is here deferibed, 
practice demands us to make fome neceffary diftinclions. 
If the dyfentery is of the inflammatory kind, there will 
be a high degree of fever—hard full pulfe— extreme pain of 
the belly, which, on handling, increafes, and, after vomiting, is 
iiill more diflrefling—the head aches—the countenance is flufhed 
—fometimes the belly is difleudcd—in quantity the evacuations 
aie ftnall. 
If of the putrid kind, there will be a hitter take in the 
mouth—fhiverings now and then come on, as it purfues its cottrfe 
— the feverifli afFeftions are flight—the face pale—the evacuated 
matter variouiiy coloured—beiides which, a bilious vomiting, 
fometimes accompanied with worms, is an aflfociate. 
If of what is termed the malignant sort, which it may- 
be from the very beginning, or occafioned by the milder fort 
degenerating irom conlfitutional defeat or mifmanagement—the 
pull'e is then weak—the ft length fails fuddenly—the countenance 
has a cadaverous ai'ped—the voice is weak—the head heavy — 
there is great oppreffion at the pit of the fiomach, attended with 
flight convulfions, ficknek, and frequent fainting—and, now arid 
then, eruptions of different kinds make their appearance, fucli 
as thofe of the miliary clafs, l'pots like flea-bites, and thrufh. 
CAUSES. It is fuppofed to arife fiom acrimonious matter 
of a putrid nature ; because it makes its appearance in moift 
warm kafons, adapted to generate putrefcency, chiefly attacks 
thofe of fcorbutic habits, (61.) and originates from vapours of tenesmodal, dysenteric, intestinal flux. 
putrefeent blood; particularly becaufc it foftens and corrupts 
the parts affedled, generates air very copionfiy, and renders the 
faeces highly putrid ; and alfo becaufe, on the dill'edtion of bo- 
dies dying of this complaint, the intellines, efpeeially the colon 
and redlum, (43, 45.) are preternatnrally thick, diftended with 
air, inflamed, ulcerated, and in a mortified flare—the inner or 
villous coat abraded—the bile gretnifh like a leek, vifeid, and 
often of a black colour—and the blood very dark in appear- 
ance. 
CURE. Of whatever nature this difeafe may be, the indi- 
cations are fimilar, and depend upon evacuating the acrimony, 
or determining it to other places—weakening its adtion-r-allevi- 
ating the diftrefling fymptoms, by rendering the intellines lefs 
fenfible to its irritating eftedls, in its first stages—in the last, 
recovering the tone, and giving ftrength to the relaxed and wea- 
kened veilels. 
To promote thefe purpofes, in full habits, where there are 
apparent fymptoms of inflammation, the patient fhould be bled 
once or twice, according to their urgency, and the ftrength of 
the patient. 
In the next place, the llomach and intellines fhould be unload- 
ed by emetics and cathartics—twelve grains of powdered ipeca- 
cuanha, and one of tartarized antimony, fhould be well mixed to- 
gether* and divided into three parts, and one given every fecood 
hour—no liquid fhould be taken after the firfl dofe ; but after the 
third, weak beef tea, or chicken broth, fhould he drank liberally 
to encourage the vomiting—after which a llight opiate will be 
requiiite. 
Should the emetic produce fmart evacuations upwards and 
downwards, the fucceeding day it is not decenary to order any 
thing except a grain of opium, mixed with three or four grains 
of ipecacuanha into pills, with fyrup of white poppy heads, and 
given at bed-time. 
But fhould the emetic not have produced any purgative ef- 
fects, a purging powder, made of thirty grains of rhubarb, and 
three of calomel, mult be adminiltered the morning following— 
As for my own part, in the beginning of this complaint, I pre- 
fer the oil of caltor emuluon, (No. 66.) as it relaxes the coats 
of the llomach, fheaths the acrimony, produces evacuations, and 
mitigates the pains of the bowels. 
But as is the nature of the difeafe, fo thould be the eledticn of 
our purgatives—if of the inflammatory kind, the falines are pre- 
ferable, (>72,)—if the putrefceni, the antifeptic, as tamarinds, 
cream of tartar, &c; (No. 23, 24. 50, 51.) but in every cafe, 388 
DYSENTERY, OR 
after the effedls is produced, an opiate fnoukl be adminifleied at 
night. 
In the intermediate fpaces of time, fmall dofes of nitre, accom- 
panied with anti-uonials anti laline mixtures, may be exhibited, 
joined with fheathing medicines, iuch as gum tragacanth, arabic, 
flarcii, if the fever keeps up—or fhould it be of the low malign 
newt, gentle cordials are proper. 
However, fhould not the difeafe foon yield to this mode, but 
the fymptoms Hill continue, particularly griping and purging- 
fmall dofes of ipecacuanha may be given, l'ufficient only to cre- 
ate anaufea, (No, 133,1 increafing or decreafing the dofe agreea- 
ble to the effects, and joining it with antii’eptics, cooling, or 
cordial medicines, as the particular nature of the cafe may re- 
quire. 
Should the ftools continue remarkably vifeid and oftenfive, e- 
very fecond or third day a purgative fhould be given, and at night 
an opiate. 
We rnuft proceed in this manner, till, from the regularity of 
the pulfe; the eetiation of pain, and propenfity to lte>ols, as well 
as from the want cf them, we may conclude the difeafe termi- 
nated—but fhould not thele appearances occur in the courfe of a 
few days, we have reafon to apprehend the greateft danger—we 
mull then, if the fymptoms continue as violent as at'firfl, have 
retourfe to fomentations, (No. j 11 -) and glyflers of the fheath- 
ing and anodyne fort, made of milk, broth, marfh-mallow or 
linfeed decoction, with (larch and tinfture of opium. 
Befides the ipecacuanha, other medicines are recommended, 
and, if we believe the recommendation, falling little fhort of 
infalibility, viz. form two to ten grains of created glafs of anti- 
mony, from ten to fifteen grains of powdered Colombo every 
three or four hours—the deco&ion of femirauba bark is confi- 
tlered as a fpcc'jic, and faid to remove the difeafe without the 
danger or inconveniencies attendant on aflringents, (No. 334.) 
At the cloie of the complaints aftringents are ufeful, parti- 
cularly tonics ; and, indeed, alio when the moft violent fyrup- 
toms of fever, pain, and tenefmus have ceafed, to relieve the re- 
laxed ftatc of the veflels. 
In purfuing the modes here laid down, we fball feldom fail of 
curing this complaint; but fhouid it be accompanied with a pu- 
trid malignant fever, there will be little hope of a recovery— 
however, we fhould try the cfie&s of ANTISEPTICS, (ig2 to 194.) 
particularly wine, infufibns. of bark and ihake-root, with a few 
drops of tincture of opium in each dofe, and the free ule of fu- 
bacid fruits, (i92.) taken by themfelves, or fqueezed plentiful- 
ly into other liquids—indeed, fiuir, and things of a fimilar na- COMMON DIARRHOEA.' 
ture, will form, in thefe cafes, the proper plan of diet—but when 
dyfenteries are unattended with any high degree of putrefaction, 
decoftions, and jellies of rice, fago, tapioca, falep, the white de- 
coction, chalk mixture, weak chicken-broth or beef tea, are 
rnoft proper—though all folid animal food muft be avoided. 
When flatulencies become diftreffing, which will fometimes be 
the cafe, chamomile flower tea, infuiion of cinnamon or cloves, 
or liquids impiegnated Rightly with other aromatics, may be 
occafionally adminiflered with great advantage. 
However, we have had inffances of l'ome of thefe complaints 
which were epidemical, and from their nature fo extremely de- 
llructive, as exceeded the powers of medicine, fuppofed to be 
owing to their deducing their origin from acrimonious humours, 
highly cauflic—in which a total lofs of ftrengtli, fwelling of the 
belly, finking of the pulfe, a difcharge of blackifh ftools, and 
clammy fweats, were certain figus of the irremediable Rate of 
the difeafe. ‘ > /' 
With refpetl to the common diarrhoea, if it is unattended 
with any weaknefs, lofs of appetite, or febrile affections, and is 
moderate in quantity, it very often is of fervice to the conititu- 
tion, and is rather conducive to health than otherwile ; but fhould 
it run on to too great excefs, it will require the fame means for 
its cure, and will be conquered much more eafily than the dy- 
fentery—and, indeed, all the other fpecies we have fpecified ie- 
quire the fame treatment—at the beginning clearing the firft paf- 
lages of any irritating contents, by proper emetics and cathar- 
tics ; next foliciting the flow of fluids to the furfaee by diapho- 
retics, and flrengtbening the flom-achand bowels by tonic aftrin- 
genis, bitters, flrengthening medicines, an riding on 
horfeback, at the clofe of the complaint. 
With regard to the HEPaTirriioea, ive muff proceed as 
sdvifed in that diforder called tabes hepatica, or hepatic con- 
fumptiou, (334. 335.) 
CHAP. II. 
H/EMORRHAGES, 
Tj'UOM the Greek words am a, fanguis, blood, and rennumi, e- 
•*- ruippo, to break our, or ‘ ‘ SANGUINARY EVACUATIONS. 
sanguinary evacuations. 
All thefe eiFufions of blood are confidered as morbid, which 
either flow from particular parts not naturally accuflomed to prol 
dace fuch evacuations ; or, though producing them periodically, 
ftill afford them in too great quantity, or return at too quick 
periods, that the machine, by thefe means, is fo injured, as to 
experience fome defect in executing its fundHons properly, and 
confequendy falls into a difeafed flate, attended with a greater 
or lefs degree of danger, according to the violence of the efifu- 
fion, or to the confequence of the part ftom whence it flows. 
Now all haemorrhages arife, either when the circulatory pro- 
pullive powers are increased to a great degree of violence; or 
that the refiftance of the blood on its part ai d the reflets fhould 
he diminiflied ; or that each of thefe things fiiould happen at 
one and the fame time. 
Hence, then, we find, that complaints of this nature may he 
occafioned in four different ways—-by the veffels being ruptured, 
dilated, or eroded ; or, by the blood having loll its natural vif- 
cidity, and becoming to thin—under any of thefe circumflances, 
the veffels not being capable of confining the blood w ithin its 
proper channels, occahon haemorrhage—whence arife a variety 
of thefe complaints, taking their names from the places from 
whence the blood iffues; or the aflion of the parts producing, 
inflead of their natural, thefe fanguinary difeharges. 
Hence bleeding of the nose, named epistaxis; from 
the Greek word epifiaa-o, fanguinem e nafibus ftillo. 
Spitting of blood-—hemoptysis, or hemoptuon, from 
aima, fanguis, blood, and ptuo, to fpit. 
0 ? 7 l * l 
Vomitting of blood—-HEMATEMESis, aima, fanguis, and 
e;neo, to vomit. 
Making bloody urine—hematuria, aima, blood, and 
ouron, urine. 
Piles—haemorrhoids, aim a, fanguis, blood, and r'heo, fluo, 
to flown 
Menorrhagia, huvie, menfes, and to flow. 
In all morbid effufions of blood, from whatever place they if- 
fue, we endeavour to find out the proximate or a£Hng caufe be- 
fore enumerated, and form the modes of cure accordingly ;— 
but as effufions of blood from the lungs is of the molt dangerous 
nature, we fhall felect that, in order to point out the particular 
mode of proceeding, and occafionally advert to what deviations 
may he neceffary on account of the difference of fituation of the 
part #ffe£tetl. COUGHING UP OF BLOOD. 
391 
$ i. Spitting of Blood, or HjEivfopTYsis, 
All morbid effufions of blood through the mouth take this 
general name, except that which is vomited up—and this appel- 
lation we think improper—if blood conies from the gums or 
throat, or drops from the fuperior part of the nofe internally in- 
to the fuperior part of the fauces, it may be tight ; for the effu- 
fion externally will onlv be attended with a fpirting, flight cough, 
or hawking ; but, when from the lungs, the cough is more 
confiderable—we fhaU therefore diflinguilh the complaint of 
which we are about to treat, by the tewu, 
§ 2. Coughing up of Blood. 
DESCRIPTION. In this complaint, for the tnoit part, a 
chilltiefs—lafiitude—coMnefs of the feef—difficulty of breathing 
come on-—a weight, or undulating fenfation is felt about the 
diaphragm—-flatulence in the belly—and pain in the back—at 
length there comes on a tickling and itching in the windpipet 
from whence iffues forth bicod—if it is recent, the colour is 
flotid, the fluid frothy, and coughed up in large mouthfuls— 
but it is not always of a very florid colour—in fome cafes it is 
of a blacker hue, as it remains and concretes more or lefs in the 
veficles. 
From the fymptems here enumerated it appears, that a fpafm 
of the whole machine takes place before the effufion. 
CAUbES. The remote or inducing are faid to be, a fullnefs 
of blood, brought on by fome accuftomary evacuations being 
impeded, if, at the fame time, the action of the velfels fhould 
be flrongly increafed by anger, violent motion, living upon too 
hot food or liquids, or violent cough, fhould the exertions in 
protruding tire faeces in coftive liabits be too powerful—-long 
expofure to fevere cold, caufing a contraction on the furface of 
the body and the external veffels, air pofiefling too much levity 
in very high fituations, a fuppreflion of the menfes or piles, too 
great a rarefaftion of the blood, fpafmodic contractions of fome 
of the vifeera, feirrhus obitructions in the neighbouring 
vifeera, or a feirrhus or polypus in the veffels of the lungs 
themfelves—or, in line, whatever determines too la:ge a quan- 
tity to the lungs, and caufes it to circulate too foicibly 
againft the vefieis which aie not cbftruCted, or feme difeafes 
which break down the texture of the blood, or erode the veffels, 
as feurvy, pulmonary confumption, fmall-pox, or thofe depend- 
ing upon a putrelcent acrimony of the fluids. 
Thole which are proximate or immediate we have before enu- 392 
COUGHING UP OF BLOOD. 
rnerated, (627, 623.) but moft commonly it is a rupture of the 
veffels preceded by an univerfal fpafm. 
CHARACTERISTIC SIGNS. A flufning of the cheeks, 
fenfation of uneafinefs, or pain, fometimes heat in the bread, a 
tickling of the fauces, cough, and throwing up of florid coloured 
blood, often frothy. 
People moft fubjeft to this complaint are thofe of (lender, 
delicate frames, who have long necks, are narrow chefted, wliofe 
blood is acrid and copious, and are between twenty-five and 
thirty years old. 
CURE. This difeafe is always to be confidered of a very 
dangerous nature, and requires very early and efieftual affiftance 
—in doing which, we muft. endeavour to folicit the blood from 
the lungs, moderate its heat, take off the external fpafmodic af- 
fe&ions., and heal the vefiels, if ruptured.—if then it proceeds 
from too great fullnefs we muft: have recourfe to bleeding, in 
proper quantities, and at fuch intervals as the neceffity of the 
cafe demands—all animal foodmuft he prohibited, even the weak- 
eft broths—and the diet Jloould he hy no means nutritious, but fhould 
chiefly confift. of vegetable juices, fuch as burned turnips, apples, 
oranges, panada, thin gruels, ices, and fuch Ample materials— 
the liquids allowed fhould be nitrated emuifions, Seltzer water 
wivh milk, or barley water, thin whey, or toall and water drank 
cold—the body fnould be kept at perfect reft, feldom in a re- 
cumbent pofture, nor fhould the patient be allowed to fpeak, 
fcarce at all; nor, indeed, fhould any thing be permitted that 
can in the lead increafe the motion of the lungs—opiates fliould 
be exhibited now and then, if neceffary, to procure reft, and the 
body kept open by glyfters, (No. 25, 26.) or gentle cooling a- 
perients, (171, 172.) that the blood may not be impeded in ifs 
circulation downwards. 
The mind of the patient fhould be kept perfectly at eafe—and 
the firlt and fecond bleeding fhould be copious, from large ori- 
fices, and quickly repeated, if the violence of the cafe requires 
it—for one free bleeding in this fiage is of infinitely more fer- 
vice than a number of [paring ones. 
Nitre fnould be given freely in any eligible form, as it is 
much to be depended upon ; for it leffens the motion of the 
blood, and allays its heat, confequently prevents fttong vafcular 
aclion, and the expanfive power of the blood. 
Keeping the body open with cooling aperients, (171, 172.) 
particularly Glauber’s falts largely diluted, (No. 13,5-! is ex- 
tremely ufeful, taken now and then, till the efleft is produced 
twice, or oftener. 
Should the cough be very troublefome, fome of the oleagi- BLEEDING OF THE NOSE. 
393 
nous medicines, (No. 81 to 84.) to which nitre maybe added, 
and given to allay the pulmonic irritation. 
This method in common and recent cafes will almofl always 
fucceed; but when it proceeds from previous injury in the tex- 
ture of the blood, and weaknefs of the lungs, conllitutir.g that 
kind which is habitual or confumptive, little can be expected 
from bleeding ; for this, by weakening the fyftem, and contri- 
buting more to diflfolve the texture of the blood, feems rather 
calculated to increafe the niifehief, inafmuch as it adds power to 
its caufes ; fmall dofes of antimonials, (180.) or ipecacuanha, 
(180.) are moll likely to produce good fcffe&s, by determining 
the flow of blood to the furface, and demulcents, (ib8.) by ad- 
ding to the vifeidity of the fluids. 
And fhould the pain, difficulty of breathing, and cough, ceafe 
with the efflux of blood, we may give tonic medicines, as de- 
codlion of bark, (193.) to which may be added the balfam of ca- 
pivi, (163.) or fome of the mild balfamic clafs ; for we may rea- 
fonably infer, that there is no more extravafatcd fluids in the pul- 
monary veficles. 
But it fometimes happens unfortunately, notwithflanding all 
our efforts, that though the efflux of blood may be flopped for a 
few hours, or days, it will return with a quick hard pulfe, trou- 
blefome cough, oppreffion, and difficulty of breathing, then we 
may have reafon to be alarmed, and fear a fupervening confump- 
tion—in this cafe we have little to depend upon but general re- 
medies, fuch as goats whey, afs’ milk mixed with Seltzer water 
-—or the waters of Briftol fhould be had rccourfe to—riding, 
fwinging, failing, and a milk diet; for fome have, by thef'e means 
being rigidly purfued, happily recovered. 
Slight vomits may alio be given three or four times a week, 
early in the morning, merely to give two or three motions— 
three or four grains of ipecacuanha is fufficient and fully ade- 
quate to anfvver every ufeful purpofe. 
§ 3* Bleedings of the Nose 
are not commonly attended with much, inconvenience, and gene- 
rally yield to topical applications—which may be had recourfc 
to, if the pulfe becomes weak and ftnall, the cheeks and lips 
lofe their natural colour, and the extremities be feized with un- 
ujfual coldnefs—the common remedies are fmelliog at vinegar, 
or folutions of white vitriol, applying dofils of lint by them- 
felves, or loaded with lome ftyptic, as llyplic Hindu re, alum, 
&c. cold wet cloths, or cold iron applied to the nape ot the 
neck. VOMITING OF BLOOD. 
394 
But when the affection is accompanied with any great increafe 
of vafcular a6lion, which will be attended with a flrong, quick, 
full pulfe, heat, head-ach, and other fymptoms, indicative of 
too ffrong vafcular power, we muff have reconrfe to bleeding, 
and fuch remedies of the cooling kind as we have advifed, (392, 
See.)—but fhould vafcular debility, or the blood being in a looie 
diffolved ftate, be the caufe, we muff depend upon aftringenfs 
and tonics, paticulai ly bark and the vitriolic acid—creating nau- 
fea and gentle vomiting is recommended, as advifed, (394.)— 
if by thefe means a. period is put to the haemorrhage, the body 
fhould be kept in a hate of perfect quietude—if collive, aperi- 
e nts and glyffers fhould be exhibited, and a. paregoric fhould be 
given at night. And as almoff all active hemorrhages arife from 
too great plenitude, occafioned by the fuppreffion of feme natu- 
ral difeharge, particularly in young full habits—in older confu- 
tations, which are fupported by plentiful, or more copious diet 
—whence they are preceded by pain and fullnefs of the head, 
occalioning drowfinefs—in order, therefore, to form a preven- 
tive plan, abftinence is neceffary, keeping the head cool, the bo- 
dy open, making the flighted, fuppers, and thofe of the moil light 
and refrigerating diet; but they are altogether better avoid* 
ed. 
§ 4, Vomiting of Blood, or ILxmatemesis. (390.) 
The charaCteriftic marks of this difeafe are, frequent naufea 
or efforts to vomit, and at the fame time a rejection of bloody 
materials by the mouth, mixed with fuch as have before been, 
fwallowed—from whence the ftomach feels lbme alleviation ; 
buc the blood vomited up is grumous—and the flools which, 
fucceed afterwardj are black. 
This affection, however, is more common tc women than to 
men, and lefs frequent in both than the making of bloody urine. 
—-I] a women in this difeafe mould raenltruate, Ihe is cured ; 
for it often is occasioned by a fuppreffion of the rnenfes—and in 
men, from an obfhuCtron of the bleeding piles, and alfo from 
infarction of the liver arid fpleen—ftill it may be occafioned by- 
other . caufts', fuch as full and free living—fwallovviug down 
caniismtly hu ge quantities of fucculent or juicy food, at the fame 
time indulging in indolence—apd the blood pufhed forwards in 
the courle of circulation too rapidly, by fevere exercife, running, 
riding, fits of anger, and the too free ufe of vinous and fpiutu- 
ous liquors. 
CURE. In thefe cafes, though bleeding may be fometirr.es 
Bccefiiirjj it i.HUi.1 be ceutioufly repeated.-—we mult be governed BLOODY URINE, 
395 
by the flrength of the patient, which is fometimes apt to fad 
fuddenly—-the pulfe readily flags;—-the fanguinary flux is apt to 
be extremely copious, and often occafions fainting—Nor Ihould a- 
ny thing be given that is likely, in the lead degree, to be oiTen- 
five to the flomach.—As therefore it is effentialiy neceifary to 
have the body kept open, we mufl depend upon glyfters chief- 
ly—though rhubarb in fmall doles, if the Jiomach will hear it, 
has been recommended. 
Weak, broths, with fome of the aflringent vegetables unboil- 
ed fuch as plantain-ground ivy-—cup-mofs—nettles—or ra- 
ther their exprefled juice, may be given—-infution of red roles 
—floes—or cold water, acidulated with the vitriolic acid—maybe 
adminiflered as drink-—alfo ices—and at night gentle opiates, 
mixed with aftringents of the milder clafs-avoiding all thole 
which are likely to create naufea—fuch as alum, white vitriol, 
& c. 
In all the different fpecies of this complaint it will be necef- 
fary to proceed in this manner.—But if the fupprefEon of the 
menfes, or of the bleeding piles, fhould be the caufe, tbefe are 
to be folicited to their natural paflages by proper means ; or 
ihould they arife from affcdions of the liver, or fpleen, fuch 
medicines fhould be exhibited as are calculated to relieve them, 
as much as the date of the flomach will permit. 
Bat here we mail obferve, that in the middle of pregnancy, 
they are rarely injurious; but if in fever, they are always fatal, 
if the blood be black and fetid ; nor fhould we flatter ourfelves 
with much hope, if they proceed from enlargements of the 
fpleen, or liver, and induration, or fhould there be fainting to 
any degree of feverity. 
§5* Bloody Urine, or Hematuria. (390.) 
In this complaint, the matter palled through the urethra is 
either pure blood, or bloody urine, that is, urine having acquired 
intenfe rednefs from being mixed with fome particles of blood. 
The moft common caufcs of which are Hones, or gravel lacera- 
ting the different parts of the urinary paffages ; but it may be 
occafioned by venereal exceffes, as blood may ifl’ue from the 
ferninai veflels (two membranaceous cellular tubes, lying on 
each fide, between the bladder, (50.) and rectum, (45-) on the 
outfide of the vafa deferentia, (.53.) and all'o from the proftate 
glands ; (.54-) hence are they confidered amongfi the caufcs, as 
are alfo diffolution of the blood, or violent exertions of the 396 
or hematuria. 
circulatory powers, in fevere inflammatory fevers, particularly 
in the fmall-pox. 
Whatever may be the caufe, two points are to be confidered, 
whether there is an inflammatory, or, putrefactive difpofkion in 
the blood. 
If the former is prevalent, and the habit full, we muft bleed, 
and that repeatedly, till we have taken off the general plenitude, 
and allayed the intenfenefs of the aCtion of the vafcular fyftem, 
the bowels fnould be kept open with faline purges and manna, 
(172.) and emulfions with gum arabic, and cooling decoCtions 
of linfeed tea mixed with nitre, fhould be freely adminiftered, 
and the uva urfi (139.) may be adminiftered, which in this cafe 
I have feen extremely efficacious, other aftringents are not 
advifeable. 
If the second,—tonics—aftringents—andbalfamics—as bark 
—lime water—tinCture of rofes—alum whey fhould be had re- 
courfe to, to reftrain, as quickly as poftible, the efflux of blood 
—and by continuing afterwards the nfe of the bark, joined with 
the balfam of capivi—drinking chalybeate waters, and ufing a 
milk diet, endeavouring to ftrengthen the tone of the fyftem, 
and prevent a relapfe. 
But without either of the conftitutional tendencies above re- 
cited, fhould the caufe be a fuppreffion of menfes, or piles, and 
thefe cannot be reftored or folicited to their natural paffages— 
occafional bleeding will be a falutary fubftitute. 
Or fhould it deduce its origin only from calculi, during the 
fits of pain we muft guard the parts againft the effects of their 
ftimulus, by emollient and demulcent remedies, (140—187.)—- 
retherial fpirits of nitre, and fuch like—afterwards we muft 
endeavour to ftrike at the caufe, as recommended in pain of the 
kidneys. (364.) 
Here we mull obferve, that in all cafes of great pain, opiates 
fhould not be forgot, efpecially if ftone or gravel is the caufe— 
and, indeed, in difeharges from the ureters, and kidneys, the 
infufion of carrot-feed (No. 123 ) has not been flightly recom- 
mended. 
But in all cafes of bloody urine, all powerful aftringents 
fliouid be mduftrioufly avoided, left they fhould produce too 
ftrong a conftri<5tion of the paflages, and from thence coagula- 
ted blood might be reftrained, productive of inflammation, or 
forming a nucleus, or bafis for a (tone. 
Sometimes tlic urine will appear to be extremely high-co- 
loured, as if blood had been mixed with it—of this it is necef- 
fary to be certain ;—which may be difcovered by {training the 
urine through fine linen—perfectly clean—if there ihould be PILES, OR 
397 
any admixture of blood, it will be flained of a red colour—if 
not, there will be no fuch appearance.—And laftly, great care 
fhould be taktn in properly diferiminating between bloody 
urine, and fariguineous difcharges of a gonorrhoea, or clap—or 
from piles making their exit through the urinary paffages - 
and critical difcharges iliould be diltinguiftied from thofe that 
are not. 
§ 6. Piles, or Hemorrhoids. (391.) 
Thefe have been divided into the open and blind—the firj 
when they are attended with an effufion of blood-—the laf, 
when they give no fuch appearance—or into exterior and interi- 
or, from their fituation. 
They are not always, however, to be confidered as a difeafe,, 
for they are a very falutary difeharge, and fometimes periodic, 
preventing a number of other complaints, which are apt to ap- 
pear, on their being imprudently expelled, or flopped 1 have 
known people, from this caufe, labour fometimes under a va- 
riety of internal aflections, which have all vanilhed on their 
re-appearance. To thofe alflided with gout—who are hy- 
pochondriacal— hyfterical—fubjedl to complaints of the kid- 
neys, or bladder-—to fciatic pains—afthma—mental de- 
rangement, and fome others, they are confidered to be highly 
ferviceable. Hence, whilfl they continue moderate, and appear 
to be a falutary effort of a nature to relieve herfelf from iome 
fuperfluous load—there is no need of medical affiftance. But 
if they are extremely and conftautly painful, or pour forth a 
large quantity of blood, fo that the patient experiences great de- 
bility, and grows thin, they then may be confidered as morbid. 
Thofe who are difpofed to become corpulent, eat, and dnnk 
freely ;—whole habits are relaxed—-coftive—plethorifc—from 
indolence, or any other caufe, are molt liable to this complaint; 
befides, ftrong purges will alfo bring them on. Thefe canfes 
induce obflru6tion in, inflammation, and fvvelling of, thofe vef- 
fels called haemorrhoidal; whence, about the anus, there will 
be livid, painful tubercles ; from which frequently iflue blood, 
which alfo fometimes flows without any vifible tumour, attend- 
ed often with a load, and pain of the head, giddinefs, and pain 
of the loins and anus. 
CURE. When there is no efflux of blood, from the piles ; they 
are generally attended with i'uch great degrees of pain, that 
people are afraid of going to ftool. Under thefe cireumftances, 
if people are of full habits, bleeding, abflemious diet, and 
piild aperients—(Noe 3. 22 to 24. 66. 135, or 136.) to take off 398 
Haemorrhoids. 
the fullnefs, and preventive coflivenefs, ffould be had recourfe tq, 
—after, w arm olive oil may be applied to the part—or diluted 
oflead (139) with camphorated fpirits and lime wa- 
ter juice of houfeleek—to any of which may be added tinc- 
ture of opium. The patient fhould, as much as poffible, be 
kept in a recumbent pollure ; and, when fitting up, avoid pref- 
fure on the parts—-or heating them-—for which purpofe a chair, 
fluffed round the edges, with a vacuity left in the center, fhould 
be ufed- 
The diet fliould be of the mild laxative, emollient kind, nor 
any thing taken which can heat, or caufe the blood to circulate 
with too great freedom. 
When the piles are of the breeding sop.t, and it 
becomes neceffary to flop the flux of blood, cloths dipped in 
vinegar and water may be applied to the loins, and anus, which 
failing, or not loon fucceding, a gentle emetic may be adminif- 
tered, (No. it.) and after the operation, the anodyne draught, 
(No. 4 ) 
In thefe cafes, the indications of cure are very obvious. To 
take off the fuperincumbent preffure from, and leffon the aftion 
of the veflels, towards the affe&ed part; to flrengthen the tone 
of the veffels relaxed, and take off local irritation. 
Eut as thefe difeharges are brought on by infarclions and cb- 
ftruftions of the liver, other things are neceffary to be done, in 
order to prevent a relapfe ; for under thefe circumftances pa- 
tients are liable to frequent returns ; hence, in order to remove 
the caufes, we muft have recourfe to fuch medicines and regi- 
men as have been advifed in paiii of the liver from thofe four- 
ces (page 351.) 
Sometimes this difeafe will arife merely from want of flrength, 
and tone in the re£lum, (46.) —Preparations of iron, (139.) unit- 
ed with bitters, asquaffia wood—gentian—chamomile—andfuch 
like, and continued for fome time, are highly beneficial,—and 
bathing the parts with a fponge dipped in cold water, twice e- 
-very day.—And in every fpecies w7e mull carefully avoid all 
aloetic aperients—for they are too apt to ffimulate the re£lum, 
—nay, rhubarb will fometimes have this effect ; hence, as it i s 
of the utmoft confequence to keep the body open, fhould there 
be occalion, and that moderately ; for flrong purging will exaf- 
perate, rather than alleviate the complaint, the gen tip it aperients, 
(171, 172.) fliould only be infilled uppn, and thofe given in fuch 
quantities, and at fuch intervals, as merely to keep the bowels 
empty. This difeafe has been obferved alfo to originate from 
excels of grief, long continued, as w7ell as from a pro full on of 
the meulhual diicharge—and jmoft probably is caui'ed by a gc- iE^morrhoids. 
399 
neral relaxation of the folids, brought on by a torpid flateof the 
nervous fyftem ; whence the fluids, deprived of proper circula- 
tion from the ina&ivity of the vafcular propulfive power, form, 
congetlions, which fix in thefe parts. 
Changing the fcenes of life—travelling—diffipating gloomy 
ideas by feeing new objedls—and diverting the attention, are 
amonglt the belf calculated remedies, in thefe cafes—which have 
been greatly aided by taking four fpoonfuls, three or four times 
a day, of bark infufed in lime-water. (No. 137.) 
Where the piles have continued a long time, occafioned by 
a continued acrimonious loofenefs, I have known them cured, 
by gentle vomits—fmall dofes of ipecacuanha in a flrong decoc- 
tion of nettles and opiates—adminiftering after the pain had ceaf- 
ed, and the loofenefs perceptibly abated, bark joined with cha- 
beates. 
CHAP. III. 
ON FLUXES. 
When the Serum or Lymphatic Part of the Fluids are evacuated in 
too copious Quantities. 
A LL fluxes may be faid to be of the ferous kind, which de- 
pend upon an evacuation of fome of the fecreted fluids, and 
are neither of the alvine nor fanguineous clafs. In this place, 
however, we ihall treat only of the 
Diabetes, 
from dicibaino, permeo, to pafs through, or a 
Morbid Discharge of Urine. 
When, therefore, the evacuation of urine happens in fuch 
quantities, be the colour or l'mell what it may, fo as to bring on 
emaciation, or falling away of the flefli—vreaknefs—lofs ot ap- 
petite, and third, we may coufider it as a difeai'e under this de- 
nomination. 
DESCRIPTION. Bcfides an unufual flux of urine, it ’s ac- 
companied with fevere third—the mouth is clammy and dry— DIABETES, &C. 
400 
and the patients fpit up frequently frothy foliva-*-they complain 
of heat in the vifeera—the urine is limpid, fometime-s fweet, and 
has generally not an unpleafant fmell—there is a kind of fullqefs 
of the loins, tedicles, and feet—he£tic fever—after which fuc- 
eced a tabes, and death. 
It ieldom attacks young people, but thofe advanced in the 
latter dages of life, Who have been ufed to chink freely of vi- 
nous liquors, and employed in the feverer occupations. 
CAUSES. The remote or inducing, preceding febrile difeafes, 
particularly if they are fubdued by immoderate evacuations— 
too long continued ufe of acidulated waters, particularly in a 
cold climate, or diuretic medicines—alfo the bite of a ferpent 
called dipsas, from the Greek word dipfa, fitis, third, becaufe 
it occafions fo great third as often proves mortal. 
The proximate or immediate, an increafe of action of the fe- 
cretory veffels of the kidneys, arifing from a date of relaxation, 
and a thin acrid ferofity of the circulating fluids, and a too pow- 
erful determination cf them to the kidneys. 
CHARACTERISTIC SIGNS. A preternatural difeharge 
of urine, immoderate in quantity, and of long continuance, at- 
tended commonly with lots of appetite, emaciation, and heftic 
fymptoms. 
CURE. The indications are, to lefTen the action of the fe- 
cretory veffels, by altering their relaxed date, and corre&ino- 
the too great ferofity and acrimony of the fluids—hence we 
mud apply to the ufe of infpiffants, diaphoretics, ftimulants, and 
tonics—and as foliciting a flow of liquids to the fkin will pre- 
vent too great a determination to the kidneys, in order to keep 
a free and condant date of perfpiration, the patient fhould wear 
a flannel fnirt next the fkin, ufe moderate exercife, and dry 
fri&ion. 
Alum'whey is flroogly recommended, (No. 138.) four oun- 
ces to be taken at leait three times a day—lime-water drank 
alfo, wbild the warmth in quenching continues, taken as freely 
as the third requires, has been faid to exceed the ufe of Briftol 
water, which by fome has been confidered as a fpecifie in this 
difeafe—half an ounce, or fix drams of oak bark infufed in two 
pints of lime-water, and the chalybeate waters, have had their 
powerful advocates. 
White vitriol is a ufeful afirin-cnt, (139.) but fome depend 
on half a grain of blue vitriol twice a day in any proper 
liquid. 
Preparations of iron, (139.) or elixir of vitriol joined with 
bark, (193, 194.) are r,° inferior tonics ; and, by flrengthening 
the habit, contribute much in the promotion of perfpiration. ephidrosis. 
Rhubarb, (173.) has been recommended as efficacious in lay- 
ing the foundation for the l'uccefs of antilpafmodics. 
As a iiimulant, tinfture of canthandes, (17,5.) is by fome in 
this cafe looked upon as a fpecific. 
Notwithstanding the third is a very diflreffing fymptom, a- 
queous liquids fhould be avoided—they fliould be impregnated 
with fome infpiffating ingredient, as comfrey-root, or made 
with lime ■, and thefe fhould be ufed as common drink—boiled 
meat is lefs ufeful than roaited—broth made of beef may be al- 
lowed—fhell-iifh—wild fowl—jellies in fmall quantities, and of- 
ten repeated—tapioca, milk, rice gruels, and l’uch fimilar viands, 
may be permitted. 
Opiates all'o at night will be fervicesble given with fome pre- 
parations of iron and d aphoretics. (No. 139.) 
This difeafe fometimes affe&s hyfteric patients, who pafs 
large quantities of limpid urine ; hence it is called hyjhricus— 
fometimes it fupervenes intermittents ; hence denominated inter- 
mittejis—fometimes it attacks people worn out by the gout, in 
whom, during the painful fits, the urine is fmall in quantity, 
and turbid ; but in the intervals of the difcharge, from perfpi- 
ration being defective, becomes clear, watery, and copious. 
To the general plan, which we have before laid down, we 
mult therefore lubjoin antifpafmodics, under the firft circum- 
ltance—under the fecond, tonics, particularly bark—and under 
the third, invigorating cordials, agreeable to the fpecific nature 
of the cale. See Hysteria, Intermittent Fever, and 
Gout. 
Sometimes people will be affected with a morbid evacuation 
of fweat, where that difcharge is remarkable for its quantity, 
quality, and unfeafonabienefs— called 
§ 2. Ephidrosis, or Morbid Evacuation of Sweat 
from ephidroo, fuderam movere, to occafion fweating, which is 
proportionable to the quantity of perfpirable matter contained 
in the blood, to the velocity with which it is feparated, and to 
the heat or laxity of the pores of the Ikin—when it arifes from 
an increafed circulation of the blood, it is a&ive—when it de- 
pends upon the laxity of the Ikin, and fuperabundance ot ferum, 
it is pallive. 
When the fweat is cold, it denotes fuperabundance of perfpi- 
rable ferum, and a relaxed date of the Ikin—when warm, velo- 
city, and, at the fame time, fortuity of tiie blood. 
But when thefe profufe l'weatings are connected with miliary, 
he£tic, or other fevers, we are not to confider the difcharge as 
a difeafe which requites management particularly adapted to it- 
felf, we mult endeavour to deliroy or evacuate the feeds of the 402 
MORBID SWEATING.’ 
febrile afle&ion, as by that mean's only can we conquer its coft- 
fequences ; for in thofe cafes the fweating is purely fymptom- 
atic. 
But when profufe difeharges of the {kin come on without 
any evident cauie or fever, flowing chiefly in the nights, and oc- 
cafions falling away of the flefh, lofs of ftrength and appetite, 
with lownefs of fpirits, it then requires medical affifianCe. 
CURE. Here are indicated a diverfion of the flow of fluids, 
a dccteafe of their ferocity, and our endeavqurs to give general 
force and tone t,o the fyftem. 
Hence purgatives, at proper intervals, will anfwer the firft 
and fecond indications—tonics and {lengthening medicines the 
laft, fuch as preparations of iron, bark, betters, fteel waters, mo- 
derate exercife, and the ufe of the cold bath—to which we would 
add, the frequent adminiftratioo of milk. 
Properly lupporting, and judicioufly increafing the alvine dif— 
charges, are in this cafe extremely beneficial; for thefe divert 
the flow of fluids from the Ikin, as in the former cafe increafing 
perfpiration folicited the humours from their determination to 
the kidneys. 
When this complaint arifes, as it fometimes does, from a 
fcorbutic acrimony, and the blood being in a loofe diflolved 
ftate, which is very often fucceeded by that fpecies of confump- 
tion called atrophy—the fweat pours forth in the middle of 
winter under the flighted covering, and at the fame time affedls 
the patients with reftleflhefs and anxiety ; nor do they ceafe till 
the vitiated humours are in a great meafure difeharged by this 
cuticular flux. 
Here, as well as where the fvveats are of different colours, the 
remedies recommended are, the juices of frefii vegetables, fubacicl 
fruits, and the ufe of tonics, particularly bark. FORMS OF MEDICINE, 
403 
T fI E 
FORMS of MEDICINE 
PRESCRIBED AND REFERRED TO IN 
MIXED, REMITTENT, INTERMITTENT, and ERUP- 
TIVE FEVERS—also IMFLAMMATORY, PAINFUL 
DISEASES, and FLUXES. 
No. 70. Bark Draught. 
Take Deco#ion 1 ounce. 
Tin#ure 
Powder 
Extra# 
\ an ounce, 
of each 10 grains. 
of Bark, 
Syrup of Quinces, 2 drams. 
Mix.— 
71. Infusion of Quassia Wood and S\take«root. 
Take of Quaffia Wood, 11-2 dram. 
Snake-root, 1 dram. 
Boiling Water, 1 pint. 
Infufe.—-Dose. Four fpoonfuls. 
72. Oak Bark Bolus. 
Take of Oak Bark in Powder, 6 grains. 
Alum, 3 grains, 
Chamomile Flowers in powder, 8 grains. 
Syrup, fufficient to form a Bolus. 
To be taken every third or fourth hour.--The Extra# or Pow- 
der of the Scale Cup may be ufed in the fame proportion-—or 
the Pomegranate Bark, and Chamomile Infufion, (No. 60.) 
may be alio exhibited. 
No. 73. Bark Glyster, 
Take of Bark Deco#ion, 
Diftiled Water, 
Extract of Bark, 
of each 2 ounces. 
2 drams. 404 
FORMS OF MEDICINE. 
Olive Oil, \ an ounce. 
Tincture of Opium, 8 drops. 
Mix.—And let this be thrown up every fourth hour. 
74. Bark Cream. 
Take of Bark Powder, 1-2 an ounce. 
Extract of the fame, 2 drams. 
Cream, i 1-2 ounce. 
Sugar, 3 drams. 
Mix—Dose. Two or three fpoonfuls every fccond, third, or 
fourth hour, according to the exigencies of the cafe. 
75. Asringent Draught. 
Take Cinnamon Water, 1 1-?. ounce. 
Spirits of Cinnamon, 2 drams 
Ele6tuary of Scordium, 1 fcruple. 
Syrup of White Poppy Heads, 2 drams, 
Mix.— 
or—76. 
Take of Infufion of Rofes, 2 ounces. 
Spirits of Cinnamon, 2 drams. 
Extradl of Logwood, 10 grains. 
Syrup ofWhite Poppy Heads, 2 drams. 
Mix Either of thefe may be given every three or four hours, 
—-or the quantities of thefe may be enlarged, and formed into 
mixtures, of which two or three fpoonfuls may be adminifler- 
ed occafionally. 
77. Astringent Opiates. 
Take Infufion of Rofes, 2 ounces. 
Columbo-root powdered, 10 grains. 
Tincture of Opium, 6 drops. 
Syrup of White Poppy Heads, 1 dram. 
Mix— 
Take Infufion of Logwood, 
Lime Water, 
or—78. 
of each 6 drams. 
Tin&ure of Catechu, 2 drams. 
Opium, 6 drops. 
Syrup of White Poppy Heads, 1 dram, 
Mix.—Either of thefe may be taken every fifth or fixth hour. 
No. 79. Calomel Powder. 'FORMS OF MEDICINE. 
Take Prepared Calomel, 2 fcruples. 
Crabs Eyes, 2 drams. 
Tartarized Antimony, I grain. 
Let thefe be rubbed well together, and ten or twelve grains ad* 
miniftered for a dole. 
80. Purging Powder. 
Take Rhubarb, 
Jalep, 
. . 6 grains, 
in powder, 0 
r 3 grams. 
Ginger, 1 grain, 
Mix.— 
81. Oily Emulsion. 
Take Oil of Sweet Almonds, 1 ounce. 
Gum Arabic, 2 drams. 
Fine Sugar, 1-2 an ounce. 
Mix thefe well together, then gradually add 
DecofHon of Barley, 8 ounces. 
Dose. Three or four fpoonfuls often in the day. 
82. Oily Linctus. 
Take Oil of fweet Almonds, 1 ounce. 
Gum Arabic, 3 drams. 
Syrup of Marlh-mallows, I 1-2 ounce. 
Mix thefe well together. Dose. Two or three fpoonfuls of- 
ten in the day, or, it may be acidulated with a few drops of 
dilute vitriolic Acid—or, an ounce of Syrup of Lemon maybe 
added. 
°r—83. 
of Oil of Sweet Almonds, 1 ounce. 
Gum Arabic, 3 drams. 
Syrup of Wild Poppy, 1 1-2 ounce. 
Dilute vitriolic Acid, which will give it a grateful aci- 
dity. 
Mix.—Dose, as above. 
84. Spermaceti Mixture. 
Take fpermaceti, (diffolved in a pro-^ 
per quantity of Mucilage of Gum V 1 1-2 dram 
Arabic, or Yollc of an Egg,) 
Cinnamon Water, 6 ounces. 
Syrup of Wild Poppy, 1 ounce. 
Mix.—Dose. Two table fpoonfuls occafionally. 
No. Discutient Fomentation. 
Take of common Fomentation, 2 pints. 
Crude Sal Ammoniac, 2 drams. FORMS OF MEDICINE.’ 
Common Vinegar, 
Spirits of Wine, 
of each 2 ounces, 
Mix— 
Take of fimple Lime Water, 
Common Vinegar, 
Camphorated Spirits, 
86. Camphorated Lotion. 
of each 4 ounces. 
Mix.— 
87. Alternative Mercurial Pills* 
Take Gum Guiacum, 1 dram. 
Calomel prepared, 
Precipitated Antimony, 
of each 2 fcruples. 
Balfam of Capivi, fufficient to form thefe into a mafs 
—and make of every dram twelve pills. 
88. Decoction of the woods. 
Take Sarfaparilla, o ounces. 
Guiacurn Wood, 
Saffafras Shavings, 
of each 1 ounce. 
Boil thefe in three pints of water till they are reduced to two 
adding towards the clofe, 
Liquorice-root bruifed, 1-2 an ounce. 
Then ftrain it for ufe. 
or—89. 
Take Sarfaparilla, 2 ounces. 
Bark of the Root of Mezereon, 1-2 a dram. 
Boil thefe in the fame manner as above, and add the liquorice! 
90. Antiputrescent Lotion. 
Take of Lime Water, 16 ounces. 
Camphorated Spirit, 3 ounces. 
Spirit of Sal Ammoniac, 1-2 an ounce. 
Mix 
pi. Anodyne Eye Water. 
Take Rofe Water, 2 ounces. 
Tindture of Opium, 2 drams. 
Mix 
No. 92. Vitriolic Solution. 
Take Purified White Vitriol, 6 grains. 
Role Water, 2 ounces. 
Tindture'of-Opium, 30 drops. 
Mix- FORMS OF MEDICINE. 
407 
93. Detergent Gargle. 
Take Decoction of Barley, 8 ounces. 
Common Vinegar, 1 ounce. 
Tin&urc of Myrrh, 1-2 an ounce. 
Honey of Rofes, 1 ounce. 
Mix— 
94. Amtiseptic Gargles. 
lake Tincture of Rofes, 8 ounces* 
Honey of Rofes, 6 drams. 
Tincture of Myrrh, 1-2 an ounce. 
Spirit of Sea Salt, fuflicient to create an agreeable acidity, 
Mix.— 
95. Expectorant Mixture. 
Take Pectoral Deco&ion, 8 ounces. 
Ammoniacum Milk, 
Oxymel of Squills, 
Mix.— 
or each 3 drams. 
or—9 6, 
Take Acetated Ammonia, 2 ounces. 
Diftilled Water, 5 ounces. 
Myrrh in powder, 40 to 60 grains; 
Nitre purified, 1-2 a dram. 
Vitriolated Steel, 15 grains. 
Balfamic Syrup, 6 drams. 
Mix.—Dose. Three or four fpoonfuls two or three times 3 
day. 
9/. Saline Purging Mixture. 
Take Epfom Salt, 6 ounces, 
diffolved in Boiling Water, 1 pint. 
Dose, Two or three fpoonfuls every half hour. 
98. Oily purging Mixture. 
Take Oil of Caftor, 2 ounces. 
Diftilled Water, 5 ounces. 
Unite them with a proper quantity of the Yolk of Egg, or Mu- 
cilage of Gum Arabic, and then add 
Syrup of White Poppies, 1-2 an ounce. 
Mix.—Dose. Two lpoonfuls every fecond hour. 
or—No. 99. 
Take of Oil of Sweet Almonds; 1 ounce. 
Manna, 1 ounce. 
Rochelle Salt. t> drams. forms of medigine. 
408 
, 
diflblved in Infufion of Senna, ' 6 ounces. 
Mix, as before directed, and let this be taken in the fame rnati- 
ner. • 
Take Jalap in powder, 
Polychreft Salt, 
100. Purging Pills. 
of each 1-2 a dram. 
Venice Soap, , 6 grains. 
Opium, 1 grain. 
Let thefe be formed into fix pills for 3, dofe. 
or—101. 
Take Extract of Jalap, jo grains. 
Refin of Jalap, 
Calomel prepared, 
of each 3 grains. 
Opium, * 1 grain. 
Syrup of Rofes, fufficient to form four pills for a dofe. 
102. Suppository. 
Take of Honey, 
Common Salt, 
of each an equal 
quantity. 
Boil them to the confidence of a foft pill, and roil a portion 
of this up about the thicknefs of a Goofe’s quill, and an inch 
long, which pafs into the redbum—Aloes, Bitter .Apple, or 
fome other ingredient of this fort may be occafionally mixed 
with them. 
103. Irritating Glyster. 
Take the Decoftion for Glyiters, 1-2 a pint. 
Tin&ure of Aloes, 1 ounce. 
Comraou Salt, 2 drams. 
Linfeed Oil, 2 ounces. 
Mix.— 
104. Purging Antimonial Mixture. 
Take Diftilled Water, 5 ounces. 
Epfom bale, 2 ounces. 
Tartarized Antimony, 2 or 3 grains* 
Syrup of Rofes, 6 drams. 
Mix.— . 
No. 105. Calomel Bolus. 
Take Calomel prepared, from g to 6 grains. 
Tartatized Antimony, r-8 of a grain. 
Conferve of Hips, 10 grains, 
Mix, with tbs addition of Syrup, into a bolus, to be taken at FORMS OF MEDICINE. 
bed-time, and in the morning after the following draught; 
106. Purging Draught. 
Take ofTnfnfion of Senna, 2 ounces. 
Tinihire of Aloes, 1-2 an ounce. 
Tindlure of Senna, 3 drams. 
Syrup of Rofes, 1-2 an ounce. 
Spirit of Lavender. 2 drams. 
Mix.— 
107. Volatile opiated Liniment. 
Take of Soap Liniment, or the 7 
1 ■’ r ' t 2 ounces. 
.Liniment of Ammonia, J 
Tint!ure of Opium, 2 drams- 
Mix— 
ic8. Aloetic Pills. 
Take Extract of Bitter Apple with Aloes, 1 1-2 dram* 
Calomel, 20 grains- 
Oil of Carraway-feeds, 10 drops* 
Syrup of Rofes, a fufficient quantity to form pills. 
Dose. From ten to twenty grains. 
109. Aperient Soap Pills. 
Take Venice Soap, 1 1-2 dram- 
Rhubarb powdered, I dram. 
Calomel prepared, 10 grains. 
Syrup of Ginger, fufficient to form pills* 
Dose. T wenty grains;. 
no. Sedative Liniment. 
Take Oil of Almonds, 1 ounce. 
Amber, from to to 20drops* 
Tin&ure of Opium, I dram* 
Mix— 
hi. Sedative Fomentation. 
Take the Heals of the White Poppy ) number. 
bruited, 3 
Let thefe be boiled in forty ounces of Water to twenty, then add, 
Vinegar, . 3 ounces. " 
Fixed Ammcniacal Salt, j diams* 
Mix— 
No. ii2- Opiated Plaister. 
Take Burgundy Pitch, a quantity fufficient to form a plaiftcr 
of a proper lize, to which add ten grains of Opium* 410 
FORMS OF MEDICINE. 
113. Opiated cordial Mixture. 
Take Peppermint Water, 6 ounces. 
Spirit of Juniper, I ounce. 
Opiated Confedtion, 1 dram* 
Syrup of Saffion, 1-2 an ounce* 
Mix*—Dose* Three or four fpoonfuls. 
114* Glyster with bttter Apple. 
Take the Common Glyfter Deco&ion, 8 ounce;, 
in which boT 
Senna, 2 drams. 
* - Bitter Apple, 1-2 a dram, 
ftrain, and add, 
Linfeed Oil, 2 ounces- 
Hbney, I ounce. 
Sal Ammoniac, 2 drams. 
Mix— 
115. Purging Pills. 
Take Refin of Talap, or 1 r • „ 
c J 1 or 6 grains* 
ocammony,' j J 0 
Rub thefe well with Mucilage of Gum Arabic, and Crumbs of 
Bread, fufficient to form th ee or four fmall pills. 
116. Sedative Glyster. 
Take Common Glyfter Deco&ion, or *1 , 
Barley Water, } 6 °UnCM' 
Tindture of Opium, i dram. 
Mithridate, x 1-2 dram* 
Mix- 
117. Deobstruent Soap Pills. 
Take of Soap, 
Myrrh, K of each l dram* 
Amnioniacum, 
Ammoniacal Iron, 1-2 a dram* 
Rhubarb in powder, 1 dram. 
Syrup of Rotes, fufficient to form pills. 
Dose. Fifteen or twenty grins. 
No. i'i8* Opiated Emulsion. 
Take Caftor Oil, 2 ounces* 
Tincture of Senna, 1 1-2 ounce* 
. ——Opium, 40 drops. 
Peppermint Water, 5 ounces* 
Syrup of White Poppies, l-a an ounce* 
Mix*—Dose. Three Ipoonfuls* rOttMS OF MEDICINE. 
up. Ofiated Antimonial Powders 
Take Antimon:al Powder, 4 grains. 
Opium, 2‘grains. 
Rhubarb in Powder, 5 grains, 
To be ad mini lie red every eight hours. 
120. Vitriolic Mixture* 
Take or Blue Vitriol, 1-2 a dram. 
Dillillcd Water, I 1-2 pint. 
Mix --Dose, F.orn one tea-fpoonful to two tablerfpoonfuls 
every two or three hours, till it products its effect. 
121. Balsam of Peru Draught. 
Taka of Balfam of Peru, from 10 to 30 grains. 
M of Gum Aarbic, fufficient to mix into a 
(draught, with 
Peppermint Water, 1 1-2 ounce. 
Syrup of Ginger, 2 drams. 
122. l'EREBINTHINATE MIXTURE. 
Take Oil of Turpentine, from 1 to 2 drams. 
Mucilage of Gum Arabic, fufficient to form a mixture, 
with Peppermint Water, 6 ounces; 
Tincture of Rhubarb, I ounce. 
Syrup of Saffron, 1-2 an ounce, 
Dose, four fpoonfuls two or three times a day. 
123. Infusion of Carrot-seed. 
Take the Seeds of wild Carrot, 1-2 an ounce. 
Boiling Water, 1-2 a pint. 
When cold, add to it a little Milk and Sugar, and drink it twice 
a day. 
124. Glyster. 
Take either of the Glyfters, No. 25, 26. in whiph diffolve, by 
means of the Yolk of Egg, 
Venice Turpentine, 2 drams. 
No. 125. Antimonial nitrated Powder; 
Take Antimonial Powder, 3 or 4 grains 
Nitre purified, 10 grains. 
Crabs Clayvs prepared, 8 grains. 
Mix.— 
126. Volatile Saline Mixture. 
Take Water of Acetated Ammonia, 2 ounces. 
Polychreft Salt, l 1-2 dram. FORMS OF MEDICINE, 
Syrup of Wild Poppy, 1-2 an ounce* 
Pennyroyal Water, 6 ounces. 
Mix— 
127. Mustard Whey- 
Take Bruifed Muftard-i'eed, ' 1 ounce. 
Cow’s Milk, 1 quart* 
Boil them together, ar.d ftrain off the Whey. 
jab’. Gum Guaiacum Draught. 
Take Gum Guaiacum, from 20 to 30 grains. 
Mucilage of Gum Arabic, fufficient to form a draught, 
with Peppermint Water, 1 1-2 ounce. 
r' 1 c ■ ■ r a • ~\ from 20 to 30 or 43 
\ Compound Spirit or Ammonia, J> di ops 
Syrup of Saffron, 2 drams- 
129. Guaiacum and Calomel Bolus. 
Take of Gum Guaiacum, 20 or 30 grains. 
Calomel prepaied, 3 giains- 
Oil of Carraway-feeds, 2 drops. 
Conferve of Orange-peel, 20 grains. 
Syrup of Saffron fufficient to form a bolus. 
~ 130 Stimulant Plaister. 
Take of Soap Plaifter, * “ . 
Gum ditto, . J 
Powdered Spanifh Flies, 1-8 part of the whole? 
Mix.— 
131. Antimonial cordial Diaphor ftic Bolus. 
lake of Atimonial Powder, --- — 3 grains. 
vZile&dt of Hartlhorn } of cach « «rains' 
Aromatic Confe£Hon, 10 grains. 
Syrup of Saffron, fufficient to form a bolus. 
No. 132. Camfhorated Liniment. 
Take Camphor, 1 drams- 
Oil of Almonds, 1 1-2 ounce* 
Mix— . 
133. Nauseating Powder. 
Take ipecacuanha Powder, 1 grain. 
Nitre, or Aromatic Powder 10 grains* 
To be taken every third hour. 
/I34- Decoction of Semirauba. 
Take of Semirauba Bark, 2 drams* FORMS OF MEDICINE 
413 
Didllled Water, 
20 ounces boiled to 
16 ounces. 
Dose. Four fpoonfuls. 
135. Aperient cooling Solution. _ 
Take Virriolated Natron, 1 ounce. 
Nitre, 2 drams. 
Diffolve them in one quart cf Water-gruel, then add. 
Syrup of Rofes, 1 ounce. 
Mix—Dose. Eight fpoonfuls. 
136. Gentle aperient Electuary. 
Take Compound Electuary of Senna, 1 1 -2 ounce. 
Precipitated Sulphur, 3 drams. 
Syrup of Roles, fufficient to form an ele&uary. 
Dose. Quantity of a Nutmeg. 
137. Tonic Infusion. 
Take Peruvian Bark in grofs powder, 2 ounces. 
Infufe it for three days in 
Lime Water, 2 pints* 
drain and add, 
' Tinfture of Cinnamon, 1 ounce. 
Compound Spirit of Lavender, 1-2 an ounce. 
Mix.—Dose* Two ounces- 
138- Alum Whey. 
Take Cow’s Milk, 2 pints. 
Alnm, 3 drams- 
Boil thefe together, and drain off the Whey for ufe. 
Dose. Four ounces. 
No. 139. Opiated Chalybeate Bolus. 
Take of Ammoniacal Iron, 8 grains. 
Powder of Antimony, 6 grains. 
Opium, I grain 
pr Tinflure of Opium, drops. 
Conferve oi Rofes, 1 fcruple. 
Syrup ot Quinces, fufficient to form a bolus. 
SECTION XVI. 
NERVOUS AFFECTIONS. 
TTNDER this head we are to enumerate thofe particular coin” 
■ plaints in which the iierves are primarily and principally NERVOUS AEFFCTIONS, 
concerned, as the catifes from whence difordrr? of this kind are 
produced.—And here we (hall be under the neceflity of reafon- 
ing from effeCls, becaufe we cannot point out the precife mode 
of the aClion of the nervous fyftem ; for neither from the labour* 
of the anatomifts, nor phyfiologifts we are ceitain of the ftruc- 
ture of the nerves t’nemfelves, nor of the means by which they 
produce fuch a wonderful variety of aCtions in different parts of 
the human machine. 
We, therefore, in order to avoid cavil, attempt to materialize, 
as it were, qualities ; and fpeak of the different degrees of influ- 
ence which this part of the fyftem exercifes ; and attributes 
complaints ariling from this fourcc, either to that influence being 
too ftrong, mutable, or too weak* producing spasm, convul- 
SiqN, or palsy ;—according, therefore, as we find the different 
parts fubfervient to nervous influence affeCted, fo do we confider 
the different ftates of its power. And if we add to the account 
the different degtees of mufcular irritability inherent in the ha- 
bit, which urift confider as independent of nervous influence, yet 
for its continuance fupported by that influence, (27.)—we fhall 
be furnifhed with a tolerable clear idea of the nature of differ- 
ent nervous complaints, fo called, and be enabled to conceive, 
pretty difti-nCtly, the reafons why fuch an amazing variety of 
affeCtions can arife from one and the fame fource ; for in fpaf- 
modic afteCtions, the mufcular fibres, thrown into a ftate of con- 
tractility, remain in that ffate for lbme time ; in convul/ive, con- 
traction, and relaxation take place, and alternate with each o- 
ther—(145, 146, 147-) and in paralytic there appears to be a 
deprivation, or debility of that influence; as fometimes 
an alteration in the irritable power of the paufcular fibres, with 
refpeCt to the different degrees they pofiefa. the order we 
have let down there ntrvous complaints, (hall we treat them* 
and firft—©£ fpafmodic affeCtions :— 
C H A P. ’ I{ 
1. Tetanus'; - 
SO called from the Gfeek word teino, firmo—and its varieties 
—EMPKOSTHOTONO'§i-tfrom emprojihort, ante, beforv«~~epijl- 
hon, pone, behind—and TRISMUS, from trjzo, ftridor. Thefis