THERAPEUTICS: OR THE ART OF HEALING. BY THOMAS MARRYAT, M. D. NULLIUS ADDICTUS JURARE IN VERBA MAGISTRI. HOR. FOURTEENTH EDITION. BRISTOL: PRINTED BY ROSSER & CO. BRIDGE-PARADE, FOR T. BECKET, PALL MALL, LONDON Price, in Boards, Four Shillings. 1800.  (iii) PREFIXED TO THE TENTH EDITION. AS this book is now calculated for private families, there is no one in the English language will be of such real use to them. Here is no lamentation over the invalidity of domestic medicines. To offer an inefficacious, or even a precarious medicine, betrays a want of common sense and common honesty too; for it can answer no other purpose than to transfer money out of the pocket of the afflicted into that of the Apothecary. Those recommended here are by no means of that description: he that uses them will assuredly find relief, without the least possible disadvantage. Efficacious medicines are always the safest: there are none taken from that enormous mass of poisons in the Scotch Dispensary; no hazardous ones. Such as are offered have already proved efficient in thousands of cases. Cheapness is an object that has never been lost sight of. Thus, for instance, half an ounce of vitriolic acid (for one penny) in a pint of water, is a perfect cure for the Itch. To give one illustration of the utility and importance of this Treatise to industrious poor families.—From FLATU- LENCIES originate more disorders than from all other causes; as loss of appetite, lowness of spirits, wakefulness, listlessness: wandering pains in the sides, bowels, and be- tween the shoulders, costiveness, sometimes a purging: gra- a2 velly (iv) velly disorders, difficulty of breathing, all the horrors at- tending the hypochondrical and hysterical affections, and those which are called Nervous; to which may be added, al- most every internal sensation that tends to render life uncom- fortable. This interefling observation has never before been made public by any other Author. The reader, by turn- ing to the Article Flatus, or Windy Disorders, will find certain, and I need not add, innocent remedies, which will remove the cause of, as well as the above-mentioned disor- ders themselves, when infested by them. The Author has now done with the Public, to whom he has devoted his best and most faithful services. In a very little time the hand that writes this will be motionless for ever: at such a serious period he may expect some confi- dence from his reader. Throughout his whole life (even from his childhood) he never felt any passion so predominant, any satisfaction so great, as in alleviating the miseries and increasing the happiness of mankind. All other pleasures are nugatory and unworthy of pursuit. To this purpose he devoted two hours every day, in all the places where he resided, to relieve the poor. To this he has sacrificed ease, health, affluence, time, studies, and property. Human nature is burthened with innumerable evils; every man should lend a helping hand to lessen the dreadful aggregate. He who can give the slightest pain to a fellow-creature, or procure advan- tage to himself by the sufferings of another, is an animal unworthy of existence. BRISTOL, July 1, 1791. ADVER- (v) ADVERTISEMENT TO THE NINTH EDITION. THIS Work has passed through five quarto editions at one guinea, and four in oc- tavo. In the eighth (1788) which was Six Shillings, the prescriptions were first adjust- ed, and the names of the medicines altered ac- cording to the New London Pharmacopæia. By omitting every thing that doth not imme- diately apply to practice, the Author has at length completed his design of condensing the whole into a pocket volume. This, he hopes, will be an acceptable ser- vice to the Practitioner, as well as of intrin- sic and diffusive utility to mankind. a3 EPISTLE  (vii) EPISTLE DEDICATORY. TO THE ENGLISH APOTHECARIES. GENTLEMEN, THIS Treatise was originally intended for your service, and is now presented to you in as finished a state as I am capable of raising it to. The first Latin edition being soon disposed of in the year 1758, I was requested to give it in English; this I complied with less reluctantly, because a person had already published a translation of the prescrip- tions, with his own directions for their application. He was, indeed, by no means equal to the task; yet his motley work passed through several editions. In a lapse of above thirty years since its first publication, I have, with unre- mitted sedulity, made such alterations and additions as seemed necessary or useful, attentively observing the opera- tions of nature, confirming those observations by experience, with the advantage of a practice as extensive and as success- ful as that of any Physician in Europe. The result of all my observations, and of infinite combinations, during the space of forty years, cannot be unacceptable to ye. Let me add, that there is not a single prescription in the subsequent pages that you can ever make use of to the possible prejudice of viii EPISTLE DEDICATORY. of any person. He that would triffle with the life or health of a fellow-creature, is an object of the severest reprehen- sibility. It has afforded me great satisfaction to know that many of you, who are very eminent in their profession, have for several years administered the prescriptions in this TREA- TISE, with success equal to their most sanguine expectations. As to your pecuniary interest, I never consulted it, and consequently have no reason to expect that you should con- sult mine. Nor have I swerved from the Evangelical rule in that respect, having treated you full as well as myself. The object ever most dear to me was to mitigate the suffer- ings, relieve the miseries, and remove the pains of my fel- low-creatures; to this purpose has my life been devoted. It is with this sole view that I inscribe my work to you. The only favor I ever did, or ever shall request of you is, to dis- pense my precriptions with your usual fidelity and accuracy; to say the truth, I have very seldom had any reason to com- plain: for this (as you are entitled to them) be pleased to accept the warmest acknowledgments of GENTLEMEN, Your humble Servant, THOMAS MARRYAT. PREFACE. (ix) PREFACE. THE publication of a new Pharmacopœia by the Royal College has rendered it necessary for the Author to make some alterations in most of his prescriptions. As this was a task no one could perform for him, it was also one of the most difficult and troublesome he ever engaged in. Many of them required trials, and frequent trials too, after they were adjusted to the London Pharmacopœia. The whole merit of these formulæ consists in their combinations; the least addition or alteration might create an incredible dif- ference in their effect. Many of these prescriptions he can without hesitation pronounce invaluable, on account of those fortunate combinations. We want, says an ingenious Scotch Professor, remedies! remedies! remedies! Surely it is the peculiar province of the Physician to fabricate and apply them. It is his busi- ness to conjoin those ingredients, which alone, or taken sepa- rately would prove inert or nugatory: yet when combined by medical acumen are pointedly directed, and attain energy sufficient to remove the respective disorder. In this, too little adverted to, the whole skill and merit of the Physician consists. x PREFACE. consists. There is scarce a solitary subtance in nature that will remove any one disease always, brimstone excepted, even that cannot be depended on, if used only internally. Has not this triplicate epiphonema bewildered and mis- led many? Has it not stimulated every Scotch pupil to rummage the whole catalogue of poisons? If he can find one, the use of which, on account of its deleterious qua- lity, has for some centuries been proscribed, if he is lucky enough to administer it without killing his patient, like Archimedes, he cries out Eureka, and skips about in an intoxicating extasy. It is presented to the public eye, and he is flushed with the fascinating hope of seeing his remedy hitched up with the curious range of poisons in some future edition of that wonderful production, the Edinburgh Dis- pensatory. With humble submission to the above-mentioned learned professor, we are in no want of materials, if we have skill enough to combine them with propriety. There are in the New London Pharmacopœia more than sufficient to frame a remedy from for any disorder in its own nature curable: as to the other sort the unhappy patient has no chance of being discharged cured from any other place than the Royal Edin- burgh Infirmary. The effects of due combination are beyond measure asto- nishing. We may assign sufficient reasons why two pow- ders, separately inodorous, when combined possess the acutest pungency: or when two liquids perfectly cold, as soon as united xi PREFACE. united take fire and burst into flame, even in the exhausted receiver of an air-pump. In the human body there are so many chemical processes carried on, and such a variety of operations of nature, that the utmost limits of our knowledge of the modus operandi seem to terminate in probability.— Such a combination has produced such an alteration; it is highly probable that such a cause may produce the same ef- fect: as for instance, I have seen a great number of cases wherein the asafœtida has been given in large quantities, and for a considerable time to no purpose; when joined with a chalybeate, it had soon the desired effect. A person labouring under an angina pectoris, wheezing, snorting, and struggling for existence, after every expira- tion, in inexpressible agonies, was entirely relieved from his distress in a few minutes, by half a grain of opium com- bined with the same quantity of cantharides, though opiates had been given before, with aggravation of the complaint. This was a remedy. Opiates exhibited alone will often disappoint the practi- tioner; combined with quicksilver, or an antimonial, or both, as the exigency of the case requires, will almost immediately answer the end designed. The same medicine joined with kali, cantharides, or ipecacuanha, or even chalk, according to the intention and skill of the prescriber, will take an in- credible effect. The bark, that magnum Dei donum, as Dr. Mead calls it, is too often trusted to alone, and with scanty success; com- xii PREFACE. bined with ammonia, or kali, or nitre, or iron, or opium, according to the case, will prove a sovereign remedy: quick- silver itself requires sometimes rhubarb, and sometimes opi- um to assist its operation and efficacy. Guaiacum may be given in large quantities without advantage—dissolved in compound spirit of ammonia, will soon free the patient from his pains. The tartarised antimony, I have lately observed, has in many cases a much better and quicker effect when combined with wine than any other form. This the au- thors of the New London Pharmacopœia were apprised of, as appears by their order to keep a tartarised antimonial wine as an officinal; of an ounce of this wine with two drachms of syrup, if a tea-spoonful is given every three or four hours, it is the most expeditious and efficacious remedy for all fevers of children without exception. It is indeed a feast to the scientific taste to trace that exquisite skill of com- bining so manifestly displayed in that incomparable work.— In this the art of healing wholly consists. To combine with propriety is neither to be learned from books, nor from the mouths of professors; nor is it taught even in that extraor- dinary seminary where every thing else is taught, the glory of the North, the wonder of the world! He who would acquire it must have lain the broad basis of a liberal education, and have attained a most extensive knowledge of things. He ought to know what the learned have thought before him in former ages, and different na- tions. He should possess a vivid imagination, a tenacious memory, and sound judgment to discriminate with precision between things discrepant and things homo geneneous. He must xiii PREFACE. must be well acquainted with the effects of matter on matter. He should have been present at the dissection of a hundred or a hundred and fifty subjects. He must be no stranger to Botany, Chemistry, Pharmacy, or Surgery. His applica- tion must be indefatigable, and his attention to the opera- tions of nature calm, steady, and unremitted. He must be cautious, circumspective, and attentive to the minutest cir- cumstances, with patience and perseverance unrelaxed. By travelling he ought to have informed himself of a variety of things which he could never learn at home. Such a one, by continued observation, and painful experience, may qualify himself to acquire the knowledge of proper and efficient com- binations, consequently of the Art of Healing. From hence it is plain that this Art is to be learned, not to be taught. No books in the world will ever make a Physician. To faci- litate the learning of it should excite the most strenuous en- deavours of those whose business it is to instruct others in the preparatory sciences. To seek for specifics is inexcusable peurility, or the suggestion of desponding indolence. Like some who being in possession of every thing they do want, are incessantly hunting after what they do not want, or that which is unattainable. In cases of difficulty or danger, a Physician must be re- sorted to: for common disorders, the reader will find reme- dies in this book, and rules sufficiently plain to apply them. I now take my final leave of the Public; for at my time of life I cannot expect to make any more discoveries of im- portance, especially as I feel the passion for solitude daily in- b creasing: xiv PREFACE. creasing: it is true, existence is not worth possessing, if it doth not contribute to the ease and happiness of the existence of others. Should I be fortunate enough to mark the pecu- liar effect of any combination in future, an account of it will certainly be found amongst my papers after my decease. READER farewell! and rest assured that the most exalted and refined felicity springs from the disinterested and un- wearied endeavours to lessen the evils of life, and add to the enjoyments of your fellow-creatures. PREFACE, (xv) PREFACE, TO THE FIFTH, AND FIRST EDITION IN OCTAVO, PRINTED IN BIRMINGHAM. FROM the frequent and repeated solicitations of his friends in BIRMINGHAM, to comprise the ensuing work in a pocket volume, the Author has been induced to pre- sent the Public with a treatise, which has been hitherto sold for a guinea, at the price of five shillings: nor can he think any compliment he is capable of paying to this town suffi- ciently expressive of that great sensibility with which his heart is penetrated for their very extraordinary and indulgent partiality towards him. He hopes the exultation is no ways culpable that springs from his heart-felt satisfaction, that none have had reason to repent of the confidence reposed in him. He has not the least intention of attempting to vindicate any thing in this work. Whatever is indefensible he would be the first to execrate; but it may with safety be asserted, that the practitioner who makes use of the methods recom- mended, must be extremely unfortunate who should be always unsuccessful. b2 This xvi PREFACE. This work was not noticed by the Monthly Review till the publication of the fourth edition. See the Monthly Review for April, 1775. That the medicines prescribed are some of the keenest edge tools of physic, must be acknowledged; for, perhaps busy minds might entertain some suspicions of the sagacity or dexterity of that workman who should prefer the use of blunt ones; and if the old adage is true, such a one stands the worst chance of cutting his fingers. The dry vomit cannot deserve the unkind terms of rugged and surly; for the only teasing or vexatious circumstances I have ever known to attend it is, that it sometimes would not vomit at all; and, in cases where that effect has been neces- sary, I have been obliged to double the dose, even in delicate habits, before it could be procured; though, strange as it may seem, the quantity of either ingredient alone would have puked pretty smartly. The Author confesses his temper is naturally sanguine, and that he may sometimes have expressed himself in terms rather too strong; but when it is considered that he relates nothing which his eyes have not seen, some allowances should be made for said strength of expression. He would esteem that person as his best and dearest friend who points out his faults. Whether he is right or wrong in his speculative no- ions, appears to him a matter of equal moment with, whe- ther a goose stands on her right or her left leg. But whe- ther mankind are misled in things relating to their health is an xvii PREFACE. an affair of the last importance, and he would rather perish than offer any thing to the Public which could be the least deceptious on this head. He thought himself the first person who ever gave vomits in internal hœmorrhages, till a gentleman, about ten years after the publication of his treatise, dispelled his vanity, by putting into his hands a book, wrote by old Dr. ROBINSON, above forty years ago, wherein are related a vast number of cases, in which he succeeded by vomits only. It may not be amiss in this place, to make some remarks on that prima facie absurd prescription, under the article Dysentery, of paper boiled in milk. When it was first com- municated to me, by an ancient physician, on the Continent, it afforded no small employment to my zygomatic and bucci- nator muscles. The good-natured old gentleman, without taking any offence at my mirth, only observed, that I might in the course of practice, meet with some things seemingly as ridiculous, which would prove of no small efficacy. Many years passed without the least thoughts of it, till being called to a gentleman's son about nine years of age, previously at- tended by four Physicians, who could be of little service, be- cause the child obstinately refused to take any medicines.— Ashamed to mention the paper dose to any of my brethren, I asked the mother if her son was fond of milk;—she replied in the affirmative; the paper was boiled in it; and, when I visited him the next morning, he was perfectly recovered. At that time I felt a similar sensation with honest Tristram, when reflected on his behaviour to the poor monk. Some time xviii PREFACE. time after, a lady who had been seized with the most dread- ful dysentery I ever saw, in a quarter of an hour after taking the boiled paper, was well. There is certainly nothing so common as to impute effects to causes by no means adequate to the production of said effects. Of this error the Author has been particularly cautious, even to a refined scrupulosity; but where the effect has cœteris paribus, invariably followed, he thought himself entitled for the future to expect it. The large doses of volatiles and narcotics to be met with in these pages, may startle the reader. It is to be feared they are often trified with by an inexcusable temerity. It is a certain fact, that small doses, at different times, have often no good effect, and that the opportunity of saving our patient, which a large dose at first might have effected, is irretriev- ably lost. An extensive experience has convinced me, that many lives are to be preserved by an happy temerity. With respect to the colic, or any other painful disorder, the best method of using electricity, I know of, is, first to draw a few sparks from the affected place, and then to draw the pained part into the electrical circuit, and immediately after to give another shock, at right angles, to the former. The Author did not chuse to adopt any systematical or re- gular arrangement of diseases; but those of which great multitudes have come under his care, are all treated in the subsequent manner. A definition of every disease is first given, sometimes in- deed, not very accurate, but popular and intelligible; for his chief xix PREFACE. chief aim was to express himself with as much plainness and perspicuity as the nature of things would admit of. The various causes by which it may he occasioned follow. The reader will here meet with many latent and unsuspected ones, and some that were never observed before, yet well worth his serious and careful attention. All the diagnostics are subjoined, and pathognomonic symptoms, without which it cannot exists (to preclude all possibility of a mistake) to give him a competent knowledge of the difference of distempers, and enable him to treat them with certainty and precision. The invariable prognostics are added to satisfy a natural curiosity which prompts us to inquire whether it will termi- nate in health, another disease, or death: nor is the least regard paid to any authors, unless we have seen their asser- tions confirmed by a series of instances, and irrefragable experience. The cure is the next and most important point that comes under consideration, including the regulation of the non-na- turals, particularly the dietetic regimen. According to the plan laid down, it is impossible to err in this case, or to be at a loss in knowing whether evacuations are necessary, and which are the most eligible. For instance, if there is too great a quantity of vital heat accumulated, and that accumu- lation be universal, a vein must be opened; but if it exceeds not in quantity, or the accumulation be only partial, as in hectics, xx PREFACE. hectics, slow fevers, &c. nothing can exculpate the practi- tioner for proposing that operation. Lastly, a variety of prescriptions are given, adapted to the various circumstances of the case, and such only as have often proved successful. My attachment (perhaps too violent) to formulæ I readily confess, partly owing to the necessity of writing some scores over night, without which precaution it would have been im- possible to assist the numbers of poor who applied to me in several places where I have been. In what manner they were acquired is of little concern- ment to the reader; some were discovered by accident, others originate from hints received from old physicians, though by far the greatest part are the result of severe study; the utility of which has been confirmed by long, extensive, and painful experience. Such as they are, mankind are welcome to them, as I have no other object in view but their benefit_ He who can conceal that which would be of advantage to millions, for the emolument of a paltry individual, is a despicable wretch, that deserves very ill of society. Si quid novisti rectius istis; Candidus imperti, si non his utere mecum. HOR. THERAPEUTICS: THERAPEUTICS: OR, THE ART OF HEALING. OF FEVERS IN GENERAL. A FEVER exists when the motion of the blood is preternaturally accelerated, which increased mo- tion seems to be caused by an effort of nature to expel something out of the body which ought not to be re- tained within it; but this effect becomes a primary dis- ease from the incapacity of nature to remove it. By Nature, is meant that motive power by which those functions are performed, which are entirely inde- pendent on our own direction or consent; such, for instance, as the pulsation of the heart and arteries, the secretions, &c. Spontaneous actions, or those which are chiefly so, being objects of eligibility, are therefore by physicians termed non-naturals. The proximate cause of fevers is irritation (which may occasion a spasmodic affection of the whole ner- vous system) commonly owing to an obstruction of in- sensible perspiration: when the particles of this mat- ter are thrown back into the circulation, they may stag- nate in, and plug up the extremities of the capillary ar- teries, or bring on spasmodic constrictions of them. An irritation may also be owing to other causes, as acrid food or liquors, affections of the mind, hunger, A the (2) the absorption of pus, any thing acrimonious coming into contact with the extremity of a nerve, intense study, agrypnia, profuse, venery; propulsion of the blood into the lymphatics, which is then called an inflam- mation. The diagnostics of an inflammatory fever. Parching heat, intolerable thirst, high coloured urine, without sediment; velocity, hardness and fullness of the pulse, pain in the head, side, back, or loins; a dry furry tongue, anxiety about the præcordia, difficult respi- ration, coma vigil and aversion from food. Fevers generally begin with a previous sensation of chillness, shivering, or intense cold; less or more, longer or shorter, external or internal, according to the variety of subjects, causes, or fevers themselves. The prognostics. Every fever terminates in health, another disease, or death. In health, when the morbific matter is subjugated by the fever, loosened, rendered moveable, and at length expelled by insensible perspiration, Sweat, salvia, vomiting, urine, or diarrhœa; a crisis usually coming on within fourteen days. In another disease, when the vessels are injured by too violent an exagitation; the more fluid parts dissipated, the rest incrassated, and the critical matter deposited in vessels which are obstructed, dilated, or ruptured; hence arise pustulous, red spots, erysipelas, phlegmons, buboes, schirri, exanthemata, abscesses, gangrenes, and mortifications. In death, when the increased accumulation of the vital heat overcomes the elasticity of the muscular fibre, and retains the heart in its diastole; or when the fluids are de- stroyed by the force of the solids, hence arise inflam- mations, superations, gangrenes in the vital viscera, and (3) and aphthous ulcers in the primæ vitæ; which last, though seldom noticed or suspected, appear from dis- sections to be a common cause of death. The curative indications. These direct to the correc- tion and expulsion of the acrid irritating matter, with unremitted attention to the vis vitæ, that it may not be too much diminished; while the motion of the blood must be restrained within due bounds, and the redun- dance of heat expelled. As to regimen, fresh air is absolutely necessary, which may be admitted by the door or windows, as often and as long as may be thought convenient; vinegar should be frequently thrown on a red hot iron in the room: nor would it be a trifling melioration of the air to set pots near the bed with some of the aromatic plants growing in them, such as lavender, rue, rosemary, or mint, but by no means to suffer any herbs which are not in a state of vegetation to continue in the same room with the patient, nor these after sun-set Clean linen refreshes, and may safely be allowed every day, or every other day at farthest. Let him not to be con- fined wholly to his bed, but sit up every day, as long as he can without fatigue. He should be plied plentifully with diluting liquids, for it is impossible that he can drink too much: what the fluid is, is not very material, provided it be taken in immense quantities: even cold water, if required, may be drank with safety and advantage. The subse- quent diluents are exceeding suitable, viz. barley water, with forty drops of spirit of nitrous æther in every pint, decoction of hartshorn, cider whey, tea prepared from balm, sage, mint, penny-royal, or mother of thyme. A lemon squeezed into a pint of water, and sweetened to the taste with treacle, is of considerable utility. Three spoonfuls of vinegar in a pint of water, sweetened with honey, is another very proper ptisan, as is also vinegar whey. A2 When (4) When nature verges towards a secretion, diaphore- tics, or at least a warmer regimen becomes necessary to help on coction and a crisis; depuration is the work of nature: if she is languid, assist her with cardiacs, aromatics, and volatiles: then blisters are highly proper (especially to the corpulent), to quicken the circulation, dissolve the viscid and too bulky sanguineous corpus- cles, and to forward secretion through the miliary glands. When the fever is subjugated, let the patient take that which affords the smallest employment for the chylopoietic organs, with antiputrescents, salts and acids; whatever food is allowed should be given in small quantities and often repeated: spoon-meats, broth, panada, bread pudding, and such like. It is a fortunate circumstance that persons, while a fever con- tinues, seldom feel any inclination to eat, for the chyle cannot then be properly elaborated. After the ravages of a fever, and to remove that distressing langour which arises from too profuse evacuations, nothing is so pro- per as strong broths drank as frequently and as copi- ously as the stomach will bear. I have often enjoined the use of them, though the pulse continued quick and ticking, while flushings and partial heat remained, and the patients were thought to be at the last gasp, with amazing success. If a vehement craving is manifested of something par- ticular to eat, and if it be often requested—let it be what it will, it ought not to be refused: in the decline of fevers, there seems to be something in these untoward hankerings of nature analogous to the pica in chlorotics, whose eager desire of chalk and tobacco pipes is by no means, as some suppose, the cause of their disorder, but the predominant acid in their stomach (the primary disorder), which naturally instigates them to feed on such things. The cure. If the strength of the patient will bear it, use venæ-section. Cooling (5) Cooling clysters may be administered with great propriety, as, Take of pure nitre two drachms, Honey of roses one ounce, Sweet whey seven ounces. Make it a clyster. It will be found no inconsiderable auxiliary (especially for children) to bathe the feet and legs with warm water two or three times a day. The following mixture may be drank at pleasure. Take of pure nitre half an ounce, Juice of lemons seven ounces, Cochineal two drachms, Water a gallon, Sugar as much as you please. Let it be made a mixture. On the first appearance of a fever the subsequent bolus will generally answer and remove it in a few hours. Take of pure nitre, Camphire of each a scruple, Conserve of wormwood half a drachm. Make it a bolus to be taken at night, and if necessary, to be repeated the next morning, the patient being con- fined to his bed till the sweat goes off. Any fever may be soon extinguished by the use of the following powders: Take of tartarised antimony, five grains, White sugar (or nitre) a drachm. Let (6) Let them be well rubbed in a glass mortar, and be di- vided into six powders: one to be taken every three hours, notwithstanding the nausea the first may possi- bly occasion. If they bring on a diarrhœa, they should be still continued, and it will soon cease spontaneously. If these are taken (which is most commonly the case) without any manifest inconvenience, let there be seven grains in the next six powders; and in the next, ten. Here I beg leave to retract what I said in the former editions of this work, viz. that till sickness and vomi- ting was excited, this noble medicine was not to be de- pended on.——For I have since seen many instances wherein a paper has been given every three hours (of which there have been ten grains in six powders) with- out the least sensible operation, either by sickness, stool, urine, or sweat, and though the patients had been un- remittedly delirious for more than a week, with subsul- tus tendinum, and all the appearances of hastening death, they have perfectly recovered without any other medicinal aid, a clyster every other day excepted. I have lately seen a great many cases similar to the above, and the tartarised antimony has invariably produced the same effect. ARDENT FEVER. AN ardent fever is attended with a preternatural and universal heat; if it is continual and termi- nates in twenty-four hours, it is called Ephemera; if it should last longer, it is termed Causus or Synochus. The putrid. Synochus, as the Antients called it, has for its concomitants a burning heat, vehement thirst, aversion from food, intolerable anxiety, a dry furred tongue, unnatural respiration, restless nights, and a crude, thick, or red urine without sediment. The (7) The cause, as has been already remarked, is irritation. If that which ought to be expelled from the body is re- tained within it, a consequential putrefaction ensues, from whence the putrid synochus and other putrid dis- eases. The diagnostics, or pathognomonic symptoms are in- tolerable thirst, prodigious heat over the whole body, the tongue dry, rough, yellow, or black: coarctation of the lungs, consequently difficult and laborious respi- ration, quickness and hardness of the pulse; pain in the head, flame-coloured urine, costiveness, anxiety about the præcordia, agrypnia. The prognostics. It is most commonly mortal on the third or fourth day, or resolved by an hæmorrhage. The face red and clammy; the urine thin, small in quantity, black or bloody; a parotis not suppurating, spasmodic constrictions of the bronchia, all forebode great danger. But if the patient snatches, fumbles with his fingers, gathers up the bed clothes, seems to pick straws, drops involuntary tears; if purple or livid spots appear, if the hypochondres are inflated, the extremities cold, with catchings of the breath, insensibility, cold sweats, hic- coughs, ratling in the throat: any of these are delete- rious symptoms, and most of them generally quick fore- runners of the last catastrophe. The cure. Assist nature in her efforts to expel the morbific matter in the same method whereby she at- tempts to do it, whether by hæmorrhage, vomiting, sweat, or urine.—Give great quantities of diluting li- quids. Draw off blood from a large orifice as soon as possible, and repeat the operation according to the in- dication of symptoms, though after the third day phle- botomy cannot be used with propriety. If (8) If the vital strength has been indiscreetly reduced by too frequent venæsections; on recovery, give cardiacs, volatiles, and strong broths. When the fever remits, give the Peruvian bark. The medicines which have been found successful in the cure of ardent fevers are to be met with below: either of which formulæ may be adopted according to the dis- cretion of the practitioner, or the tartarised antimonial powders recommended under the article, fevers in ge- neral. Take of pure nitre, two drachms, Compound powder of contrayerva, Calcined antimony, of each one drachm. Make into six powders. One to be taken every three (or two) hours. Or, Take of prepared kali, Pure nitre, of each a scruple, Pure water, an ounce, Spirit of nutmeg, Juice of lemons, of each two drachms. A draught to be taken every third hour. Or, Take of acetated kali, half a drachm. Pure nitre, fifteen grains, Pure water, an ounce and a half, Spirit of Nutmeg, two drachms, Compound spirit of ammonia, twenty-five drops. A draught to be repeated every three hours. The use of cardiacs is not to be dispensed with even in disorders arising from a plethora; for if nature is not kindly supported, she cannot free herself from such disorders; add to which, the languor arising from ne- cessary evacuations is sometimes fatal for want of pro- per strengtheners and nutritious restoratives. INTER- (9) INTERMITTING FEVER. AN intermitting fever (or ague) is one that returns after the patient is wholly free from it for one, two, or more days, with fresh and increased exacerba- tion. The causes. A viscidity of the arterial fluid, occa- sioning a quicker and stronger contraction of the heart; an obstruction, or unequal distribution of the vital heat; a predominant acid in the primæ viæ; so that the cause seems rather to originate in the nervous influence, for the bark will profligate this disorder, and the same drug is equally efficacious in the removal of hysteric passions. The diagnostics. An oscitancy, sensation of lassi- tude, rigor, quaking, paleness of the extremities, diffi- cult respiration, anxiety about the præcordia, nausea, vomiting, pain in the back; loins, and limbs, the pulse quick and small, the urine thin and crude; then follow heat, flushings, redness, strong pulse, intense thirst, violent pain in the head, and the urine red as in a con- tinual fever; afterwards the patient falls into a profuse sweat, the symptoms remit, the urine grows thick, with a sediment like brick-dust; sleep and debility succeed. The prognostics. Sometimes it changes its type, and is converted to a dangerous continual fever; but this is peculiar to plethoric habits. Sometimes it terminates (in cachectic habits, or if not treated scientifically) in a dropsy, jaundice, phthisis, or scirrous tumours of the abdomen; though these disorders may with more pro- priety be imputed to bleeding, than be numbered among the natural consequences of intermittents. If properly managed, it is to be subjugated with great facility. The cure. If plethoric, which is very rarely the case, bleed. If there is much nausea, furriness of the tongue, a bitter taste in the mouth, or frequent retchings, give A3 a puke (10) a puke immediately. The following repeated every morning, will be alone sufficient to remove most inter- mittents. Take of blue vitriol, Antimony tartarised, of each eight grains. Make into three powders. Let one be taken early in the morning, fasting,, in a large spoon about half full of water: let the patient strain, but drink nothing with it till he ejects some yellow or porraceous matter; if his sickness doth not then go off of itself, half a glass of brandy should be taken; if that should come up imme- diately, the repetition of it will settle his stomach, and he may then go about his usual business. If this method should be objected to, the bark may be administered as follows, with certainty of success. Take of red Peruvian bark, two scruples, Crude salt ammoniac, five grains, Syrup of orange peel, as much as will make it into a bolus. To be taken every third or fourth hour, during the ab- sence of the paroxysm, washing it down with a glass of port wine, or (which is a very elegant method of dis- pensing it,) Take of red bark, one ounce, Extract of liquorice, two drachms, Oil of sassafras, half a drachm, Mucilage of gum arabic, as much as will make it into an electuary. The size of a walnut to be taken three or four times a day, during the apyrexy. If the patient suffers under great debility, a chalybeate ought to be joined with the bark, as, Take (11) Take of red bark, an ounce, Green vitriol, a drachm and a half, Mucilage of gum arabic, enough to make it an electuary. Dose, the quantity of a nutmeg, three or four times a day, in the time of intermission. Should the bark be importunately objected to, either of the following formulæ will be found to answer ex- pectation: the first is most proper for them whose hot fits are the longest. Take of prepared kali, two drachms, Pure water, seven ounces, Spirit of cinnamon, an ounce and an half, Water of ammonia, half an ounce, Tolu syrup, an ounce. Of this mixture, let three large spoonfuls be taken every three hours, with a draught of cammomile tea. Or, Take of elecampane root, Flowers of sulphur, of each an ounce, Syrup of orange peel, enough to make an elec- tuary. Dose, the size of a walnut, thrice a day. As auxiliaries to expedite the cure, a tea-spoonful of one of the following bottles of drops may be given with either of the above medicines, twice, or thrice a day. Take of water of kali, six drachms, Water of ammonia, two drachms. Make into Drops. Or, Take (12) Take of compound tincture of gentian, six drachms, Diluted vitriolic acid, two drachms, as before. Or, Tincture of muriated iron, twenty drops twice a day. N. B. The flowers of sulphur (in costive habits) given in large quantities, as a table spoonful two or three times a day, will remove most agues. PLEURISY. A PLEURISY is an inflammation of the membrane that lines the ribs, or of the intercostal muscles; the first is called the true, the latter, the spurious, or bastard pleurisy. It attacks all parts of the pleura, and sometimes the mediastinum. It rarely, if ever invades children, or those who have a predominant acid in their stomachs. If owing to another disease, it is called symptomatic; otherwise idiopathic. The cause, is that which determines matter to the pleura; or a metastasis of matter from other disorders, or that of ulcerous tumors, absorbed by the veins; or whatever is the cause of an inflammation; as, expo- sing the naked body to the cold air after exercise; drinking cold water when hot; a blow, a fall, a con- tusion; neglect of usual exercise, or customary evacua- tions; carrying a weight disproportionate to the strength; inflammatory disposition of the blood; a plethora. The diagnostics. An acute continual fever, a hard pricking, serrine pulse; a violent fixed pungitive pain in the side, greatly exacerbated in inspiration: on hold- ing the breath, or in expiration, the pain is milder; a cough almost incessant; a dry furred tongue; the res- piration (13) piration small, frequent, and operose; great anxiety about the præcordia ; perpetual moaning, restlessness, agrypnia. The prognostics. If an hæmoptoe supervenes within three days, it is a sign that the disease will not be of long continuance: if later, it will be the more tedious; if a spitting doth not come on within fourteen days, the consequence will be an empyema and tabes. If it ap- pears mild on the fifth day, and is aggravated on the seventh, it generally proves mortal. The fifth day is often the last. If the expuition be of a dark brown co- lour, tough and excreted with difficulty, this, for ob- vious reasons, is a deadly symptom. The prognosis de- pends much on the respiration: if that is very anhelous, and the patient be really peripneumonic, though he seems hearty, speaks strong, and is in his perfect senses, yet in a few hours the shears of Atropus will perform their office. If a whitish viscous buff should appear on the surface of the drawn blood, or if it be a relapse, the case is dangerous. If a white light spitting is thrown off, and the fever is not very high, the heat equally distributed through- out the whole body, the thirst not very intense, the expuition performed with facility, the spirits not sunk, the dozes easy, and finish without starting; these are all good signs, and where they appear, the cure is not difficult. The cure. Begin with venæ-section from a large orifice, to be repeated as there is occasion, but not af- ter the disappearance of the white crust. Give plenti- fully, and as often as possible, of diluting liquids, blood warm, particularly Rhenish wine-whey, or any of those recommended under the article, FEVERS in general. The tartarised antimony powders, under that article, are not to be omitted. In the interim, viz. two hours after each powder, i. e. every fours hours, let one of the following draughts be given. Take (14) Take of spermaceti, (dissolved in a little of the yolk of an egg,) half a drachm, Pure nitre, a scruple, Pure water, an ounce, Tolu syrup, two drachms, Water of ammonia, thirty drops. Or, Take of acetated kali, half a drachm, Pure nitre, a scruple, Purified salt of amber, seven grains, Pure water, an ounce and half, Syrup of marsh-mallows, two drachms. If the form of a bolus is more agreeable, Take of pure nitre, Olibanum, of each a scruple, Camphire, ten grains, Balsam of Peru, ten drops, Oil of juniper, five drops, Syrup of marsh-mallows, enough to make them into a bolus. Or, Take of pure nitre, Rattle-snake root, of each a scruple, Opiate confection, enough to make a bolus. To facilitate expuition, and appease the cough, let one of the subsequent auxiliaries be used, viz. twenty drops of balsam of copavia on sugar, twice or thrice a day, which has no heating quality, as some suppose, but on the contrary, lowers the pulse; I have seen ad- mirable effects from it. Or, a tea-spoonful of volatile liquor of hartshorn, which is an excellent attenuant. Or, a tea-spoonful of spirit of nitrous æther, either of these to be given in water, two or three times a day. This linctus may be allowed at pleasure, to abate the violence of the cough. Take of conserve of roses, half an ounce, Juice of Seville oranges, Oil (15) Oil of olives, of each an ounce, Syrup of white poppies, two ounces. Make it a linctus. As topical applications are extremely necessary to re- move the pain, and discuss the inspissated fluids, the reader is here presented with various forms which have proved efficacious, though perhaps a vesicatory on the part pained, is as eligible as any of them. Take of water of ammonia, Oil of olives, of each half an ounce. Make it a liniment, with which the affected side should be often bathed. Or, Take of linseed oil, an ounce, Camphire, half an ounce, Oil of aniseed, a drachm. Make it a liniment. Or, apply the simple plaister, or the cummin cataplasm. Or, Take of fœnugreek, Cummin seeds, of each an ounce and half Linseed meal, an ounce, Honey, two ounces, Oil of olives, enough to make it a poultice. Or, cupping, with scarification. QUINSY. A QUINSY, or Angina, is an inflammatory fever, owing to a defluction upon, or some injury done to the thorax, fauces, or lungs, which occasions a dif- ficulty of deglution and respiration. It (16) It sometimes appears without any sign of a tumor, ex- ternal or internal, and is then owing to spasmodic con- striction, and requires the same treatment with the suf- focating catarrh. That which is the object of present consideration is, when there is a real tumor in some part of the organs of the fauces, tonsils or circumjacent muscles. It is usually divided into four species, viz. Cynanche, when the internal muscles of the larynx are affected without an apparent tumor; Pardcynanche, when the external muscles of the larynx are affected without ap- parent tumor; Synanche, when there is an internal tu- mor impeding respiration; Pardsynanche, when the ex- ternal muscles of the fauces are inflamed with a tumor: there are also other species of it, such as the watery, schirrous, suppuratory, gangrenous and convulsive, as well as inflammatory Angina. The cause. Stagnation of a vitiated fluid in the ves- sels, from whence arises a compression of the muscles, as must be the case in all inflammations. The obstruc- tion of insensible perspiration may occasion this. The diagnostics. Difficulty of swallowing, laborious respiration, rigidity of the neck, pricking pains about the cheeks, danger of suffocation, a violent fever, some- times with and sometimes without a tumor. The prognostics. If no swelling appears, it is dan- gerous. If the tumor is large and respiration very ope- rose, present help must be afforded; for if the patient is not soon relieved, suffocation will ensue. The cure. The regimen must be the same as in ar- dent or other inflammatory fevers; for we treat not un- der this head of the pituitous Angina. Let blood be drawn from the arm, the jugular, or the sublinguals, according to the strength of the patient. The part af- fected may be touched with the honey of roses, ren- dered (17) dered acrid. with vitriolic acid. A lump of sugar soaked in camphorated spirits of wine may be suffered to dis- solve slowly in the mouth. Use appropriate gargarisms, linctus; warm cataplasms, for warmth molifies and dis- cusses; vesicatories, clysters, lenient cathartics, and if nothing else will avail, bronchotomy, which may be performed with the utmost safety; were it otherwise, such cases as these would warrant the most hazardous enterprize that could afford the least gleam of hope. I shall now offer some medicines to the choice of the practitioner, the use of which has been attended with success. Seven drops of oil of amber on a lump of sugar, to be kept in the mouth without moving till dis- solved: this has often produced an amazing effect. Take of long pepper, an ounce, Winter's bark, Cloves, of each half an ounce. Boil in a pint of new milk, and let the vapor be re- ceived into the mouth through an inverted, funnel. Take of barley-water, half a pint, Rose-water, an ounce, Honey of roses, two ounces, Pure nitre, half an ounce. For a gargle, to be held in the mouth till it grows warm, and then to be spit out; to be used every three hours. Take of litharge plaister, enough to be spread on a piece of soft leather, that may reach from ear to ear. Take of pure water, four ounces, Honey, two ounces, Spirit of wine camphorated, half an ounce, Spirit of scurvy-grass, two drachms, Water of ammonia, a drachm and a half. For (18) For a gargle to be used every three hours: Take florentine iris root, an ounce, Flowers of sulphur, Long pepper, of each a drachm and half, Oil of wormwood, a drachm, Rectified spirit, enough to make a cataplasm, to be applied warm. Give the tartarised antimony powders. See FEVERS in general. Or, Take of prepared kali, Pure nitre, of each a scruple, Cochineal, five grains, Pure water, an ounce and half, Compound spirit of ammonia, twenty-five drops. A draught to be taken every three hours. Take of acetated kali, Pure nitre, of each a scruple, Volatile salt of hartshorn, seven grains, Pure water, an ounce and half Spirit of nutmeg, two drachms, Sugar, as much as will make it palatable, for a draught, to be taken every three hours. Twenty or thirty drops of either of the subsequent, may be used as auxiliaries, three or four times a day. Spirit of vitriolic æther, Spirit of nitrous æther, Volatile liquor of hartshorn. PERIP- (19) PERIPNEUMONY. A TRUE Peripneumony is an inflammation of the lungs; the parts affected are the bronchial or pul- monic arteries, or the laterial lymphatics; the blood be- ing either obstructed in the former, or propelled into the latter. The cause. Any thing that is the cause of an inflam- mation, which has been already assigned under the ar- ticles Fevers in general and Pleurisy. The diagnostics. A small, sometimes soft, always un- equal, undulatory and frequently dicrotic pulse; swel- ling of the eyes and cheeks; a little frequent and some- what tussiculous respiration; redness of the face, deli- rium. The prognostics. It terminates like all other inflam- mations, in health, another disease, or death. In health, if a plentiful yellow spitting comes on; or even if the expuition be sanguineous; if the respiration begins to be performed with greater facility. In another disease (as a vomica or abcess) if the in- flammatory matter cannot be resolved within fourteen days, as may be known by the cessation of pain, while the dyspnœa remains, the cheeks and lips reddening, with a soft, weak and undulatory pulse. In death, if both lobes of the lungs are affected at the same time; if a coma somnolentum supervenes, a pros- tration of the vis vitæ with grievous depression of the spirits; frequent shedding of tears; complaint of heat in the throat, coldness of the extremities, unabating de- lirium. The (20) The cure is various, according to the different state of the disease and symptoms. Rest of body, and a little dissipation of mind, are highly requisite; as also are baths, vapors, clysters, mild cathartics; medicines, such as in pleurisy, with which in every respect, the treat- ment should be nearly similar, phlebotomy excepted, which must be used sparingly, and with the utmost cau- tion. Boil elder flowers, mallow leaves, and flax-seed, in milk, and let the vapor be received into the fauces by means of a funnel. When the matter is resolved and absorbed by the re- fluent blood, great care must be exhibited, that it doth not settle on some noble part; for which purpose give attenuants, resolvents, demulcents, diluents, absorbents, diaphoretics, diuretics, or cathartics, pursuing that me- thod of expulsions which is pointed out by nature, I shall now, according to custom, propose some remedies, the efficacy of which has been often experienced. For common drink, let the compound decoction of barley be given, or the next. Take of barley decoction, a pint, Simple oxymel, two ounces, Pure nitre, half a drachm. The breast should be often bathed with the following embrocation, three or four times a day at least; I have seen marvellous advantage from it: Take of tincture of opium, Vinegar, of each an ounce, Make a fotus, to be used cold. Take of balsam of copaiva, an ounce. Let ten drops be taken on sugar, three or four times a day; whatever else is given, this is not to be dispensed with. A linctus may be used at pleasure, as, Take (21) Take of conserve of hips, half an ounce, Oil of sweet almonds, an ounce, Tolu syrup, two ounces. Take of spermaceti, (dissolved in the yolk of an egg) a scruple, Pure nitre, ten grains, Pure water, an ounce and half, Tolu syrup, a drachm, Compound spirit of ammonia, twenty-five drops. Make a draught to be taken every two hours. Take of acetated kali, half a drachm, Purified salt of amber, seven grains, Cochineal, five grains, Pure water, an ounce and half, Tolu syrup, a drachm. Make a draught to be taken every fourth hour. PHRENITIS. A PHRENITIS is an inflammatory fever; attended with a constant and fierce delirium. The cause. An inflammation of the brain, or its me- ninges, or of the sentum transversum. If it arises from a primary affection of the brain, it is called idiopathic; if the brain is secondarily affected, symptomatic. The diagnostics. The absurd behaviour of the pa- tient; incoherent, wild or unmeaning discourse; red- ness, rolling, and glaring of the eyes; throbbing, and an undulatory motion of the temporal artery, coma vi- gil, with an acute continual fever. The (22) The prognostics. The true phrenitis is generally mortal on the third, fourth, or seventh day at farthest. If it doth not exacerbate oh those days, it will terminate in a lethargy, or incurable mania. In old men, or origina- ting from an inflammation of the ilium, or lungs, it is mortal. White stools, or white urine are the harbin- gers of death. Æruginous vomiting, spitting at the bye standers, gnashing or grinding of the teeth or snatch- ing of the bed clothes, are the forerunners of a dissolu- tion. If accompanied with laughter, if a gentle sleep supervenes, or the delirium abates at times, a recovery may be expected. The cure. It is to be taken from an inflammation, in general. Open the jugular vein, or (which is prefer- able) the temporal artery. Give antiphlogistic eccopro- ticks, as tamarinds, salts, &c. diluting nitrous draughts, clysters two or three times a day; apply emollient fo- mentations to the anus; if it swells wash with rectified spirits of wine. A fotus should be frequently used to bathe the whole head with, as, Take of camphorated spirit, Compound tincture of lavender, Vinegar, of each an ounce. Bathe the feet and legs frequently with the fotus communis warm. After proper evacuations, apply ve- sicatories to the feet, which have often exceeded my expectation. Opiates. Take of tamarinds, two ounces, hail in a pint and half of water, strain, and then add Currant rob, Glauber's salt, Juice of lemons, of each two ounces. Of this mixture let a tea-cupful be taken every hour till a purging supervenes. Take (23) Take of salt of hartshorn, a scruple, Spermaceti, (dissolved in the yolk of an egg) fifteen grains, Purified salt of amber, ten grains, Pure water, an ounce and half. Let the draught be repeated according to the urgency of symptoms. Or, Take of pure nitre, half a drachm, Camphire, ten grains, Purified opium, three grains, Aromatic confection, enough to make a bolus. Take of camphire, a scruple, Æther, half an ounce. Let it be put into a spoon, and swallowed as quick as possible. PARA-PHRENITIS. A PARA-PHRENITIS is an inflammation of the di- aphragm. This disease is sometimes mistaken for another, which is nothing surprising, for it requires no small degree of sagacity and medical acumen, to dis- criminate an affection of the stomach, kidneys, colon, liver, or pancreas, from that of the midriff. The cause is the same as that of other inflammations. The diagnostics. An accute continual fever, attended with an inflammatory pain, which is greatly exacerbated by every inspiration, or coughing, or sneezing, or eva- cuation of the excrements or urine; a sensation of reple- tion in the stomach, nausea, deep, quick, small, suffo- cative, and painful respiration; perpetual but not vio- lent delirium, frequent laughter, risus Sadonicus, great anxiety (24) anxiety of the præcordia, difficult deglution of solids, convulsions, hiccoughs. The prognostics. This disorder is always extremely dangerous. If the diaphragm supperates, the pus either falls into the cavity of the abdomen or breaking up- wards, produces an empyema. In all other respects the prognostics are the same as in the pleurisy. The cure. Clysters may be administered every hour, even if the bowels became paralytic; for they will ea- sily and soon recover their natural tone without medical assistance. When pus is collected and matured, it must be evacuated. Endeavour to abate the inflammation by bleeding and an antiphlogistic regimen, proceeding ex- actly in the same method as you would treat a pleurisy, which see. MADNESS. MADNESS is a total privation of the due exercise of reason, from some fortuitous injury to the or- gans of cogitation. The cause. A preternatural accumulation of the vital heat, or nervous influence in the brain, with some im- pediment to its usual course from thence along its ner- vine conductors. It is justly called by Galen, intempe- ries ignea cerebri. Its principal seat seems to be in the cortical, while the usual determination of it to the me- dullary part of the brain is prevented; consequently the cerebellum not equally parcipitating of this enlarged quantity of heat, the exit of more than the customary quantity by the par vagum to the heart is precluded; for this disorder is sometimes attended with little or no fever. The (25) The diagnostics. A languid redness of the face, wild- ness and rolling of the eyes, ghastly staring, mischievous- ness, absurd discourse, a plethora. The prognostics. If attended with laughter and ra- ving, it is easier to be removed than if accompanied with sober, steady, studious fixedness of the thoughts on a particular object. There are few cases even if her- editary which will not yield to a proper method of cure. The cure. Elicit the vital heat from the cerebrum, and empty those vessels which perhaps by their turgid- ness occasion that pressure which prevents the usual in- flux by the par vagum. Open a vein; if a fever super- venes, it is a good sign, as I have often observed; this operation should be frequently repeated, for no persons can bear the loss of blood better than maniacs, nor is there any case in which it is so necessary to draw it off, and so many times. After due evacuations, apply vesi- catories, particularly to the head. Drastic cathartics should be given, and emetics can scarce be exhibited too often. Hence note, that disorders of the head by no means contra-indicate the use of vomits. In the declination of this distemper, the greatest care and attention must be paid to all the non-naturals, to preclude a relapse, which is not uncommon where these are neglected. The cold bath is then peculiarly ser- viceable, as is also the plentiful use of broth, which last is not improper, either in the beginning, increase, or state of this distemper. Take of tartarised antimony, seven grains. Let this powder be repeated every hour till it vomits. I have known six of them taken with out any sensible effect. Five grains at least should be given every day, and the use of the following draught continued for a considerable while: Take of prepared kali, two scruples, Pure water, an ounce and half, B Make (26) Make a draught, to be taken twice or thrice a day. See HYPOCHONDRIA. PRACTICAL OBSERVATIONS ON INFLAM- MATORY CASES. IT hath been observed by some ingenious physicians, that inflammatory disorders are by no means so com- mon to be met with as they used to be: to assign the premitive reasons would be no easy matter, for man- kind do not seem to be much more sparing in the indul- gence of their appetites, more averse from wine, or more discreet in their regimen than their forefathers were. May it not with greater propriety be attributed to the in- creased accuracy and precision wherewith practitioners discriminate diseases, who are not so apt as they were for- merly to impute every pain or flushing heat to an in- flammation. The rapid improvements made in the me- dical art within these few years, have occasioned even the abolition of several diseases, whose imaginary exist- ence exceedingly puzzled our ancestors. Another observation, which is equally just and me- lancholy is, that when inflammatory disorders appear, they have generally a fatal termination. Is it not pos- sible that this may, in some measure, be owing to a too hasty and frequent repetition of venæ-section? Na- ture will exert amazing efforts to relieve herself, when the vis vitæ is not much impaired; and I cannot help expressing my apprehensions, that in these cases, in which bleeding is absolutely necessary, it may yet be pursued so far as to incapacitate nature for carrying on the animal functions. For these ten years past I have not lost one patient by an inflammatory fever, yet never ordered blood to be drawn more than once in any case, maniacal ones excepted. As (27) As there are several other inflammatory disorders, which have not been noticed in the preceding pages, it may not be amiss to observe, that a similar, if not the same treatment, is equally proper for them all. Some indeed, as has been instanced in the peripneumony, re- quire a more sparing use of phlebotomy than others. It is to be feared, that to a to liberal use of the lancet, that mortification may be ascribed, which so often su- pervenes an inflammation, as that of the ilium, easy dis- covered by the hasty evanescence of the pain. When there is no inflammation or inflammatory disposition of the blood, nothing can exculpate the practitioner for drawing blood; this would be a wanton waste of the most useful and important of all fluids, and the most neces- sary for the support of animal life; but even in these ca- ses the utmost caution is requisite, lest a putrid disor- der should be manufactured from an inflammatory one. It is not an uncommon (though often an irretrieveable) error, to mistake an obstruction, or acrimony, or seri- ous tumor, for an inflammation, which, if real is—when the rea particles of the blood are forced into the lymphatics, and cannot possibly exist without its pathognomonic sys- tems, viz. violent and universal heat, parching thirst and restlessness, as well as pain in the inflamed part. Inflammatory disorders are far from being common, and many diseases are too often groundlesly ascribed to this cause: that the too precipitate use of the lancet has produced dreadful consequences, I have, in number of instances, been a sorrowful and unavailing witness to. How many have been hurried off the stage by being bled for a pain in the side, owing to an incipient ulcer in the lungs! There are various sorts of fevers, which mimic those of the ardent kind, in which venæ-section must be abstained from. I was in a country one au- tumn where one of these anomalous fevers raged, it spread only through a circle of six or seven miles dia- meter: it resembled, in every respect, an ardent fever, the pulse only excepted, which was neither hard nor full: every one who was bled died, and every one who was not bled recovered: it never shifted its type, though B2 it (28) it commonly continued seventeen days. Those who took the tartarised antimony seemed to be soon freed from all febrile symptoms, yet remained weak, uneasy, and greatly out of order, without being able to tell their com- plaint, as long as the rest. The antiphlogistic method was pursued by them all, nitre, prepared kali, and such like, were the medicines administered, and with suc- cess; yet phlebotomy once used always proved fatal. The peremptory axiom of the famous Dr. MEAD, viz. “in omni febre phlebptomia prius est instituenda,” is certainly not true, or warranted by experience. In plethoric habits, or in real inflammations, from what has been observed, the reader may easily per- ceive what method is requisite for the treatment of any inflammatory case, in whatever part the inflammation may be situated. When the pain is very intense, opiates may be safely and happily administered; of this I have given but few instances in the foregoing sheets, that no countenance might be given to the indiscriminate use of a medicine, where a perfect knowledge of the case, and the discreet direction of a skilful hand, are absolutely necessary. In painful spasmodic constrictions of the capillary vessels, narcotics are undoubtedly indicated: of all the various pretences to be their correctors, I believe none so well deserves that name as the prepared kali, ERUPTIVE FEVERS. THE SMALL-POX. THE Small-pox is a fever of the malignant and con- tageous kind, attended with a general eruption of particular pustules, affecting the human species only, and each individual but once. The variolous pustules in (29) in time become sanious, but those in the measles ap- pear red, dry, and branny, without suppuration. The cause. It seems to be connate with us, and to latitate until some violent exagitation of the blood, from the introduction of a variolous particle, raises the semi- nal ferment, and occasions the appearance of those eruptions. The diagnostics. A frequent and strong pulsation of the brachial and temporal arteries; redness of the eyes, pricking pains in the skin, severe pains in the head, back, and loins; a febrile heat, greatly increased in three or four days, with thirst, vomiting, palpitation of the heart, difficult respiration, tremblings, rigor, deli- rium, convulsions, restlessness, hoarseness, fixedness of the eyes, a ptyalism, purple spots; bladders full of clear water, commonly called the white hives; the pustules usually appear on the third and fourth day, and arrive at their state on the ninth or eleventh, in the distinct sort; in the confluent, they break forth on the fifth day, and continue till the fifteenth or twenty-first. The prognostics. When the pustules come out sud- denly, first red, then white; broad, round, few, dis- tinct, plump, and sharp at the top, there is little dan- ger. If preceded by convulsions in children, it is a good sign. If they come out irregularly, or imme- diately disappear, are exceeding small, confluent, or shew black spots, or a dint in the middle; if attended with a diarrhœa, (in adults) difficult respiration, dry husky cough, bloody stools or urine, continuing deli- rium, colliquative evacuations; these are all very bad symptoms, and most of them deadly. Adults suffer most. Gravid women generally miscarry. The cure. Phlebotomy can rarely be used to advan- tage in any disorder attended with cutaneous eruptions; however, if a lean, plethoric body should be invaded, and the pulse hard, venæ-section becomes necessary. The body should be kept soluble, the vis vitæ sup- ported; (30) ported; let the patient have a constant accession of fresh air in his chamber, a clean shirt every other day at farthest; which may in the worst cases be allowed without any hazard; for common drink, ap- ples boiled in water, or milk and water, equal parts; or wine-whey, or cyder whey, or vinegar-whey, or barley-water, accidulated with spirit of nitrous æther, or spirit of vitriolic æther, or the compound barley decoction; the more he drinks the better. In the con- fluent sort, there arises a ptyalism in adults, and a diarrhœa in children, either of which ought to be en- couraged. To prevent a secondary fever, give lenient cathartics, to be repeated as the strength will bear, at the distance of two, three, or four days, until five purges have been given. After the thirteenth day, the patient may drink plentifully of warm small beer. If the expuition is vis- cid and tough, or molests by its excess, (as it will some- times excoriate the parts) use appropriate gargarisms, syringings, or masticatories. The diarrhœa in adults, on the first eruption, should be restrained by opiates. To preserve the face from disfiguration, previous to the appearance of the eruptions, or while they are coming out, the extremities may be bathed with warm milk, or semicupia of the same may be used. The cooler the patient is kept the fewer the pustules will be. Emetics are of great service in the beginning. Clys- ters may be given occasionally: in cases when the pa- tient is very low, on the approach of a crisis, a good effect may be reasonably expected from versicatories. A narcotic may be administered every night in the con- fluent sort, and ought to be, if the patient is not coma- tose; such as, Take of pure water, an ounce, Tincture of castor, twenty-five drops, Tincture of opium, fifteen drops, Compound spirit of ammonia, Compoun (31) Compound tincture of lavender, of each thirty drops, Syrup of white poppies, half an ounce. A paregoric draught to be taken every night if neces- sary. A linctus is a very convenient and agreeable form to convey a medicine that may increase the ptyalism, and at the same time prevent its being troublesome.— The following is extremely desirable, and may be taken as often as is required, with equal pleasure and advan- tage: Take of conserve of hips, half an ounce, Tolu syrup, Oil of olives, of each an ounce, Vitriolic acid, enough to render it a gratefully acid linctus. If, after recovery, there seems to be a tendency to a phthisis, removal is necessary into a warm dry air, and the regimen should be pursued that is recommended un- der that article. To prevent pitting, let this liniment be applied to the face three or four times a day: Take of camphire, two scruples, Spermaceti, half an ounce, Oil of olives, an ounce, Make it a liniment. It is scarcely necessary to observe, that if an hæmop- toe should appear in the decline of the disease, the use of the bark is indicated. It is to be hoped, that in a little time the practice of inoculating children under three months old will be- come universal, and put an entire end to the ravages of this loathsome and dangerous disorder. The (32) The following medicines have been peculiarly ser- viceable in some very alarming cases: Take of prepared kali, a drachm and half, Pure nitre, half a drachm, Pure water, six ounces, Spirit of cinnamon, Juice of lemons, of each an ounce, Tolu syrup, half an ounce; Of this mixture three spoonfuls to be taken every sixth hour. Or either of the subsequent boles may be given every sixth hour: Take of compound powder of contrayerva, Mercury with sulphur, of each a scruple, Castor, ten grains, Tolu syrup, enough to make it a bole. Take of mercury with sulphur, a scruple, Snake-root, Castor, of each ten grains, Syrup of white poppies, enough for a bole. If a draught is more eligible, one of these draughts may be taken every six hours, viz. Take of acetaled kali, Aromatic confection, of each a scruple, Pure water, an ounce and half, Spirit of nutmeg, two drachms, For a draught. Or, Take of calcined antimony, a scruple, Pure nitre, ten grains, Purified salt of amber, five grains, Cochineal, four grains, Pure water, an ounce and half, Make it a draught. Or, Take (33) Take of kali tartarised, a scruple, Pure water, two ounces, Tolu syrup, a drachm, For a draught. SLOW, NERVOUS, & MILIARY FEVERS. THE Slow Fever is so called from the gentleness of its progress, and length of its continuance. The Nervous Fever receives its name from a sup- posed morbid quality in the nervous influence, or a re- laxed state of the nerves themselves, which is just as imaginary as the other. To say the truth, nervous dis- orders is a mighty handy and convenient expression to conceal ignorance. The Miliary Fever is so termed, from the resem- blance of its eruptions to millet seed. They all proceed from the same causes, and require the same method of treatment. The causes. A deficiency and unequal distribution of the vital heat; consequently, a declension of the powers of nature, a lentor, viscidity of the fluids; a relaxed state of the arterial system, or spasmodic con- strictions of the capillary arteries, some error in regard to the non-naturals. The diagnostics. Chills and flushings, lassitude, nausea, prostration of the strength and spirits, listless- ness, heat in the palms of the hands and soles of the feet, (a certain sign of bradypepsy) while all the rest of the body is cold, and emaciates fast: a sensation like cold water thrown down the back, the pulse quick, weak, and unequal, pale urine, coma, heat and dry- B3 ness (34) ness of the tongue, sometimes with, and sometimes without thirst; miliary eruptions, anxiety, tinnitus au- rium; cold, clammy, or colliquative sweats; convul- sions, delirium, subsultus tendinum. The prognostics. All the symptoms are exacerbated towards night, a tingling noise in the ears is generally the forerunner of a delirium: a copious spitting, or gentle breathing sweats are good signs; profuse sweats are bad ones; insensibility, twitchings of the tendons, involuntary evacuations of the excrements, urine, or tears, are preludes to the last catastrophe. The cure. All evacuations are inadmissible, vomits only excepted; sometimes very lenient clysters, such as new milk and sugar, may safely be administered, if nature inclines to stool. Give mountain wine whey, meat broths strong as the stomach will bear; jellies, panado, with spice, wine, or brandy in it: such things as these may be often offered, though ever so little is taken at a time; the medicines necessary are attenu- ants, restoratives, nervines, and cordials. If the sweats are profuse, let warm napkins be frequently ap- plied to the neck, breast, and abdomen; for though gentle sweats are of service, when they become pro- fuse, they only tend to the dissolution of the patient in a double sense: in this case red port wine and water may be allowed. The neck and breast should be exa- mined every day, for eruptions commonly appear in those parts first: their portent is good, and they indi- cate the use of cardiacs. Take of ipecacuanha, three grains, Antimony tartarised, one grain. Let this powder be taken every morning, out of a spoon half full of water: nothing should be drank either during the operation, or until the nausea goes off spontaneously. Many unexpected recoveries have been (35) been owing to this powder alone. The following also have been amazingly efficacious: Take of aromatic confection. Castor, of each a scruple, Precipitated sulphur of antimony, three grains, Syrup of ginger, enough to make a bolus. To be taken every fourth hour, washing it down with three spoonfuls of the following julep: Take of the camphire mixture, Musk mixture, of each four ounces, Volatile liquor of hartshorn, half an ounce. Or, Take of compound powder of contrayerva, Musk, of each a scruple, Tolu Syrup, as much as sufficient to make it a bole. To be taken every sixth hour, washing it down with this draught: Take of Salt of hartshorn, Aromatic confection, of each a scruple, Pure water an ounce and half, Spirit of nutmeg, half an ounce. The bark, when proper. PUTRID, MALIGNANT, AND PETECHIAL FEVERS. THESE may be classed together in the same man- ner with the last three, because they are each pro- duced by similar causes, and require very little, if any difference, (36) difference, in the method of treating them: to this class also belong the gaol or hospital fever, and the pesti- lence. The cause. A putrescent acrimony, or infectious miasmata, The obstruction of insensible perspiration is no uncommon cause of putrid fevers; for the reten- tion of those particles within the body which ought to have been thrown out of it, may, and often does, oc- casion a speedy putrefaction, especially when there is the least pre-disposition in the fluids to such a dissolution. The diagnostics. Pain in the temples or orbit of the eye; the eye, heavy, yellowish or somewhat inflamed; the face bloated, and of a cadaverous aspect; faintness, operose respiration, frequent sighing, erratic pains, the pulse small, sometimes quick, and sometimes the same as that of a person in perfect health; black tongue, bit- ter taste in the mouth, crude vapid urine; livid pete- chiæ, from the extravasation of grumous blood in the cellular membrane, vibices, aphthæ, furred lips and teeth, little thirst, tinnitus aurium lumbago, colliqua- tive evacuations. The prognostics. A mild diarrhœa is serviceable; the petechiæ florid, a smarting red rash, scabs on the nose or lips, watery vesicles; are all good symptoms. Black urine, or stools, small dusky spots, dun, or greenish; a lurid efflorescence, large livid blotches, black vibices, sweats profuse, cold or clammy; griping and bloody stools, coma and coldness of the extremities, are all symptoms of an approaching dissolution. The cure. The intestinal canal may be cleansed, and the drain kept open by small doses of rhubarb. The regimen necessary is much the same with that in the pre- ceding chapter, particularly with respect to wine, though Rhenish is generally the most eligible, but in case of colliquative evacuations, red port is preferable; give also freely of the vegetable and mineral acids, particu- larly (37) larly the muriatic, Peruvian bark, astringents, antisep- tics, camphire and opiates. Let vinegar be frequently thrown on a hot iron in the room, and a little of the bark of cascarilla be now and then burned in it. Vo- latile alcalis may be used sparingly; but throughout the whole stage of this disorder, withhold the lancet, as you tender the life of the patient. The formulæ subjoined have been peculiarly successful; Take of Red bark, half a drachm, Camphire, three grains, Syrup of saffron, enough to make a bole. To be taken every fourth hour, drinking after it three table spoonfuls of the following mixture: Take of pure water, six ounces, Spirit of horse rhadish, Vinegar, of each two ounces, Sugar, as much as you please. Or, Take of compound powder of contrayerva, two drachms, Tormentil root, Myrrh, of each one drachm, Make into six powders; one to be taken every fourth hour, with the subsequent draught: Take of pure water an ounce and half, Lemon juice, half an ounce, Cochineal, five grains, White Sugar, what you please. Or, Take of Red bark, half a drachm, Opiate confection, from ten grains to half a drachm, Syrup of saffron, enough to make a bole. To (38) To be taken every sixth hour, and washed down with the above draught. Or, Take of burk of eleutheria, half a drachm, Winter’s bark, Myrrh, of each a scruple, Syrup of Saffron, enough to make a bole. To be used as the former. The tartarised antimony powders and opiates, to re- strain the diarrhœa, if requisite, or Norris’s Drops. PUTRID SORE THROAT. THE Putrid Sore Throat is a disorder of the malig- nant kind, which has not been perfectly described or known till within these few years. The cause. A putrid diathesis of the fluids. The diagnostics. Fullness and soreness of the throat, a sensation of stiffness in the neck, redness of the arms, hands, or breast: frequent sighing, nausea, anxiety about the præcordia, languidness, great dejection, re- peated sneezings, agrypnia, thin crude urine, a pulse quick and small, bloated countenance, swelling of the maxillary and parotid glands and tonsils, ulcerations, sloughing of the ulcers. The prognostics. The prognostics depend on the pro- gress of the putrescent acrimony, and on the respira- tion. The cure. All evacuations are deleterious, espe- cially phlebotomy. It requires a similar treatment with other putrid fevers, but is the least rebellious of them all, for the cure is not very difficult. As it is some- times (39) times epidemical, the best orvietan, or preventive, per- haps, is to drink freely of red port; at a time when it was exceedingly rife, they who used this prophy- lactic escaped the disorder. Cordials and gargarisms seem the only necessary aids, as, Take of aromatic confection, half a drachm. Castor, a scruple, Pure water, an ounce, Spirit of nutmeg, two drachms, A draught to be taken every fourth hour. Or, Take of aromatic confection, a scruple, Snake root, Castor, of each ten grains, Syrup of saffron, enough to make a bole, To be swallowed every fourth hour. Take of compound barley decoction, an ounce, Tincture of myrrh, Red wine, Honey of roses, Vinegar, of each half an ounce, For a gargle, to be used occasionally, or every two or three hours. Or, Take of gum arabic, two ounces, Dissolve in one pint of pure water, for a gargle; to which may be occasionally added, as much vitriolic acid as is agreeable. If the ulcers spread or increase, add to the above solution four grains of muriatic mer- cury, dissolved in five drops of the muriatic acid. Be- ware of the use of nitre in this disorder. THRUSH. (40) THRUSH. APHTHÆ, or the Thrush, are little ulcerous tuber- cles, which affect the inside of the mouth, sto- mach, and intestines. The cause. A saline, viscid, or acrimonious lymph. The diagnostics. They appear first on the tongue, or in the corners of the mouth. The prognostics. If white, pelluced, thin, scattered, and superficial, they are of little consequence; if brown, opaque, black, thin, or run together, they forbode some danger. When they have passed through the bo- dy and appear at the anus with excoriation, apply me- lasses. The cure. Assist nature as in other fevers. They are often fatal to adults: whether they who escaped them in their infancy are the only persons liable to be attacked by them, is at least problematical. The treat- ment is the same with that of a miliary fever. The fol- lowing gargle is excellent for infants, viz. Take of gum arabic, two drachms, Lime water, an ounce and half, Tolu syrup, two drachms, It may be used every hour, and if swallowed can do no prejudice to the child. Take of pure nitre, a drachm, Three whites of eggs, Rose water, six ounces, Tolu syrup, an ounce, Let it be made a gargle, for adults, to be used occasion- ally; or the following, which wall answer the same pur- poses: Take (41) Take of gum tragacanth, a drachm, Pure water, seven ounces, Honey of roses, one ounce, Vitrolic acid, twenty-five drops. MEASLES. THE Measles require a treatment not much different from the small-pox. They are both natives of Africa. The cause. Infectious miasmata sui generis. The diagnostics. Small, dry, red spots, like flea-bites; they never supperate, but arrive at their state in four days; an almost perpetual cough, weakness, soreness, or running of the eyes, swelling of the eye-lids, running of the nose, convulsions. The prognostics. It is not a dangerous disorder if not rendered so by mismanagement. The cure. Nature is the best physician in this case; nor does she stand in need of any medicines to assist her. Venæ-sectlon appears to be highly improper, and is most certainly often productive of the most disagreeable consequences; I never ordered it in my life in this case, yet never lost one patient in the measles; nor to say the truth, did I ever hear of one that died who was not bled. If convulsions precede or accompany the erup- tion, they are by no means a bad prognostic; the tinc- ture of asafœtida may then be given with great advan- tage, fifteen or twenty drops three or four times a day. The linctus under the article small-pox may be used at pleasure, as in the small-pox, the little patient cannot be kept too cool. The drink may be cyder-whey, vine- gar-whey, butter-milk,, or for weakly children, thin broth. Medicines are seldom necessary during this dis- order; (42) order; but as soon as the eruptions begin to disappear, cathartics should be exhibited, as in the small-pox, which for obvious reasons, are necessary after all eruptive fe- vers. The subsequent drops are of great efficacy in re- moving the cough which so often remains after the measles. Take of balsam of copaiva, an ounce. Let ten drops be taken on brown sugar, morning and night. SCARLET FEVER THE Scarlet Fever is so called on account of the co- lour of the skin, or the large, red, vivid blotches in it. The causes. Viscidity, acrimony, an unequal distri- bution of the vital heat; the protrusive force of the heart overcoming the resistance of the solids, wherefore chil- dren are most subject to it. It seems to be in some de- gree infectious. The diagnostics. They appear from the definition. The prognostics. If attended with anxiety, dejec- tion, or oppression at the pit of the stomach, the liberal use of cardiacs is indicated. It is seldom dangerous if left to nature, without any officious interpositions. To drink plentifully of diluting liquids, and to be kept cool, is all that is requisite. Many children have perished by the use of the lancet, which is intended to remove that straitness and suffocating sensation so common in this disorder; these do not originate from repletion, but from depletion; a little tartarised antimony and cordials are the most eligible remedies. The (43) The cure. Let wine-whey be given freely. The patient should not be kept warm; let his linen be shifted every day. After the third day one of the following formulæ may be used: Take of calcined antimony, Acetated kali, of each a drachm, Pure water, seven ounces, Spirit of nutmeg, Tolu syrup, of each an ounce. A mixture, one or two spoonfuls to be taken every sixth or fourth hour. Or, Take of aromatic confection, two drachms, Calcined antimony, one drachm, Purified salt of amber, a scruple, Pure water, seven ounces, Spirit of nutmeg, two ounces, Tolu syrup, an ounce. A mixture, of which two spoonfuls may be given every fourth or third hour. Take of spirit of nitrous œther, an ounce. Let twenty drops be given in every draught of liquid that the patient takes. PHTHISIS. A PULMONARY Phthisis, or consumption, is owing to an ulcer in the lungs, whereby the whole body is gradually emaciated and consumed. The cause. That (whatever it is) which occasioned the stagnation of the blood in the lungs, till it is con- verted into purulent matter; this may be owing to a teneritude (44) teneritude of the arterial vessels, an acrid blood, debi- lity of the fibres of the viscera, long neck, straight breast, depressed scapulæ, an ulcer in the liver, spleen, pancreas, kidnies, mesentery, or uterus, a metastasis of matter, neglect of customary exercise. The diagnostics. A slight fever, generally exacer- bated towards evening; too great, but particular heat; flying stitches, hectic flushing, pain in the stomach or breast, pain in the side, the patient lying with most ease on the affected side; hereditary disposition, the age from sixteen to thirty-six; indigestion, frequent spitting; night sweats, particularly profuse towards morning, sen- sation like cold water thrown down the back; diarrhœa, a bloody, frothy, or fœtid expuition, wasting of the flesh, languor, lassitude, peevishness, great unevenness of tem- per, sudden starts and bursts of joy terminating in tears, incurvation and lividness of the nails, quick and inter- rupted respiration; a teazing and almost incessant cough, worst in the night, aversion from food, facies, hippo- cratica. The prognostics. An hereditary phthisis is the most dangerous. If the cough is very troublesome, the res- piration operose, the saliva stinking. The ancles swel- led, the body much wasted, the evacuations colliqua- tive, and the countenance Hippocratic, death seems to be approaching with hasty strides. A phthisis attended with a total obstruction of the catemenia, produced by bleeding, is absolutely incurable. A phthisis in which the vomica breaks suddenly, the expuition white and cocted, the appetite and digestion tolerably good, is easily curable. The cure. Bleeding is inadmissible. The non-na- turals require the strictest attention. New milk should be taken for breakfast and supper; if it purges it must be boiled; cow’s milk is preferable to that of asses; goat’s whey is too diluent, and I have seen several fatal effects from the use of it. Meat broths may be taken as (45) as strong as the stomach will bear, particularly of pork; jellies prepared from any animal substance should be taken as often as possible. Let the patient ride on horseback every morning, if too weak to sit alone, he must be supported by one that rides behind him, for riding in a morning is absolutely necessary. A warm, dry, clear air, the Bristol waters; Spa water, or for common drink, infusion of linseed, decoction of bran, or for change, sago, salep, or chocolate. Tea pre- pared from coltsfoot flowers, and sweetened with ho- ney, I have no small reason to recommend the use of; snails or earth worms boiled in milk are serviceable, as are shell fish of all sorts, wild fowls, generous wines and spices. Conserve of red roses may be eaten to the quantity of two or three ounces in a day, with vast ad- vantage. Acids are sometimes serviceable, stomachic plaisters, a Burgundy pitch plaister between the shoul- ders, to be kept on for some weeks; vesicatories, but above all things the dry vomit, as, Take of tartarised antimony, three grains, Ipecacuanha, ten grains, Make into three powders; let one be taken in a morn- ing fasting, twice or thrice a week, not drinking any thing during the operation. Or, if the diarrhœa is very violent, Take of Ipecacuanha, four grains. Blue vitriol, one grain, Let this powder be taken (as before) every morning. In an incipient ulcer of the lungs, when the pain in the side has been exceedingly troublesome, recourse has been often had to the lancet, which is the ready way to bring on an incurable phthisis. I appeal to the con- science of the practitioner, whether he has not fre- quently experienced this consequence. N. (46) N. B. When an ulcer in the lungs is formed, the urine discharged at night is very turbid the next morn- ing. The balsam of copaiva ought never to be omitted in the cure of this disorder; let twenty drops be taken on sugar in powder every night and morning. If the diarrhœa is not excessive, as it seldom is at the begin- ning of a phthisis, I have often found that the subse- quent mixture will carry of the hectic, which generally terminates in the appearance of a rash. Take of prepared kali, Calcined antimony, of each a drachm, Pure water, seven ounces, Spirit of nutmeg, two ounces, Compound spirit of ammonia, half an ounce, Tolu syrup, an ounce, Of this mixture, let two spoonfuls be taken every sixth or fourth hour. Or, Take of prepared kali, two drachms, Mint water, seven ounces, Tolu syrup, an ounce, A mixture. Three spooofuls to be taken twice or thrice a day, to which may be added (if the diarrhœa is exces- sive) half an ounce of tincture of opium camphorated. If the diarrhœa should prove, as it often does, the most troublesome and dangerous symptom, it should be restrained by opiates; as three, four, or five grains of the opiate pill, and as many of rhubarb, which may be taken at bed time, to be repeated occasionally; or, Take of asafœtida, Precipitated sulphur of antimony, Myrrh, of each a scruple, Pure opium hard, four grains, Simple syrup, enough for twelve pills. Two (47) Two every night, or oftener. A scruple of the astringent red gum may be used for the same purpose, or the same quantity of the tormen- til, or bistort root; but the boles and sealed earths are worse than useless. Take of blue vitrol, five grains, Dissolve in an ounce of tincture of cantharides. Of these drops let twenty be taken twice a day, increasing the dose one drop at a time, till it amounts to a tea- spoonful. They have often effected wonders; but with this, or whatever other medicine is used, let not the balsam of copaiva be neglected. I shall subjoin two more formulæ, from which also I have experienced the most desirable consequences: Take of red bark, six drachms, Extract of liquorice, two drachms, Oil of aniseed, forty drops, * Filings of iron, two scruples, Mucilage of gum arabic, as much as is suffi- cient to make an electuary. The size of a walnut to be taken night and morning. Take of gum ammoniac, a drachm, Precipitated sulphur of antimony, two scruples, Squills, ten grains, Filings of iron, one scruple, Simple syrup, enough to make into two pills. Number thirty-two: let two or three be taken night and morning. See COUGH, and the following. * Or nitre, two scruples, as the hectic is less or more. EMPYEMA. (48) EMPYEMA. AN Empyema is a collection of pus or matter in the cavity of the thorax. The cause. The rupture of a vomica: this proceeds from an inflammation, bruise, or wound (if closed too soon) of any of the five parts, viz. the lungs, pleura, diaphraghm, mediastinum, or pericardium. The diagnostics. Twenty days from the time that the inflammation began; from the signs of the disap- pearance of a vomica, a new pain, dry cough, sensa- tion of pressure on the midriff, lying with ease on one side only, viz. on that where the matter is congested, a slow fever, expuition of purulent matter, thirst, the face flushed, the eyes hollow, redness of the cheeks, swelling of the abdomen; on leaning forwards, danger of suffocation. The prognostics. If the pus is whitish, and of good consistence, the expuition easy, the respiration free, and the mind calm, these are all good signs; but if, after the rupture, there be an accumulation of pus, pu- trefaction of the fluids, sanious stools, and Hippocratic countenance, if will prove fatal. The cure. To determine the pus externally must be attempted at all events, by proper medicines or cutting: the operation is to be performed between the third and fourth rib, behind, numbered from below.* In the mean time keep the body open, and give terebinthi- nates, as, Take * I have known it often to succeed, though sometimes the patient dies tabid. After the operation use detergent interjections every day of barley water well acidulated, and keep open the wound some weeks with a leaden canula. (49) Take of common turpentine, Olibanum, of each what quantity you please. Form into a mass of pills of five grains each; three to be taken twice or thrice a day. Or, Take of red bark, an ounce, Balsam of copaiva, Spermaceti, of each half an ounce, The yolk of an egg, Honey of roses, as much as is sufficient to make an electuary. The size of a nutmeg to be taken twice or thrice a day. HAEMOPTOE. A SPITTING of blood is sometimes an idiophatic disease, to which some persons are subject at times for many years, without any manifest inconve- nience. The cause. Teneritude of the fibres of the lungs. The diagnostics, or concomitant symptoms, are sen- sations of soreness in the breast, of weight in the dia- phragm, a husky cough, pallid countenance, lank hair, flabbiness of the flesh, dislike to exercise. The prognostics. Bleeding generally ensures a se- verer return, or brings on an incurable phthisis. If that evacuation has not been premised, the cure is not difficult. The ingenious Monsieur Le Sage has, in his usual sprightly manner, graphically delineated a scene where- in the grim Monarch is represented with awful dignity, C conferring (50) conferring the doctoral cap on all those medical stu- dents who take a solemn oath never to deviate from the present method of practice, and ranking them among the number of his truest and dearest friends. In his time and country, the picture bore no very enlarged features; but in this enlightened age, and in a nation teeming with Philosophers, who will take nothing on trust, whatever deference may be due to a generally received opinion, it can certainly be no unpardonable crime to call the propriety of it in question; and if it is found unsupportable by experiments, to militate against it. Of this kind, it is presumed, is that too general one of the necessity of blood-letting in internal hæmorrhages, which I have often seen prove highly pernicious and productive of fatal consequences. Of what signification is it whether a person loses his life by bleeding from a natural or artificial orifice? I once knew a family, of which two brothers and two sisters were each at different times seized with an hæmoptoe; they were all bled five or six times, and not one of them survived many weeks after their respective attacks; another brother was taken in the like manner, who sus- pecting the effects of the lancet, applied to me, and al- though he at that time laboured under a confirmed lues, he was soon (without bleeding) restored to, and still continues in, perfect health. Innumerable instances have I been witness to of the most alarming hæmorrhages, which have all yielded to the use of vomits, and the method lain down below, without a single application of the lancet: if then, as is evident, phlebotomy is not necessary to the cure, is it not more eligible to preserve that important fluid, than to lavish it away without cause, and thereby de- stroy the health and shorten the lives of those who com- mit themselves to our care? The cure, I never failed of success with those who had not been bled. The first thing given was, always the dry vomit, as, Take (51) Take of tartarised antimony, Blue vitriol, of each two grains;* This powder should be taken in a spoon half full of water; let the patient strain, which straining he may provoke, if necessary, with his finger or a feather, but drink nothing until he throw up some yellow or porra- ceous matter, and if his sickness does not then go off, half a glass of raw brandy will settle his stomach, if that should be returned immediately, which is some- times the case, a repetition of the same will answer ex- pectation. Give twenty drops of the balsam of co- paiva, night and morning, for several weeks, to pre- vent a return, and the following electuary: Take of red bark, six drachms, Flowers of sulphur, three drachms, Pure nitre, one drachm, Precipitated sulphur of antimony, a scruple, Mucilage of gum arabic, enough to make an electuary, The size of a nutmeg to be taken twice or thrice a day. So long as the spittle is in the least tinged, the follow- ing mixture should be used, which may from the first invasion be drank at pleasure: Take of gum arabic, two ounces, dissolve in pure wa- ter a pint, Pure nitre, two scruples, Tolu syrup, an ounce. Of this mixture four large spoonfuls may be taken every two or three hours. A scruple of roach-allum may be given occasionally. Or the red astringent gum. The conserve of roses may be taken at pleasure.—See WEAKNESS OF THE SOLIDS. * The tartarised antimony may be given first, and as soon as the nausea commences, the vitriol immediately exhibited. C2 HÆMORRHAGES. (52) HÆMORRHAGES. ALL Hæmorrhages (the piles only excepted) require precisely the same treatment with the foregoing article, which see. In acute disorders, internal hæmor- rhages proceed from a plethora, but I never yet met with one instance of a chronical hæmorrhage in a plethoric habit. HICCOUGH. THE Hiccough is a convulsive motion of the sto- mach and midriff. The cause. An acrid irritating matter, adhering to the left orifice of the stomach; the diaphragm is affect- ed by consent of parts. Sometimes repletion may oc- casion it, and sometimes depletion. The diagnostic is sufficiently obvious. The prognostics. Sneezing generally removes it, or compression of the artery at the wrists; or frequent sip- ping of any liquid, or stopping both ears for a minute or two, or holding the breath, or a sudden fright, or fixing the eyes intensely on an object in an oblique di- rection. Proceeding from wounds, profuse evacua- tions, in asthmas, or at the close of a malignant fever, it is always a dangerous, and often a deadly symptom. The cure. Emetics and cathartics are indicated, if it arises from repletion; if from depletion, diaphoretics, diuretics, opiates, clysters, and fomentations; as the common fomentaton, or tincture of opium and vinegar, of each equal parts, to bathe the pit of the stomach with. Of the following formulæ the practitioner may select that which is best adapted to the case. In (53) In the decline of fevers, give a tea-spoonful of the diluted vitriolic acid in a glass of water frequently. Take of the musk mixture, five ounces, Tincture of castor, two drachms, For a draught. A tea-spoonful of these drops may be taken, and repeated pretty often, if necessary. Take of compound tincture of lavender, six drachms, Compound spirit of ammonia, too drachms, For a bottle of drops. Take of prepared kali, two scruples, Tincture of cardamoms, two drachms, Pure water, an ounce and half, Spirit of horse-rhadish, too drachms, A draught to be repeated as there is occasion. Take of vitriolated natron, o«e ounce, Pure water, seven ounces, Tincture of asafœtida, half an ounce, —opium, a drachm, A clyster. Take of salt of hartshorn, Aromatic confection, of each a scruple, Musk, fifteen grains, Oil of mint, five drops, Syrup of orange peel, enough for a bolus. Take of castor, Musk, of each a scruple, Oil of cinnamon, three drops, Purified opium, two grains, Syrup of saffron, enough for a bole. Either of the above boles may be given according to the urgency of the symptoms. ERYSIPELAS. (54) ERYSIPELAS. ERYSIPELAS, or St. Anthony's Fire, is an exter- nal inflammation, which generally affects the face, and sometimes the breast. St. Anthony was supposed, like many of our modern saints, to take great pleasure in adding to the miseries of mankind; but in these times, we readily exculpate said saint from having any hand in the infliction of this disorder. The cause. Those which produce an internal inflam- mation, or an acrid humor, heats and colds, errors in the non-naturals, an obstruction of any customary eva- cuation. The diagnostics. Swelling of the part, with pain and redness; inflammatory pimples; if pressed lightly by the finger, the appearance of a white spot. The prognostics. It is removeable without much dif- ficulty; is no ways dangerous, unless the eruptions are repelled by cold, and then very disagreeable conse- quences may ensue. The cure. Being a cutaneous disorder, venæ-section may be dispensed with, which cannot be necessary when any eruptions appear on the skin. It is a com- mon observation with ignorant practitioners, that the blood which they have let is exceeding bad, and it is much better such blood should be out of the body than in it; if this argument were worthy of refutation, it might be asked, whether drawing off a pint or two from a pipe of bad wine, would have any tendency to ameliorate the remainder? Dr. Sangrado's method was much more plausible, in taking away the whole mass, and refilling the vessels with the bland warm element. If the blood is bad, it must be mended in the body, and the use of proper alteratives is indicated; but to decrease the quantity of it is to lower the vital powers, to render nature (55) nature incapable of performing her necessary functions, and to preclude the good effects of those alteratives, which might afterwards be administered. Diaphoretics will greatly assist nature in expelling that which is offensive: diuretics are exceeding service- able in this disorder; mild cooling cathartics are also of considerable utility. As for example: Take of elder rob, an ounce, Pure nitre, half a drachm, Pure water, five ounces, A gently sweating potion to be taken at night going to bed. Take of spirit of nitrous æther, an ounce. Of these drops let a tea-spoonful be taken twice or thrice a-day. Take of vitriolated natron, ten drachms, Purified salt of amber, seven grains, Pure water, three ounces and a half. For a purging draught, to be taken in the morning. As external applications will expedite the cure, the reader is presented with several efficacious ones below; though perhaps wetting the parts two or three times a day with camphorated spirit of wine, is not inferior to any of them. Take of the internal elder bark, two ounces, boil in a pint and half of water to a pint; then add of Soft soap, an ounce and half, Make a fomentation, to be used night and morning. Or, the decoction of hellebore. Take (56) Take of camphorated spirit, an ounce and half, Compound tincture of lavender, three drachms, Oil of amber, one drachm, A liniment to be used morning and night. Or, Take of water of acetated litharge, forty drops, Rose water, five ounces, A lotion. Take of camphorated spirit, an ounce, To be applied three or four times a day; as soon as the parts are dry, rub on a little of the following liniment: Take of the ointment of white calx of mercury, an ounce and half, Essence of lemons, twenty drops, Make it a liniment. NEPHRITIS. A NEPHRITIS is an inflammation of the kidnies. The causes. The same as of other inflammations; whatever plugs up the extremities of the capillary arte- ries; a wound, a bruise, an abscess, a tumor, lying too long on one side, a calculus, whatever hinders the free passage of the urine; whatever forces the thicker parts of the blood into the urinary canals, as riding hard, running, leaping, or a plethora. The diagnostics. Difficulty of, or uneasiness in making urine, sensation of heat in making it, perpe- tual inclination to make it, total suppression of it, a fever, (57) fever, numbness of the thigh from an affection of the psoas muscle, bilious vomiting, costiveness. A neph- ritis is always attended with a fever; a calculus not al- ways. In a nephritis the pain is continual; in the cal- culus, or fit of the stone, the pain intermits. The prognostics are much the same as in other in- flammatory disorders. To persons in years, it is most commonly fatal; the patient often falls into a tabes dor- salis; sometimes a schirrus is formed; sometimes it is succeeded by a palsy, or incurable lameness, a dropsy also, and atrophy. If a calculus is formed from the concretion of the sabulus saburra too bulky to pass through the ureter, the case is helpless, unless it is ex- tracted by the knife; this operation has been performed, but never with success, as the author ever knew or heard of. The cure, as in other inflammations, venæ-section, diluting liquors, emollients, antiphlogistics, clysters, fomentations, lenient cathartics, semicupia: if the pain is very excrutiating, opiates; Dieuretics, nitre excepted, are improper at first; for common drink, the almond milk. Take of syrup of marsh-mallows, Oil of olives, of each an ounce, Compound spirit of ammonia, two drachms, Pure water, seven ounces, by agitation. Make an emulsion, three spoonfuls to be taken every fourth hour. Take of Venice turpentine, half an ounce, The yolks of two eggs, Pure water, five ounces, Linseed oil, three ounces, Oil of turpentine, Oil of aniseeds, of each a drachm, Syrup of marsh-mallows, two ounces, A clyster. C3 As (58) As soon as bloody water is evacuated, give honey and oil of olives, of each an ounce, for a draught, and let twenty drops of balsam of copaiva, or balsam of Peru, be taken on sugar thrice a-day. Take of Venice soap, four scruples, New milk, two ounces, Pure nitre, a scruple, Syrup of marsh-mallows, Alcohol, of each two drachms, Make a draught, to be repeated twice or thrice a-day. Take of pure nitre, a scruple, Purified salt of amber, ten grains, Pure water, an ounce, Tolu Syrup, a drachm, A draught to be taken every third hour. Take of Ointment of hog’s lard, an ounce, Oil of turpentine, two drachms, A liniment, with which the loins may be anointed two or three times a-day. Take of magnesia alba, Spermaceti, Rhubarb, of each two scruples, For six powders. Let one be taken every fourth hour, till the body is sufficiently open, Take of gum arabic, two ounces, Pure water, a pint, Acetated kali, Syrup of marsh-mallows, of each half an ounce, A (59) A mixture, of which let three spoonfuls be given every three hours. Take of Chio turpentine (dissolved in the yolk of an egg), half a drachm, Spermaceti, Acetated kali, of each two scruples, Pure Water, an ounce and a half, A draught to be taken every fourth hour. Take of gum arabic, Spermaceti, of each a drachm and half, Acetated kali, one drachm, For six powders, one of which should be taken every two hours. If the pain is exceeding great, as it often is, give three grains of pure opium. ULCER IN THE KIDNIES OR BLADDER. The cause of an ulcer in the above-mentioned is ei- ther a calculus, or something corrosive received into the stomach, venereal virus, scorbutic diathesis, contusion, inflammation, obstruction, or erosion. The diagnostics of an ulcer in the kidnies are bloody urine of a fœtid smell, with scales in it: sanious, or purulent urine. In this case rhubarb in small doses, frequently given, is an admirable medicine. Ulcers in the bladder are more dangerous, and often attended with unsupportable agonies. In an ulcer. of the kidnies, the urine is discharged without much diffi- culty or uneasiness; is reddish, often bloody, with car- uncles in it. In an ulcer of the bladder, the difficulty of (60) of making urine is very great, the pain dreadful; less blood, but large quantities of purulent matter accom- pany the urine, especially in women. The prognostics. In habits of body that are caco- chymic, phthisical, or to persons in years, they are al- ways dangerous and often mortal. The cure is the same. Lenient purges should be given, as cassia, rhubarb, manna, and tamarinds, for the alvine tube must be kept open; small mead, cooling ptisants, a milk diet, lime-water, and twenty drops of balsam of copaiva on sugar morning and night, should by no means be omitted. Injections of milk and lime- water. If the pain is excruciating (as in all other dis- orders without exception) the use of opiates is demanded; give two scruples of olibanum, and three grains of pure opium, made into a bole with balsam of Peru. Take of gum arabic, two ounces, Soap, one ounce, Gum guaicum, Jalap, of each two drachms, Balsam of copaiva, enough to make an electuary. The bigness of a nutmeg to be taken morning and night. Take of tincture of balsam of Peru, an ounce, A tea-spoonful to be taken twice a day. The solution of muriatic mercury. See LUES. Women declining into the vale of years are exceeding liable to internal latent ulcers, which greatly resemble ulcers in the bladder, with respect to the violence of the pain, and indeed every other symptom, the pus in urine excepted. The subsequent electuary has always an- swered my expectation in removing that troublesome complaint, and I would recommend it to those who are tormented (61) tormented with pain in parts contigious to the neek of the bladder. Take of elecampane, an ounce, Sweet fennel seeds, half an ounce, Black pepper, Balsam of peru, of each two drachms, Honey, enough to make an electuary. Dose, the size of a nutmeg morning and night. If the body is costive, add two drachms of jalap to it. Let her also take twenty drops of balsam of copaiva twice a- day, upon brown sugar. STONE. THE Stone, or human calculus, originates from a concretion of sabulous saburra, chiefly owing to the selenites in water; from the heat of the body, laxity of the fibres, or predisposition of the fluids to deposit this earthly matter; perhaps from a deficient attraction among their own particles to preserve its suspension: it is often formed into a hard friable substance. The causes. The water we drink seems to be the chief cause, which has more or less of an earth in it, and, if you please, something of a petrifying quality; claret, ale, and all those liquors which ferment strongly in the sto- mach, and consequently occasion the terrestrial parts of the urine to cohere together; the appulse of an acid gas, obstruction or coarctation of the urinary canals. Any extraneous substance in the bladder, which will soon form a nucleus. The diagnostics. A sensation of numbness, torpidity, or painful pressure in the thigh; nausea, frequent retch- ings; the urine thin, bloody, small in quantity, ex- creted with great uneasiness, or totally suppressed; pain in the glans penis, tenesmes. The (62) The prognostics. If both ureters are at once affected, if the urine is totally suppressed, the extremities cold, or the urine continues bloody after the fit is over, the disorder will be of long continuance, and most probably terminate in death. In ancient persons it is always very dangerous. The cure. This dreadful disease authorizes us to summon every possible and immediate medical assist- ance, as clysters, purges, antiemetics, oil of aniseeds, terebinthinates, fat broths, fomentations, opiates, the catheter, lithotomy. To prevent a return, equal quan- tities of lime-water and butter-milk should be drank at meals, and for a constancy, to the quantity of three pints in a day. Claret, malt, and all fermenting li- quors should be abstained from. Spirits of all sorts, (having passed the state of fermentation) diluted with water, are no ways prejudicial. Take of balsam of Peru, (dissolved in the yolk of an egg) two drachms, Decoction for a clyster, five ounces, Oil of olives, two ounces, Tincture of opium, two drachms, A clyster. This will always give immediate ease in the most racking pain. Or, Take of vitriolated natron, two ounces, Water, six ounces, Tincture of asafœtida, half an ounce, Tincture of opium, one drachm. A clyster. Take of balsam of Peru, Oil of aniseeds, of each two drachms, Mucilage of gum arabic, seven ounces, Tincture of jalap, half an ounce, A (63) A mixture; three spoonfuls to be taken morning and night, or as there is occasion. To preserve the patient from returns of this horrid distemper, Take of gum arabic, two ounces, Venice soap, one ounce, Grains of Paradise, Jalap, of each two drachms, Balsam of copaiva, enough to make an elec- tuary. Dose, the size of a walnut, morning and night. Se- veral have I seen who for many years had not been one moment free from pain, perfectly cured by this elec- tuary; a relation of what it has performed in a vast va- riety of cases, would be enough to shock the belief of the most credulous. Take of liquorice root, three ounces, Boil in a quart of water; half a pint to be drank twice a day. Take of tincture of balsam of Peru, an ounce, A tea-spoonful night and morning. OPTHALMY AND DISORDERS OF THE EYES. AN Opthalmy is an inflammation of the eye, or ad- nata, with redness, swelling, and discharge of a hot water, or matter. It is commonly divided into dry and moist; when slight, called Phlogosis; if there be some redness in the albugineous coat, Taraxis; when the eye-lids can scarcely be closed, Chumosis; if ac- companied with a profuse discharge of red rheum, Epi- phora, (64) phora, Suffusio, Phylctæna, Glaucoma, Hypopyon, Al- bugo, and Pterygium, &c. are all to be treated much in the same manner. The cause. Some irritation, or the same with that of other inflammations. The diagnostics. It is known by the red colour of the tunica conjunctiva: the other disorders of the eyes, by a distillation of bloody acrid rheum from their angles; a scalding water; a collection of matter, or water in vesicles under the cornea; filmes, motes, specks, &c. The prognostics. If it continue long, it sometimes turns to a glaucoma, or cataract, or gutta serena (which requires the internal use of medicines, as mercurials, &c.) In general, it is not difficult of cure. The cure. If the eyes are glued up in the morning, let them be bathed with warm milk. If the patient is plethoric, bleed; then give a gentle purge, such as, Take of vilriolated natron, an ounce, Purified salt of amber, seven grains, Pure water, three ounces, Syrup of buckthorn, half an ounce, A purging potion. Issues are exceedingly serviceable, vesicatories likewise applied to the temples, behind the ears, or to the nape of the neck; no small advantage will result from a seton, which should be cut perpendi- cularly, and not horizontally, as is the usual custom.— Sternutatories should not be omitted, as the compound powder of asarum. Or, Take of white hellebore root, a scruple, Florentine oris root, ten grains, Euphorbium, three grains. Of this powder let a pinch be taken, as if it were snuff, every night after getting into bed. If (65) If a hot water distils from the eyes, or if films, specks, &c. appear, the subsequent eye-water is, I believe, not to be excelled; the eye may be washed with it three or four times a day, and as much of it allowed to be worked in the eye, by frequent winking, as can be well borne. Take of white vitriol, fifteen grains, Spirit of wine rectified, Lime water, of each half an ounce, A collyrium. Or, Camphorated spirit, an ounce, A collyrium. Or, if that gives too much pain, Take of water of litharge acetated, seven drops, Rose water, an ounce, A collyrium, to be used three or four times a day. Or, Take of water of litharge acetated, sevem drops, Tincture of opium, Lime water, of each half an ounce, A collyrium. If the sight is very weak, and is daily impairing, put a drachm of allum into the white of an egg, let them be well whisked up together, and smear the eye-brow and eye-lid with it every night. If there be a scorbutic acri- mony in the fluids, Take of mercury with sulphur, an ounce and half, Gum arabic, half an ounce, Honey, enough to make an electuary. The dose, the size of a nutmeg morning and night. In (66) In opthalmies proceeding from a scrophula, (which by the way most opthelmies do) the bark is not only a certain but expeditious remedy, as, Take of red bark, an ounce, Extract of liquorice, two drachms, Mucilage of gum arabic, enough for an elec- tuary, The size of a walnut to be taken morning and night. When the edges of the eye-lids look red and raw, or discharge, Take of white calx of mercury, a scruple, Cerate of acetated litharge, an ounce, Smear them with a feather dipt in it night and morning. A cataract requires the operation, viz. depression or extraction of the chrystaline lens. If a gutta serena is curable, it must be helped by electricity, sternutatories, the dry vomit, the aluminous egg application, and such alteratives as mercurials and antimonials. CATARRHAL FEVERS. CATARRHAL Fevers are generally slow and mild, exacerbated toward evening, when the equilibrium of the atmosphere is destroyed; they are accompanied with pains in the joints, stoppage of the nose, deafness, head-ach, cough, and listlessness, &c. They are com- monly called colds. They produce, when neglected, innumerable disorders, as they originate from an abate- ment or obstruction of insensible perspiration, if that perspirable matter is retained in the circulation which ought (67) ought to have been thrown out of the body, it may soon putrify, and occasion fevers pessimi moris. Hence ob- serve how hazardous and frequently fatal (though little suspected) that custom must be of bleeding for a cold, when no plethora subsists. To attenuate viscidities, few medicines are preferable to the acetated kali. When cold is first taken, an opiate (which acts by effecting a temporary plethora) if not costive, will often remove it like an amulet, as, Take of tincture of opium, thirty drops. At bed time. Or, Take of Opiate pill, five grains, Tartarised antimony, one grain, A pill to be taken at going to bed. If the symptoms are very alarming, give two grains of the tartarised antimony well rubbed with ten grains of white sugar, for a vomit, drinking nothing during the operation. Either of the following are exceeding efficacious in the removal of a cold, and far preferable to bleeding: Take of prepared kali, a drachm and half, Pure water, seven ounces, Water of ammonia, Tolu syrup, of each half an ounce, A mixture. Let three spoonfuls be taken every fourth hour. Take of mercury with sulphur, an ounce and half, Crude antimony, Gum guaicum, of each two drachms, Honey, enough to make an electuary, The (68) The quantity of a nutmeg to be taken morning and night. N. B. Those who value their health, and are liable to colds, should lie with very light covering in bed.— One pair of blankets is at all times sufficient. COUGH, SUFFOCATING CATARRH, AND HOARSENESS. A COUGH is a convulsive motion of the diaphragm, generally owing to an irritation of the larynx. By chewing a hard crust, or piece of sea biscuit, on going to bed, the glands will be emptied of that acrid saliva wherewith they are distended, and consequently that teasing defluxion will be prevented, and that tickling sensation which is so troublesome in the night. A plais- ter of Burgundy pitch between the shoulders will won- derfully relieve a cough: it should be worn continually for some weeks. If the thyriod gland is swelled so as to render deglutition difficult, apply a poultice of bread and milk to the throat, and a vesicatory to the neck. The Suffocating Catarrh is an affection of the larynx, when the aspera arteria is irritated, and the glottis con- stringed, so as to endanger immediate suffocation. If plethoric, bleed: let the face be held over the steam of boiling milk; a bread and milk poultice be wrapped round the throat, and give an emetic,* antispasmodics, opiates, and agglutinants. A Hoarseness is an affection of the aspera arteria, caused by an effusion of a thin acrid lymph, or an abra- sion of its internal mucus. Half a pint of new milk, with *Take of antimony tartarised, ten grains, Pure water, an ounce. Of this let a tea-spoonful be taken every half hour, till the effect is produced. (69) with half a pound of suet dissolved in it, and drank warm, will almost instantaneously relieve, but is by no means a pleasant draught. Take of sulphurated oil, five drachms, Oil of aniseeds, one drachm. Of this bottle of drops, let ten be taken on sugar three or four times a day. It is an admirable medicine for a cough, as well as for hoarseness. To return to a cough. Nettle seeds mixed up with honey into an electuary, is no despicable remedy; the size of a nutmeg to be taken night and morning. Or a spoonful of the expressed juice of turnips twice a day, sweetened with as much sugar candy as will render it palatable. Or, two ounces of garlic, infused in a bot- tle of mountain wine, a glass-full morning and night. Or, (which exceeds every thing else) balsam of copaiva, an ounce; of these drops take twenty twice a day on sugar. Or, balm of Gilead. Or, if not costive, Take of tincture of opium camphorated, an ounce, A tea-spoonful night and morning, in a glass of water. Or any of the following medicines, the efficacy of which may be depended on: Take of flowers of sulphur, an ounce and half, Elecampane, six drachms, Balsam of copaiva, half an ounce, Myrrh, two drachms, Oil of aniseeds, a drachm, Tolu syrup, enough for an electuary, The bigness of a nutmeg twice or thrice a day. Take of asafœtida, Gum ammoniac, of each a drachm, Squills (70) Squills powdered, a scruple, Simple syrup, as much as is sufficient, Make twenty-four pills, two to be taken night and morning. Take of diluted vitriolic acid, twenty drops, Night and morning. If costive, Take of asafœtida, a drachm, Sulphur of antimony precipitated, two scruples, Socotrine aloes, one scruple, Squills dried, fifteen grains, Simple syrup, enough for pills, Twenty-four; two to be taken night and morning. Or, Take of asafœtida, a drachm, Filings of iron, Precipitated sulphur of antimony, of each half a drachm, Socotrine aloes, one scruple, Simple syrup, enough for pills, Twenty-four. Take of conserve of orange peel, half an ounce, Oil of olives, Tolu syrup, of each an ounce, Vitriolic acid, enough to make it gratefully acid, A linctus; a tea-spoonful to be taken at pleasure. Take of coltsfoot flowers, an ounce and half, Horehound, Hysop, of each half an ounce, boil a little in a quart of water, Extract of liquorice, two drachms, Make (71) Make a mixture, of which a tea-cupful may be drank twice a day, or oftener. Take of red bark, six drachms, Extract of liquorice, two drachms, Myrrh, one drachm, Mucilage of gum arabic, enough for an elec- tuary, Dose, the size of a chesnut, twice a day. PERIPNEUMONIA GNOTHA. THE Bastard Peripneumony, or Humoral Asthma, is a disease very different from the true Perip- neumony, and owing to a redundance of serum in the lungs, which are overflowed as it were, with a cold pi- tuita: this phlegm stagnating in the cellular membrane or extremities of the capillary branches of the pulmo- nary artery, produces effects very similar to those of a real inflammation, though the necessary discrimination is to be made with great facility. The causes. A deficiency of vital heat; diminution of the vis vitæ; redundancy of serum; teneritude of the muscular fibre, indolence, or inactivity, preceding dis- orders, profuse evacuations, whatever puts too speedily in motion that which stagnates in the lungs. The diagnostics. The patient is at first seized with a sudden coldness and rigour, and loses his strength very fast; pallid countenance, sensation of weariness, lassi- tude, shortness of breath, spasmodic constriction of the lungs, a slight hectic fever, ropiness of the saliva, anxiety about the præcordia, swelled ancles, increasing debi- lity, a teasing cough, anorexia. The (72) The prognostics. It is a very fallacious distemper. Sometimes it terminates (and very often, in cachectic habits) in sudden and unexpected death. It is always attended with danger, for there is no disorder of which more persons die; perhaps every one is peripneumonic for a few minutes at least before a natural death, be- cause the blood that is propelled from the right ven- tricle of the heart, from the declension of muscular mo- tion, cannot then pass through the anfractuous angus- tiæ of the lungs, without occasioning the anhelous res- piration. The cure. It is unnecessary to say that in this case phlebotomy would be deleterious. For common drink give the compound decoction of barley with large quan- tities of hydromel; vesicatories of no small dimensions are necessary, and should be frequently repeated. A seton should be made on the side of the sixth vertebra of the neck, in a perpendicular form; change of air is of considerable utility, though even to one no better than that which the patient was in before; acids may be given with advantage, for the generally received opinion that they are inimical to the lungs, is not con- firmed by experience; broths are useful. A tea-spoon- ful of the expressed jusce of garlic may be administered night and morning with great advantage. The dry vo- mit must not be omitted, as, Take of blue vitriol, Antimony tartarised, of each seven grains, For three powders; one to be taken twice or thrice a week in the morning, fasting; let the patient strain, without drinking any thing till some yellow or greenish matter is ejected, and then, if the nausea does not go off, take half a glass of brandy; if that should be thrown up, a repetition of it will soon settle the stomach. Take of balsam of copaiva, an ounce, A bottle of drops. Of (73) Of these let twenty be taken on sugar night and morn- ing. Whatever other medicines are used this ought not to be dispensed with. Diuretics are singularly service- able, and one that will give place to no other, is, Take of tincture of cantharides, an ounce, A tea-spoonful to be taken night and morning. Lenient cathartics are absolutely necessary, which should be repeated according to the strength of the pa- tient, as, Take of rhubarb, a drachm, Gamboge, fifteen grains, Calomile, ten grains, Simple syrup, enough for twelve pills, Two or three to be taken every morning, one at a time, at an hours distance each. Or, Take of asafœtida, a drachm, Tartarised antimony, half a drachm, Simple syrup, enough for pills, Twenty-four. Take of extract of cassia, an ounce, Four figs, Liquorice root, Senna leaves, of each two drachms, Boiling water, four ounces, Infuse and strain for a purging draught. Or the follow- ing, which is a very elegant one: Take of senna leaves, three drachms, Lemon peel, two drachms, Tartarised kali, ten grains, Compound decoction of barley, four ounces, D Let (74) Let it be poured boiling hot on the ingredients, and when cold strain for a purging potion. Take of rhubarb, five scruples, Precipitated sulphur of antimony one scruple, Balsam of copaiva, enough to make into pills, Number twenty-four; two to be taken once or twice a day. For persons upwards of fifty. Take of gum ammoniac, Precipitated sulphur of antimony, of each a drachm, Squills, a scruple, Simple syrup enough for pills, Twenty-four; two to be taken morning and night. See COUGH, and the following. N. B. In a confirmed Hydrothorax give Mr. Tick- el’s Anodyne Æthereal Spirit, with the above-mentioned rhubarb, or tartarised antimony pills, once or twice a week. Or, (which is the only certain remedy) the ex- pressed juice of artichoke leaves. See DROPSY. ASTHMA. AN Asthma is a difficult and laborious respiration, owing to the compression, coarctation, or obstruc- tion of the pulmonary vessels, and is either continual or periodical. The cause of a continual asthma is a compression of the veins, bronchial vessels, pulmonary vesiculæ or nerves; this may be occasioned by a hydrops pectoris, empyema, phlegmon, abscess, vomica, tubercles, po- lypus (75) lypus in the blood vessels, coagulation of the blood it- self, corpulence, gibbosity, adhesion of the lungs to the pleura, emphysematous tumors of them, inflamma- tion of the stomach, infarction of the bronchial glands. The cause of a periodical asthma is a compression of the vessels and bronchial vesiculæ, owing to a slow ha- litus, or acid gas, which impedes the course of the ner- vous influence along the par vagum, and in some mea- sure expels it, not leaving a sufficiency of vital heat to distend the bronchial vesiculæ to their usual extent; this appears sooner or later, as the fermentation in the stomach is sooner or later performed, as I have observed in numbers of instances. It commonly succeeds other diseases, as an intermittent, variolæ, the measles, ca- tarrh, peripneumony, cachochymy, hysterics, and un- necessary phlebotomy, or a sudden change of the non- naturals, especially of the air. It seems not to be an idiopathic disease. The proximate cause of both is a spasmodic constric- tion, coarctation, or irritation of the organs of respi- ration. The diagnostics appear from what has been observed above. A difficult respiration when the breath is drawn oftener and quicker than usual is called Dyspnœa. A frequent and large respiration, when the diaphragm and intercostal muscles are violently agitated with snorting or wheezing, is termed an asthma. The greatest diffi- culty of breathing, when the patient cannot fetch his breath without sitting upright in bed, and even not then without the vehement and operose working of the mus- cles of the breast and scapula, is nominated orthopnœa. The prognostics. A plethoric asthma is easily cured, requiring only the discreet use of phlebotomy, or cup- ping. A spontaneous diarrhœa is an exceeding good sign. If it is inveterate, or if the patient is advanced in (76) in years, the case is difficult. If pus is formed, it fore- bodes convulsions, a phthisis, or dropsy. If owing to another disease, it requires the same treatment with the respective disorder. The cure. The diet should be taken from those things which are easiest of digestion, and consequently ought to be of animal substance, which will not only digest with greater facility, but ten times sooner than any of the vegetable tribe. Milk should be taken for breakfast and for supper; broth, spoon-meats, and much the same regimen is requisite as in the phthisis. A clear, dry air, exercise, clysters, a seton cut in a perpendicular direction, issues, a Burgundy pitch plaister between the shoulders, perpetual vesicatories, frequent emetics, ca- thartics, the balsam of copaiva, and the dry vomit. See COUGH and PERIPNEUMONIA GNOTHA. The asthmatic pill: Take of asafœtida, a drachm, Precipitated sulphur of antimony, two scruples, Socotrine aloes, one scruple, Oil of aniseeds, twenty drops, Simple syrup, enough for pills, Twenty-four; two to be taken morning and night. Or, if very costive, Take of asafœtida, a drachm, Socotrine aloes, Filings of iron, of each two scruples, Simple syrup, enough for pills, Twenty-four; two to be taken morning and night. Or, the ammoniac pills in the last article. If opiates may be given with safety, viz. if the body is sufficiently open, to render the nights more tolerable, and to procure a truce, Take (77) Take of opiate pill, one drachm; Make into twelve or sixteen pills, one to be taken at bed-time. Or, Take of tincture of opium camphorated, an ounce, A tea-spoonful (more or less) in a glass of water, night and morning. Take of antimomy tartarised, three, four, five, or more grains, As the case requires, for a vomit; to be taken fasting, and drinking nothing after it for two or three hours; to be repeated every week or ten days. The following electuaries have been extremely ser- viceable: Take of flowers of sulphur, an ounce and half, Elecampane, an ounce, Balsam of copaiva, half an ounce, Oil of aniseed, a drachm, Tolu syrup, sufficient to make an electuary, Dose, the bigness of a nutmeg every morning and even- ing. Or, Take of red bark, an ounce, Extract of liquorice, three drachms, Tolu syrup, enough for an electuary, The size of a nutmeg to be taken twice or thrice a day. AUXILIARIES. Take of shavings of sassafras, Coltsfoot flowers, Maidenhair, of each equal parts. Of (78) Of this half an ounce may be made into tea, to be drank instead of common tea, sweetened with honey. Take of onions (or leeks) two ounces, Boil in a pint and half of water to a pint, strain, and let a tea-cupful, sweetened to the taste, be taken two or three times a day. Raw onions, with plenty of pepper and salt, may be eaten every day to great advantage. Take of conserve of squills, half an ounce, Tolu syrup, Oil of olives, of each an ounce, Vitriolic acid, twenty drops, A linctus, to be taken at pleasure. Take of tincture of cantharides, an ounce, Of these drops a tea-spoonful may be taken twice a day. Take of coltsfoot flowers, or leaves, an ounce, Boil in a pint and half of water to a pint; squeeze them dry. Let this pint be drank every day, very warm, holding the face first over the steam, while boiling hot, till cool enough to drink. N. B. Half an ounce of horehound may be added. See FLATUS, and PERIPNEUMONIA GNOTHA. CEPHALALGIA. CEPHALALGIA is a sensation of pain in the head. Cephalæa is an inveterate (and supposed hereditary) pain in the head. Hemicrania (79) Hemicrania is a pain in the middle of the head.— They are all owing to the same causes, and require the same method of cure. The causes. Little acrid particles of blood or lymph, which vellicate or distend the membranes or nervous fibrillæ; strong liquors drank too profusely, spasms, staying too long in the heat of the sun, immoderate ex- ercise, intense study, fermentation in the stomach, acid gas, or halitus, a deficiency of heat in the encephalon, a plethora, costiveness. The diagnostics is sufficiently obvious. The prognostics. If symptomatic it is to be profligated by the removal of that disease which is the occasion of it. The more superficial the easier it is to be cured; the deeper, the sharper, and if of long continuance, with the more difficulty. If accompanied with a verti- go, noise in the ears, strabismus, or deafness, if not removed, it will end in a lethargy; if with æruginous vomiting, in a mania. A defluxion of blood or pus from the nostrils often cures it. Turbid urine indicates a continuance of the malady. If the pain strikes into the orbits, is accompanied with giddiness, and the pa- tient be advanced in years, the cure is very problem- atical. The cure. If it proceeds from the stomach, give an emetic, if from a plethora, (which a chronical head- ache rarely, if ever does) bleed or cup. If from a re- dundance of acrid serum, with costiveness, which is an usual concomitant, if not the procatarctic cause, aloetic purges are the surest and most expeditious remedy.— Vesicatories, setons, cephalic plaisters, sternutatories, diaphoretics, and opiates, are ail indicated, and may be made use of according to the discretion of the practi- tioner. A blister may be laid over the whole head, and kept on till it comes off of itself, which will be on the fourth or fifth day. For common drink valerian tea is excellent. (80) excellent. Sitting for a few minutes with the feet im- mersed in warm water will sometimes yield instanta- neous relief. Ginger is the most excellent of all ner- vines; in this and all other disorders affecting the nerves, it may be given to two scruples, twice or thrice a day: few fits will withstand its power. Slight electrical shocks will often remove it. If external, which may be known by increasing on pressure, dissolve a drachm of camphire in half an ounce of æther, and pouring a little into the palm of the hand, let it be applied to the pained part. If an old and crabbed case, give the dry vomit, as, Take of blue vitriol, Antimony tartarised, of each two grains and a half. Let this powder be taken in half a spoonful of water in the morning, fasting, without drinking any thing du- ring the operation; but when yellow or greenish matter is thrown off from the stomach, half a glass of brandy may be taken to remove the nausea; if that is rejected, as it will be if there is more corrupted bile to be thrown up, a repetition in a few minutes after will soon settle the stomach. Plaisters of Burgundy pitch may be ap- plied to the temples, or behind the ears, a fomentation for the whole head of equal quantities of tincture of opium and vinegar, will often give ease; or equal quan- tities of camphorated spirit, compound tincture of la- vender and vinegar. An errhine may be given to snuff up the nose, of brandy and vinegar equal quantities; or of camphorated spirit. Sternutatories ought not to be omitted, as white hellebore root, or asarabacca leaves. A pinch of either (in powder) to be taken as if it were snuff, every night after getting into bed. If the pain is very excruciating in the night, thirty or forty drops of tincture of opium may be taken at bed time, and the next morning a draught given, composed of an ounce of aloetic wine, and half an ounce of cin- namon water. Habitual (81) Habitual head-achs, arising from constipation of the bowels, soon yield to the following pills: they are in- deed a noble medicine, and too much cannot be said in their praise. The author has ordered them many thou- sands of times, and they never disappointed his expect- ations. Take of socotrine aloes, one drachm, Precipitated sulphur of antimony, Filings of iron, of each half a drachm, Simple syrup, enough to make into pills, Number twenty-four; two to be taken night and morn- ing, if they do not open the body too much. Or, Take of socotrine aloes, Filings of iron, of each a drachm, Precipitated sulphur of antimony, Calomel, of each a scruple, Simple syrup, enough to make into pills, Thirty-two; two to be taken every night. Take of prepared kali, half an ounce, Water, a pint, A tea-cupful night and morning. If the patient is not costive, and the pain returns pe- riodically, give the bark. EPILEPSY. AN Epilepsy is a sudden prostration of the vis vitæ, with a violent concussion of the muscles, and loss of the senses, both external and internal. It is called catalepsy, caducus, catoche, morbus sacer, comitialis, and Herculeus. D3 The (82) The causes. A bad conformation of the encephalon; corruption or erosion of the meninges; quicksilver, by what means soever conveyed to the brain; an increased flux of serum into the head, hydatides on the corpus callosum, violent exercise, profuse venery, strong think- ing, a fright, all vehement affections of the nervous system, excruciating pain, hysterics, irritation from worms, toothing, an acrid humour, the infection of the variolæ, the obstruction of some secretion; various sorts of vapors, as the steams from liquors in a state of fer- mentation, or an acid gas. The diagnostics. A sensation of weight in the head, or of pressure over the eyes; of heaviness in the joints, frothing at the mouth, foolishness, tinnitus aurium, for- getfulness, a thin and crude urine, gnashing of the teeth, a deprivation of all feeling; paleness of the coun- tenance, inordinate motion of the tongue, shrieks, clenched hands, sudden fall to the ground, dimness of sight; from the violence of the paroxysm, an ejection of food, mucus, lymph, or bile; involuntary discharge of urine, semen, or excrements; on recovery, no re- membrance of what has passed; impaired intellects. The prognostics. It is either idiopathic or symptom- atic. If hereditary, and a delirium supervenes after the fits, it is incurable. From the frequency of the fits arise loss of memory, dulness, stolidity, palsy, apoplexy, and death itself. An involuntary excretion of the fœ- ces, the fits being of long duration, and the brain, pri- marily affected, are signs that the cure will not be affected without great difficulty. If the cause is in the solids, it is irremoveable From the injuries which the nerves suffer, there follow contractions, deformity, and dis- torsions. In children, when a quartan supervenes, the fits go off. If owing to worms they are easily curable; if to spasms, and properly treated, they are not very refractory. The cure. In the paroxysm, let a loud noise be made in the ear, and apply water of pure ammonia to the nose, (83) nose, or blow up the nostrils a little white hellebore, or black pepper; bathe the temples and wrists with vine- gar; if the mouth can be opened, put into it fifteen or twenty drops of oil of amber on powdered sugar, or give a drachm of tincture of castor in half an ounce of strong cinnamon water. As I never saw a plethoric epileptic, I never ordered the use of the lancet for any one, nor can I think it by any means allowable. Purges are of- ten proper, and of considerable utility, even twice or thrice a week; so are chalybeate waters, issues, setons, blisters, the cold bath, alkalis, anthelmintics, anti-hys- terics, cardiacs, nervines, opiates, lancing the gums, the trepan, electricity, and the dry vomit. The diet should be of animal food for dinner, with milk constantly for breakfast and supper: vegetables of ail sorts are to be avoided, wines also, and malt liquors; spirits diluted with water may be drank with safety.— Gentle and frequent exercise is absolutely necessary, change of air and amusements are not to be neglected. Take of blue vitriol, Antimony tartarised, of each seven grains, For three powders, one of which should be taken at least twice a week, in the morning fasting: let the pa- tient strain, without drinking any thing, till he throws up some yellow or greenish matter, and if his sickness doth not go off, take half a glass of brandy; if that should be puked, another half glass will perfectly settle the stomach. Nothing can be more mild, safe, or gentle, than one of these vomits, and I have known great numbers of persons, by whom the repetition of them was more eagerly requested than opiates have been by those who were in pain. I shall now subjoin all the medicines which I ever used that proved efficacious in the removal of this dis- order, and many hundreds of cases I have been for- tunate enough to succeed in. Let it be added that the dry (84) dry vomit was never omitted, excepting in those cases which were owing to worms, or spasms, and then the following pills and drops have never once failed to an- swer expectation. Of the rest the most proper must be left to the choice of the prescriber. Take of socotrine aloes, Filings of iron, of each a drachm, Simple syrup, enough for pills, Number twenty-four; two to be taken night and morn- ing (if not too opening) washing them down with a glass of water, in which put two tea-spoonfuls of these drops: Take of tincture of asafœtida, two ounces, For a bottle of drops. Take of white hellebore, a scruple, Ginger, ten grains, Euphorbium, two grains, Of this snuff let a pinch be taken every night, after getting into bed. If laxative, Take of red bark, an ounce, Valerian root, six drachms, Ginger, half an ounce, Mucilage of gum arabic, enough for an elec- tuary, Dose, the quantity of a walnut night and morning, or oftener. Take of valerian root, an ounce, Red bark, six drachms, Factitious cinnabar, half an ounce, Filings of iron, a drachm and half, Mucilage of gum arabic, enough for an elec- tuary, Dose, (85) Dose, the size of a walnut morning and evening, wash- ing it down with two tea-spoonfuls of the following drops, in a glass of water: Take of volatile tincture of valerian, an ounce, For a bottle of drops. Take of ginger, half an ounce, To be divided into six powders, one to be taken twice a day. Take of madder, half a drachm, A powder, to be taken night and morning. See CE- PHALALGIA. FLATUS. FLATULENCIES are of all disorders the most com- mon, and have, perhaps, the least attention paid to them, notwithstanding that few persons are free from some disagreeable circumstances owing to wind, for the too rapid escape of the aereal acid from vegetables eaten, proves the source of some of the worst and most crab- bed chronic cases. The causes. An acid gas arising from a too speedy fermentation in the stomach. It is not easy to imagine what a variety of bad consequences are produced from the detention of elastic air in the bowels. Many of these disorders are by the common people called the spleen in men and the mother in women. The diagnostics. Breaking wind upwards, downwards; incessant eructations, pain in the stomach, rumbling noise in the bowels, loss of appetite, heart-burn, sour breath, (86) breath, sensation of pent-up wind, borborygmy; acid or nidorous belchings; bad taste in the mouth, tumor at the pit of the stomach; swelling of the abdomen, or the right epigastre; pain in the left side, dyspnœa, head- ach, sensation of fulness after eating; nausea, especially in the morning, obstructed bile, costiveness, passing of worms or slime, spasms of the urinary vessels, some- times a diarrhœa, ash-coloured excrements; in females, generally an obstruction of the catamenia. It is almost an inseparable concomitant of all bilious or gravelly com- plaints. The prognostics. If of long continuance, it will re- quire some time, but no great difficulty, to remove. If the wind is not determined downwards, the disorder, though seemingly cured, will, return. In sanguinous habits, or if attended with an habitual diarrhœa, it is most troublesome to manage. The cure. The predominant acid in the stomach is to be corrected and destroyed by alkalis, emetics, and eccoprotics; the wind is to be expelled by proper carmi- natives, nervines, and cardiacs; the alvine tube to be kept open by aloetics, or antimonials; if accompanied with a diarrhœa, give the bark, with opiates; ginger, cas- tor, opiate confection, tincture of asafœtida, and such like. A milk diet, at least morning and evening, is very adviseable. Abstinence from fruit, vegetables, malt, and other fermenting liquors, is indispensably ne- cessary; animal food, and spirits diluted with water, may be used safely, and the warmer any liquor is drank the better. Pains, sickness, and common disorders of the stomach, are soonest removed by half a pint of boil- ing water taken as hot, and as fast as it can be supped. Obstinate fixed pains in the sides and loins, of many standing, have soon yielded to the following carmina tive: Take of bay berries, six drachms, Grains of paradise, too drachms, Socotrine (87) Socotrine aloes, Filings of iron, of each two scruples, Oil of turpentine, two drachms, Simple syrup, enough to make an electuary, The bigness of a nutmeg to be taken night and morning. This, though not a pleasant, is a most powerful me- dicine, the wonderful efficacy of which I have experi- enced in a great many thousands of instances. Elastic air pent up in the vessels, is often the cause of these fixed pains, as well as of rheumatic complaints (which may be known to be the cause by their being worse in bed), and of vagrant spasms. In such cases, some chaly- beate water, with half as much boiling water poured on it, should be drank to the quantity of half a pint, two or three times a day. If attended with a diarrhœa. Take of opiate confection, an ounce, Red bark, six drachms, Grains of paradise, three drachms, Filings of iron, one drachm, Syrup of ginger, enough for an electuary, The quantity of a nutmeg to be taken twice or thrice a day. The following tincture is well deserving a place in the shops. Take of bay berries, two ounces, Grains of paradise, an ounce, Ginger, half an ounce, Proof spirit, a pint, Digest without heat for three days, strain and sign the carminative tincture. Take (88) Take of the above carminative tincture, Volatile tincture of valerian, of each an ounce, Two tea spoonfuls to be taken night and morning. Or, Take of the above carminative tincture, an ounce and half. Tincture of asafœtida, an ounce, Of these drops, let two tea spoonfuls be taken night and morning. If costive, Take of socotrine aloes, a drachm, Precipitated sulphur of antimony, Asafœtida, Filings of iron, of each half a drachm, Simple syrup, enough for pills, Number twenty-four; two to be taken night and morn- ing, washing them down with two tea-spoonfuls of either of the above drops. Or, if not very costive, Take of asafœtida, a drachm, Precipitated sulphur of antimony, Socotrine aloes, of each half a drachm, Simple syrup enough for pills, Number twenty-four; two to be taken night and morn- ing, taking after them a tea spoonful of the following drops in a glass of water. Take of chian pepper, or Long pepper, powdered, half an ounce, French brandy, a gill, Digest without heat for three days, and filtre. Drops, Take (89) Take of caraway seeds, three drachms, Galangal, one drachm, Of this powder, a tea-spoonful may be taken occasion- ally (when much oppressed with wind) in a glass of wa- ter, with a tea-spoonful of the last-mentioned drops. To restore the overstrained fibres to their proper tone, after the stomach and bowels are well cleared, Take of diluted vitriolic acid, half an ounce. Of these drops let twenty or thirty be taken thrice a day. It might not be amiss to propose the following ques- tions to every patient in all chronical complaints, viz. have you any thing of the heart-burn; any sourness or heat in your stomach? Does water ever rise in your mouth in the morning; do you feel a nausea or sick- ness at your stomach in the morning? are you oppressed with wind in your bowels? Do you find ease in dis- charging it? Does it ever rise up in your throat, or seem to fly between your shoulders? Have you any pain in your left side? do you feel a sort of weight or pressure over your eyes? Have you a sensation of ful- ness after eating, a fluttering about your heart? Any swelling at the pit of your stomach, or pain on the right side of it, or under the blade bone of your right shoulder? Do you not feel a faintness and sinking with- in you? Are you costive? Do you find any difficulty or uneasiness in making urine? Does it seem hot? Do you ever void any worms or slime? Any difficulty of breath- ing? A single affirmative to either of those questions will warrant the use of one of the above formulæ, mu- tatis mutandis, according to the circumstances of the case; a due combination of such antispasmodics, car- minatives, and anti-acids, keeping open the intestinal canal; or restraining the alvine discharge, if excessive; will, to the no small surprise of the practitioner, in a vast variety of chronic cases, soon restore the unhappy sufferer (90) sufferer to a perfect state of health, by removing the cause of the disease, as the writer of this has joyfully experienced in many thousands of instances every year, for these twenty years past. HYPOCHONDRIA. THE Hypochondriacal affection, melancholly, or lowness of spirits, is a sort of delirium without a fever. This disorder is commonly supposed to originate from the imagination, because it is intensely fixed on one particular object; but, in fact, it is entirely owing to a laxity of the muscular fibres throughout the whole vascular system. The cause. A deficiency of the vital heat in the cerebrum (a cause diametrically opposite to that which produces the phrenitis, though the effects are similar,) this may be expelled therefrom by that, whatever it is, which dissipates the finer fluid parts, and fixes the rest, as agrypnia, profuse venery, an acid gas, any excessive evacuation, particularly that of insensible perspiration; grief, disappointment, fear; the immoderate use of sal- lads, fruits, vegetables of all sorts, sugar, fermenting liquors, vinous or malt; indigestion, flatulencies, a se- dentary life, severe studies, want of exercise, indolence. The diagnostics. The absurdity of the patient’s be- haviour, inactivity, dislike to motion, anorexia, bor- borygmi, costiveness, oppression from wind, frequent sighing, anxiety about the præcordia, great dejection, prostration of the vital powers, internal sinkings, load at the stomach, palpitation of the heart, taciturnity, wild incoherent discourse, ridiculous notions, the mind being fixed on one object. The prognostics. An appearance of the piles is a good sign. It is sometimes very tedious, but seldom very (91) very difficult to cure. If improper methods are used, such as bleeding, &c. it often terminates in madness, blindness, an epilepsy, or apoplexy. The cure. Draw off the patient’s attention from his favourite object as much as possible. Exercise must be taken, generous wines may be drank freely, as moun- tain, red port, or Madeira: or, which is more eligible, spirits diluted with water. The most nourishing diet is necessary, as milk, meat broths, particularly of pork; strong soups, jellies, sago, vermicelli, flummery, salep, eggs; all sorts of shell fish, as lobsters, crabs, oysters, &c. flat fish, as turbots, skait, dories, plaice, &c. soups made of lampries, or cray-fish; every species of wild fowl, especially grouse, partridges, and pigeons; any animal food taken in large quantities, and often repeated. He should abstain from vegetables, fruit, and malt liquors. In this, or in any other case arising from weakness of the solids, bleeding is inadmissible, it would be preposterous practice indeed to bleed an hy- pochondriac. Let the patient drink the chalybeate waters, use carminatives, very mild cathartics, corro- borants, aromatics, fœtids, perfumes, volatiles, sternu- tatories, aloetics, emetics, mercurials, blisters, setons, steel, the cold bath, infusion of horse-rhadish, valerian tea and ginger. See FLATUS and EPILEPSY, under which articles there is scarce one prescription that is not of considerable utility in this malady. Begin the cure with the dry vomit, as, Take of tartarised antimony, Blue vitriol, of each seven grains, For three powders; one to be taken on an empty sto- mach twice a week. Either of the under-mentioned pills may be given to vast advantage, as gentle cathar- tics; they have been often proved: Take of extract of black hellebore, Aloe pills, of each a drachm, For (92) For twenty-four pills; two to be taken night and morn- ing, or occasionally. Take of asafœtida, a drachm, Socotrine aloes, Filings of iron, of each half a drachm, Simple syrup, as much as is sufficient, Pills, number twenty-four; two to be taken morning and night. Or, Take of socotrine aloes, a drachm, Filings of iron, Precipitated sulphur of antimony, of each half a drachm, Mucilage, enough for pills, Twenty-four; two morning and night. Take of red bark, six drachms, Compound powder of myrrh, Ginger, of each half an ounce, Tartarised iron, a drachm, Tincture of cantharides, enough to make an electuary. Of which (if not costive) the size of a chesnut may be taken morning and night. Take of volatile tincture of valerian, an ounce, Of these drops two tea-spoonfuls may be taken in a glass of mountain wine twice or thrice a day. Take of compound powder of assarabacca, White hellebore root, of each a scruple. Of this snuff let a pinch be taken every night at bed time. Errhines seem to deserve a much higher rank in practice than they have hitherto obtained. Take (93) Take of diluted vitriolic acid, an ounce, Of these drops give twenty-five thrice a day. APOPLEXY. AN Apoplexy is a sudden abolition of the external and internal senses, and of all voluntary motion, with sometimes a full pulse and large respiration. There are four species or degrees in it. The first is, when the patient breathes, during the paroxysm, in a manner very little different from that in perfect health. The second, when the respiration is intermitting, an- helous, and inordinate. The third, when the breath cannot be fetched with- out great struggling, and nature is obliged to exert all her efforts to carry on a most operose respiration. The fourth, when respiration for some time totally ceases. The cause is that which wholly impedes the efflux of the nervous influence into the cellular coats of the or- gans of sense and motion. One would imagine that the ancients were acquainted wtth the real cause of it, from the derivation of its name Apoplexia, from Apopletto to strike. The above effect may be produced from a plethora, and too great an accumulation of blood in the ventricles of the brain, but much more commonly pro- ceeds from a deficiency thereof, and a redundance of viscid serum; as also may be reckoned among the pre- disponent causes, a large head, thick neck, corpulence, spasmodic contractions of the vessels, osseous protube- rances (94) rances within the cranium, acrimony of the lymph, ir- regularity of the non-naturals, a too liberal use of nar- cotics, frequent ebriety, extravasated blood; inordinate venery, especially of persons in the decline of life; the affections of the mind, an acid gas, blows, bruises, and mercurial vapours. The diagnostics. Preceeding the paroxysm, dimness of sight, loss of memory, a sudden and acute pain in the head, swelling of the jugulars, vertigo, an unusual cold- ness of the extremities, supine indolence, drowsiness, oscitancy, tremblings, a strong pulse, and redness of the face. The reader may observe that the signs are given indiscriminately of the sanguineous* and serous apoplexy. In the paroxysm, deprivation of all sense and motion; the eyes are closed as if he was dead; snoring, an unequal interrupted respiration, insensi- bility. The prognostics. The fourth degree is always fatal, because the conductors from the cerebellum are affected. If the pulse is weak, respiration difficult, the patient old, or has been seized before in the same manner, loud snoring, cold sweats, frothing at the mouth; these are all symptoms of a fatal tendency. An apoplexy often terminates in a palsy. A strong pulse is a sign of reco- very; if succeeding phlebotomy, the patient will un- doubtedly do well. The cure. Let the patient be laid on his back, with his head raised. If plethoric, bleed; which will pre- sently relieve by removing the cause. Hippocrates with great justice asserts that venæ-section always kills or cures in an apoplexy: the reason is evident, because it is always owing to too much or too little blood. Pro- per means to be used are sternutatories, emetics, vesi- catories, particularly to the feet, cathartics, and corro- borants. * I never yet saw one sanguineous apoplexy. In (95) In the fit, if cachochymic, as is most commonly the case, he should be rubbed with warm flannel, or bathed with rectified spirit, and instead of phlebotomy use er- rhines. Bleeding is too generally performed in fits of all sorts, though there are very few instances in which they do not originate from a laxity of fibres and defi- ciency of blood. Those who are so busy with the lan- cet, ought to be reminded, that there is yet no repeal of the sixth commandment. Take of white hellebore, Long pepper, of each a scruple, Euphorbium, seven grains, Let some of this powder be blown up the nose, through a quill, or some tobacco smoke, or a little of the fol- lowing errhine: Take of camphorated spirit, Brandy, if each an ounce, Water of ammonia, half an ounce, An errhine and fotus. A fomentation also for the head may be used of spirits of wine, compound tincture of lavender, and oil of am- ber, equal parts. A clyster should be injected as soon as possible, as, Take of tobacco, Rue, of each a handful, Penny-royal, Coloynth, of each two drachms, Boil in ten ounces of water, strain, and administer it warm. As soon as possible give the following purge or vomit: Take of senna leaves, Tamarinds, of each an ounce, Rhubarb, (96) Rhubarb, three drachms, Volatile salt of amber, a scruple, Macerate in twelve ounces of boiling water. Of the colature, give two ounces every hour till it pnrges suffi- ciently. Or, Take of tartarised antimony, Vitriolated mercury, of each five grains in powders. An emetic, drinking nothing during the operation. To prevent a return, let him take two tea-spoonfuls, twice a day, of volatile spirits of valerian, with one of the subsequent electuaries, or pills: Take of valerian, an ounce, Ginger, six drachms, Red sulphurated mercury, two drachms, Syrup of orange peel, enough for an electuary, Dose the quantity of a nutmeg, twice a day. Take of red bark, an ounce, Castor, Galangal, of each two drachms, Syrup of orange peel, sufficient for an electu- ary, as before. Take of socotrine aloes, Long Pepper of each a drachm, Simple Syrup, enough for pills, Twenty-four; two to be taken morning and evening. PALSY. (97) PALSY. A PALSY is a laxity or immobility of a particular part, sometimes with a deprivation of the sense of feeling. If the whole side is affected, it is called Hemiplegia. The cause. A sudden shock, from some impedi- ment to the course of the vital heat along the nerves from the cerebrum, medulla oblongata, or spinal mar- row, which lacerates the cellular tunic of the muscles, destined for voluntary motion; this may be occasioned by a redundance, (though I never met with such an in- stance) but is more commonly owing to a deficiency of the nervous influence, and consequently of blood. The diagnostics. Flaccidity of the parts, a diminished sensation in, or incapacity of moving them; distortion of the muscles, tremors, wasting of the part, involun- tary tears, despondency. The prognostics. A partial palsy in young persons is easily curable; in children from dentition will disap- pear of itself. In those who are advanced in years, or if universal, or if succeeding an apoplexy, or if it is attended with a marasmus, in these cases little hope is to be indulged. A fever or spontaneous diarrhœa, are favourable symptoms. The cure. The regimen must be indicated from the cause. If (as has been always the case with every pa- ralytic that I have ever seen) there is a laxity of the muscular fibres, and weakness of the soiids, let the spina dorsi be rubbed with a warm flannel, even to an inflam- mation, and be bathed with oil of amber night and morn- ing, from which method alone, and a large vesicatory, to the os sacrum and lumbar region, I have recovered many who had lost the use of the lower extremities. Apply a tight ligature to the part affected; if the leg, a straight stocking should be worn. Give Venice soap E at (98) at first in pretty large quantities, and ginger and mer- curials. Let the intestinal canal be kept open, and vesi- catories be laid on the affected parts, or one of the fol- lowing topics be used: Take of cantharides, an ounce and half, Rectified spirit, a pint, Digest warm for three days; a fomentation to be used twice a day. Or, Take of spermaceti ointment, an ounce, Oil of amber, half an ounce, Oil of pepper, a drachm, Euphorbium, nine grains, A liniment, as before. The cold bath should be repair- ed to every morning; let the patient be just covered with water, and be taken out immediately, without a second dip. The warm bath is pernicious. Chalybeate waters should be drank, and electricity be tried, which I have sometimes known to be effectual, but oftener to fail. Emetics are extremely serviceable, particularly the dry vomit. See EPILEPSY. The following medi- cines have answered the Author's expectation: Take of horse-rhadish scraped, Mustard-seed bruised, of each two ounces, Galangal sliced, half an ounce, Infuse in a quart of boiling water close stopped till cold; a tea-cupful to be taken twice a day. Take of cassumunar, Ginger, of each an ounce, Oil of turpentine, half an ounce, Honey, enough for an electuary, Of which let the bigness of a nutmeg be taken thrice a day. Take (99) Take of Tincture of guiacum, two ounces, Of these drops give two tea-spoonfuls in three quarters of a tea-cupful of new milk night and morning. The cold bath should not be omitted every morning till well. A tea-spoonful of tincture of cantharides, and twenty drops of tincture of muriated iron, twice a day. DROPSY. A DROPSY is a tumor of the abdomen, from an extravasation of serum in its cavity, or a stagna- tion thereof in the vessels, whereby they are distended and often ruptured. This may happen in many other parts of the body, as for instance, the hydrocephalus internus, hydrops pectoris, ovariorum, &c. When the lymph is contained in little vesicles in distinct cells, like a bunch of grapes, these are called Hydatides. There are three sorts of this disorder. Anasarca, or Leucophlegmatia, when the lymph stagnates in the whole habit of the pinguedinous sub- stance, or cellular membrane. Tympanites, when the turgescence of the abdomen is owing to the rarefied vapour, ichor, or putrefied fat; this is to be known by the tightness of the skin; the belly, if struck, sounds like a drum, from whence its name; no fluctuation of water can be perceived. In this case the paracentesis is sometimes fatal, (nothing issuing but pus) and sometimes succeeds. Ascites, when the lymph is collected in the duplica- ture of the peritonæum, or cavity of the abdomen: this is to be known by the quashing of water, to be felt on pressure of the hypogastre. E2 The (100) The cause. Whatever occasions a stagnation of the fluids in their vessels, the lymphatics to burst, and the lymph to fall between the membranes; as acute dis- eases, tumours, schirri, hard drinking, stoppage of the necessary or usual evacuations, profuse bleeding, espe- cially of the corpulent, who can never well bear the loss of blood; many fat persons have been bled into dropsies. The diagnostics. Swelling of the ancles, insteps, or feet; afterwards of the abdomen, dyspnœa, heavi- ness, thirst, lassitude, torpor, costiveness, a slow hec- tic fever, leanness, no sweat; the urine crude, or red, white, and small in quantity, excreted with difficulty, sometimes totally suppressed, anorexia, a teazing cough. The prognostics. If taken in time, it is easily cura- ble; in the worst stages a cure is not to be despaired of if the patient will for four or five weeks persist in an entire abstinence from all liquids, a lump of sugar soaked in brandy excepted, which may be taken two or three times a day; if this is suffered to dissolve gra- dually in the month, it will sooner appease the most in- tense ragings of thirst than copious draughts of water. Many have recovered of this disorder in the most hope- less state, by that means, with the use of proper evacu- ants. If attended with a teazing cough, difficult respi- ration, quick pulse, prostration of strength, high-co- loured urine, total suppression of it, obstinate costive- ness, intolerable thirst, (and the patient will indulge it) abscesses, lurid spots on the thighs, the body ema- ciated, the countenance pallid, and of a cadaverous as- pect; these are the harbingers of death. The cure wholly consists in evacuating the waters which are gathered, and in preventing their collection for the future. To this end conduce cathartics, diu- retics, detergents, emetics, (particularly the dry vomit) diaphoretics, and (the sooner the better) the paracen- tesis: after these, corroborants, stomachics, chalybeats, and astringents. In (101) In every stage of this disease, the region of the abdo- men should be bathed with sweet oil every night and morning, and twenty drops of the balsam of copaiva be taken on sugar twice or thrice a day. The purges from which I have experienced the most extraordinary effects are: Take of rhubarb, two drachms, Gamboge, Precipitated sulphur of antimony, of each half a drachm, Vitriolated quicksilver, a scruple, Simple syrup, enough for pills, Number thirty-two; the dose two or three morning and night. Or, Take of rhubarb, a drachm and a half, Gamboge, half a drachm, Calomel, a scruple, Simple syrup, enough to make into pills, Twenty-four; two to be taken night and morning. Take of gamboge, a drachm, For three powders, one of which should be taken in the morning fasting, twice or thrice a week. As to diuretics, no small service may be expected from the broom ashes, and the tincture of cantharides, which are far superior to any of that tribe in this case. An ounce of the expressed juice of florentine orris root, taken twice a day, has cured several dropsicals, as I have been told by a brother Physician; I never tried it. Of the expressed juice of artichoke leaves a tea-cupful three or four times a day has certainly been effectual. Emet- ics are sometimes wonderfully efficacious; they ought not to be of the mildest sort. What I have usually given is, Take (102) Take of vitriolated quicksilver, five grains, Antimony tartarised, four grains, Let this powder be taken fasting, and nothing be drank during the operation. If the thighs are much swelled and hard, apply a warm fomentation of strong brine every night. From the above sylloge, the scientific practitioner may select that which will sufficiently answer his most sanguine expectations; nor need he question the safety with which any of them may be administered, any more than that of the following narcotic diaphoretic, which has performed apparent miracles: the patient should lie between two blankets instead of sheets, and the quan- tity of water which it will cause him to evacuate by the skin, is such as is beyond all belief, and that without the least diminution of the vis vitæ; though the removal of a load from a man’s shoulders can scarcely be sup- posed to weaken him. This Herculean medicine is, Take of purified opium, Ipecacuanha, of each four grains, Vitriolated quicksilver, two grains. A powder to be taken at bed-time. In an anasarca, use oil to the belly, and the balsam of copaiva inwardly. If the legs are much swelled, they should be retained in an horizontal position for the chief part of the day, and straight stockings be worn. A gentle emetic every other morning, such as five grains of ipecacuanha, and the subsequent electuary and drops, I have found sufficient for a cure: Take of conserve of squills, an ounce and half, Magnesia alba, an ounce, Rhubarb, three drachms, Simple syrup, Enough (103) Enough for an electuary; the bigness of a nutmeg to be taken twice a-day. Take of gamboge, half a drachm, Spirit of ammonia, an ounce and half, Of these drops let a tea-spoonful be taken night and morning, or oftener, as occasion requires. When the cure is nearly effected, to restore the fibres to their proper tone, it may not be amiss (as on restoration from the dropsy also) to use Take of red bark six drachms, Filings of Iron, one drachm, Mucilage of gum arabic, enough for an electuary, Dose, the size of a nutmeg, twice or thrice a day. In a tympanites, (as also in a dropsy) a salivation has sometimes succeeded. See FLATUS. Perhaps it would be more eligible to use aloetic purges, corroborants, and stomachics only, and leave the rest to nature. JAUNDICE. THE Jaundice is a copious effusion of the bilious fluid, throughout the whole habit of the body. The cause is most commonly an obstruction of the bile, from viscidities, or calculous concretions in the biliary duct, or in the liver itself, a schirrus of the liver; or a too profuse secretion of bile. The diagnostics. Of an overflowing of the bile, a yellow colour of the skin, especially in the tunica albu- ginea of the eyes, a bad appetite, thirst, bitter taste in the mouth, bilious vomiting, pain in the stomach or bowels, (104) bowels, tumor at the pit of the stomach after eating, in- creasing in size and hardness; pain or swelling of the right hypochondre, periodical colics, borborygmi, list- lessness, itching in the skin, the urine and fæces in- tensely yellow. Of an obstruction of the bile the diagnostics are white or cineritious stools: obstinate constipation; the colour of the skin black, nidorous eructations. The prognostics. If recent, it is easily cured; a black turbid urine indicates the profligation of the disease: the yellower the skin the easier, the blacker the harder it is to be removed. From a schirrus in the liver, calculi in the vesica fellea, or if inflations of the hypochondres supervene, great danger is foreboded. In a state of pregnancy it is of little consequence: parturition cures it. It sometimes terminates in a dysentery. The cure. Venæ-section is unnecessary. The diet should by no means be vegetable. A couple of raw eggs fasting ought not to be omitted, and if repeated three or four times a day, great advantage will result in every stage of this disorder. As to medicinal assistance, begin with the dry vomit, if there is no reason to sus- pect the existence of a calculus in the gall bladder, though even then it may be administered with safety, but the patient will suffer more pain; a clyster, there- fore or cathartic, may be preferable. Avoid chaly- beates at first, for an incurable schirrus of the liver may be the consequence of their premature use, though they are the best of medicines in some stages of this disorder. For children the following is equally safe and efficacious: Take of chalk, ten grains, Rhubarb, five grains, Filings of iron, one grain; This (105) This powder may be repeated night and morning, or as there is occasion. If a clyster is thought necessary, an ounce of soft soap, in seven ounces of the decoction for a clyster, is an excellent one. I have been told that an ounce of the expressed juice of dandelion will cure the yellow jaundice, if taken twice or thrice a day; I never tried it. The balsam of copaiva is of considerable utility.— Either of the subsequent medicines may be depended on, to answer all the ends which can be desired; one of the electuaries may be made use of first, the chaly- beate pills to perfect and confirm the cure. The choice must depend on the circumstances of the case, and skill of the prescriber. Take of turmerick, Venice soap, of each an ounce, Columba root, a drachm and half, Rhubarb, half an ounce, Oil of juniper, two drachms, Simple syrup, enough for an electuary, Dose, the size of a nutmeg, twice or thrice a day. Or, Take of conserve of orange peel, Venice soap, of each an ounce, Magnesia alba, six drachms, Rhubarb, two drachms, Tolu syrup, enough for an electuary, The size of a nutmeg night and morning. Take of socotrine aloes, a drachm, Asafœtida, Precipitated sulphur of antimony, Filings of iron, of each half a drachm, Simple syrup, enough for pills, Number twenty-four; two to be taken morning and night. E3 Take (106) Take of columba root, Rhubarb, of each a drachm, * Precipitated sulphur of antimony, half a drachm, Tincture of cantharides, enough for pills, Thirty-two; two or three to be taken night and morning. Take of gum guaiacum, a drachm and half, Quicksilver pills, Camphire, of each a drachm, Simple syrup, enough for pills, Number thirty-two; two to be taken night and morn- ing. Or, the powders at the close of this article. Rhubarb alone, if skilfully administered, will remove almost any jaundice. Or, Take of rhubarb, any quantity, Soap, enough for pills, size of a pea. Two, three, or four, night and morning, enough to keep the body gently open. In habitual bilious colics, opiates may be given at discretion. The patient is often seized with a violent pain in the stomach and right side, a nausea succeeds, with vehement retchings, till the calculus passes through the ductus choledochus into the duodenum, and he is then in a moment as well as if nothing had happened, until another calculus obstructs the passage, and then the same tragedy is acted over again. I have seen per- sons to whom these fits have returned thrice in twenty- four hours. The following medicines have relieved them: Take * Or, filings of iron, half a drachm, and five grains of tartarised antimony. (107) Take of prepared kali, two drachms, Calcined antimony, one drachm, Pure water, seven ounces, Sugar, as much as you please. Of this mixture let three spoonfuls be taken thrice a day, with two tea-spoonfuls of the subsequent drops: Take of volatile tincture of valerian, two ounces. Or, Take of columba root, a drachm and half, Grains of Paradise, Rhubarb, of each half a drachm, Make into six powders, one to be taken night and morn- ing. See JAUNDICE. VENEREAL DISORDERS. A CLAP is a flux of matter from the glands called lacunæ, situated in the internal parts of the urethra in men, and of the pudenda in women, the fluid which oozes from the secretory glands in their natural state, was designed to lubricate the passage, and line it with a viscous mucus, which might sufficiently defend the extremities of the nerves from being irritated by the salts or acrimony of the urine. When this mucus is abraded and carried off by the attenuated discharge, oc- casioned by the venereal virus, which irritates their ori - fices, the urine causes an intolerable pungent, smarting, or burning sensation. Hence this disorder is called by the French Chaudpisse. The cause originates from an acid virus, or infectious miasmata, acquired by impure coition: these insinuate themselves into the minute mouths of the lacunæ, and consequently increase their diameter, whence a copious running of thinner matter than usual must issue. Cow- per’s and the prostrate glands are often affected. This (108) This distemper is by no means a native of Europe, but was first imported by Christopher Columbus to Na- ples from America, and spread through that city with prodigious rapidity. Somewhat more than a year after his return from his first voyage, the French army sat down before Naples, in the year 1492. The Neapo- litans being distressed by a scarcity of provisions, thought it necessary to discharge the most useless persons from their town, amongst whom were the courtezans, who were received by the besiegers with their usual polite- ness to that sex; the horrid ravages which this disorder soon after made in the camp obliged the French to raise the siege; upon this account it obtained the name of the French disease, and will in all probability ever retain it, notwithstanding the umbrage France has taken at it, and the repeated efforts she has made to shake off the opprobrium. It was then a new disorder, and certainly was never known in Europe before; for whatever has been ad- vanced to the contrary might easily be refuted; the physicians were puzzled, the people were alarmed, for it was supposed to be equally as infectious and fatal as the pestilence; neither monasteries nor nunneries were exempt from it, nor even the holy fathers of the con- clave; it was to be catched (heaven bless us!) by being in the same room with an infected person, or walking on the same side of the way in the street—but, how- ever, with due deference to the characters of those times, it cannot be taken without contact. So deplo- rable was the situation of affairs then, that thousands were deserted, and left to rot without the least assistance. But it being foreign to my design to enter into the history of diseases, I shall only observe, that there is no distemper which is better understood in this enlightened age, nor any one that is with more certainty, or with greater facility, to be cured, even in all its stages, and without that nauseous (though formerly reputed neces- sary) process of salivation. The (109) The diagnostics. Three or four days (generally) after the infection is received, the running comes down with a titillating sensation; difficulty in making urine; smart- ing or scalding; sometimes the cavernous bodies of the penis are puffed up, appear like a spunge, and are of an astonishing bulk; the matter yellow or green, which last is the worst colour it can be of, because it indicates an incipient gangrene; phymosis, when the prepuce cannot be brought back; paraphymosis, when it is tucked down behind the glans and cannot be brought forward to cover it; chordee, or great pain when the penis is erected; frequent stimulations to venery. When the infectious matter has crept into the lymphatics, and from thence is conveyed into the blood, a dry pox is the consequence: though perhaps the miasmata are of a nature quite different from those which produce a clap: yet if the running is stopped too soon in the latter, the symptoms of the former will undoubtedly appear, which are as follows: buboes in the groin, chancres, crystallines, a swelled testicle: warts, mariscæ, fici, rhagades, condylomata, blotches; green seedy excres- cences, on the neck, breast, shoulders; ulcers in the head, eyes, nose, or fauces; mortification, nocturnal pains, tingling in the ears, gummi, nodes, tophs, a rash, scurf, crusts, scabs, caruncles and carnosites in the urethra, total suppression of the urine, bloody urine: atrophy, or wasting of the flesh; erratic pains in the sides; difficulty of breathing, especially when lying on the back; clavus hystericus, corona veneris; softness and rotteness of the bones. This affection of the bones is not unjustly ascribed more to the too liberal use of quicksilver than to the venereal virus: thus it may be observed that the nose falls when the salivation is at its heighth. Many symptoms mimic venereal complaints, which are entirely owing to the lodgments of quicksilver in the minutest vessels; sulphur clogs and chokes this active mineral. I have known numbers who thought that they laboured under a confirmed pox (when they were actually freed from the venereal venora) who have been not only relieved but perfectly cured of all their complaints (110) complaints by the use of an electuary composed only of flowers of sulphur and honey; dose, the bigness of a walnut night and morning. The prognostics. If the running is imprudently tied up before the infection is extirpated, a confirmed pox is the consequence, as is often the case also from the use and frequent repetition of drastic cathartics; for the natural elasticity or springiness of the fibres from such an irritation, will squeeze the infection into the blood. The miasmata will sometimes float about in the fluids for several weeks, before there is any appearance of those dreadful consequences which will sooner or later in good earnest take place. It is easily cured in any of its stages, by due care and proper medicines. It is curable with much less difficulty in men than in wo- men. The old method of giving a calomel bolus at night and a purge next morning, is justly exploded, for it tears the constitution to pieces, is at best a precarious, and often a fallacious procedure; by this means many a pox has been manufactured from a very trivial injury. Salivation is not necessary even in the worst cases, nor is there any one to be cured by it who is not much more easily cured without it. When eruptions appear, with all the indications of a pox, what can be more ri- diculously absurd than to melt down those salts into the blood that they may pass off by the salival glands, when nature so plainly points out the method by which they ought to be expelled. The solution of muriated quick- silver hereafter-mentioned, with a proper liniment to open the pores and increase their diameter, will enable her to throw them off by perspiration; salivation is only the effect of an alteration made in the fluids, which al- teration is as easily made without producing that dis- agreeable and nauseous consequence; nor will it always succeed, for I have known many who have been sali- vated (111) vated four, yea, five times, without success, yet have found no difficulty in curing the same persons afterwards by much milder methods. The cure. In a recent injury the intestinal canal should be kept gently open; bleeding and violent purg- ing are equally improper and useless; there need be no alteration of the usual method of living, nor are the ef- fects of the inflammation, as it is called, in the least to be dreaded. I have known several, who have been drunk every night ’till the cure was completed, without suffering any other inconvenience than an increase of the smart in making water, which must be the conse- quence of an increased running, an event in every other respect by no means undesirable. Of the * stronger quicksilver ointment let the size of a small hazle nut be used night and morning, to be rubbed on the perinæum, between the testicles and fundament, and the inside of the thighs. If injections are permit- ted, a tea-spoonful of oil of olives may be used night and morning. Or a scruple of calomel in an ounce of mucilage; a tea-spoonful of this also may be used twice a day, two grains of muriated quicksilver dissolved in six ounces of mucilage, which in most cases, used as a lotion, would alone be sufficient for a cure; however, without any injection, if the quicksilver ointment is made use of, and one of the following formulæ is given internally, such a method is as safe, certain expeditious, and radical, as any in the power of medicine; this I have experienced in some thousands of instances. N. B Nitre is often prejudicial, and sometimes great- ly increases the uneasiness in making water. Take * Or, which is neater, of white calx of quicksilver, three drachms, ointment of hog's lard, half an ounce, (112) Take of gum arabic, two ounces, Red sulphurated quicksilver, half an ounce, Julap, three drachms, Oil of sassafras, one drachm, Balsam of copaiva, enough for an electuary, Dose, the size of a nutmeg, morning and night. Or, Take of gum arabic, an ounce and half, Quicksilver, with sulphur, an ounce, Gum guaiacum, Jalap, of each two drachms, Balsam of copaiva, sufficient for an electuary. The bigness of a nutmeg to be taken twice a day. Or, Take of rhubarb, four scruples, Calomel, one scruple, Simple syrup, enough for pills. Twenty-four; two at night only. Or, Take of muriated quicksilver, five grains, Muriatic acid, five drops, Rhubarb, a drachm, Simple syrup, enough for pills, Twenty-four; two to be taken every night and morn- ing. Take of muriated quicksilver, ten grains, dissolve in muriatic acid, ten drops, then add compound tincture of lavender, an ounce, For a bottle of drops; twenty to be taken in a glass of white wine,‡ or milk,‡ or water gruel,‡ or water, morning and night, with two scruples of gum arabic in powder. The ‡ These disguise the disagreeable taste best. (113) The author scarcely thinks it worth his while to ob- serve that he was the first person (as far as he knows) who gave the muriated quicksilver inwardly: the above solution he invented after innumerable trials in the year 1753, and has used it ever since; he has ordered it some thousands of times, and is fully persuaded that if it is properly managed, there is no stage of this disorder, in which it will not prove efficacious, nor has it ever once deceived him. The only secret in the manage- ment of this medicine, is to give it in such a manner that it may act beyond the primæ viæ and not run off by stool; there is then no desirable effect which may not be expected from it. One motion in the twenty-four hours is natural, one may be produced by the drops; but if the patient should have more than two in a day, let the dose be diminished to fifteen, ten, seven, or even five drops. A CONFIRMED POX. Chrystallines need only be snipped, and the acrid lymph will be evacuated. A proper application to heal them with is, Take of ointment of elemi, half an ounce, Red nitrated quicksilver, a drachm, To be applied twice a day. Buboes, if soft, white, or flabby, disperse by rub- bing in the stronger quicksilver ointment, as before- mentioned, every night and morning, at the same time taking inwardly the above drops. If the buboes are red, hard, and look angry, let the bread and milk cataplasm be applied to them till they break; the last prescribed ointment is an excellent dres- sing, or the gum plaister; they may be kept open with a pea, like an issue, as long as it is thought necessary. Some indolent tumors of this sort require opening. Warts, (114) Warts, rhagades, &c. cut off, and apply a caustic; if this is not permitted, use the stronger quicksilver oint- ment. Or touch with these drops night and morning, A scruple of muriated quicksilver dissolved in an ounce of water. Caruncles try to break with a wax candle, if that doth not succeed, then with an armed probe apply, Take of ointment of elmi, Red nitrated quicksilver, of each half an ounce, Water of kali, twenty drops, A liniment. At the same time let not the stronger quicksilver ointment be omitted, but be rubbed externally on the perinæum twice a day. Carnosities require the same method of treatment with caruncles. Phymosis, Paraphymosis, Chordee, Swelled præpuce, Chancres, Soak the penis in warm milk night and morning, Avoid the least ap- plication of mercurial ointment to it. And, Take of water of acetated litharge, twenty-five drops, Rose water, three ounces, A lotion to be used frequently. Chancres may be touched night and morning with a lotion of a scruple of muriated quicksilver, dissolved in an ounce of water, and dressed with, Take of the strongest quicksilver ointment, Tar ointment, of each equal parts. Crusts (115) Crusts, scabs, blotches, and ulcers in the throat, if venereal, give the above solution of muriated quicksilver, and let a little of the subsequent powder be sprinkled on a hot iron, and the fumes be received in the fauces by means of an inverted funnel, twice or thrice a day. Take of red sulphurated quicksilver, two drachms, Frankincense, two scruples, Camphire, seven grains, A suffiment. And, Take of muriated quicksilver, two grains, Muriatic acid, two drops, Rose water, six ounces, A gargle to be used night and morning. If owing to the relicts of the quicksilver (which is a very common case), give the sulphur and honey. A swelled testicle. Give immediately five grains, at least, of vitriolated quicksilver, and, Take of camphire, Oil of olives, Oil of aniseeds, of each half an ounce, A liniment to be used every two or three hours. Or, Take of water of litharge acetated, two scruples, Pure water, five ounces, A lotion, in which let a piece of linen rag be dipped and laid on the testicle; when dry, to be again repeated, or kept constantly wetted, and the bread and milk poul- tice at night; if it is not resolving on the next morning, give a bolus of half a drachm of compound extract of colocynth, with ten grains of the quicksilver pills. The warm (116) warm bath will hasten its removal. It should be sus- pended pretty tight by a bag truss, till well. Take of rhubarb, a drachm, Calcined quicksilver, a scruple, Simple syrup, enough for pills, Twenty-four; two to be taken every night, or one night and morning. Or, if laxative, Take of gum guaiacum, one drachm, Pure opium, half a drachm, Calcined quicksilver, fifteen grains, Simple syrup, enough for pills, Number thirty-two; two to be taken every night. Or, Take of muriated quicksilver, ten grains, Spirit of nitrous œther, an ounce, Of these drops let twenty be taken night and morning, in a glass of water. Take of winters bark, Mezereon, of each an ounce, Boil in a gallon and half of water to a gallon; when the boiling is almost finished, add an ounce of prepared kali to every pint. Of this apozem let half a pint be drank twice or three times a day, which, with the above drops or pills, will remove nocturnal pains, nodes, tophs, &c. If the nocturnal pains are very grievous, rub on the shins some of the stronger quicksilver ointment every night, and give two of the following pills every other (or every) night, viz. Take of colocynth, two scruples, Purified opium, one scruple, Precipitated sulphur of antimony, Vitriolated (117) Vitriolated quicksilver, of each ten grains, Simple syrup, enough for pills, Number twelve. Cuticular eruptions will soon vanish, if rubbed over with the following liniment, morning and night; Take of hog's lard, an ounce, Precipitated sulphur, two drachms, White calx of quicksilver, two scruples, Water of kali, a drachm, Oil of sassafras, twenty drops. See SCORBUTIC ERUPTIONS. The sarsa and china root are said to possess wonder- ful virtues; but the author, after a long series of fair trials, was so unfortunate as not to be able to discover them. GLEET. A GLEET is a drain of matter from the urethra. The causes. An ill-cured clap; salivation; profuse venery; a strain; laxity of the fibres. The diagnostics. From the abrasion of the mucus, heat of urine; indifference to coition; pain in the back or loins; general debility; hanging down of the testi- cles; lowness of spirits; loss of appetite; at going to stool the discharge of a glairy matter, in colour and consistence like the white of an egg; the colour of that which oozes is sometimes brown and sometimes yellow, of which last colour it may continue to be (if of long duration, or in those who have been frequently injured) without any remaining infection. The (118) The prognostics. If white or ropy, or thin and glairy, or if flocci appear in the urine, it is easily cured. If of long standing, it will require some time to muzzle it. There is no case so obstinate, but may be cured by some of the subsequent medicines. It has been the malleus medicorum, yet I never met with one (though I have had great numbers who were deemed incurable) with whom I did not succeed. The cure. The patient should abstain from all vege- tables, acids, and sugar, if the case be inveterate, all fermenting liquors; malt or vinous spirits, diluted with water, are harmless. The most proper regimen is— rising early in the morning; gentle exercise; the cold bath, just plunging over head and ears (every morning) and coming out immediately without taking a second dip, or remaining one moment in the water; any ani- mal food, particularly pork, pigeons, partridges, growse, flat fish, shell fish, eggs, jellies: for breakfast and sup- per, milk. From the medicinal classes; detergents, astringents, corroborants, chalybeates, balsamics, fotus, injections, and dry vomit. Isinglass chewed to the quantity of half an ounce a day, and the saliva swal- lowed, is an excellent auxiliary. The glans penis should be frequently washed: much depends on clean- liness. The following formulæ are such as have proved successful, and I never used any other; Take of gum arabic, two ounces, Olibanum, two drachms, Filings of iron, one drachm, Cantharides, a scruple, Balsam of copaiva, Enough for an electuary. The bigness of a chestnut to be taken night and morning. Take of red bark, an ounce, Gum guaiacum, Olibanum, of each half an ounce, Tincture of Cantharides, Enough (119) Enough for an electuary. Dose, the size of a nutmeg twice a day. If costive, Take of conserve of orange peel, an ounce and half, Gum guaiacum, half an ounce, Rhubarb, two drachms, Oil of cloves, one drachm, Tincture of cantharides, Sufficient for an electuary. The size of a walnut to be taken night and morning. Or, Take of socotrine aloes, Filings of iron, of each a drachm, Cantharides, nine grains, Simple syrup, enough for pills, Twenty-four. Two to be taken every night, Or, if the body is too open, Take of purified opium, twelve grains, Cantharides, seven grains, Filings of iron, Asafœtida, Precipitated sulphur of antimony, of each half a drachm, Simple syrup, Enough for pills, twenty-four, two every night. Take of tincture of Peruvian balsam, Compound tincture of benzoin, of each an ounce. Of these drops let two tea-spoonfuls be taken twice or thrice a day. The testicles and parts adjacent should be bathed with a fotus of brandy and vinegar, equal parts, at going to bed (120) bed, and on rising in the morning. Vinegar and water, or vinegar alone, is an excellent injection. Or, Take of acetated ceruse, four grains, Calomel, a scruple, White vitriol, five grains, Rose water, eight ounces, For an injection. A tea-spoonful to be used night and morning. Or, Take of muriated quicksilver, two grains, Muriatic acid, too drops, Rose water, eight ounces, For an injection as before. Or, † Take of blue vitriol, a scruple, Boiling water, an ounce and half, Dissolve in a copper vessel, and make an injection as before. DIARRHŒA. A DIARRHŒA is an immoderate, or too frequent discharge of the excrements. If the matter ex- creted is undigested food, it is called a lientery. If crude, of an ash-colour, or whitish, it obtains the name of cœliac passion. If the fœces are sufficiently digested and aqueous, it is then a diarrhœa. The cause of a lientery is whatever impedes ferment- ation in the stomach, or irritates its villous coat. Cœliaca † This Herculean remedy requires some eare and nicety in the ma- nagement of it, viz. to lower it with water to such a point as to give little or no pain at first. (121) Cœliaca arises from an obstruction of the lacteals, or deficiency of bile. A diarrhœa is from a redundance of serum, which may be owing to consent of parts, as a humid cerebrum, dentition, balbution, &c. from a too large quantity of food taken, at least such a one as is disproportionate to the powers of the digestive or chylopoietic organs; a morbific quality, lubricity of the intestines, laxity of the muscular fibres, deficiency of heat, sometimes from an effort of nature to relieve herself by making a push at the bowels, and thereby carrying off a morbid colluves. The diagnostics. They in general appear from what has been said, to which may be added bilious, black, slimy, or viscid excrements; tenesmus; spumous, greasy, or aqueous dejections; sometimes like pieces of putrified flesh; anorexia, faintness, lassitude, prostration of the vis vitæ, frequent gripings, borborygmy, swelled legs, an emaciated habit, cold sweats, spasms, a slow hectic. The prognostics. If of long duration, it weakens and excoriates the viscera, from whence arise debility, dy- sentry, atrophy, inspissation of the fluids, universal lax- ity of the solids, and accumulated acrimony. Critical evacuations without much pain ought not to be checked: let a few doses of rhubarb be given to expel the noxious saburra and assist nature in her intentions. In a long continued series of moist weather, it is epidemical, from the exhaurition of the vital heat; in old age it is dange- rous. Supervening a pleurisy or peripneumony (Hip- pocrates justly observes) formidable: it is bad, says the same author, if the stools are very aqueous, white, yellow, or frothy, worse if black, livid, little and glutinous.† The cure. Let the patient be removed to a clear dry air; for the most healthy bodies are liable to this disor- der on visiting a moist climate. Exercise should be F taken, † These are what nurses call death stools. (122) taken, particularly riding on horseback in the morning; for diet, animal food, broths, jellies, and rice milk; the cold bath. For common drink, dcoction of harts- horn; clysters are of considerable service, especially in case of a tenesmns: as, Take of starch, a drachm and half; dissolve in six oun- ces of water, then add Oil of olives, an ounce, Tincture of opium, a drachm. Astringents must be given, opiates ought not to be neglected, nor the dry vomit. Begin the cure with an emetic, viz. a scruple of ipecacuanha, and one grain of blue vitriol; then a linient cathartic; after which, if the pain still continues, an anodyne. The reader will find a sufficient number of prescriptions, which have been successful, subjoined. Take of rhubarb, a scruple, Toasted nutmeg, fifteen grains, Prepared kali, ten grains, Syrup of orange peel, enough for a bole; To be repeated occasionally. Take of compound powder of chalk, with opium two drachms, Toasted nutmeg, Mastich, of each a drachm, For six powders; one to be taken twice a day, drinking after it four sponfuls of the following mixture: Take of the chalk mixture, seven ounces, Strong cinnamon water, two ounces. Or, Take of tormentil root, Red astringent gum, of each a drachm, For (123) For six powders; one to be taken twice or thrice a day. Take of the compound powder of chalk, with opium, two scruples, Filings of iron, three grains, Syrup of white poppies, enough for a bole. To be taken at bed time. Take of conserve of red roses, an ounce and half, Compound powder of gum tragacanth, an ounce, Syrup of white poppies, enough for an electuary, Dose the size of a nutmeg, three or four times a day. Take of opiate pill, myrrh, Mastich, of each two scruples, Simple syrup, enough for pills, Number twenty-four; one to be taken twice or thrice a day. Unripe blackberries kept in powder are worthy a place in the shops; half a drachm may be taken twice or thrice a day, or the same quantity of extract of log- wood. When the diarrhœa is subjugated, to recover the appetite and restore the tone of the fibres, Take of red bark, an ounce, Aromatic powder, three drachms, Filings of iron, Galangal, of each one drachm, Syrup of orange peel, enough for an electuary, The size of a nutmeg to be taken night and morning. Take of tincture of catechu, six drachms, Compound Tincture of lavender, two drachms, A bottle of drops; a tea-spoonful night and morning. F2 Or, (124) Or, Twenty drops of the muriated tincture of iron, Night and morning. DYSENTERY. A DYSENTERY is a flux of blood from the bowels. The causes. An acrid blood, erosion of the intes- tines, abrasion of their mucus; long continuance of a diarrhœa, somewhat acrimonious eaten or drank, hy- percatharses. The diagnostics. Bloody dejections, with films, slime, pieces of flesh, phlegm, bile or pus; tormina in the sto- mach and bowels; faintness, spasms, tenesmus, hippo- cratic countenance. The prognostics. If it is imprudently stopped too soon, such a method is productive of the worst conse- quences; if attended with a hiccough, syncopes, or in old persons, great danger is foreboded; from a gangrene or schirrus of the intestines, or meseraic glands, it is fatal. The cure. For diet, rice milk, fat broths, and in the summer time, berries of all sorts may be eaten at pleasure, particularly strawberries. The expressed juice of the solanum is said to be a specific in this disorder, with what truth I know not; the cerated glass of anti- mony has been strongly recommended: I have seen in- stances wherein it has succeeded, but more wherein it has failed. The buds of birch powdered and mixed up with conserve of red roses, is a medicine that will sel- dom disappoint expectation; this has for many years been (125) been sold at a guinea a gallipot, and is still used in the navy. The conserve of roses itself is no despicable re- medy, for I have often known it to answer alone, when taken to the quantity of two or three ounces in a day. Begin the cure with a dose or two of salts; after which a little rhubarb may be given; then give three or four grains of ipecacuanha, and two grains of tartarised antimony every morning; with any of the following formulæ: Take a sheet of white paper, cut into slips, boil in a pint and half of milk to a pint, to be taken at twice. N. B. This never deceived me. For common drink, two ounces of gum arabic may be dissolved in a quart of water, sweetened to the taste. Two scruples of the compound powder of chalk with opium, should be given every night. Take of conserve of red roses, two ounces, Yellow wax, half an ounce, Filings of iron, Galangal, of each a drachm, Syrup of orange peel, enough for an electuary, The size of a nutmeg to be taken twice or three times a day. Or, Take of red bark, six drachms, Tormentil root, Red astringent gum, of each two drachms, Syrup of ginger, enough for an electuary, Dose, the size of a nutmeg, thrice a day. Take of compound powder of gum tragacanth, two ounces, Spermaceti, half an ounce, Balsam of copaiva, enough for an electuary, The (126) The bigness of a nutmeg to be taken morning and night Take of red astringent gum, four scruples, Colomba root, two scruples, Purified opium, ten grains, Simple syrup, enough for twenty-four pills, Two to be taken night and morning, or oftener if occa- sion. CHOLERA MORBUS. THE Cholera Morbus is a disorder of the stomach and bowels, always accompanied with vomiting and purging. The cause. An acrid bile, which may be vitiated by various means; as by eating more than can be digested; by taking too copious a draught of cold water; by con- tinuing too long in the cold bath; by a deficient secre- tion of the pancreatic juice; by profuse evacuations, or feeding voraciously on fat or fruit. The diagnostics. It is most common in autumn; retching, nausea, purging, griping, spasms, contrac- tions of the hands and feet, bitter taste in the mouth, green colour of that which is ejected, and dejected, sometimes it is black; tremors, cold sweats, facies Hip- pocratica. The prognostics. If the inclination to go to stool abates first, it is a good symptom. Syncopes, a dicro- tic or rebounding pulse, proclivity to evacuate, super- seded by faintness, tumor at the pit of the stomach, all these signs denote great danger; in ancient persons death. The (127) The cure. Give plentifully of thin broths to facili- tate vomiting; the custom is not yet relinquished of ad- ministering a puke, though it seems to be needless; broth also may be thrown up in clysters. Or, Take of white poppy seeds, Cucumber seeds, of each half an ounce, boil in ten ounces of water to seven, Oil of castor, two ounces, Nitre, four scruples, Acetated ceruse, a scruple, For a clyster. For common drink, give a decoction of a crust of bread well toasted, till broth can be prepared, or coffee. Apply a bit of cotton dipped in the following mixture to the pit of the stomach: Take of camphire, a scruple, Tincture of opium, two drachms, Oil of nutmegs, cloves and mint, of each twenty drops: Or, bathe the pit of the stomach frequently with bran- dy, or camphorated spirit. Take of calcined antimony, Rhubarb, of each a scruple, Purified opium, two grains, Simple syrup, enough for a bole. To be taken as soon as the patient has had plentiful evacuations upwards and downwards, and begins to grow faint, washing it down with the following draught: Take of peppermint water, an ounce and half, Spirit of cinnamon, half an ounce, See COLIC and VOMITING. TENESMUS (128) TENESMUS. A TENESMUS is a continual desire of going to stool without voiding any thing more than an acrid mu- cus; the part affected is the rectum, or its sphincter. It is rarely an idiopathic disease. The cause. A laxity of the fibres; spasmodic con- striction; a paralytic affection of the sphincter ani; abrasion of the mucus of, ulcer, or acrid irritating fluid in the rectum; hæmorrhoides, worms, stone, diarrhœa, dysentery. The diagnostics. A pungent pain in or about the rectum; frequent inclinations to go to stool, without correspondent evacuations; violent straining without voiding any thing but a viscid or bloody mucus; sensa- tion of lassitude, faintness. The prognostics. If idiopathic, and the patient is not subject to a prolapsus ani, it is by no means formi- dable or rebellious; if it proceeds from an ulcer in the strait gut, or if it is symptomatic in a diarrhœa or dysen- tery, or accompanied with syncopes, it portends great danger, and demands immediate assistance. The cure. Use emollient fomentations and clysters: let the body be kept as still as possible, and in an easy position. Take of gum arabic, an ounce, dissolve in seven ounces of whey, to which add A drachm of tincture of opium, For a clyster. Or, Take of new milk, five ounces, Sweet oil, two ounces, Tincture of opium, a drachm, For a clyster. Or, (129) Or, the starch clyster in diarrhœa. Take of flowers of sulphur, Rhubarb, of each a scruple, Purified opium, two grains, Simple syrup, enough for a bole, To be repeated as there may be occasion. Take of conserve of red roses, an ounce and half, Spermaceti, Elecampane, of each half an ounce, Rhubarb, a drachm, Syrup of white poppies, enough for an electuary, The size of a nutmeg to be taken morning and night. PILES. THE Piles are a painful and sometimes periodical tu- mor in the lower part of the rectum; if they dis- charge blood, they are called the bleeding piles; if not, the blind piles: according to the size and shape, they are nominated verucal, uval, moral, or vesical. The causes. A plethora, a cacochymy; violent ex- ercise, particularly hard riding; neglect of usual eva- cuations, laborious efforts in parturition; constipation of body, straining hard at stool, lentor; viscidity, or acrimony of the fluids. The diagnostics. Swelling of the anus, great pain at going to stool, voiding of blood, sensation of a pungent pain: heat, or weight and pressure in the anus. The prognostics. They sometimes, though rarely, inflame and become gangrenous; sometimes grow ul- cerous, and bring on a fistula. If they continue long F3 without (130) without being resolved, they are extremely troublesome and even render life burthensome. If they happen pe- riodically, and are always attended with a discharge of blood, they are salutary critical evacuations, and to stop them may prove dangerous, unless the bleeding is very profuse and occasions faintness, weakness, or loss of appetite. The cure. Due regard must be paid to the cause from whence they spring, and the concomitant symp- toms with which they are attended. If owing to a ple- thora bleed; or order a diluting sparing regimen, with the liberal use of fruit, vegetables, cucumbers, and such like. But if they appear in a cachectic habit, it is needless to say that all these things should be avoided, and those only proposed which are easiest of digestion. Note,—The viands which digest soonest, and afford the most laudable nutriment, are milk, eggs, partridge, chicken, shell fish, jellies, and pork; there is no vege- table that digests so soon as animal substance: the bones of birds will be converted into a mucus in the stomach in less time than even bread, as I have found by fre- quent experiments. Nature never designed that man- kind should use a vegetable diet only, and it is astonish- ing that Dr. Cheyne should recommend it to hypo- chondriacs, and to persons subject to the gout; though indeed he retracted what he had wrote on this head be- fore he died. The means necessary for the relief of patients in this disorder, are fomentations, liniments, astringents, atten- uants, resolvents, sulphureous medicines, and opiates. For the bleeding piles. Take of expressed juice of yarrow, —of plantain, each five ounces, Sugar, as much as you please, Of (131) Of this mixture let four spoonfuls be taken night and morning. Or, syrup of elder berries. If the patient is costive, Take of electuary of senna, an ounce, Precipitated sulphur, seven drachms, Jalap, one drachm, Syrup of buckthorn, enough for an electuary, Dose, the size of a nutmeg, morning and night. If he is of a lax habit, Take of compound powder of chalk, Olibanum, of each a drachm, Simple syrup, enough for pills, Number twenty-four; two to be taken once or twice a day. A fotus may be used, of an ounce and a half of lime water, with half an ounce of tincture of opium. Or, half an ounce of the spermaceti ointment, with seven grains of hard opium: this ointment, or the above, should be applied two or three times a day to the rec- tum and the blind piles, when painful. Take of quicksilver, with sulphur, an ounce and half, Precipitated sulphur, half an ounce, Rhubarb, a drachm and half, Honey, enough for an electuary, The bigness of a nutmeg to be taken night and morning. The parts may be touched three or four times a day with hog’s lard, or oil of amber, or camphorated spirit. The following electuary is not only excellent in this disorder, but I have seen amazing effects from it in the cure of a fistula. Take (132) Take of flowers of sulphur, Elecampane, of each an ounce, Sweet fennel seeds, half an ounce, Black pepper, two drachms, Balsam of copaiva, or honey, enough for an electuary, Dose, the size of a walnut, twice or thrice a day. HEART-BURN. THE Heart-burn is a painful sensation of heat and sourness about the left orifice of the stomach, which is called cardia, from whence its name, viz. Cardialgia. The cause. An acid acrimony, arising from a too rapid fermentation in the stomach; the corrosive steams of this acid effect the plexus of the nerves on the upper orifice of the stomach. The diagnostics. Acid eructations, a hot burning pain at and above the scrobiculus cordis, an involun- tary flux of tears, nausea; vomiting soon after meals, of a greasy inflammable pituita; spasms in the stomach and bowels; the rising of water in the mouth, particu- larly in the morning; sickness soon after rising from bed; borborygmi, flatus. The prognostics. It is never dangerous, but extremely troublesome, especially after riding or smoaking; those who are subject to it are free from inflammatory fevers; it is sometimes a tedious while ere it can be eradicated, though always curable; if it is suffered to continue long, it may occasion a cephalalgia, vertigo, epilepsy, and convulsions of all sorts. The (133) The cure. The spasmodic or rheumatic pain in the stomach requires the use of aromatic heating medicines, as a scruple of camphire, in half an ounce of æther; this noblest of all antispasmodics should be taken in a spoon, without mixing any thing with it, or swallowing any thing immediately after it; the tincture of guaia- cum, half an ounce in six ounces of water; opiates, aloetic purges, chalybeates, and the dry vomit. See FLATUS. The gout in the stomach is soon removed by the above-mentioned solution of camphire in æther, the guaiacine tincture; drinking moderately of spirits or Madeira wine, or the liberal use of opiates. Periodical pains are to be removed by the bark, or if they do not yield to that, by the dry vomit. Whatever ferments speedily in the stomach should be avoided, as vegetables, fruit, sugar, wines, malt and all liquors that have not passed the state of fermentation; Madeira is said to be the only wine which will not fer- ment in the stomach. The dinner should be made of animal food, and nothing but water drank with it; the breakfast and supper should be milk, A draught of milk and water will generally relieve the pain, when- ever it is violent. The cure may be perfected by the occasional use of chalk or magnesia troches, oyster shells, bole, terra lemnia, red coral, crabs eyes or claws, egg shells, burnt hartshorn, liquorice, chalk, or lime stones, the oils of nutmeg, cloves, or cinnamon. Take of gum arabic, two ounces, Prepared kali, six drachms, Pure water, a pint and half; When the gum is dissolved and the salt, add four ounces of spirit of cinnamon; of this mixture three or four spoonfuls may be taken twice or three times a day. Of (134) Of the aloetic wine two tea-spoonfuls may be taken morning and night. Or, thirty drops of water of kali, in a glass of water. Take of socotrine aloes, Filings of iron, of each a drachm, Simple syrup, enough for pills, Number twenty-four; two to be taken morning and night. In very obstinate cases an emetic should be premised, then a purgative of two ounces of the aloetic wine; after which, either of the above formulæ will complete the cure. COLIC THE Colic is a severe pain in the belly, affecting the epigastre or hypochondres; the part affected is the glut colon, sometimes the ilium. The causes. Distention from flatulencies, acid gas, irritation of the villous coat of that intestine, crudities, costiveness, ruptures, solution of continuity, scybals, acrimony of the bile. The diagnostics. A violent pain in the abdomen, at one time affecting the whole of it, another time deter- mined to one point; sometimes shifting from place to place, sometimes fixed, while the belly swells as if it would burst; the patient is costive, makes but little urine; a fever and strong pulsation in tue abdomen are its usual concomitants, with vomiting, rugitus, or rol- ling noise in the intestines, but always a vehement and tensive pain. In the bilious colic yellow or greenish matter is ejected, the eructations are nidorous, the thirst is more intense, and the fever higher than in the flatulent colic. The (135) The Colica Pictonum infests the hands and feet. For this the balsam of Peru has been found an excel- lent remedy; the dose thirty or forty drops, to be re- peated as there is occasion. The Stone Cholic must be treated with a view to its cause. See STONE. The Hysteric Colic is not dangerous. See HYSTER- ICS. The prognostics. If the pain is mild, or if it inter- mits, and the constipation of body is not very refracto- ry, it is easily cured. If the pain is fixed, and there be no passage downward; if it is attended with intoler- able restlessness, vomiting, fainting, hiccoughs, cold sweats, and delirium, there is no small danger. It not unfrequently terminates in a palsy, jaundice, epilepsy, or dropsy. If owing to an inflammation of the bowels, and the pain suddenly vanishes. it will prove fatal, for the parts are then sphacelated. The cure. The concominant fever is of less conse- quence than it is often imagined to be, being only symptomatic, and when the cause is removed, will cease of course. In general phlebotomy is unnecessary, and superinduces much worse disorders, for those just men- tioned (when colics terminate thus unfavourably) are not little obliged to the lancet for their existence. Clysters are peculiarly serviceable, because they are soonest conveyed to the affected part, and expedite the discharge by stool. The use of opiates (as in all pain- ful disorders) is indicated. Semicupia are highly bene- ficial. In the Bilious Colic, tartarised antimony, clysters, aloetic, or rhabarbine purges and anodynes are to be used. See JAUNDICE and FLATUS. In Hysteric Colic, cordials, diaphoretics, anti-hyste- rics, clysters, and chalybeates, are indicated. In (136) In the Stone Colic, carminatives are of little service: regard must be paid to its original cause. See STONE. In the Flatulent Colic begin with a purgative clyster; if attended with a high fever, and the patient is really plethoric, draw off six or seven ounces of blood. Then, Take of common water, six ounces, Oil of olives, two ounces, Vitriolated natron, an ounce and a half, Tincture of opium, a drachm, For a clyster. Or, Take of balsam of copaiva, (dissolved in the yolk of an egg) half an ounce, Mountain wine, six ounces, Linseed oil, two ounces, Purified opium, five grains, A clyster. Or. Take Colocynth, a scruple, Purified opium, ten grains, Vitriolated quicksilver, Precipitated sulphur of antimony, of each five grains, Simple syrup enough for pills, Eight; two every hour till the pain ceases. Take of wine of aloes, two ounces and a half, Syrup of buckthorn, half an ounce, A draught to be taken immediately, Or, Take of Tincture of senna, two ounces and a half, Syrup of roses, half an ounce, Purified salt of amber, ten grains, A draught. If (137) If the pain continues after the draught begins to work, use the above pills, one occasionally. I have known electricity often remove the colic: to say the truth, I never knew it tried without giving im- mediate relief; it has sometimes returned, but a repe- tition of the same has had the same effect as before. Ten or fifteen grains of allum often repeated, are said to cure an habitual colic. ILIAC PASSION. THE Iliac passion is an inversion of the peristaltic motion of the intestines; consequently in this case nothing can pass downwards. It is called Volvulus and Miserere mei. The causes. The introsusception of a superior part of an intestine into a lower; or a contra; induration of fœces in the rectum into scybals; vomiting irritation, a rupture, acrid bile. The diagnostics. A most acute pain in the small, sometimes in the large guts; generally about the um- bilical region; above it, a tumor; difficulty in making urine: the anus so fast closed by a spasm, as to become totally impervious; it comes on slowly, while the tu- mor in the belly grows bigger and harder; vehement straining, ejection of excrements by the mouth, difficult respiration, cold sweats, hiccoughs, frigidity of the extremities, syncopes, subsultus tendinum, idiotcy. The prognostics. This terrible disorder is incident to persons of all ages; to old persons it is fatal; hiccoughs and convulsions are the forerunners of death; so is a sudden disappearance of the pain, being the sign of a mortification. The (138) The cure. I have relieved some after the fœces came up at the mouth, by cold pediluvia. Let the patient be taken out of bed, and being supported by two persons, throw water as cold as can be procured on the feet, then dash it on the legs, and in a few seconds more on the thighs; after wiping them dry, replace him on the bed, and in a quarter of an hour, if a stool is not produced, repeat the same manœuvre; if the second operation fails success it is not to be expected. If it proceeds from a hernia reduce the intestine, if possible. If plethoric, which is seldom the case, a little blood may be taken away. Inject, if it can be done, a clyster of tobacco smoke, it is an Herculean remedy; then give a clyster of seven ounces of oil, with a drachm of colocynth boiled in it. Some give five ounces, or even half a pound of live quicksilver, for a dose; if void- ed by stool the patient will recover; if retained as it often is, it expedites his end; I have found it in the sig- moid flexture of the colon. For several nights after re- covery a paregoric will be necessary. The following simple draught has been exceeding serviceable: Take of tincture of aloes, an ounce, Syrup of white popies, Oil of olives, Vinegar, of each half an ounce, Spermaceti, two drachms; A draught, to be taken every three hours. Take of vitriolated natron, two ounces, Pure water, six ounces, Tincture of asafœtida, Tincture of opium, of each two drachms, A clyster. Take of colcocynth, two scruples, Purified opium, one scruple, Vitriolated (139) Vitriolated quicksilver, Precipitated sulphur of antimony, of each ten grains, Simple syrup, enough for pills, Twelve; two to be taken occasionally. APPETITE BAD. WHEN the appetite is depraved, or the stomach deprived of its usual appetence for food, or when a nausea is felt at the sight or smell of victuals, a per- son is said to labor under an anorexia. Apepsia is when the digestive organs are incapable of elaborating the aliment into chyle, or a lost digestion. Bradypepsia is when digestion is performed slowly and with great difficulty, or a diminished digestion. Dyspepsia is when the food cannot so properly be said to be digested as converted into a morbid colluvies not fit for nutriment, and may therefore be called a Depraved Digestion. They all proceed from the same causes, and require the same method of cure. The causes. A laxity of the muscular fibres of the stomach, a glutinous pituita; a deficiency of the secre- tions, particularly that of saliva or the gastric fluid; grief, fear, the mind being intensely fixed on one ob- ject, hard drinking, former voracity, profuse excre- tions, want of sleep or exercise, deficiency of heat in the stomach, severe studies. The diagnostics. Frequent retchings, paleness, bor- borygmi, tension of the scrobiculus cordis, nidorous eructations; (140) eructations; after long continuance without food no inclination to eat; at the sight of victuals nausea; after eating vomiting and swelling at the pit of the stomach, sensation of coldnes in the stomach. The prognostics. It often terminates in a marasmus, dropsy, jaundice, or cachexy, and the patient dies ta- bid. It is always of bad consequence if of long conti- nuance, for the patient gradually grows worse while the disorder increases in obstinacy. There are but few cases which are irremediable. The cure. The patient should humour his stomach by eating whatever he feels the least inclination for, and of that a little at a time, and often. For diet, see PHTHISIS, HYPOCHONDRIA, IMPO- TENCY, and WEAKNESS OF THE SOLIDS. The chalybeate waters are useful, or if from frequent acts of intemperance and ebriety, the Bath waters; acids, bitters, change of air, exercise, sleeping soon after meals, gentle cathartics, astringents, aromatics, but above all the dry vomit. Take of ipecacuanha, five grains, Blue vitriol, one grain; Let this powder be taken in the morning fasting, three times a week, without drinking any thing during the operation. Take of aloetic pills, a drachm, Precipitated sulphur of antimony, Filings of iron, Myrrh, of each half a drachm, Simple syrup, enough for pills, Number thirty-two; two to be taken twice a day. If not costive, Take (141) Take of conserve of wormwood, an ounce and half, Galangal, Zedoary, of each half an ounce, Syrup of orange peel, enough for an electuary, Dose, the size of a nutmeg, twice a day. Take of aloetic pills, too scruples, Snake root, a drachm, Long pepper, half a drachm, Oil of cinnamon, twenty drops, Simple syrup, enough for pills, Number thirty-two; two to be taken morning & night. A tea-spoonful of the compound tincture of gentian may be taken thrice a day, or tincture of orange peel, or of the diluted vitriolic acid. See FLATUS. BULIMUS. BULIMUS, or canine appetite, is so called from the constant propensity that is felt to eat, and the vo- racity with which the food is devoured. The causes. A digestion too quick, a too liberal use of acids, immoderate evacuations, worms, acrimony of the gastric fluid. The diagnostics. are sufficiently obvious. The prognostics. It is often succeeded by a Bulimia; that is when the same inclination to eat remains without the power, and after the patient does eat, he faints. If not cured, it terminates in a lientery, a cachochymy, or atrophy. The (142) The cure. Let fat meat and fat broths be the principal diet; sweet wines or new beer, the chief li- quids that are drank. Give emetics, particularly the dry vomit, and aloetic cathartics. If it proceeds from worms, Take of quicksilver, with sulphur, Tin of each two drachms, For six powders; let one be taken morning and night. Take of socotrine aloes, Filings of iron, Asafœtida, of each two scruples, Oil of wormwood, enough for pills, Number twenty-four; two to be taken twice a day. Take of socotrine aloes, Filings of iron, of each a drachm, Calomel, Colocynth, of each a scruple, Simple syrup, enough for pills, Thirty-two; two to be taken night and morning. Take of Mutton suet, four ounces, New milk, eight ounces, For a draught, to be drank warm. Opium may be given occasionally, not in less doses than three grains. See WORMS. VOMITING. (143) VOMITING. THE cause of vomiting is a convulsive or inverted motion of the stomach, owing to some irritation of the nerves of its left orifice, which may be occasioned by consent of parts, as sailing, tickling the throat, &c. to a laxity also of its muscular fibres, acid acrimony, or redundance of bile. The diagnostic is obvious. If idiophatic, no part is affected but the stomach. If symptomatic, reference must be had to the primary disorder. The prognostics. It is often a critical expulsion of an acrid morbific matter, and should then be promoted by an emetic and broth. If of more than two days conti- nuance, (at times) or if the patient is always sick after eating, it ought to be prevented, or it will terminate in an anorexia, marasmus, or paralytic affection of the stomach. The cure. Give a gentle emetic, or five or seven grains of ipecacuanha, every morning fasting, for a few days, letting it work itself off without drinking. Its prevention is to be secured by anti-emetics, nervines, cardiacs, and opiates. Repeated applications of cam- phorated spirit to the pit of the stomach; fomentations and stomachic plaisters may be used: it would not be amiss to apply them under the left shoulder rather than to the pit of the stomach. Preparations of mint are of great utility, either the essential oil, or an infusion of the leaves in the distilled water of the same. If it pro- ceeds from an acid acrimony, give plentiful draughts of broth, and a drachm of the magnesia alba occasionally. A scruple of colomba root as often as is necessary. See COLIC, CHOLERA MORBUS, FLATUS, and AP- PETITE BAD. Take (144) Take of prepared kali, two scruples, Conserve of wormwood, half a drachm, Let this be washed down immediately with two ounces of lemon juice, or vinegar, or a draught composed of an ounce of lemon juice, and one ounce of peppermint water. Take of bay berries, half a drachm, Grains of Paradise, Galangal, of each ten grains, Oil of cinnamon. Oil of mint, of each three drops, Purified opium, two grains, Syrup of orange peel, enough for a bole, To be taken at bed time. A tea-spoonful of compound tincture of lavender may be taken occasionally, or of colomba, or of casca- rilla. SYNCOPE. SYNCOPE, or fainting, proceeds from an obstruc- tion of the efflux of the nervous influence along the par vagum. The causes. Weakness, intense pain, hunger, thirst, anorexia, profuse evacuations, excess of external heat, passions of the mind, hysteric affections, uterine furor. The diagnostics. Paleness, cold sweats, low flutter- ing pulse, trembling, cessation of motion and sense. The prognostics. It is always dangerous, excepting in hysterical paroxysms, and then it is of little conse- quence. (145) quence. From excessive evacuations, or after convul- sions or supervening the ravages of a fever, it is often fatal. The cure is to be effected by nervines, cardiacs, ster- nutatories, volatiles, opiates, the aromatic confection, ginger, a generous diet, and the cold bath. See EPILEPSY, FLATUS, and WEAKNESS of the SOLIDS. Take of the chalk mixture, seven ounces, Spirit of cinnamon, two ounces, Compound tincture of lavender, Syrup of tolu, of each half an ounce, A julep, of which give three or four spoonfuls as there is occasion. It is a most excellent cordial. Take of volatile tincture of valerian, an ounce and half, Compound tincture of lavender, half an ounce. Two tea-spoonfuls of these drops to be taken in a glass of water two or three times a day. POISONS. IF Poisons have been taken internally, give immedi- ately three grains of blue vitriol, and five grains of the yellow emetic quicksilver, with frequent and large doses of sweet oil afterwards, and two scruples of kali every three hours. For the bite of a mad dog. Apply a cataplasm of pickled herrings to the part affected: or a caustic with the following dressing, half an ounce of gum elmi, and two drachms of the red nitrated quicksilver. Use musk, alkalis, mercurials, and immersion in salt water. G Take (146) Take of camphire, a drachm and half, Precipitated sulphur of antimony, Vitriolated quicksilver, of each half a drachm, Simple syrup, enough for pills, Number thirty-two; one to be taken morning and night. N. B. I fear all the above, and the famous Orms- kirk medicine too, are equally useless, if the dog be really mad. For the bite of a viper. Bathe the part affected with warm oil often. Sting of an insect. Apply a piece of allum wetted to the part frequently, or balsam of Peru and Hungary water, of each equal parts; or of oil of olives and oil of turpentine equal parts, or camphorated spirit, tincture of myrrh, of each equal parts; or of water of ammonia and oil of amber, of each equal parts, or, an aqueous solution of opium. PALPITATION OF THE HEART. A PALPITATION of the heart is a preternatural systole of that viscus. The causes. It is often owing to a plethora, to poly- pous concretions, sometimes to a deficiency of nervous influence, or influx disproportionate to the elasticity of the muscular fibre, indolence, ebriety, acid gas, spasms, acrimony of the fluids. The diagnostics. A fluttering pulse, temporary stop- page of the breath, a preternatural pulsation on the left side, to be felt by the hand, and sometimes to be heard. The (147) The prognostics. If it is owing to fleshy excrescencies or grumous clots, it is incurable: if from a plethora, it is to be removed by bleeding only; if from an acid halitus, easily curable by alcalis and cardiacs. If of long continuance, it often terminates in an apoplexy. The cure. It must be treated according to the cause it proceeds from. If the patient is not plethoric, avoid all evacuations and use one of the subsequent remedies; A scruple of camphire, dissolved in half an ounce of œther, For a draught. Take of compound tincture of lavender, Tincture of castor, of each half an ounce, Of these drops let two tea-spoonfuls be taken twice or thrice a day. Take of gum arabic, two ounces, dissolve in Pure water, a pint, Tincture of cantharides Oil of turpentine, of each half an ounce, Two or three spoonfuls of this mixture to be taken night and morning. SPASMS, OPISTHOTONOS, CONVULSIONS. SPASMS owe their origin to an irregular or unequal influx of the vital heat into the affected muscles; or great deficiency thereof. They require the use of vesi- catories, emetics, and antispasmodics, such as gum am- moniac, asafœtida, valerian, musk, blue vitriol, or which is second to none of them, a scruple of camphire in half an ounce of æther. G2 Painful (148) Painful spasms demand the liberal use of opiates. In the opisthotonos and the locked jaw, purified opium may be given, even to the quantity of seven or eight grains for a dose, washing it down with seven or eight ounces of the musk julep, or two grains frequently repeated, i. e. every hour, till the end is answered. Convulsions of all sorts in children yield to the fol- lowing: Take of prepared kali, a drachm, Tincture of asafœtida, half an ounce, Peppermint water, an ounce and half, Let a tea-sponful be given three or four times a day. DIABETES. A DIABETES is a preternatural discharge of urine. The causes. An obstruction of insensible perspiration, dilatation of the renal glands, to great attenuation of serum, laxity of the fibres, hard drinking. The diagnostics. If of long standing, or supervenes on the departure of a fever, it is dangerous: proceeding from weakness of the solids, it is difficult of cure: in old persons seldom removeable. The cure. For diet, see PHTHISIS and HYPOCHON- DRIA. Astringents, chalybeates, balsamics, mineral acids, agglutinants and corroborants are proper in this case, as also is the cold bath. A vesicatory applied to the os sacrum has an admirable effect. For common drink, the decoction of hartshorn may be given, with an ounce of infusion of roses in every pint; or lime-water, or (149) or the Bristol waters, or allum whey, which will some- times effect a cure alone: it may be prepared by putting two drachms of roch-allum powdered in a pint of boiling milk: half a pint to be drank twice a day. If costive, let aloetics be given. The dry vomit is of considerable utility. The following have been all found serviceable. See DIARRHŒA. Take of mastic, a drachm and half, Balaustines, Olibanum, of each half a drachm, Simple syrup, enough for pills, Number thirty-two; three to be taken twice or thrice a day, Take of compound tincture of lavender, an ounce, Vitriolic acid, half a drachm, Of these drops, let a tea-spoonful be taken thrice a day. Or, of Tincture of cantharides, A tea-spoonful, morning and evening. Take of gum arabic, an ounce, Red bark, six drachms, Red astringent gum, half an ounce, Tincture of cantharides, enough for an elec- tuary. Dose, the size of a nutmeg, twice a day. WORMS. (150) WORMS. WORMS are of three sorts, teretes, or the round worm, whose seat is in the stomach; tænia, or the tape worm, which is to be found in most of the in- testines; ascarides, or the small worm, seldom to be met with but in the rectum. The cause. Ova received with the food. The diagnostics. Inflation of the abdomen; violent pain and spasms in the stomach and bowels; itching of the nose or anus; fœtid breath, voracity, the excre- ments greasy, or greenish, or slimy; coma, nausea, moistness of the mouth and slavering in the night, grind- ing of the teeth, faintness, cold sweats, delirium, con- vulsions; shocks, similar to electrical ones; flushing heats, flying pains, anxiety, alternative swelling and subsidence of the veins, the pulse weak and intermit- ting, thirst, paleness, vagrant stitches, epileptical pa- roxysms, paralytical strokes, which go off spontaneously on the removal of the cause. The prognostics. If they remain long in the intesti- nal canal, they produce a variety of unaccountable dis- orders: strange and incredible are the effects which are occasioned by these detestable vermin; few persons are wholly free from them, particularly females. If after they are destroyed they are not conveyed out of the body, a putrid acrimony may be the consequence; small doses of cathartics should be continued for some time after they are killed, not only for the above reason, but to cleanse the bowels from the adhering ova. The cure is to be effected by aloetics, chalybeates, oils, oleous clysters, prepared kali, or oil of wormwood, which may be applied to the navel, or plaister of aloes and galbanum may be smeared over with it, and applied to the umbilical region for children. New milk in a decoction (151) decoction of quicksilver, two ounces to a pint for four doses: flowers of sulphur mixed up with honey, the size of a nutmeg to be taken night and morning; red sulphurated quicksilver is an excellent anthelmintic, as also are the filings of pewter, which may be given to adults to the quantity of a drachm, fasting, or the same quantity of tin. The following pills are equal to any thing in efficacy: Take of socotrine aloes, Filings of iron, of each a drachm, Calomel, a scruple, Simple syrup, enough for pills, Number twenty-four; dose, two morning and night. Or, Take of quicksilver with sulphur, an ounce and half, Seeds of santonicum, half an ounce, Honey, enough for an electuary, The size of a walnut to be taken night and morning. Or, if of a laxative habit, Take of red hark, an ounce, Coralline, half an ounce, Mucilage of gum arabic, enough for an elec- tuary, Dose, the bigness of a chestnut morning and night. See WORM FEVER. SCURVY AND SCORBUTIC ERUPTIONS. THE Scurvy is a cachochymic diathesis of all the fluids. The causes. An acidity, an acrimony, or (at Sea) putrefactive quality in the blood, often introduced by a moist (152) moist air, obstructed perspiration, putrid water, poor- ness of blood, that part of salted provisions which has not taken salt, (for salt itself, so far from producing the scurvy, is an excellent antiscorbutic) eating too plenti- fully of fruit. Surfeits, as they are called, and scorbu- tic eruptions, originate from the too liberal use of vege- tables. Few persons are entirely void of all scorbutic complaints. The sea scurvy is a disorder that requires treatment very different from this we are treating of, though the effects are somewhat similar; for vegetables and acids are the most expeditious remedy for seamen, especially on shore; but they ought to be totally ab- stained from, by those who never use the sea, and are troubled with cuticular eruptions. Scorbutic eruptions are so common, that the author has met with some thou- sands of these cases in a year, and never one that he did not succeed in the cure of; but lest his invariable order to abstain from all vegetables and acids should startle the reader, he begs leave to observe, that so far from being singular in this point, he has heard the same advice given by the greatest and best Physicians of this or any age or country; it were needless to add that he means Dr. Fothergill. The diagnostics. An acute pain in the head, a sen- sation of dulness, erratic pains in the limbs, blackness of the skin, sponginess and putrefaction of the gums, oozing of blood from them; rottenness of the teeth, fœ- tid breath, an unequal pulse, diarrhœa and dysentery; frequent shiverings, a palpitation not seldom fatal; swellings in the joints, vitiated appetite, borborygmi, tormina in the bowels, sometimes costiveness; the urine pale, red, or gravelly; nausea, hiccoughs, livid spots on the skin, sometimes converted to foul ill-con- ditioned ulcers, crusts, scabs, scabies, cuticular erup- tions, which itch intolerably, appearing in general, first on the thighs, then on the arms and hands, sometimes scattered on the breast or over the whole body; red an- gry pimples, carbuncles, vesicles full of a hot acrid lymph, elephantiasis, contractions, stiffness of the joints, vertigo, (153) vertigo, convulsions, lowness of spirits, frequent sigh- ing, dyspnœa. See LEPROSY. The prognostics. This is a distemper which is ex- ceeding crabbed and refractory, has been always reck- oned very difficult to cure, and dangerous. If not scientifically treated it frequently terminates in a dropsy, atrophy, hypochondria, or apoplexy. As the old me- thod of treating it has been hitherto somewhat unfor- tunate, the author can with some justice, as well as confidence, recommend a new one, which has never yet baulked his expectations. The cure. When eruptions appear they are most for- cible pleaders against bleeding; the lancet is in these cases always pernicious. A milk diet is proper, at least for morning and evening; for dinner, animal food, with plenty of salt, but no vegetables. For regimen, see HYPOCHONDRIA and WEAKNESS OF THE SOLIDS. Give lenient cathartics, errhines, the chalybeate waters, aluminous waters, salt water, bitters, balsam of copaiva, but above all, the dry vomit. I shall now communicate to the reader all the various medicines I have used, the efficacy of which has been proved by a most extensive and successful experience. Take of aloetic pills, Precipitated sulphur of antimony, Gum guaiacum, of each two scruples, Simple syrup, enough for pills, Number twenty-four; two to be taken morning and night. Take of muriated quicksilver, ten grains dissolve in Muriatic acid, ten drops, then add Antimonial wine, an ounce, Of these drops let twenty (or if they purge, fifteen) be taken twice a day, G3 Take (154) Take of quicksilver with sulphur, an ounce and half, Gum guaiacum, half an ounce, Crude antimony, Snake root, of each two drachms, Syrup of orange peel, enough for an electuary. Dose, the size of a nutmeg, night and morning. If not costive, Take of red bark, on ounce and half, Winter's bark, half an ounce, Mucilage of gum arabic, enough for an elec- tuary, The size of a nutmeg to be taken twice a day. To cleanse the skin entirely from any remaining eruptions, defœdations, or from gingivous tumors. Take of sharp pointed dock roots, two ounces and a half, Extract of liquorice, two drachms, Winter's bark, half an ounce, Boiling water, a quart. Let them stand for twelve hours, then strain. Of this mixture let a tea-cupful be taken in the morn- ing, (fasting) and at night. If a dentifrice is thought necessary, Take of French bole, Burned allum, Myrrh, of each a scruple, To be used every morning. Or, Take of florentine-orris root, Burned allum, Lac (155) Lac, of each a drachm, Honey, acidulated with spirit of vitriol, enough for a mixture. As Scorbutic Eruptions are generally attended with a most troublesome pruritus, especially in bed, let the parts affected be anointed night and morning with the tar ointment; or if that, though powerfully efficacious, is objected to on account of the smell, Take of ointment of white calx of quicksilver, an ounce, Water of kali, Essence of lemons, of each twenty drops, To be used night and morning. Or, Take of white calx of quicksilver, two scruples, Cerate of acetated litharge, an ounce, Oil of rosewood, ten drops, An ointment, to be used night and morning. Or, Take of ointment of white hellebore, ounce, Water of kali, twenty drops; An ointment, as before. Or, the Neapolitan ointment. Take of the diluted vitriolic acid, Water, of each four ounces; A lotion, to be used night and morning. Or, Take of muriated quicksilver, ten grains, Muriatic acid, ten drops, Rose water, two ounces, As before. A liniment, to wash the eruptions night and morning, with a rag dipped in it. One (156) One of the above ointments, particularly the tar oint- ment. Or, Take of calomel, two scruples, Tar ointment, an ounce, To be rubbed in night and morning, and then wiped off with a dry cloth; should always be used when there are eruptions on the skin, and one of the above-men- tioned prescriptions be taken inwardly at the same time, particularly the mixture or drops, which will effectually free the patient in a few days from this disagreeable disorder. It will wonderfully expedite the cure if the following powder be used by way of snuff; a pinch of it to be taken every night after getting into bed: Take of white hellebore root, a scruple, For a sternutatory powder. ITCH. THE Itch is a cutaneous disorder, too well known to need description. The cause. An infectious miasma sui generis. The hypothesis of its being wholly owing to animulcules is highly problematical. The diagnostics. These are to be discriminated from scorbutical eruptions by their minuteness; from vene- real ones by not blotching; and from both, by their principally infesting the parts between the fingers; with a sensation of heat that invariably accompanies the itch- ing. The prognostics. It is attended with no danger. It is never difficult to cure in any habit. The (157) The cure. See SCORBUTIC ERUPTIONS, under which article the reader may find several elegant and efficacious liniments, either of which will answer his expectations in the cure of the itch, (particularly the solution of muriated quicksilver, the tar ointment, or the ointment of white precipitate) and of all cuticular eruptions, whatever cause they arise from: they will also cure red faces, freckles, morphew, grubs, tetters, ringworms, or any defœdations of the skin. The tar ointment with calomel should be used for a day or two morning and night, and then one of the others twice a day also, till the skin is perfectly clean: taking, during the use of the latter, the mixture recommended under the article SCURVY. Bleeding and purging are useless and improper in this as well as in all other cutaneous disorders. If internals are requested, though they are seldom necessary, either of the subsequent ones may be given with propriety and advantage: Take of vitriolic acid, half an ounce, Three or four drops to be taken in a glass of water night and morning. Take of quicksilver, with sulphur, an ounce and half, Calcined antimony, two drachms, Syrup of orange peel, enough for an electuary, The size of a nutmeg to be taken morning and Night. Or, Take of flowers of sulphur, an ounce and half, Nitre, two drachms, Honey, enough for an electuary; Dose, the bigness of a chestnut, night and morning. For children, Take (156) Take of vitriolic acid, five drops, Rose water, fifteen drops, Ointment of hog's lard, an ounce, Essence of lemon, fifteen drops, A liniment, to be used night and morning. For adults, Half an ounce of vitriolic acid, in a pint of water, A lotion, to be used twice or thrice a day. Take of muriated quicksilver, ten grains, Muriatic acid, ten drops, Camphorated spirit, two ounces, A lotion, to wet the parts with, night and morning. Or, The decoction of hellebore, Or, Take of white calx of quicksilver, a drachm, Ointment of hog's lard, an ounce and a half, Water of kali, a drachm, Essence of lemon, fifteen drops, A liniment, to be used night and morning. See SCOR- BUTIC ERUPTIONS. LEPROSY AND ELEPHANTIASIS. THE Leprosy is a cutaneous disorder, which appears in whitish dry scabs, and often spreads over the whole body. Sometimes one leg only is affected, which swells to an enormous bulk, then called Lepra Græco- rum and Elephantiasis. The (159) The causes. Obstructed perspiration, weakness of the solids, poverty of blood, an ill-cured itch, the re- mains of which will often lurk, appearing and disappear- ing, though not totally, for many years, and at length will break forth in this dry scurf, gradually enlarging. The diagnostics. Sometimes it is confined to the palms of the hands only, with fissures which run parallel to each other; sometimes to a little below the elbows; one while on the face only; another in white hard scales on the neck, generally appearing most on the thighs, or on the hands and arms; intolerable itching; the elephant’s leg. The prognostics. The Leprosy confined to the skin, without any remarkable tumor, is easily curable; the Elephantiasis not without much difficulty and time. The cure. For the Leprosy give the most nourishing diet, as eels, &c. and use precisely the same method as that recommended under SCURVY and SCORBUTIC ERUPTIONS, which see. For the Elephantiasis give the solution of muriated quicksilver in antimonial wine, under SCURVY. Let the whole leg be wrapped up in a cloth, on which the following liniment is to be spread, to be renewed night and morning. Take of tar ointment, an ounce, Water of acetated litharge, half a drachm, Camphire, a scruple, Calomel, two scruples, A liniment. EVIL. (160) EVIL. THE Struma, Scrophula, or King’s Evil, is so called from an imaginary cure performed by the Royal touch. The cause. An acrid blood, hereditary disposition, the venereal virus conveyed in semine. Those who are of habits exaltedly scorbutic, or in whom the itch has not been perfectly cured, (strange as it may seem) may beget a sciophulous offspring. Weakness of the solids. The diagnostics. Glandular tumors, serpiginous ul- cers, erosions of particular parts, contractions, distor- tions, sinuous abscesses. The prognostics. This disorder is not easily extirpated. If the tumors in the neck are not dissipated or opened, a glandular consumption generally ensues. Fistulous abscesses in scrophulous patients are rarely, if ever curable, unless by the following: Take of muriated quicksilver, two grains, Muriatic acid, two drops, Rose water, five ounces, Lint dipped in this to be applied night and morning. The cure. For regimen see PHTHISIS. The bark is the most noble remedy in strumous cases, when the patient is not of a costive habit. Burnt spunge is often used to advantage, and madder; sea-water also, but the dry vomit is inferior to no other remedy. The following I have given with manifest utility. Take of muriated quicksilver, ten grains, Muriatic acid, ten drops, Antimonial wine, an ounce; Of (161) Of these drops let an adult take twenty in a glass of wa- ter, morning and night. Take of quicksilver, with sulphur, two ounces, Crude antimony, two drachms, Honey, enough for an electuary; Dose, the size of a nutmeg night and morning. Externally apply the tar ointment with calomel twice a day. Or, Take of muriated quicksilver, ten grains, Pure water, an ounce and half, Tincture of cantharides, half an ounce, For a lotion, till the tumors lessen; if not, apply a poul- tice of bread and milk till they break, and then dress with Take of calomel, two scruples, Tar ointment, an ounce, To be applied morning and night. Or the above solu- tion in rose water. FALLING DOWN OF THE ANUS. THE falling down of the fundament is owing to a laxity of the fibres of its sphincter, or to a paralytic affection of them. It is easiest to be reduced by the pa- tient himself, lying on his back, writhing himself from side to side, crossing his legs, &c. with the application of sweet oil. When it is reduced, let a warm flannel be applied and frequently repeated; some of the following powder may be thrown on a red hot heater in a close- stool, and the anus be placed over it. If it cannot be reduced apply dephlogisticated air. Take (162) Take of aromatic powder, Mastic, of each a drachm and a half, White amber, Balustines, of each a drachm, A suffiment. The subsequent drops have proved of considerable utility: Take of Rectified spirit, half an ounce, Oil of turpentine, two drachms, Vitriolic acid, one drachm, Twenty to be taken twice or thrice a day. Take of Tormentil root, Dragons' blood, Mastic, of each a drachm, Simple syrup, enough for pills, Number twenty-two; three to be taken night and morn- ing. The red astringent gum will be of considerable ser- vice. See DIARRHŒA and DYSENTERY. STRANGURY. A STRANGURY is a partial suppression of urine, while the efforts to discharge it are attended with pain. The causes. Irritation, too long detention of urine, obstruction of it, spasms, paralytic affection of the de- trusores urinæ. The (163) The diagnostics. Frequent desires to make water, its coming away with difficulty and uneasiness; but little made at a time with great pain; sensation of heat and smart when the dribbling is over; pruritus. The prognostics. If symptomatic, it is easily helped, as from blisters in fevers, &c. If idiopathic, it is dan- gerous; in old persons frequently mortal; it often ter- minates in an incurable ischury. The cure. Let the patient abstain as much as possi- ble from liquids, and take food that is balsamic and light of digestion, and make use of agglutinants, as linseed tea, fomentations, emollient clysters, lenient cathartics, oleous injections, mild diuretics, cardiacs, opiates, warm semicupia, cold pediluvia, or the catheter. If it pro- ceeds from spasms give half an ounce of æther with a scruple of camphire in it. If from a paralytic affection of the detrusors, Take of red bark, an ounce and half, Compound powder of tragaeinth, half an ounce, Mucilage of gum arabic, enough for an elec- tuary. The size of a nutmeg to be taken every two hours. In other cases the following remedies have been at- tended with success: Take of oil of olives, five drachms, Camphire, two drachms, Oil of aniseeds, one drachm. With this liniment let the pubes and perinæum be anointed every hour. Let two ounces of horse-rhadish scraped be boiled in a pint of ale, thrown into a close-stool, and the vapour be received. Take (165) Take of gum arabic, two scruples, Nitre, one scruple, Camphire, five grains, Oil of aniseeds, four drops, Aromatic confection, enough for a bole, To be repeated as there is occasion; or the balsam of Peru mixture, under the article STONE. If the pain is vehement give two or three grains of purified opium. URINE SUPPRESSED. A DYSURY is when the patient feels inexpressible difficulty in making water. An Ischury is a total suppression of urine. The causes. An inflammation, abrasion of the mucus that lines the urethra, deficient secretion of it; ulcers, diarrhœa, gonorrœa, vesicatories, acid food, hard riding, hard drinking, the stone. The diagnostics. On an attempt to make water the pain begins; after it is evacuated, a violent smarting and sensation of heat; most severe at the extremity of the urethra. The prognostics. Proceeding from another disease, reference must be had to the original cause. If consti- tutional, the case is difficult. An Ischury in old persons, or when the water cannot be reduced by the cathether, is generally mortal; the last resource is immersion of the feet in cold water. A (166) A few cases I have met with of persons not much ad- vanced in years, where there has been no inclination to make water, nor has there been any in the bladder; fre- quent nauseas have been the only other symptom of want of health. On dissection the kidnies have been found wasted. The cure. The patient should use diluent liquors, whey, aluminous waters, agglutinants, blomange broths, jellies, balsam of copaiva, gum arabic, decoction of marsh-mallow roots, new milk warm, absorbents, and such as are proposed under STRANGURY, which see. See also the balsam of Peru mixture, under the article STONE. URINE, INCONTINENCE OF. IF the patient cannot hold his water, let a blistering plaster be applied to the os sacrum, of the same size and shape, to be kept on four or five days, or till it comes off of itself, and, Take of red bark, six drachms, Red astringent gum, two drachms, Tincture, of cantharides,, enough for an electuary. Dose, the size of a nutmeg night and morning. Or, for an adult, A tea-spoonful of tincture of cantharides, Night and morning, in milk. LETHARGY. A LETHARGY is an involuntary drowsiness, or continual propensity to sleep. The (167) The causes. A deficiency of vital heat in the cere- brum, foggy food, excess of pituita, indolence, using sleep after dinner, omitting customary exercise, lentor, viscidity of the fluids, spasms. The diagnostics. They are obvious from what has been already observed, to which may be added a me- mory much impaired. The prognostics. In young persons, if they are in- vaded in the summer time, it is easily cured; in winter if the patient is attacked, and feels a great prostration of strength, it is dangerous. In old persons, if the urine is white, it is scarcely curable. The cure. Removal into a clear dry air is necessary. The diet should be as in HYPOCHONDRIA, which see. Bleeding often renders it incurable. A bladder may be filled with hot water, and laid on the head, which should be rubbed with warm flannel, or use some of the applications recommended under the article HEAD- ACH. Touch the palate with a feather dipped in boil- ing water. The proper remedies are sternutatories, acrid clysters, stimulants, aromatics, volatiles, chaly- beates, vesicatories, the dry vomit, and plasters to the head when shaven, as, Take of galbanum, two drachms, Pellitory, Long pepper, Castor of each a drachm, Balsam of Peru, sufficient to make a plaster. Take of salt of hartshorn, Purified salt of amber, of each a scruple, Lisbon wine, two ounces, A draught to be taken every night. Take of volatile tincture of valerian, Tincture of guaiacum, of each an ounce, Of (168) Of these drops let two tea-spoonfuls be taken twice or thrice a day. Take of socotrine aloes, Filings of iron, Asafœtida, of each two scruples, Precipitated sulphur of antimony, Vitriolated quicksilver, of each one scruple, Simple syrup, enough for pills, Thirty-two; two or three to be taken night and morn- ing. IMPOTENCE. IMBECILITY is an inaptitute for coition: Impotency is a total incapacity of that action. The causes. A deficiency of vital heat, or some im- pediment to its proper efflux from the spinal marrow; weakness of the solids, profuse venery, ill-cured claps, gleets of long continuance, gravelly disorders anorexia, mastupration, frequent bleedings. The diagnostics. Flaccidity and hanging down of the testicles, coldness of the glans penis; few, weak, or no erections; pain or weakness in the loins, wandering stitches in the sides and groins, cephalalgia, vertiginous disorders, involuntary emissions without erections, hy- pochondria. The prognostics. If idiopathic, the cure is difficult; in old men, impracticable; if the patient is young, and has no other complaint of any consequence; or if it pro- ceeds only from indiscreet excesses, it is easily curable; if accompanied with a gleet, let that be first muzzled before the cure is attempted. The (169) The cure. Great regard must be paid to the non-na- turals. The patient should keep his mind constantly employed, to prevent as much as possible the incursion of venereal desires or thoughts. He should rise early in the morning, take a great deal of exercise, stopping short only of fatigue. The less fluids that are drank the better, the whole quantity ought not to exceed two quarts in the twenty-four hours. Let the diet be of shell-fish of all sorts, particularly lobsters, crabs, or oy- sters; of flat fish also, as scait, turbot, dories, and plaice, especially the skin of the latter; or of any wild fowl, the most eligible of which are pigeons, partridges, and woodcocks; add to which eggs, lampries, eels of all sorts, which are by no means inferior to vipers; cavear, strong meat soups, any animal (but no vegetable) food, par- ticularly pork, calf’s head, with the skin on; calves’ and neats’ feet, or trotters. Milk is the best breakfast and supper. Brandy and water the most proper to drink at dinner. All agglutinants, chalybeates, and aromatics are useful; opiates also, which powerfully increase the secretion of semen. The testicles should be bathed night and morning with equal parts of alcohol and vine- gar ’till they cabbage; nor is it a matter unworthy of at- tention, always to wipe the glans dry after making urine. See WEAKNESS of the SOLIDS. Sterility is owing to the same causes, and requires the same method of treatment. To give prolificity to the semen, by determining a sufficient quantity of the nervous influence to it, nothing equals the oil of cloves, by means of which many have proved fathers, after all previous efforts had for many years been fruitless: this, therefore ought not to be omitted in any medicines that are given, calculated for that purpose. It may not be amiss to observe in this place, that the balsam of Peru has an effect directly opposite to that of the said oil. The following formulæ powerfully stimulate to con- jugal intercourses, furnish ability equal to desire, and seldom fail to render those intercourses prolific. Take (169) Take of oil of Cloves, half an ounce, dissolve in The yolk of an egg, then add, Tincture of cantharides, an ounce and half: Of these drops let two tea-spoonfuls be taken night and morning. Take of socotrine aloes, Filings of iron, of each two scruples, Purified opium, ten grains, Cantharides, six grains, Oil of cloves, ten drops, Simple syrup, enough for pills, Sixteen; two to be taken every night. Take of aromatic powder, Cloves, of each a scruple, Ambergris, Musk, of each five grains, Purified opium, Cantharides, of each one grain, Oil of cloves, five drops, Syrup of orange peel, enough for a bole; To be taken every night for a month, keeping the body soluble, during which time the patient should have no connection with his wife. Take of oil of cloves, six drachms, Oil of nutmegs, one drachm: Of these drops, ten may be taken on sugar night and morning- Take of oil of cloves, ten drops, Mucilage of gum arabic, half a drachm, Pure water, an ounce; A draught to be made according to art, and taken morning and evening. See GLEET. H GOUT. (170) GOUT. THE Gout is a chronical disease, most commonly af- fecting the feet. If it attacks the knees, it is cal- led Gonagra; if the hands, Chiragra; if the elbow, Onagra; if the shoulder, Omagra; if the back or loins, Lumbago. The causes. Irregularity with respect to some of the non-naturals, immoderate venery, feeding frequently and immoderately on fat, great fatigue, a moist cold air, a contusion, tartarous wines, fermenting liquors; acid gas, as appears from the sour sweats and acid eruc- tations so common in arthritic paroxysms; fruit, vege- tables; the passions of the mind, indolence. The diagnostics. A most intense pain, as though a wedge were fixed between the joints; or as if the part were in a press; sometimes it seems stretched to such a degree, that the unhappy patient is ready to think that it will burst every moment: when this is the case, it is seldom more than six hours before the pain abates and welcome sleep succeeds. Sometimes the sensation is similar to that which would be brought on if the parts were gnawn by carnivorous animals. Those who have been long tormented with it, have often a cretaceous matter issue from the bursting of the small vessels, which is an induration of the nervous filaments, and is actually chalk; for the nerves seem to be originally con- stituted of a chalky earth, lengthened into fibres by animal glue. The prognostics. If hereditary (which with humble submission to Doctor C. it certainly may be) it is most difficult to relieve. It is generally supposed to be incu- rable, as all disorders are said to be which we know not how to cure. The fits may undoubtedly be rendered mild- er, and perhaps be totally prevented by pursuing the subsequent method; it has succeeded in the removal of many (171) many inveterate gouts, though they were of long stand- ing and had been every year exacerbating. The cure. Let the patient live wholly on animal food or use a milk diet, and for change take meat broths; he may drink plentifully of two milk-whey; but must ab- stain from all vegetables, claret, and malt liquors; spi- rits diluted with water will not hurt him. Exercise is absolutely necessary, and too much cannot be taken, nor can it be too often repeated, if it does not proceed to fatigue. The mind should be kept as calm and com- posed as possible; amusement and a little dissipation of thought is necessary. If the gout seizes the stomach, give immediately half an ounce of æther with a scruple of camphire in it; let it be taken alone in a spoon, without swallowing any liquid for some minutes after it; if the sensation it occasions is disagreeable, he may rinse his mouth with a little cold water, and spit it out. It is an admirable remedy, and never deceived me. To fix an erratic gout, and bring on a regular fit, give asafœtida inwardly, and bathe the great toe and metatarsus with water of ammonia. If the fit comes on in good earnest, Take of camphire, fifteen grains, Purified opium, Ipecacuanha, of each three grains, Precipitated sulphur of antimony, Vitriolated quicksilver, of each two grains, Aromatic confection, enough for a bole, To be repeated as occasion requires. Let this be washed down with the following draught: Take of tincture of guaiacum, six drachms, Pure water, eight spoonfuls. H2 After (172) After taking this bolus and draught, the patient should lie between flannel sheets. Let the draught be repeated every night for some time, with the addition of two drachms of elixir of aloes, if costive, and that the gout is incurable is a proposition that will no longer be taken for granted. The alvine canal should be kept open with aloetics and quicksilver; all bitters and alkalis are useful; nor is it amiss to bathe the feet every night in warm water with a handful of salt in it. As to the application of leeches, or opening the saphœna when the fit is coming on, I never saw any good effect from it, nor can a gouty person be bled without great hazard and danger. As to burning cotton on the part affected, notwithstand- ing the authority with which it comes recommended, I could never persuade any person to try the experiment. If topics are desired, quick-lime and honey for an epi- them seems to be the most eligible one. Or, Take of vitriolic acid, forty drops, Hog's lard, an ounce, A liniment, to be applied often to the part affected. Or a vesicatory. To prevent a return let one of the subsequent medi- cinee be given and continued for some months; they are adapted to the various circumstances of different patients, and the choice must depend on the skill of the practitioner. Two tea-spoonfuls of the tincture of guaiacum, or, One of water of pure kali, May be taken night and morning. Take of gum guaicum, Camphire, of each a drachm, Precipitated sulphur of antimony, Vitriolated (173) Vitriolated quicksilver, of each a scruple, Simple syrup, enough for pills, Number thirty-two; two, or three to be taken every night. Take of aloetic pills, a drachm and half, Filings of iron, half a drachm, Precipitated sulphur of antimony, Vitriolated quicksilver, of each a scruple, Simple syrup, enough for pills, Number thirty-two; two to be taken night and morn- ing. Take of germander, Ground pine, of each an ounce, Lesser centaury, six drachms, Gentian root, half an ounce, Syrup of ginger, enough for an electuary. The size of a walnut, to be taken twice or thrice a-day. Take of red bark, an ounce, Winter's bark, three drachms, Mucilage of gum arabic, enough for an electuary, Dose, the size of a nutmeg, thrice a day. Take of cammomile flowers, Ginger, of each an ounce, Galangal, two drachms, Grains of Paradise, Oil of mint, of each one drachm, Syrup of orange peel, enough for an electuary, The bigness of a nutmeg, to be taken morning and night. In emaciated habits, two drachms of the tartarised iron may be added to either of the above electuaries. RHEUMATISM. (174) RHEUMATISM. THE Rheumatism is a painful disorder, the seat of which is in the membraneous part of the body: it is sometimes mistaken for the gout. The causes. A viscidity of that mucus which is de- signed to lubricate the joints and facilitate their motion, heats and colds, moist air, relicts of the venereal dis- order, large quantities of quicksilver taken, scrophulous diseases, acrid serum, deficiency of vital heat. The diagnostics. Wandering pains, a fixed pain in the shoulder, hip, loins, arm, leg, knee, thigh, breast, side, or head, the part seldom red, the pain felt most when the part is in motion, or the pain being most se- vere at night, when the patient begins to grow warm in bed. N. B. This is the case, when the cause is elastic air. Sometimes it is attended with a fever, then called the hot rheumatism, preceded by chills and rigor; persons in years feel the attack in their head and bowels. The prognostics. If idiophatic, the chronic rheuma- tism is curable with great facility, however difficult so- ever it may be thought to be; the author has a right to speak, with some confidence on this subject, for he has certainly had the management of as many rheumatic cases as any human being, without finding any of them rebellious to the method hereafter proposed. If impro- perly treated it is very apt to return periodically. If symptomatic, the cure of it depends on the removal of the primary disorder. Bleeding in the chronic rheu- matism, protracts the cure. The cure. If attended with an ardent fever (then called the acute rheumatism) let it be treated in just the same manner as an ardent fever; when there is a re- mission (175) mission give the bark, which by the way, will remove any rheumatic disorder, if exhibited scientifically, and in large quantities, with proper combinations. The lancet has been esteemed necessary in a chronic rheu- matism, but it is never really so; for if it should yield a temporary relief, such a relief is purchased at a vast expence. The diet should be the same as in the gout, which see. Let the part be kept warm, bathed with oil of turpentine night and morning, or a blistering plas- ter be laid on it. Buckbean tea, though nauseous, is no bad auxiliary. The dry vomit will greatly expedite recovery, and in many cases effect a cure alone. Take of tartarised antimony, ten grains, For three powders. One to be taken every other morn- ing, fasting. Take of tincture of guaiacum, six drachms, Tincture of aloes, one drachm, Oil of turpentine, half a drachm, To be taken in eight spoonfuls of milk or water every night till well. Four or five of these draughts are gene- rally sufficient for a perfect cure. Or, Take of socotrine aloes, seven grains, Purified opium, three grains, Simple syrup, enough to make two pills, Both to be taken at bed-time, and repeated as there is occasion. Or, Take of colocynth, two scruples, Purified opium, one scruple, Vitriolated quicksilver, Precipitated sulphur of antimony, of each ten grains, Simple syrup, enough for pills, Twelve; two to be taken at night. Or, Take (176) Take of calomel,* Conserve of arum, Camphire, of each a scruple, Simple syrup, enough for a bole, To be taken at bed-time. To prevent its return, Take of flowers of sulphur, two ounces, Gum guaiacum, half an ounce, Precipitated sulphur of antimony, two scruples, Oil of turpentine, three drachms, Honey, enough for an electuary, Dose, the size of a nutmeg, morning and night. This electuary will succeed also in the cure of most cases alone. Take of tincture of guaiacum, two ounces. Of these drops let two tea-spoonfuls be taken morning and night. Take of red bark, an ounce and half, Extract of liquorice, half an ounce, Oil of aniseeds, two drachms, Tincture of Benjamin, enough for an electuary, Dose, the size of a chestnut, twice a day. Take of red bark, an ounce, Gum guaiacum, half an ounce, Oil of sassafras, two drachms, Filings of iron, one drachm, Syrup of orange peel, enough for an electuary, Dose, the size of a nutmeg, twice or thrice a day. HIP- * Procured from Apothecaries Hall. (177) HIP-GOUT. THE Sciatica, or Hip-Gout, is so called because the pain is confined to the parts about the hip. The cause. Inspissation of the mucus in the aceta- bulum, which may be occasioned by the same causes which produce the rheumatism. The diagnostics. Intense pain, as though the thigh were dislocated; it is most common with those who have not yet arrived at the years of puberty; sometimes very old persons are attacked with it; it rarely invades those of middle age; atrophy of the thigh, lameness. The prognostics. If idiophatic, it is not dangerous; if not scientifically treated at first, it may require some difficulty and time to remove; if symptomatic, reference must be had to the primary disorder; the lameness, if of long standing, is rarely curable. The cure. The regimen and medicines requisite are much the same as those just mentioned in the rheuma- tism. Vitriolated quicksilver is greatly and justly ex- tolled as an alterative in this case. It will generally yield, in a few days, to one large spoonful of volatile tincture of guaiacum, every night, in six spoonfuls of water. Some recommend whipping the part with net- tles; much more eligible topics are to be found below. Take of gum guaiacum, two drachms, Purified opium, half a drachm, Tartarised antimony, Vitriolated quicksilver, of each ten grains, Simple syrup, enough for pills, Number thirty-two; two, or three to be taken every night. Or, Take of rhubarb, a drachm, Camphire, half a drachm, H3 Calomel, (178) Calomel, twelve grains, Simple syrup, enough for pills, Number twenty-four; two to be taken morning and night. Take of camphire, Barbadoes tar, Oil of turpentine, Oil of aniseeds, of each half an ounce, A liniment, to be used twice or thrice a day. Or, Take of black soap, Honey, of each an ounce, With the white of an egg, make an ointment, as before. Take of litharge plaster, with gums, an ounce, Plaster of cantharides, two drachms, Euphorbium, one drachm, A plaster. Or, the common blistering plaster (which may be applied to the head of the fibula, if the part, or knee be swelled,) or a Burgundy pitch plaster. See RHEUMATISM. DEAFNESS. DEAFNESS must be treated according to the pri- mary disorder from which it arises, as epilepsy, lues, fevers, &c. The more plentiful the excretion of cerumen is, the easier to be cured. The methods pro- per to be taken are such as follow: purges, diaphoretics, vesicatories, setons, syringings, sternutatories, and the dry vomit. Electricity will sometimes cure it, so also will wearing their own hair in those who have been used to a wig. The (179) The common cause of deafness is a deficient, or too viscid secretion, or a constipation of the wax in the ears. A tea-spoonful of warm water poured into the ears, and suffered to continue for a minute or two in them, every night, will often produce extraordinary and unexpected effects. This is a more expeditious solvent of the ceru- men than upwards of seventy other different menstrums that were tried. Let a pinch of the following snuff be taken immediately after: Take of white hellebore root, a scruple, Euphorbium, two grains, A sternutatory powder. If the warm water will not remove deafness, after using it some weeks, nothing that is put into the ears will do it. If an insect has penetrated into the ear beyond the reach of extraction, let it be killed by dropping some of the following mixture warm into the ear: Take of tincture of aloes, half an ounce, Oil of wormwood, thirty drops, Oil of savin, twenty drops. CHOREA SANCTI VITI. ST. Vitus’ Dance is an involuntary yet irresistable motion of several muscles. The patient uses many ridiculous and antic gestures: what is very odd, those muscles only are affected which are destined for spon- taneous motion, for the heart, diaphragm, lungs, and stomach are never injured by this whimsical disorder. The cause. An unequal distribution of the nervous influence. This is often owing to an obstructed men- struation, chlorosis, acid gas, irritation from worms, weakness of the solids. The (180) The diagnostics. It is most common to females be- fore puberty; tremors, convulsions, distortions, conti- nued contraction of the antagonist muscle; working of the eyes, stiffness of the limbs, hopping about upon one leg, catchings of the hands, twisting of the fingers, ly- ing down and rising upright for many times together, various grotesque and unintended gesticulations. The prognostics. Menstruation generally cures it.— I have seen many extraordinary cases of this sort, but never met with one that was difficult to cure. When of long continuance it sometimes degenerates to an epi- lepsy. The use of the lancet (which ought by no means to be allowed in this disorder) sometimes super-induces an opisthotonos, and often an incurable phthisis. The cure. For regimen see WEAKNESS OF THE SO- LIDS, which is an inseparable concomitant of this dis- temper. Begin the cure with the dry vomit, which should be continued twice or thrice a week till the pa- tient is recovered: besides this, the following pills and drops will greatly expedite the cure. Take of socotrine aloes, a drachm, Filings of iron, two scruples, Precipitated sulphur of antimony, one scruple, Simple syrup, enough for pills, Number twenty-four; two to be taken every night, or oftener. Take of tincture of asafœtida, an ounce, A tea-spoonful to be taken night and morning. To complete the cure, let chalybeate waters be used, and the cold bath every morning, half a drachm of gin- ger may be given with great advantage twice a day.— The balsam of copaiva is of considerable utility, as also is the volatile tincture of valerian. The subsequent mixture I have seen the most desirable effects from: Take (181) Take of prepared kali, two drachms, Cinnamon water, seven ounces, Water of ammonia, half an ounce, Balsamic syrup, an ounce, Of this mixture let two spoonfuls be taken morning and night. WEAKNESS OF THE SOLIDS. IN all habits of body where there is a constitutional deficiency of vital heat, there must exist a laxity of the muscular fibre, with some of its usual concomitants, viz. habitual chilliness, flabbiness of the flesh, pallid countenance, thin lank hair, bad appetite, lowness of spirits, cuticular eruptions, flatulencies, bilious disorders, obstinate costiveness, or diarrhœa. Whatever malady such persons may labour under, bleeding is inadmissible, and must be highly improper; for such an operation will certainly prove injurious, and perhaps, (as is too often the case) fatal to the patient; purging may be of considerable utility to such persons, because they have generally a redundance of serous fluids, though never of the flat red particles. Weakness of the solids re- quires peculiar attention to the regimen and diet, for that which is received into the stomach by pounds and quarts, is much more consequential and may as well be adapted to the state of the case as that which is taken by grains and drops. For such persons a clear dry air is extremely requisite, at some distance from trees; nor is it an unimportant matter for them to take frequent walks in a garden well stored with aromatic herbs, such as rue, lavender, mint, rosemary, &c. or those herbs may be kept growing in the house, but by no means suffered to lie in it when dry or dead. Sleep should not be allowed to excess, and the less time that is spent in bed, when not sleeping, the better. The excretions must be duly regulated, for a great deal depends on a proper (182) proper regard to the evacuations: care should be taken to adjust this affair with as much nicety as possible, and to trim the balance between deficiency and excess. To such persons few things are of more importance than pleasing conversation, diversions, and a constant en- deavour to preserve a calmness and composure of mind. Gentle exercise, gradually increased, must not be neg- lected; particularly swinging, during a continuance of a moist atmosphere. The most nutritious diet is to be recommended, such for instance, as milk, which is the best breakfast and supper for all weakly persons with- out exception; no person need be apprehensive of any bad consequences from its curdling on the stomach: it is most eligible to take as it comes from the cow, unless it purges; then it must be boiled. Of broths (all which are useful) that which is made of pork is preferable; the author has seen amazing effects from it. Eggs, if they do not gripe, are very desirable, and all sorts of animal, with little (or no) vegetable food; especially shell fish, and flat fish, every species of which affords the most plenteous and the most laudable nourishment: next to these may be mentioned wild fowl, particularly par- tridges, growse, and pigeons; for change, chicken, calves feet jellies, neats feet, trotters, beef tea, soups of all sorts, cavear, and blomange. A little should be taken at a time, but often repeated: a jelly may be al- ways at hand, and cannot be too frequently had recourse to, if the stomach will bear it, for that must be con- stantly humoured, and nothing should be refused that the least inclination is felt for. Spirits diluted with wa- ter are chiefly, if not wholly to be drank; unless Ma- deira wine should be found more agreeable to the palate; if beer is allowed, it ought to be very strong and very old, but not stale. As a teneritude of the fibres, or their want of due elasticity, is owing to a deficiency of vital heat, which is greatly abated by an acid gas or vapor, persons of this frame should abstain from all those things which increase this sour halitus by fermenting too rapidly in the sto- mach, (183) mach, such as sugar, fruit, vegetables, claret, and all liquors that have not passed the state of fermentation. The medicines proper to be administered, are aro- matics, bitters, chalybeates, astringents, the bark, fœ- tids, detergents, cardiacs, mineral acids, and above all things else, frequent repetitions of the dry vomit. See PHTHISIS, FLATUS, HYPOCHONDRIA, EPILEPSY, and IMPOTENCY. PAINFUL DISORDERS. PAIN IN THE HEAD. See CEPHALALGIA. PAIN IN THE EARS. PAIN in the Ears is sometimes caused by the tooth- ach, sometimes owing to an imposthume. If idio- phatic, and attended with a tinnitus, apply plasters of Burgundy pitch, or blisters behind the ears; use warm cataplasms, sternutatories, setons, cathartics, or opiates. TOOTH-ACH. THE Tooth-ach is generally owing either to a tumor of the gingivæ, of the circumjacent muscles, or to the caries of the tooth; it may also originate from a viscidity, or acrimony of the fluids. It is common in scorbutic habits, and to those of weak solids. If it comes periodically, let the bark be taken; opiates, if necessary, may be given internally; oil of castor held in the mouth will often give immediate ease, so also will electricity. If the gums are much swelled, they may be ripened by a cataplasm of figs; smoaking tobacco will sometimes (184) sometimes discuss the tumor; sternutatories are exceed- ing useful, and so are vesicatories; warm cloths should be frequently applied, and plasters of Burgundy pitch to the temples. A tea-spoonful of tincture of opium, or brandy, poured into the ear of the affected side sel- dom fails to remove the pain, especially if a little vine- gar be previously held in the mouth. If the tooth is carious, extirpation is the quickest and most efficacious remedy: if that is not permitted, Take of purified opium, Camphire of each two grains, Oil of cloves, Oil of pepper, of each two drops, A pill, to be put into the tooth. PAIN IN THE FACE. IF the pain is over all one side of the face, or if both the maxillæ are affected, use a gargarism of brandy and vinegar, equal parts, and bathe the part outwardly with warm oil: if this method has not the desired effect, dissolve a drachm of camphire in half an ounce of æther, pour a little of it into the hand, and apply to the affected part. Take of prepared kali, two drachms, Calcined antimony, two scruples, Pure water, seven ounces, Balsamic syrup, one ounce, A mixture; three spoonfuls to be taken night and morning. PAIN (185) PAIN OF THE NECK. THIS is commonly called a Crick, and is soon helped by drawing sparks from the part when the patient is placed on an electrical stool; by the frequent appli- cation of warm cloths, or by ironing the part, or moisten- ing it with a saturated solution of camphire in æther, or compound water of acetated litharge. PAIN IN THE BREAST. See PHTHISIS. PAIN IN THE SIDE. See FLATUS. PAIN IN THE STOMACH. See HEART-BURN. PAIN IN THE BACK OR LOINS. TAKE of balsam of copaiva, an ounce. Of these drops let twenty be taken on brown sugar, night and morning. Take of Spa water, half a pint, Boiling water, the same quantity, A draught, to be drank immediately, and to be repeated twice or thrice a day. Half an ounce of tincture of guaiacum, To be taken every night, in six ounces of water. See NEPHRITIS and RHEUMATISM. PAIN (186) PAIN IN THE LIMBS. SEE RHEUMATISM. If in the Shins, give three or four grains of purified opium, with three grains of precipitated sulphur of antimony every other night, anointing them every night with the stronger blue oint- ment. WHITE-SWELLING. APPLY a blistering plaster to the knee, let it be wrapped up in it, and the plaster be kept on four days. This should be repeated every fortnight or three weeks, ’till the patient is well, giving the dry vomit twice or thrice a week. I never met with but one in- stance wherein this method failed of success in curing this formidable disorder. HERNIA. A RUPTURE is either intestinal, omental, watery, flatulent, carnous, or varicose. The two first are owing to a prolapsus of the gut ilium, or the caul into the scrotum, groin, or navel. In infants it is easily cu- rable, in adults with some difficulty. Give an emollient clyster, apply an emollient fomen- tation, reduce and retain with proper ligatures or a truss: the patient avoiding flatulent food for some time, and all violent motions of the body. Let the part be bathed night and morning with alcohol, or with lime-water. Keep the patient on his back as long as possible: I have known those who by resolutely continuing in this pos- ture for five or six weeks, have been perfectly freed from a Hernia of many years standing, though pretty much advanced in years. The (187) The watery Hernia to be known by a pellucid tumor of the testicles, is to be cured by hydragogues, diuretics, discutient cataplasms, or puncture. The strangulated Hernia also requires the hand of a surgeon. GANGRENE AND MORTIFICATION. A GANGRENE is the death of a particular part, owing to the total impediment of any communi- cation of a fluid from the arteries. It commonly affects the adipose membrane only; a Sphacelus or Mortifica- tion invades all parts, the bones not excepted. The causes. Stagnation of the fluids, ligature, or compression of the veins, cold, inflammation, wounds, bruises, luxations, fractures (especially if bound too tight) ruptures. The diagnostics. A sensation of a dull pain; a pale, ashy, brown, livid, or green colour: no resistance to the touch. Those of a mortification are insensibility, a cadaverous smell, perfectly black colour, that blackness spreading, an eroding mortiferous corruption. The prognostics. A Gangrene may be cured. A sphacelus must be extirpated. A Gangrene of the brain, bowels, or bladder, is mor- tal: of the mouth, lip, nostrils, or genitals, difficult of cure; in dropsicals, phthisicals, and scorbutics, a Gan- grene is the fore-runner of death. A mortification, if it attacks the upper parts, or brings on agrypnia, delirium, faintings, borborygmi, hiccoughs, spasms, pains which go off suddenly; cold sweats, or coma, forebodes the hasty approach of a dissolution. The (188) The cause. If a gangrene proceeds from frost, rub the parts with snow or cold water, afterwards applying, Take of compound tincture of aloes, Water of ammonia, Oil of turpentine, of each equal parts, For a liniment. To stop the progress of a mortification, there is no external application comparable in efficacy with the oil of olives: let the part be bathed with it as hot as it can be borne twice or thrice a day. I have seen incredible effects from it, even with persons greatly advanced in years. If any thing in nature will prevent a sphacelus from spreading, I believe this will. Internally give the bark, chalybeates, the blue vitriol, and opiates. Take of the opiate pill, a drachm; Make into sixteen pills; one to be taken every hour, if necessary. SCHIRRUS AND CANCER. A SHIRRUS is an induration of a glandular part, owing to a previous inflammation. The causes. That which occasions an inspissation of the fluids in the glands. If the margins of a Schirrus are inflamed so as to pro- duce an erosion of the neighbouring vessels, it is called a Carcinoma, or Cancer. A recent Schirrus, the resolution of should be at- tempted by quicksilver and blisters; if these succeed not, extirpation is necessary; if that cannot be com- plied (189) plied with, palliatives are all that can be expected, such as milk diet, the balsam of copaiva, and thirty or forty drops of spirit of nitrous æther, in every draught of li- quor that the patient takes. A cancer resists every internal means (hitherto known) of cure. I never saw any good effects from the cicuta. If extirpation is not permitted, give twenty of the following drops night and morning: Take of muriated quicksilver, ten grains, Muriatic acid, ten drops, Spirit of nitrous æther, an ounce: Drops. Muriated quicksilver may be sprinkled on the fore. To alleviate the pain, the tar ointment with calomel, applied twice a day, is, I verily believe, superior in efficacy to any other topic. I have known great num- bers whose lives have been rendered comfortable by the use of it, who before had suffered the most excruciating agonies. The same above-mentioned palliatives are requisite. If the part is extremely offensive, use a carrot poul- tice. If a cure is expected, it must be obtained from the hands of a surgeon. I have seen lately several cancers of the lip yield to the above drops and ointment. BURN. APPLY oil, or lime-water, or spread some of the calamine cerate thin on a piece of thin leather. To prevent an unsightly scar, alter the above cerate has been (190) been renewed every day, for four or five days, use a liniment (once a day also) composed of equal parts of soft soap, honey, and oil of olives. SPRAIN. FROM the situation a part must be in when sprained, nothing can be more absurd than the usual method of resting it: it should be kept as constantly in motion as possible, and it will be well in the tenth part of the time that will be requisite for the cure, if spared, which any one may be satisfied of, who will make the trial. If any fotus is used, equal parts of vinegar and brandy is the most eligible. ŒDEMA. AN Œdematous tumor is soft, whitish, cold, indo- lent, and doth not resist the touch. If a topic is necessary, I know none preferable to, Take of alcohol, an ounce, Oil of turpentine, two drachms, Water of ammonia, one drachm, A liniment, to be used three or four times a day. Or, Compound water of acetated litharge. ULCER IN THE LEGS. OF all the disorders incident to poor people, this is the most common; at least, I have seen such numbers among the infinite variety of persons who have applied to me for assistance, that I can safely aver, I have (191) have cured more ulcerated legs than any man in his Ma- jesty’s dominions; nor did I ever meet with one case that did not yield to the method hereafter proposed. The causes. A scorbutic acrimony, depauperated blood, sedentary life, poor living, moist air, damp ground. Hence it is no wonder that there are so few of the weavers in the North of Ireland free from this troublesome complaint; for they live chiefly upon po- tatoes, or oaten bread, and sit at their looms three or four feet beneath the surface of the earth. After recommending a milk diet, the only medicines which I ever ordered inwardly, were my solution of the muriated quicksilver (See CANCER,) twenty drops to be taken in a glass of water morning and night. Or, if obstinately costive, Take of gum guaiacum, Socotrine aloes, of each a drachm, Precipitated sulphur of antimony, Vitriolated quicksilver, of each a scruple, Simple syrup, enough for pills, Number twenty-four; two to be taken every night. Externally, Take of calomel, two scruples, Tar ointment, an ounce, An ointment, with which the ulcer is to be dressed twice a day for two or three weeks, and then, to com- plete the cure, let a bandage be bound over the ulcer as tight as it can be borne. And, Take of spermaceti cerate, six drachms, Red lead, two drachms, A liniment, to be applied night and morning. Or, Take (192) Take of muriatic quicksilver, two grains, Muriatic acid, two drops, Rose water, six ounces, A lotion; lint dipped in this to be applied night and morning, and wetted with it before it is removed. The sore may be sprinkled now and then with calo- mel, or the red nitrated quicksilver. CONTRACTIONS. CONTRACTION of the tendons, particularly that of Achilles, is a common cause of lameness, espe- cially in children, though this case is often overlooked. The use of many limbs (when long lost) has been re- covered when the patient could not touch the ground with his heel, by the following simple liniment. Take the yolk of a new laid egg, carefully cleared from the white, beat it up with six spoonfuls of spring water, let the thigh and leg be bathed with it morning and night, for some weeks. The effects are equally amazing and incredible. PARALYTIC AFFECTION OF THE LEGS. APPLY a large vesicatory to the os sacrum and loins. Electricity, much exercise, strait stockings, liberal use of the flesh brush, dry vomit, cold bath. See PALSY. DISORDERS (193) DISORDERS PECULIAR TO FEMALES. CHLOROSIS. THE Green Sickness, as it is commonly called, is a distemper that attacks females generally before pu- berty, and sometimes (if there is no eruption of the ca- tamenia) long after. It is also termed Febris alba and Morbus virgineus. The causes. A deficiency of the vital heat, a predo- minant acid in the stomach, a lentor of the blood, vi- tiated quality of it. An over proportionate quantity of serum, pining, inactivity, dyspepsia, too profuse secre- tion of the succus pancreaticus, vegetables, fruit, sugar, deficiency of bile. The diagnostics. A sallow, pallid, or livid counte- nance: laxity of the muscular fibres, inflated eye-lids, swelling of the ancles, and sometimes of the abdomen; indolence, aversion from exercise, especially running or walking fast; the respiration difficult and anhelous; pica and malacia, cephalalgia, a palpitation of the heart, green stools, sour breath. The prognostics. This chronical disorder is some- times of long continuance, without producing any re- markable ill consequences: sometimes sehirrosities pro- ceed from it: it is rarely difficult of cure; menstruation often carries it off. Feeding on chalk, tobacco pipes, and such like, is not the cause, but the effect of this disease. The cure. The regimen should be the same as in Weakness of the Solids. First give an emetic, the pro- perest is a grain and half of blue vitriol, not drinking I any (194) any thing to work it off; the best time to take it is in the morning fasting; afterwards, uterine cathartics and corroborants, especially chalybeates; the cold bath may be used to advantage. Exercise is necessary. Some bleed in the Saphœna; but to lessen the quantity of that important fluid in such cases, as has already been observed, is inexcusable indiscretion. From the subsequent tribes an efficacious formulæ may be easily contrived. The gums, as ammoniac, galbanum, sagapenum, opoponax, guaiacum, asafœtida, olibanum, myrrh, ben- jamin, styrax, mastic, frankincense. Aromatics, as winter’s bark, cinnamon, ginger, ze- doary, all piperines, cloves, nutmegs, and such like. Bitters, as gentian, galangal, centaury, aloes, camo- mile, carduus benedictus, which yields a pleasant bitter in a cold infusion, round birthwort, orange peel, &c. Emmenagogues, as savin, castor, dittany of Crete, borax, penny-royal, rue, mugwort, white bryony root, stinking orrach, black hellebore, salt of amber, vitriol- ated, or tartarised iron, calomel, balsam of copaiva, or compound powder of myrrh. Take of tincture of muriated iron, half an ounce, Twenty drops, night and morning. See MENSES SUP- PRESSED. WHITES. THIS is a disorder females of all ages are subject to. The (195) The causes. A laxity of the glandular fibres of the lacunæ, suppression of the menstrual discharge, sprains of the loins, hard labor, hypercatharsis, profuse bleeding, blows, falls, weakness of the solids. The diagnostics. A constant oozing from the os ex- ternum uteri of a white matter, sometimes thin, yellow, or brown: fœtid, sensation of heat in making urine, syncopes, anorexia, pain in the back and loins, increased by exercise, atrophy, Hypocratic countenance. The prognostics. It is not very easy of cure. Wo- men are generally troubled with it a great while before they apply for assistance: to this natural bashfulness they owe more bad consequences than they ever suspected. It is often productive of many dreadful disorders, which might with great facility have been prevented; as con- sumptions, procidentia uteri, dropsy, internal ulcers, &c. The cure. The most nourishing diet is necessary, as milk, meat broths, shell fish, and such like. For her breakfast, two drachms of isinglass may be boiled in milk. The dry vomit is of considerable service, as also are lenient cathartics, magnesia, which alone is some- times efficient, agglutinants, lime water, and Spa water. The most proper astringents are tormentil root, aroma- tics, roch allum, acetated ceruse, and chalybeates.— Twenty drops of the balsam of copaiva may be taken twice a day, or a tea-spoonful of tincture of cantharides, which has an excellent effect. Take of gum arabic, two ounces, Red astringent gum, Olibanum, of each half an ounce, Balsam of copaiva, enough for an electuary, Dose, the size of a chestnut, night and morning. I2 Take (196) Take of conserve of red roses, two ounces, Yellow wax, half an ounce, Rhubarb, two drachms, Filings of iron, Galangal, of each a drachm, Tincture of cantharides, enough for an elec- tuary, The size of a nutmeg to be taken twice a day. Take of blue vitriol, a scruple, dissolve in Boiling water, an ounce; An injection, to be used warm, twice a day. See GLEET. HYSTERICS. HYSTERIC Fits, notwithstanding the various shapes they appear in, are too well known to need any description. The causes. An unequal distribution of the vital heat, owing in some measure to the peculiar conformation of the uterus and its adjacent parts; suppression, or defi- ciency of the menstrual flux, sometimes to its profusion: delicacy of constitution, luxury, want of exercise, strong inclination to venery, fluor albus, want of blood, acid gas. The diagnostics. Syncopes, catchings, rising of a halitus in the throat, sometimes so as to endanger suffo- cation, convulsions, clavus hystericus, quick respira- tion, laughing, screaming, crying, the hands strongly closed, bawdy expressions, colic, cephalalgia. The prognostics. If the patient has been long trou- bled with them, they often terminate in a perpetual causeless (197) causeless timidity; madness, or all the horrors of the hypochondriacal affection, to which this disorder is very similar. It is by no means dangerous, or if scientific- ally treated, difficult of cure. The cure. All evacuations are deleterious, the dry vomit excepted, which succeeds wonderfully, if fre- quently repeated, and its propriis viribus sufficient to effect a cure; but if objected to, the practitioner will find various formulæ, which have proved efficacious, subjoined. Chalybeate waters are highly necessary; opiates are sometimes so. The cold bath. If the head is affected, let it be shaved, and a blister laid over it. See HYPOCHONDRIA, EPILEPSY, and FLATUS. Take of prepared kali, two scruples, Pure nitre, a scruple, Purified salt of amber, seven grains, Penny-royal water, an ounce and half, A draught, to be taken every night, for some weeks. Take of ginger, half an ounce, For six powders. One to be taken night and morning. Twenty drops of the oil of amber may be taken night and morning. If costive, Take of socotrine aloes, Filings of iron, Asafœtida, of each two scruples, Oil of amber, twenty drops, Simple syrup, enough for pills, Number twenty-four; two to be taken night & morning. Take of galbanum, half an ounce, Camphire, half a drachm, Oil of amber, twenty drops, A (198) A plaster to be applied to the navel. If laxative, Take of aloes, half a drachm, Purified opium, Camphire, of each a scruple, Simple syrup, enough for pills, Number twelve; one to be taken at night, or oftener. Take of red bark, six drachms, Valerian, half an ounce, Filings of iron, a drachm, Conserve of sloes, an ounce, Syrup of ginger, enough for an electuary, Dose, the size of a walnut twice or thrice a day. MENSES SUPPRESSED. AN obstruction of the menstrual flux is either total or partial, when there is a small drain, and the colour not florid, nor the appearance regular at the stated times. The same method of cure is requisite. The cause. A deficiency of blood. Some have sup- posed that an universal plethora may be a concomitant of this disorder; to speak my own sentiments, I verily believe that it is never the case; a partial plethora, in- deed, or which is the same thing, an unequal distribu- tion of the vital heat, often may and doth accompany it. The diagnostics. Anorexia, pale or bloated counte- nance, fluor albus, cephalalgia, vertigo, palpitation of the heart, pain in the loins and thighs, swelling of the ancles, hysterics. The prognostics. If it is total, the cure is difficult, but by no means impracticable, as some moderns sus- pect, (199) pect, (unless succeeded by a phthisis) or from salivation; in pinguedinous habits, it is of little consequence; if partial, easily procured; if symptomatic, the primary cause must be removed. The cure. The dry vomit is of admirable efficacy. For regimen, see WEAKNESS of the SOLIDS. If once the blood is sufficient in quantity there is no fear of the obstruction being removed. Balsam of copaiva, is an excellent auxiliary. See CHLOROSIS. One remark may not be amiss, viz. that if no extraordinary incon- venience attends the too little or too great discharge of this sort, it is best not to interfere by the use of medi- cines, but leave nature entirely to herself. Take of socotrine aloes, a drachm, Filings of iron, two scruples, Precipitated sulphur of antimony, half a drachm, Calomel, a scruple, Oil of savin, twenty drops, Simple syrup, enough for pills, Number thirty-two; two to be taken every night, or oftener. Take of compound tincture of savin, Tincture of black hellebore, of each an ounce, Of these drops let two tea-spoonfuls be taken twice a day. See FLATUS. MENSES IMMODERATE. THE menstrual discharge is sometimes so profuse as to super-induce a large tribe of the most formidable disorders. The (200) The cause. Weakness of the solids; consequently a want of elasticity in the fibres of the mouths of the ute- rine, or vaginal arteries, and deficiency of vital heat. The diagnostics. Laxity of the muscular fibre, thin, light, lank hair, flabbiness of the flesh, pallid counte- nance, syncopes, anorexia, swelled ancles, cachexy. The prognostics. If after abortion, parturition, or if the patient is above fifty years of age it must be very profuse to prove dangerous. If the age is about thirty, and it is succeeded by a spontaneous total suppression, it is always fatal. If of long continuance, and always immoderate at the periodical returns, and the patient under forty, it cannot be restrained too soon. The cure. It is surprising that all practitioners who have wrote on this subject, propose phlebotomy, by way of revulsion forsooth: such practice cannot be too much execrated. A vomit is a more speedy, more effectual, and far safer remedy. For regimen, see WEAKNESS of the SOLIDS. The exercise should be very gentle. The medicines necessary are agglutinants, astringents, corroborants, and sometimes opiates. A cloth dipped in vinegar, may be laid on the abdomen, or loins. Take of gum arabic, two ounces, dissolve in pure water, a pint, Of this mixture let a tea-cupful be taken two or three times in a day, or as often as there is occasion. Give a scruple of roch allum every half hour till it vomits; afterwards as much of the red astringent gum, as often as is necessary. She may eat of conserve of red roses to the quantity of an ounce in a day. To prevent a return, Take of red bark, an ounce, Mastic, half an ounce, Filings (201) Filings of iron, a drachm, Mucilage of gum arabic, enough for an elec- tuary. The size of a nutmeg to be taken night and morning. Take of alcohol, six drachms, Oil of turpentine, two drachms, Vitriolic acid, one drachm, Of these drops, twenty or thirty may be taken morning and night. Take of olibanum, a drachm and half, Cinnamon, half a drachm, Venice turpentine, enough for pills, Number twenty-four; three to be taken night and morning. If costive, Take of conserve of red roses, an ounce and half, Yellow wax, half an ounce, Rhubarb, two drachms, Galangal, Filings of iron, of each one drachm, Syrup of ginger, enough for an electuary, Dose, the size of a nutmeg, twice a day. FALLING DOWN OF THE WOMB. THE Falling down of the Womb is owing to a re- laxation of its ligaments, or to some violence used in labour. The (202) The cause. Falls, strains, shocks, fluor albus, the forcible (though needless) plucking away the placenta, weakness of the solids. The diagnostics. Great pain when sitting still, or at stool, difficulty of making urine, sometimes convulsions and mortification. The prognostics. If the patient is pregnant, the case is always dangerous; if the part is not reduced, it may turn gangrenous; if the ligaments are broke, scarcely curable. The cure. Let the patient try to reduce it herself, by the means prescribed under Falling down of the Fun- dament. Or, lay a crown piece, with a small piece of wax candle, lighted, on the middle of it, on the abdo- men: put a tumbler glass over it and the pressure of the air will soon restore it to its proper place. If she is with child, let the abdomen be supported by a bandage. She should be kept lying on her back (with her hips raised and her legs crossed) as long as possible. Use clysters, astringent injections, fomentations, suffiments, and pessaries. See the drops in the last article. DISORDERS PECULIAR TO PREGNANCY. NAUSEA and Vomiting. Give frequently twenty drops of diluted vitriolic acid in a tea-cupful of strong mint tea; or if necessary, opiates. See VOMIT- ING. Diarrhœa. See that article. Costiveness from the pressure of the fœtus. Admi- nister fat oily clysters. A powder composed of two parts (203) parts magnesia and one of rhubarb; of this let half a drachm be taken occasionally. Heart-burn. Two scruples of chalk and one of gum arabic may be taken as often as necessary, if not cos- tive; if that is the case, give as much magnesia, drink- ing half a pint of broth after every dose. Syncopes. Use cardiacs, volatiles, opiates, strong soups, and jellies. Longing. Whatever is craved may be given with safety, and ought by all means to be procured as soon as possible. Swelling of the ancles, legs, thighs, or breast. Use lenient cathartics, absorbents, diuretics, diaphoretics, opiates, rest; if the legs, they cannot be kept too much in a horizontal position. Pain in the loins. If from the weight of the fœtus, let the abdomen be supported by a bandage. Cardiacs and rest are necessary. Oedematous tumors of the os externam. Scarifica- tion. Dysury. Agglutinants: the catheter. Dyspnœa. See COUGH. Bearing down. See ABORTION. Flux menstrual or hæmorrhoidal, treat as at other times. False conceptions, or moles, leave to nature. If any thing is given, it should be taken from the emmena- gogue tribe. Pretty violent exercise may be used. ABORTION. (204) ABORTION. THIS and every other disorder to which a woman during the state of her pregnancy is liable, is chiefly, if not entirely, owing to a deficiency of heat and blood; which may easily be gathered from the consideration of the expence she is at for the nutrition of the fœtus, and the formation of its appurtenances; if two ounces of blood were drawn every day from a person ever so healthy for forty weeks together, let it be left to com- mon sense to determine whether such an one can stand in need of supernumerary venæ-section during that time. It is upon this account that their faces appear so thin, their noses pinched in, and various disorders attack them which originate from a deficiency of blood. If a woman with child is bled, says Hippocrates, a miscar- riage is endangered; the larger the fœtus, the more certain and expeditious will be the abortion. Expe- rience confirms the truth of this observation of the di- vine old man. I knew many ladies who used phlebo- tomy during their pregnancy, and miscarried; but on the omission of it, went out their full time and were delivered of healthy children. That all do not miscarry who are bled is true, and indeed nothing is more to be wondered at than the inexhaustible resources of nature, by which she can recover herself from the consequences of such ill-timed evacuations. To use phlebotomy be- cause her periodical visits disappear, is absurd and peu- rile, for it cannot be a manly argument that we ought to lavish away that fluid which nature demonstrates her want of by her care to preserve it. Bleeding, in a word, is always hazardous and improper during preg- nancy, and not seldom brings on convulsions and death. To this rash and inexcusable imprudence it is owing that such numbers of women who even go their full time, die in child-bed. The (205) The causes. Weakness of the solids, bleeding, blows, falls, frights, disappointment in that which was longed for. The diagnostics. Pain in the back, loins, and thighs, bearing down; cephalalgia, nausea, quick pulse, flat- ness of the breasts, syncopes, dribbling of the waters from the uterus, flooding. The prognostics. If nature is not counteracted, or disturbed by unnecessary interposition, there is seldom any danger of the mother. If the fœtus is dead (which may be known by syncopes, cold sweats, flushings, ri- gor, or the fœtus falling from side to side) nothing but mild emmenagogues should be given once or twice a day. It may continue in the uterus three or four weeks without any ill consequence, and it scarce ever exceeds that time before nature will effect its expulsion. The cure. Prevention is all we are capable of in these cases. Where there is a proneness to miscarry, from a laxity of the muscular fibres, or if she has miscarried before, it will be necessary to use the same regimen as that recommended under WEAKNESS OF THE SOLIDS, and to keep an issue constantly open. I knew a lady who miscarried twice, then opened an issue, and while it continued had three living children; she then suffered it to dry up and again miscarried; it was cut again shorty after, and she bore five strong healthy children; her issue then dried up spontaneously, after which she miscarried three times successively. The reader is left to make his own observations on this remarkable case. I have often seen amazing effects from the following: Take of French bole, Mastic, of each three drachms, Yellow wax, two drachms, Cyprus turpentine, enough for a plaster, To be applied to the loins, and worn during the time of gestation. Take (206) Take of chalk mixture, six ounces, Spirit of cinnamon, two ounces, A mixture, of which let three spoonfuls be taken morn- ing and night. Take of cannella alba, a scruple, Ginger, ten grains, Aromatic confection, half a drachm, A bole, to be taken every night. Take of red bark, an ounce, Winter's bark, three drachms, Cloves, one drachm, Oil of cinnamon, twenty drops, Mucilage of gum arabic, enough for an elec- tuary, Dose, the size of a nutmeg, morning and night. PARTURITION. THE usual time of delivery is forty weeks after im- pregnation. It has been generally supposed that about the eighth month of pregnancy, the head of the fœtus growing specifically heavier than the body, falls down on the os internum, with the face towards the mother’s back, which was before towards her belly.— This tumble, as the French call it, appears to me to be wholly imaginary, for I never dissected a woman in any state of pregnancy, that the posture of the fœtus was not the same as at the time of delivery, when the birth is natural. The fœtus receives no nourishment but by the um- bilical cord, notwithstanding the numerous arguments which that ingenious and truly excellent anatomist Heis- ter, (207) ter, has used to prove, that it swallows the alimentary liquor before expulsion; a sufficient refutation of all which is, that from the consideration of its posture, and incapacity of breathing, it is impossible. Tn a natural birth, nothing more is necessary than to support and prevent the laceration of the perinæum, leaving the rest to nature. In breech presentations, it is needless to alter the posture of the fœtus, but in all other preternatural positions, search for and extract it by the feet. If the placenta follows not immediately, use no violence; the woman may be ordered to bed: there are frequent instances of its continuance in the uterus for twelve, twenty, yea eight and forty hours, without the least ill consequence. What nature will perform in such cases is scarcely within the limits of credibility: when the head of the fœtus has been left, she has affected the expulsion of it without any assist- ance, and what is still more extraordinary, a living child has been produced from a pelvis, where there have not been more than two inches between pubes and sacrum. It would be far more eligible for practitioners to watch, wait upon, and gently operate with, than even to attempt to hurry, or disturb nature in any of the efforts she may make to relieve herself. In difficult labours, let an emmolient clyster be ad- ministered. If attended with a suppression of urine, the catheter should be introduced: sternutatories may be used to advantage; sometimes emetics and opiates; strong cardiacs ought not to be omitted. Take of balsam of copaiva, half an ounce, The yolk of two eggs, Linseed oil, six ounces, An excellent clyster. Take (208) Take of myrrh, a scruple, Purified opium, two grains, Syrup of saffron, enough for a bole, To be repeated as there is occasion. Take of penny-royal water, six ounces, Spirit of penny-royal, two ounces, Compound tincture of lavender, half an ounce, Of this mixture, three spoonfuls should be given every hour, or every half hour, with one of the following powders: Take of borax, a drachm and half, Myrrh, half a drachm, Make into six powders. To procure an easy labour. A tea-spoonful of the compound tincture of savin, taken every night for a month before the expected time, is a most certain, safe, and efficacious method, as I have experienced in a prodi- gious number of cases. Flooding. Let a cloth, dipped in vinegar, be applied frequently to the abdomen and loins, and be left on till it is dry. See MENSES IMMODERATE. Fever in child-bed. Let her be kept cool and re- ceive constant supplies of fresh air. Give the tartarised antimony in small doses with castor, and cardiacs. Suppression of the lochia. Give a scruple of com- pound powder of myrrh, two or three times a day. AFTER- (209) AFTER-PAINS. AFTER-PAINS are most severely felt by those wo- men who have had more children than one. The causes. A too quick contraction of the mouths of the uterine arteries; a distention of the ligaments, elastic air, retention of pieces of the coagulated blood. The diagnostics. Spasmodic constriction of the loins; shooting pains in the groin, abdomen, or thighs. The prognostics. They are not dangerous, nor diffi- cult to remove; if they cause a suppression of the lochia, use emmenagogues. The cure. Some give half an ounce of oil, not with- out a good effect. That which is given to drink should be supped very warm. The abdomen ought to be swathed pretty tight. Opiates may be given with safety. Take of spermaceti, half an ounce, The yolks of two eggs, Tincture of opium, Oil of juniper, of each one drachm, Penny-royal water, seven ounces, A mixture; of which let three spoonfuls be given every three or four hours, till the pains go off. Or, Take of galbanum, Myrrh, of each half a drachm, Purified opium, ten grains, Balsam of Peru, enough to make twelve pills, One to be taken every hour till the pain vanishes. SORE (210) SORE NIPPLES. DRESS them twice a day with the following lini- ment: it will not disappoint expectation. Take of spermaceti cerate, Balsam of Peru, of eacb two drachms, A liniment. DISORDERS PECULIAR TO CHILDREN. THE disorders peculiar to children are exceeding few which require any assistance. If they are kept very cool (except in winter) fed sparingly and often; have their bodies sufficiently open; be suffered to sleep little in the day time, and almost continually played withand dandled: in a word, let them not be gorged with victuals, and receive sufficient exercise, and nature will do her own business, without any interference, in all disorders that I know of, excepting those mentioned below. When children have any other complaints, the best advice I can give is, to do nothing. Frequent friction with the hand, and almost perpetual motion on the arm, are the best of all prophylactics. My intention in the seventh edition of my work was to have given more particular and diffusive direc- tions for the management of children, but am well pleased to find that intention superseded by Dr. Under- wood’s excellent Treatise on the Diseases of Children, a work worthy of the highest commendation, and which I most warmly recommend to the perusal of my reader. There is one thing indeed, in which I cannot agree with him, viz. the necessity of bleeding in the measles and hooping cough. I have only to say, I never once attended (211) attended a child in either of those disorders, which died, that had not previously been bled. This necessity, there- fore appears to me to be problematical. However, if there are any other errors to be met with in this author, I am persuaded that his work is as remarkable for their trivialness and paucity as Dr. B’s Domestic Medicine is for their magnitude and number. RETENTION OF THE MECONIUM. IF the child has no discharge by stool within six hours after its birth, let a tea-spoonful of oil of olives be given to it, or a few grains of manna, or an oleous clys- ter, or a tea spoonful of rhubarb wine, to be repeated as there is occasion. HYDROCEPHALUS. HYDROCEPHALUS, or the watery head, the best remedy for, if any, is a perpetual blister. It must not be opened; if it is, the child will be irreco- verably lost. HYDROCEPHALUS INTERNUS. THIS disorder is commonly called the dropsy of the brain, because on dissection there is found below the corpus callosum a bag of water generally as large as a goose egg, or two or three ounces of water extravasated on each side of the falx. It greatly resembles the worm fever, these particular diagnostics excepted, constant moaning, shrieking, intolerance of light, enlargement of the pupil, strabismus, and frequent lifting of the hand to the head. It is always mortal. The cause (if not preceded by a blow, or pulling the hair) is un- known. (212) known. I was once in a town where this distemper was exceeding rife. It never attacks any one after the age of puberty. As all attempts are vain, it is pity to give the patient the least painful sensation: blisters are entirely useless. They often live in this pitiable and shocking state till the fifteenth or seventeenth day after the first invasion. The only prospect is from quick- silver. CONVULSIONS. IF symptomatic, the removal of the primary disorder which occasions them is the first object. Those that are most common generally yield to the following: Take of peppermint water, an ounce and half, Prepared kali, two scruples. Balsamic syrup, half an ounce, A tea-spoonful night and morning, or three of four times a day as there is occasion. If primary, Take of tincture of asafœtida, half an ounce, Give ten drops every two or three hours. Take of new milk, an ounce, Peppermint water, half an ounce, Tincture of asafœtida, half a drachm, For a clyster. The above clyster may be given with vast advantage in all convulsive disorders in children. Note. (213) Note.—The prepared kali has all the good effects of absorbents, besides keeping open the alvine tube and urinary canals, it entirely precludes their use. In a diarrhœa, chalk may be used, which is the best of the whole tribe. SCROPHULA. HAVING already treated of the Evil, I should not have resumed the subject, but on account of re- commending a medicine which has perfectly cured infi- nite numbers of scrophulous children. Yet a very emi- nent* Physician has asserted in print, that quicksilver is of no service: I asked him, if he had used it for any length of time? His reply was, not at all, but several Physicians had asserted the same. I think my assertion, which arises from trials, and invariable success in those trials, demands as much attention. Take of muriated quicksilver, ten grains, Muriatic acid, ten drops, Rose water, half an ounce. Of these drops, let three be given to a child from two to four years old every night, or even four drops, if they do not purge (for they must not run off by stool) and the use of them continued for several months, till quite well. I have seen the most astonishing and incre- dible cures performed by them. Glandular tumors in the neck, &c. will sometimes be discussed by the tar ointment, rubbed in morning and night. If they lessen not in five or six days, Take of camphire, half an ounce, Oil of olives, six drachms, Aniseed, one drachm, A * Dr. F. the ingenious author of the Treatise on Bath Waters. (214) A liniment, to be used three or four times a day. Or, Saturnines. If it still continues to swell, or begins to look red, apply a poultice of bread and milk only, repeating it three or four times a day, and let one be laid on at bed time, to be kept on all night. This process to be con- tinued till it breaks, and for a day or two after; then dress, as you will find under the article Evil, which see. TOOTHING. IN six or seven months after birth, children com- monly begin to shew signs of dentition. It is often accompanied with some very untoward symptoms, as violent pain, symptomatic fever, convulsions, partial palsies, and severe diarrhœa. I have seen children lose the use of an arm, of a leg, and sometimes of both, till the tooth was through, and then recover immediately, without any medical assistance. The signs of cutting their teeth are, swelling of the gums, slavering, loose- ness, restlessness, and symptomatic fever. Though opiates are improper for such tender frames; yet in this case (if in any one) they may be allowed, as it is always attended with some danger; no small care is requisite to assist nature through this troublesome pro- cess. Among the many ill effects which a liberal use of Godfrey's Cordial (too often made use of by indolent nurses) or any other opiate, produces in children, may be reckoned costivenes, which is the worst habit of body a child can be subject to. Rub the inflamed gum hard and often with a lump of sugar, even till it bleeds, or give a child a piece of liquorice root to mumble, or divide the gum with a gum lancet, to facilitate the passage of the tooth. There (215) There are few disorders to which children are liable, that are not either caused by, or attended with a predo- minant acid in their stomach and bowels, partly owing to the quick fermentation of the milk in their stomachs, but chiefly to that pernicious ingredient, sugar, in their victuals; this is evident from the sourness of their breath and stools, and the green colour of the latter. Magnesia alba should be given them, not sparingly, if costive; chalk, powdered, if laxative; which two are the only medicines necessary for them while they are suckled. Perhaps it may not be amiss to observe, that five or six months are long enough for any child to suck with the least advantage to itself, or without manifest detri- ment to the mother. WORM FEVER. AS this Fever is only symptomatic, bleeding is un- necessary and improper. A few grains of nitre; or salt of wormwood may be given two or three times a day. If the fever remits, give the bark, than which there is scarce a better vermifuge. For common drink, water sweetened with honey, and acidulated with lemon juice. Of all the various medicines which are used in this case, perhaps none will prove more successful than the following powders: Take of scammony, ten grains, Calomel, three grains, A powder, to be given occasionally. Or, Take of mercury with sulphur, two drachms, Rhubarb, half a drachm, Tartarised antimony, two grains, For (216) For six powders; one to be taken twice a day. Take of Indian pink roots, an ounce, Divide into three parts; of one part make an infusion, by boiling water; two or three tea cupfuls to be taken at once, and repeated occasionally. N. B. This disorder is not uncommon with adults, especially females. TUSSIS CONVULSIA. THE Hooping, or Chin-Cough, as it is called, is dangerous, on account of those spasms of the lungs wherewith it is always attended, and from whence that matter is ejected, when the children hoop and strain, and not from the stomach, as is vulgarly supposed. Take of antimony tartarised, five grains, Water, an ounce, Balsamic syrup, two drachms, A mixture; a tea-spoonful to be taken every half hour, till it pukes, and repeated every other morning. Ten drops of the balsam of copaiva, on sugar, twice a day, ought not to be omitted. Spermaceti, dissolved in broth, is useful; so also is an electuary, composed of nettle-seeds and honey; the asafœtida, were it less nau- seous, is inferior to no medicine. They should be kept as warm as possible. The exercise of swinging is peculiarly serviceable to them. Oil of amber, or garlic, rubbed on the spina dorsi every night, will have a won- derful effect, or a Burgundy pitch plaster, to be worn constantly between the shoulders. See COUGH. Emetics (217) Emetics, eccoprotics, antacides, antispasmodics, as valerian, gum ammoniac, castor, musk, &c. are all of considerable utility, and opiates, if not costive. As a plethoric child is a prodigy indeed, I cannot conceive what phlebotomy has to do in this or any other disorder to which children are liable; whatever their ailments are, the lancet may well be dispensed with. I have seen many, too many instances, in which their lives have been sacrificed to the use of it. Take of prepared kali, two scruples, Peppermint water, an ounce and half, Balsamic syrup, half an ounce, A tea or pap-spoonful to be taken night and morning. WATERY GRIPES. IN this disorder not more than two doses of rhubarb ought to be premised, before recourse is had to astringents, such as the compound powder of chalk, with opium, which is second to none; it may be given from three to five grains, twice or thrice a day. Chalk may be freely given, and any alcalis. The inmost peel of a walnut powdered, and given at pleasure, is excel- lent; or powder of unripe blackberries. In the decline of this and the foregoing disease, large quantities of the bark, in decoction, should be used, to confirm and per- fect their health and strength. SCALD HEAD. LET the head be shaved, if it can be performed with any tolerable convenience, and apply the tar oint- ment, with calomel, rubbing it well in night and morn- ing. K Take (218) Take of tobacco, two ounces, boil in Water, a pint, Till about an ounce is evaporated; then strain, and add a drachm of water of kali. Let a cloth be dipped in this mixture, warmed, and the head be moistened with it each time, previous to the application of the ointment, and the cruel operation of plucking out the roots of the hair will be totally unnecessary. During the cure, small quantities of antimonials and mercurials, combined, will be found extremely ser- viceable, or the solution of muriated quicksilver, or the mixture under SCURVY, which see; but none of them are absolutely necessary. The above topics may be safely trusted to alone. CUTICULAR ERUPTIONS. THESE are very common with children, and are no very unpromising prognostic. They indicate a proper attempt of nature to throw off something that is offensive, consequently they ought to be promoted, and by no means to be repelled by any evacuations what- ever. Bleeding or purging would be equally injurious. In this case animal food, with plenty of salt, is neces- sary. My eldest son, at the age of four years, had a violent eruption all over his body, which soon disap- peared without any medicines, by the liberal use of salt and gravy. No diet is so proper for children as that of animal substance; and the healthiest children I ever saw were those who had been used to it from the time that they were four or five months old. The meat should be minced small, but not be deprived of its most nutritious juices, by being previously & filthily mouthed by the nurse. If children had nothing given them but milk, or half cow’s milk and half water, till they began to teethe, without either bread or sugar, and afterwards were (219) were indulged in the use of animal, with very little ve- getable food, we should rarely find any disorders among them. Vegetables require too operose a process for their tender organs to elaborate into nutritious chyle. See SCURVY, and the mixture and liniment under that article. RICKETS. THIS is a disease that affects the bones of children; the head is sometimes enlarged to an enormous size; the wrists and ancles seem protuberant, and as the bones increase in size, the child grows weaker; indeed every fibre is distended beyond its proper dimension, for the solids are by no means a match for the fluids.— It is chiefly, if not wholly, owing to the sloth and nas- tiness of the nurse. Those children who are much dandled and danced, kept clean, and frequently in mo- tion, carried sometimes on one and sometimes on the other arm, will be for ever strangers to this disorder. For the cure, emetics and rhabarbine purgatives be- ing premised, give chalybeates, the bark, change of air, plenty of exercise, which is absolutely necessary, and let the child be plunged into cold water every morn- ing; but never give it a second, much less a third dip, as is the foolish custom of some. For regimen, see WEAKNESS OF THE SOLIDS. N. B. All drops should be taken in a glass of water, unless otherwise expressed. K2 AS  (221) AS a promise is sacred, however unfairly extorted, it would be unkind for the reader to impute the insertion of the following petit piece to the vanity of the author: TO THE AUTHOR OF THE ART OF HEALING. LONG had Philosophy lain hid in night, Till sapient NEWTON rose, and all was light: So Physic hobbled on, with crippled pace, Veil’d in dark terms, or covered with grimace, Till MARRYAT laid her open to the view, With Truth adorn’d her, and with Reason too. SHARMAN HARROLD. ANTRIM, August 24, 1766. THE END.  (223) INDEX. A PAGE. ABORTION, to prevent—204 After-pains—209 Ague—9 Albugo. See OPTHALMY Anasarca. See DROPSY Angina. See QUINSY —Pectoris. See FLATULENCIES, HUMO- RAS, ASTHMA, and DROPSY Anorexia. Apepsia. See APPETITE BAD Aphthæ—4O Apoplexy—93 Appetite Bad—139 Ardent Fever—6 Arthritis. See GOUT Ascites. See DROPSY Asthma—74 B Bastard Peripneumony—71 Bloody Flux. See DYSENTERY Borborygmi. See FLATULENCIES Bradypepsia. See APPETITE BAD Bulimus 224 INDEX. PAGE. Bulimus—141 Bulimia—ib. Burn—189 C Caducus. See EPILEPSY Cancer—188 Canine Appetite—141 Cardialgia. See HEART BURN Catalepsy. See EPILEPSY Catarrhal Fevers—66 Catarrh Suffocating—68 Catoche. See HEART BURN Causus. See ARDENT FEVER Cephalalgia—78 Cephalæa—ib. Chiragra. See GOUT Cholera Morbus—126 Chlorosis—193 Chorea Sancti Viti—179 Chumosis. See OPTHALMY Colic Bilious—134 —Flatulent—136 —Of Painters—135 Clap. See VENEREAL DISORDERS Cœliaca. See DIARRHŒA Colds. See CATARRHAL FEVERS Coma Vigil. See FEVERS —Somnolentum. See LETHARGY Consumption—43 Contractions—192 Convulsions—147 —in Children—212 Cough—68 —Hooping—216 Cuticular Eruptions—153 —in Children—218 D 225 INDEX. D PAGE. Dance of St. Vitus—179 Deafness—178 Dentition. See TOOTHING Diabetes—143 Diarrhœa—120 Disorders of the Eyes—63 —Breast. See COUGH, ASTHMA, FLATULENCIES, & BASTARD PERIPNEUMONY —Painful—183 —Peculiar to Children—210 —Females—193 —Pregnancy—202 —Venereal—107 —Windy. See FLATUS Dropsy—99 Dysentery—124 Dyspepsia. See APPETITE BAD Dyspnœa. See ASTHMA Dysury. See URINE SUPPRESSED E Elephantiasis—158 Empyema—48 Ephemera. See FEVERS Epilepsy—81 Epiphora. See OPTHALMY Eruptive Fevers—28 Erysipelas—54 Evil—160 —in Children—213 F Fainting. See SYNCOPE Falling down of the Fundament—161 —Womb—2Ol Fevers 226 INDEX. PAGE. Fevers in general—1 —Ardent—6 —Intermitting—9 —Malignant—35 —Miliary—33 —Nervous—ib. —Petechial—35 —Puerperal—208 —Putrid—35 —Scarlet—42 —Slow—33 —White. See CHLOROSIS Fistula. See PILES Flatus—85 Flooding—208 Fluor Albus. See WHITES G Gangrene—187 Glaucoma. See OPTHALMY Gleet—117 Gonagra. See GOUT Gonorrhœa virulent—107 Gout—170 Gravel. See NEPHRITIS Green Sickness. See CHLOROSIS Gripes Dry. See COLIC —Watery—217 Gutta Serena. See OPTHALMY H Head-Ach—78 Hæmoptoe—49 Hæmorrhage—52 Hæmorrhoids. See PILES Heart-Burn—132 Hemicrania 227 INDEX. PAGE. Hemicrania. See CEPHALALGIA Hemiplegia. See PALSY Hernia—186 Hiccough—52 Hip-Gout—177 Hoarseness—68 Hooping-Cough—216 Humoral Asthma—71 Hydrocephalus, or Watery Head—211 —Internus, or Dropsy of the Brain ib. Hydrops. See DROPSY Hydrothorax. See PERIPNEUMONY GNOTHA Hypochondria—90 Hypopyon. See OPTHALMY Hysterics—196 I Iliac Passion, or Twisting of the Guts—137 Imbecility—168 Impotency—ib. Intermitting Fever— Ischury. See URINE SUPPRESSED Itch—156 J Jaundice—103 K King’s Evil—160 L Labor Difficult—207 Lepra Græcorum. See LEPROSY Leprosy 228 INDEX. PAGE. Leprosy—158 Lethargy—166 Lientery. See DIARRHŒA Locked Jaw. See SPASMS, &c. Looseness. See DIARRHŒA Lues, or Pox—113 Lumbago. See GOUT M Madness—24 Malignant Fever—35 Measles—41 Melancholy. See HYPOCHONDRIA Menses Suppressed—198 —Immoderate—199 Miliary Fever—33 Miserere Mei. See ILIAC PASSION Morbilli. See MEASLES Morbus Comitialis —Herculeus —Sacer See EPILEPSY —Virgineus—193 Mortification—187 N Nephritis—56 Nervous Fever—33 Nipples Sore—210 O Odontalgia, or Tooth-Ach—183 Œdema—190 Omagra Onagra See GOUT Opisthotonos—147 Opthalmy 229 INDEX. PAGE. Opthalmy—63 Orthopnœa. See ASTHMA P Painful Disorders—183 Pain in the Back—185 —Breast. See PHTHISIS —Ears—183 —Face—184 —Head. See CEPHALALGIA —Limbs—186 —Loins—185 —Neck—ib. —Side. See FLATUS —Stomach. See HEART-BURN —Teeth—183 Palpitation of the Heart—146 Palsy—97 Paralytic Affection of the Legs—192 Para-Phrenitis—23 Parturition—206 Peripneumony Gnotha—19 —Bastard—71 Petechial Fever—35 Phlogosis Phylctnæ Pterygium See OPTHALMY Phrenitis—21 Phthisis—43 Piles—129 Plague. See PUTRID FEVER Pleurisy—12 Poisons—145 Pox—113 Procidentia Ani—161 —Uteri—201 Psora. See ITCH Putrid 230 INDEX. PAGE. Putrid Fever—35 —Sore Throat—38 Q Quinsy—15 R Retention of the Meconium—211 Rickets—219 Rheumatism—174 Rupture. See HERNIA S Scald Head—217 Scarlet Fever—42 Schirrus—188 Sciatica. See HIP GOUT Scorbutic Eruptions—151 Scrophula—160 & 213 Scurvy—151 Singultus. See HICCOUGH Slow Fever—33 Small Pox—28 Spasms—147 Sphacelus. See Mortification Spina Ventosa. See WHITE SWELLING Sprain—190 Sterility. See IMPOTENCE Stone—61 Strangury—162 Struma. See EVIL Suffocating Catarrh—68 Suffusio. See OPTHALMY Syncope. See FAINTING Synochus. See ARDENT FEVER T 231 INDEX. T PAGE. Taraxis. See OPTHALMY Tenesmus—123 Thrush—40 Tinea. See SCALD HEAD Tooth-Ach—183 Toothing—214 Tussis Convulsiva, or Hooping-Cough—216 Twisting of the Guts. See ILIAC PASSION Tympanites. See DROPSY V Variolæ, See SMALL POX Venereal Disorders—107 Volvulus. See ILIAC PASSION Vomiting—148 U Ulcer in the Bladder—59 —Kidnies ib. —Legs 190 Urine Suppressed—164 —Incontinence of—165 W Watery Gripes—217 Weakness of the Solids—181 Whites—194 White Swelling—186 Windy Disorders. See FLATUS. Worm Fever—215 Worms—150 Y Yaws. See POX and SCORBUTIC ERUPTIONS.            THERAPEUTICS: OR THE ART OF HEALING. BY THOMAS MARRYAT, M. D. NULLIUS ADDICTUS JURARE IN VERBA MAGISTRI. HOR. FOURTEENTH EDITION. BRISTOL: PRINTED BY ROSSER & CO. BRIDGE-PARADE, FOR T. BECKET, PALL MALL, LONDON Price, in Boards, Four Shillings. 1800.  (iii) PREFIXED TO THE TENTH EDITION. AS this book is now calculated for private families, there is no one in the English language will be of such real use to them. Here is no lamentation over the invalidity of domestic medicines. To offer an inefficacious, or even a precarious medicine, betrays a want of common sense and common honesty too; for it can answer no other purpose than to transfer money out of the pocket of the afflicted into that of the Apothecary. Those recommended here are by no means of that description: he that uses them will assuredly find relief, without the least possible disadvantage. Efficacious medicines are always the safest: there are none taken from that enormous mass of poisons in the Scotch Dispensary; no hazardous ones. Such as are offered have already proved efficient in thousands of cases. Cheapness is an object that has never been lost sight of. Thus, for instance, half an ounce of vitriolic acid (for one penny) in a pint of water, is a perfect cure for the Itch. To give one illustration of the utility and importance of this Treatise to industrious poor families.—From FLATU- LENCIES originate more disorders than from all other causes; as loss of appetite, lowness of spirits, wakefulness, listlessness: wandering pains in the sides, bowels, and be- tween the shoulders, costiveness, sometimes a purging: gra- a2 velly (iv) velly disorders, difficulty of breathing, all the horrors at- tending the hypochondrical and hysterical affections, and those which are called Nervous; to which may be added, al- most every internal sensation that tends to render life uncom- fortable. This interefling observation has never before been made public by any other Author. The reader, by turn- ing to the Article Flatus, or Windy Disorders, will find certain, and I need not add, innocent remedies, which will remove the cause of, as well as the above-mentioned disor- ders themselves, when infested by them. The Author has now done with the Public, to whom he has devoted his best and most faithful services. In a very little time the hand that writes this will be motionless for ever: at such a serious period he may expect some confi- dence from his reader. Throughout his whole life (even from his childhood) he never felt any passion so predominant, any satisfaction so great, as in alleviating the miseries and increasing the happiness of mankind. All other pleasures are nugatory and unworthy of pursuit. To this purpose he devoted two hours every day, in all the places where he resided, to relieve the poor. To this he has sacrificed ease, health, affluence, time, studies, and property. Human nature is burthened with innumerable evils; every man should lend a helping hand to lessen the dreadful aggregate. He who can give the slightest pain to a fellow-creature, or procure advan- tage to himself by the sufferings of another, is an animal unworthy of existence. BRISTOL, July 1, 1791. ADVER- (v) ADVERTISEMENT TO THE NINTH EDITION. THIS Work has passed through five quarto editions at one guinea, and four in oc- tavo. In the eighth (1788) which was Six Shillings, the prescriptions were first adjust- ed, and the names of the medicines altered ac- cording to the New London Pharmacopæia. By omitting every thing that doth not imme- diately apply to practice, the Author has at length completed his design of condensing the whole into a pocket volume. This, he hopes, will be an acceptable ser- vice to the Practitioner, as well as of intrin- sic and diffusive utility to mankind. a3 EPISTLE  (vii) EPISTLE DEDICATORY. TO THE ENGLISH APOTHECARIES. GENTLEMEN, THIS Treatise was originally intended for your service, and is now presented to you in as finished a state as I am capable of raising it to. The first Latin edition being soon disposed of in the year 1758, I was requested to give it in English; this I complied with less reluctantly, because a person had already published a translation of the prescrip- tions, with his own directions for their application. He was, indeed, by no means equal to the task; yet his motley work passed through several editions. In a lapse of above thirty years since its first publication, I have, with unre- mitted sedulity, made such alterations and additions as seemed necessary or useful, attentively observing the opera- tions of nature, confirming those observations by experience, with the advantage of a practice as extensive and as success- ful as that of any Physician in Europe. The result of all my observations, and of infinite combinations, during the space of forty years, cannot be unacceptable to ye. Let me add, that there is not a single prescription in the subsequent pages that you can ever make use of to the possible prejudice of viii EPISTLE DEDICATORY. of any person. He that would triffle with the life or health of a fellow-creature, is an object of the severest reprehen- sibility. It has afforded me great satisfaction to know that many of you, who are very eminent in their profession, have for several years administered the prescriptions in this TREA- TISE, with success equal to their most sanguine expectations. As to your pecuniary interest, I never consulted it, and consequently have no reason to expect that you should con- sult mine. Nor have I swerved from the Evangelical rule in that respect, having treated you full as well as myself. The object ever most dear to me was to mitigate the suffer- ings, relieve the miseries, and remove the pains of my fel- low-creatures; to this purpose has my life been devoted. It is with this sole view that I inscribe my work to you. The only favor I ever did, or ever shall request of you is, to dis- pense my precriptions with your usual fidelity and accuracy; to say the truth, I have very seldom had any reason to com- plain: for this (as you are entitled to them) be pleased to accept the warmest acknowledgments of GENTLEMEN, Your humble Servant, THOMAS MARRYAT. PREFACE. (ix) PREFACE. THE publication of a new Pharmacopœia by the Royal College has rendered it necessary for the Author to make some alterations in most of his prescriptions. As this was a task no one could perform for him, it was also one of the most difficult and troublesome he ever engaged in. Many of them required trials, and frequent trials too, after they were adjusted to the London Pharmacopœia. The whole merit of these formulæ consists in their combinations; the least addition or alteration might create an incredible dif- ference in their effect. Many of these prescriptions he can without hesitation pronounce invaluable, on account of those fortunate combinations. We want, says an ingenious Scotch Professor, remedies! remedies! remedies! Surely it is the peculiar province of the Physician to fabricate and apply them. It is his busi- ness to conjoin those ingredients, which alone, or taken sepa- rately would prove inert or nugatory: yet when combined by medical acumen are pointedly directed, and attain energy sufficient to remove the respective disorder. In this, too little adverted to, the whole skill and merit of the Physician consists. x PREFACE. consists. There is scarce a solitary subtance in nature that will remove any one disease always, brimstone excepted, even that cannot be depended on, if used only internally. Has not this triplicate epiphonema bewildered and mis- led many? Has it not stimulated every Scotch pupil to rummage the whole catalogue of poisons? If he can find one, the use of which, on account of its deleterious qua- lity, has for some centuries been proscribed, if he is lucky enough to administer it without killing his patient, like Archimedes, he cries out Eureka, and skips about in an intoxicating extasy. It is presented to the public eye, and he is flushed with the fascinating hope of seeing his remedy hitched up with the curious range of poisons in some future edition of that wonderful production, the Edinburgh Dis- pensatory. With humble submission to the above-mentioned learned professor, we are in no want of materials, if we have skill enough to combine them with propriety. There are in the New London Pharmacopœia more than sufficient to frame a remedy from for any disorder in its own nature curable: as to the other sort the unhappy patient has no chance of being discharged cured from any other place than the Royal Edin- burgh Infirmary. The effects of due combination are beyond measure asto- nishing. We may assign sufficient reasons why two pow- ders, separately inodorous, when combined possess the acutest pungency: or when two liquids perfectly cold, as soon as united xi PREFACE. united take fire and burst into flame, even in the exhausted receiver of an air-pump. In the human body there are so many chemical processes carried on, and such a variety of operations of nature, that the utmost limits of our knowledge of the modus operandi seem to terminate in probability.— Such a combination has produced such an alteration; it is highly probable that such a cause may produce the same ef- fect: as for instance, I have seen a great number of cases wherein the asafœtida has been given in large quantities, and for a considerable time to no purpose; when joined with a chalybeate, it had soon the desired effect. A person labouring under an angina pectoris, wheezing, snorting, and struggling for existence, after every expira- tion, in inexpressible agonies, was entirely relieved from his distress in a few minutes, by half a grain of opium com- bined with the same quantity of cantharides, though opiates had been given before, with aggravation of the complaint. This was a remedy. Opiates exhibited alone will often disappoint the practi- tioner; combined with quicksilver, or an antimonial, or both, as the exigency of the case requires, will almost immediately answer the end designed. The same medicine joined with kali, cantharides, or ipecacuanha, or even chalk, according to the intention and skill of the prescriber, will take an in- credible effect. The bark, that magnum Dei donum, as Dr. Mead calls it, is too often trusted to alone, and with scanty success; com- xii PREFACE. bined with ammonia, or kali, or nitre, or iron, or opium, according to the case, will prove a sovereign remedy: quick- silver itself requires sometimes rhubarb, and sometimes opi- um to assist its operation and efficacy. Guaiacum may be given in large quantities without advantage—dissolved in compound spirit of ammonia, will soon free the patient from his pains. The tartarised antimony, I have lately observed, has in many cases a much better and quicker effect when combined with wine than any other form. This the au- thors of the New London Pharmacopœia were apprised of, as appears by their order to keep a tartarised antimonial wine as an officinal; of an ounce of this wine with two drachms of syrup, if a tea-spoonful is given every three or four hours, it is the most expeditious and efficacious remedy for all fevers of children without exception. It is indeed a feast to the scientific taste to trace that exquisite skill of com- bining so manifestly displayed in that incomparable work.— In this the art of healing wholly consists. To combine with propriety is neither to be learned from books, nor from the mouths of professors; nor is it taught even in that extraor- dinary seminary where every thing else is taught, the glory of the North, the wonder of the world! He who would acquire it must have lain the broad basis of a liberal education, and have attained a most extensive knowledge of things. He ought to know what the learned have thought before him in former ages, and different na- tions. He should possess a vivid imagination, a tenacious memory, and sound judgment to discriminate with precision between things discrepant and things homo geneneous. He must xiii PREFACE. must be well acquainted with the effects of matter on matter. He should have been present at the dissection of a hundred or a hundred and fifty subjects. He must be no stranger to Botany, Chemistry, Pharmacy, or Surgery. His applica- tion must be indefatigable, and his attention to the opera- tions of nature calm, steady, and unremitted. He must be cautious, circumspective, and attentive to the minutest cir- cumstances, with patience and perseverance unrelaxed. By travelling he ought to have informed himself of a variety of things which he could never learn at home. Such a one, by continued observation, and painful experience, may qualify himself to acquire the knowledge of proper and efficient com- binations, consequently of the Art of Healing. From hence it is plain that this Art is to be learned, not to be taught. No books in the world will ever make a Physician. To faci- litate the learning of it should excite the most strenuous en- deavours of those whose business it is to instruct others in the preparatory sciences. To seek for specifics is inexcusable peurility, or the suggestion of desponding indolence. Like some who being in possession of every thing they do want, are incessantly hunting after what they do not want, or that which is unattainable. In cases of difficulty or danger, a Physician must be re- sorted to: for common disorders, the reader will find reme- dies in this book, and rules sufficiently plain to apply them. I now take my final leave of the Public; for at my time of life I cannot expect to make any more discoveries of im- portance, especially as I feel the passion for solitude daily in- b creasing: xiv PREFACE. creasing: it is true, existence is not worth possessing, if it doth not contribute to the ease and happiness of the existence of others. Should I be fortunate enough to mark the pecu- liar effect of any combination in future, an account of it will certainly be found amongst my papers after my decease. READER farewell! and rest assured that the most exalted and refined felicity springs from the disinterested and un- wearied endeavours to lessen the evils of life, and add to the enjoyments of your fellow-creatures. PREFACE, (xv) PREFACE, TO THE FIFTH, AND FIRST EDITION IN OCTAVO, PRINTED IN BIRMINGHAM. FROM the frequent and repeated solicitations of his friends in BIRMINGHAM, to comprise the ensuing work in a pocket volume, the Author has been induced to pre- sent the Public with a treatise, which has been hitherto sold for a guinea, at the price of five shillings: nor can he think any compliment he is capable of paying to this town suffi- ciently expressive of that great sensibility with which his heart is penetrated for their very extraordinary and indulgent partiality towards him. He hopes the exultation is no ways culpable that springs from his heart-felt satisfaction, that none have had reason to repent of the confidence reposed in him. He has not the least intention of attempting to vindicate any thing in this work. Whatever is indefensible he would be the first to execrate; but it may with safety be asserted, that the practitioner who makes use of the methods recom- mended, must be extremely unfortunate who should be always unsuccessful. b2 This xvi PREFACE. This work was not noticed by the Monthly Review till the publication of the fourth edition. See the Monthly Review for April, 1775. That the medicines prescribed are some of the keenest edge tools of physic, must be acknowledged; for, perhaps busy minds might entertain some suspicions of the sagacity or dexterity of that workman who should prefer the use of blunt ones; and if the old adage is true, such a one stands the worst chance of cutting his fingers. The dry vomit cannot deserve the unkind terms of rugged and surly; for the only teasing or vexatious circumstances I have ever known to attend it is, that it sometimes would not vomit at all; and, in cases where that effect has been neces- sary, I have been obliged to double the dose, even in delicate habits, before it could be procured; though, strange as it may seem, the quantity of either ingredient alone would have puked pretty smartly. The Author confesses his temper is naturally sanguine, and that he may sometimes have expressed himself in terms rather too strong; but when it is considered that he relates nothing which his eyes have not seen, some allowances should be made for said strength of expression. He would esteem that person as his best and dearest friend who points out his faults. Whether he is right or wrong in his speculative no- ions, appears to him a matter of equal moment with, whe- ther a goose stands on her right or her left leg. But whe- ther mankind are misled in things relating to their health is an xvii PREFACE. an affair of the last importance, and he would rather perish than offer any thing to the Public which could be the least deceptious on this head. He thought himself the first person who ever gave vomits in internal hœmorrhages, till a gentleman, about ten years after the publication of his treatise, dispelled his vanity, by putting into his hands a book, wrote by old Dr. ROBINSON, above forty years ago, wherein are related a vast number of cases, in which he succeeded by vomits only. It may not be amiss in this place, to make some remarks on that prima facie absurd prescription, under the article Dysentery, of paper boiled in milk. When it was first com- municated to me, by an ancient physician, on the Continent, it afforded no small employment to my zygomatic and bucci- nator muscles. The good-natured old gentleman, without taking any offence at my mirth, only observed, that I might in the course of practice, meet with some things seemingly as ridiculous, which would prove of no small efficacy. Many years passed without the least thoughts of it, till being called to a gentleman's son about nine years of age, previously at- tended by four Physicians, who could be of little service, be- cause the child obstinately refused to take any medicines.— Ashamed to mention the paper dose to any of my brethren, I asked the mother if her son was fond of milk;—she replied in the affirmative; the paper was boiled in it; and, when I visited him the next morning, he was perfectly recovered. At that time I felt a similar sensation with honest Tristram, when reflected on his behaviour to the poor monk. Some time xviii PREFACE. time after, a lady who had been seized with the most dread- ful dysentery I ever saw, in a quarter of an hour after taking the boiled paper, was well. There is certainly nothing so common as to impute effects to causes by no means adequate to the production of said effects. Of this error the Author has been particularly cautious, even to a refined scrupulosity; but where the effect has cœteris paribus, invariably followed, he thought himself entitled for the future to expect it. The large doses of volatiles and narcotics to be met with in these pages, may startle the reader. It is to be feared they are often trified with by an inexcusable temerity. It is a certain fact, that small doses, at different times, have often no good effect, and that the opportunity of saving our patient, which a large dose at first might have effected, is irretriev- ably lost. An extensive experience has convinced me, that many lives are to be preserved by an happy temerity. With respect to the colic, or any other painful disorder, the best method of using electricity, I know of, is, first to draw a few sparks from the affected place, and then to draw the pained part into the electrical circuit, and immediately after to give another shock, at right angles, to the former. The Author did not chuse to adopt any systematical or re- gular arrangement of diseases; but those of which great multitudes have come under his care, are all treated in the subsequent manner. A definition of every disease is first given, sometimes in- deed, not very accurate, but popular and intelligible; for his chief xix PREFACE. chief aim was to express himself with as much plainness and perspicuity as the nature of things would admit of. The various causes by which it may he occasioned follow. The reader will here meet with many latent and unsuspected ones, and some that were never observed before, yet well worth his serious and careful attention. All the diagnostics are subjoined, and pathognomonic symptoms, without which it cannot exists (to preclude all possibility of a mistake) to give him a competent knowledge of the difference of distempers, and enable him to treat them with certainty and precision. The invariable prognostics are added to satisfy a natural curiosity which prompts us to inquire whether it will termi- nate in health, another disease, or death: nor is the least regard paid to any authors, unless we have seen their asser- tions confirmed by a series of instances, and irrefragable experience. The cure is the next and most important point that comes under consideration, including the regulation of the non-na- turals, particularly the dietetic regimen. According to the plan laid down, it is impossible to err in this case, or to be at a loss in knowing whether evacuations are necessary, and which are the most eligible. For instance, if there is too great a quantity of vital heat accumulated, and that accumu- lation be universal, a vein must be opened; but if it exceeds not in quantity, or the accumulation be only partial, as in hectics, xx PREFACE. hectics, slow fevers, &c. nothing can exculpate the practi- tioner for proposing that operation. Lastly, a variety of prescriptions are given, adapted to the various circumstances of the case, and such only as have often proved successful. My attachment (perhaps too violent) to formulæ I readily confess, partly owing to the necessity of writing some scores over night, without which precaution it would have been im- possible to assist the numbers of poor who applied to me in several places where I have been. In what manner they were acquired is of little concern- ment to the reader; some were discovered by accident, others originate from hints received from old physicians, though by far the greatest part are the result of severe study; the utility of which has been confirmed by long, extensive, and painful experience. Such as they are, mankind are welcome to them, as I have no other object in view but their benefit_ He who can conceal that which would be of advantage to millions, for the emolument of a paltry individual, is a despicable wretch, that deserves very ill of society. Si quid novisti rectius istis; Candidus imperti, si non his utere mecum. HOR. THERAPEUTICS: THERAPEUTICS: OR, THE ART OF HEALING. OF FEVERS IN GENERAL. A FEVER exists when the motion of the blood is preternaturally accelerated, which increased mo- tion seems to be caused by an effort of nature to expel something out of the body which ought not to be re- tained within it; but this effect becomes a primary dis- ease from the incapacity of nature to remove it. By Nature, is meant that motive power by which those functions are performed, which are entirely inde- pendent on our own direction or consent; such, for instance, as the pulsation of the heart and arteries, the secretions, &c. Spontaneous actions, or those which are chiefly so, being objects of eligibility, are therefore by physicians termed non-naturals. The proximate cause of fevers is irritation (which may occasion a spasmodic affection of the whole ner- vous system) commonly owing to an obstruction of in- sensible perspiration: when the particles of this mat- ter are thrown back into the circulation, they may stag- nate in, and plug up the extremities of the capillary ar- teries, or bring on spasmodic constrictions of them. An irritation may also be owing to other causes, as acrid food or liquors, affections of the mind, hunger, A the (2) the absorption of pus, any thing acrimonious coming into contact with the extremity of a nerve, intense study, agrypnia, profuse, venery; propulsion of the blood into the lymphatics, which is then called an inflam- mation. The diagnostics of an inflammatory fever. Parching heat, intolerable thirst, high coloured urine, without sediment; velocity, hardness and fullness of the pulse, pain in the head, side, back, or loins; a dry furry tongue, anxiety about the præcordia, difficult respi- ration, coma vigil and aversion from food. Fevers generally begin with a previous sensation of chillness, shivering, or intense cold; less or more, longer or shorter, external or internal, according to the variety of subjects, causes, or fevers themselves. The prognostics. Every fever terminates in health, another disease, or death. In health, when the morbific matter is subjugated by the fever, loosened, rendered moveable, and at length expelled by insensible perspiration, Sweat, salvia, vomiting, urine, or diarrhœa; a crisis usually coming on within fourteen days. In another disease, when the vessels are injured by too violent an exagitation; the more fluid parts dissipated, the rest incrassated, and the critical matter deposited in vessels which are obstructed, dilated, or ruptured; hence arise pustulous, red spots, erysipelas, phlegmons, buboes, schirri, exanthemata, abscesses, gangrenes, and mortifications. In death, when the increased accumulation of the vital heat overcomes the elasticity of the muscular fibre, and retains the heart in its diastole; or when the fluids are de- stroyed by the force of the solids, hence arise inflam- mations, superations, gangrenes in the vital viscera, and (3) and aphthous ulcers in the primæ vitæ; which last, though seldom noticed or suspected, appear from dis- sections to be a common cause of death. The curative indications. These direct to the correc- tion and expulsion of the acrid irritating matter, with unremitted attention to the vis vitæ, that it may not be too much diminished; while the motion of the blood must be restrained within due bounds, and the redun- dance of heat expelled. As to regimen, fresh air is absolutely necessary, which may be admitted by the door or windows, as often and as long as may be thought convenient; vinegar should be frequently thrown on a red hot iron in the room: nor would it be a trifling melioration of the air to set pots near the bed with some of the aromatic plants growing in them, such as lavender, rue, rosemary, or mint, but by no means to suffer any herbs which are not in a state of vegetation to continue in the same room with the patient, nor these after sun-set Clean linen refreshes, and may safely be allowed every day, or every other day at farthest. Let him not to be con- fined wholly to his bed, but sit up every day, as long as he can without fatigue. He should be plied plentifully with diluting liquids, for it is impossible that he can drink too much: what the fluid is, is not very material, provided it be taken in immense quantities: even cold water, if required, may be drank with safety and advantage. The subse- quent diluents are exceeding suitable, viz. barley water, with forty drops of spirit of nitrous æther in every pint, decoction of hartshorn, cider whey, tea prepared from balm, sage, mint, penny-royal, or mother of thyme. A lemon squeezed into a pint of water, and sweetened to the taste with treacle, is of considerable utility. Three spoonfuls of vinegar in a pint of water, sweetened with honey, is another very proper ptisan, as is also vinegar whey. A2 When (4) When nature verges towards a secretion, diaphore- tics, or at least a warmer regimen becomes necessary to help on coction and a crisis; depuration is the work of nature: if she is languid, assist her with cardiacs, aromatics, and volatiles: then blisters are highly proper (especially to the corpulent), to quicken the circulation, dissolve the viscid and too bulky sanguineous corpus- cles, and to forward secretion through the miliary glands. When the fever is subjugated, let the patient take that which affords the smallest employment for the chylopoietic organs, with antiputrescents, salts and acids; whatever food is allowed should be given in small quantities and often repeated: spoon-meats, broth, panada, bread pudding, and such like. It is a fortunate circumstance that persons, while a fever con- tinues, seldom feel any inclination to eat, for the chyle cannot then be properly elaborated. After the ravages of a fever, and to remove that distressing langour which arises from too profuse evacuations, nothing is so pro- per as strong broths drank as frequently and as copi- ously as the stomach will bear. I have often enjoined the use of them, though the pulse continued quick and ticking, while flushings and partial heat remained, and the patients were thought to be at the last gasp, with amazing success. If a vehement craving is manifested of something par- ticular to eat, and if it be often requested—let it be what it will, it ought not to be refused: in the decline of fevers, there seems to be something in these untoward hankerings of nature analogous to the pica in chlorotics, whose eager desire of chalk and tobacco pipes is by no means, as some suppose, the cause of their disorder, but the predominant acid in their stomach (the primary disorder), which naturally instigates them to feed on such things. The cure. If the strength of the patient will bear it, use venæ-section. Cooling (5) Cooling clysters may be administered with great propriety, as, Take of pure nitre two drachms, Honey of roses one ounce, Sweet whey seven ounces. Make it a clyster. It will be found no inconsiderable auxiliary (especially for children) to bathe the feet and legs with warm water two or three times a day. The following mixture may be drank at pleasure. Take of pure nitre half an ounce, Juice of lemons seven ounces, Cochineal two drachms, Water a gallon, Sugar as much as you please. Let it be made a mixture. On the first appearance of a fever the subsequent bolus will generally answer and remove it in a few hours. Take of pure nitre, Camphire of each a scruple, Conserve of wormwood half a drachm. Make it a bolus to be taken at night, and if necessary, to be repeated the next morning, the patient being con- fined to his bed till the sweat goes off. Any fever may be soon extinguished by the use of the following powders: Take of tartarised antimony, five grains, White sugar (or nitre) a drachm. Let (6) Let them be well rubbed in a glass mortar, and be di- vided into six powders: one to be taken every three hours, notwithstanding the nausea the first may possi- bly occasion. If they bring on a diarrhœa, they should be still continued, and it will soon cease spontaneously. If these are taken (which is most commonly the case) without any manifest inconvenience, let there be seven grains in the next six powders; and in the next, ten. Here I beg leave to retract what I said in the former editions of this work, viz. that till sickness and vomi- ting was excited, this noble medicine was not to be de- pended on.——For I have since seen many instances wherein a paper has been given every three hours (of which there have been ten grains in six powders) with- out the least sensible operation, either by sickness, stool, urine, or sweat, and though the patients had been un- remittedly delirious for more than a week, with subsul- tus tendinum, and all the appearances of hastening death, they have perfectly recovered without any other medicinal aid, a clyster every other day excepted. I have lately seen a great many cases similar to the above, and the tartarised antimony has invariably produced the same effect. ARDENT FEVER. AN ardent fever is attended with a preternatural and universal heat; if it is continual and termi- nates in twenty-four hours, it is called Ephemera; if it should last longer, it is termed Causus or Synochus. The putrid. Synochus, as the Antients called it, has for its concomitants a burning heat, vehement thirst, aversion from food, intolerable anxiety, a dry furred tongue, unnatural respiration, restless nights, and a crude, thick, or red urine without sediment. The (7) The cause, as has been already remarked, is irritation. If that which ought to be expelled from the body is re- tained within it, a consequential putrefaction ensues, from whence the putrid synochus and other putrid dis- eases. The diagnostics, or pathognomonic symptoms are in- tolerable thirst, prodigious heat over the whole body, the tongue dry, rough, yellow, or black: coarctation of the lungs, consequently difficult and laborious respi- ration, quickness and hardness of the pulse; pain in the head, flame-coloured urine, costiveness, anxiety about the præcordia, agrypnia. The prognostics. It is most commonly mortal on the third or fourth day, or resolved by an hæmorrhage. The face red and clammy; the urine thin, small in quantity, black or bloody; a parotis not suppurating, spasmodic constrictions of the bronchia, all forebode great danger. But if the patient snatches, fumbles with his fingers, gathers up the bed clothes, seems to pick straws, drops involuntary tears; if purple or livid spots appear, if the hypochondres are inflated, the extremities cold, with catchings of the breath, insensibility, cold sweats, hic- coughs, ratling in the throat: any of these are delete- rious symptoms, and most of them generally quick fore- runners of the last catastrophe. The cure. Assist nature in her efforts to expel the morbific matter in the same method whereby she at- tempts to do it, whether by hæmorrhage, vomiting, sweat, or urine.—Give great quantities of diluting li- quids. Draw off blood from a large orifice as soon as possible, and repeat the operation according to the in- dication of symptoms, though after the third day phle- botomy cannot be used with propriety. If (8) If the vital strength has been indiscreetly reduced by too frequent venæsections; on recovery, give cardiacs, volatiles, and strong broths. When the fever remits, give the Peruvian bark. The medicines which have been found successful in the cure of ardent fevers are to be met with below: either of which formulæ may be adopted according to the dis- cretion of the practitioner, or the tartarised antimonial powders recommended under the article, fevers in ge- neral. Take of pure nitre, two drachms, Compound powder of contrayerva, Calcined antimony, of each one drachm. Make into six powders. One to be taken every three (or two) hours. Or, Take of prepared kali, Pure nitre, of each a scruple, Pure water, an ounce, Spirit of nutmeg, Juice of lemons, of each two drachms. A draught to be taken every third hour. Or, Take of acetated kali, half a drachm. Pure nitre, fifteen grains, Pure water, an ounce and a half, Spirit of Nutmeg, two drachms, Compound spirit of ammonia, twenty-five drops. A draught to be repeated every three hours. The use of cardiacs is not to be dispensed with even in disorders arising from a plethora; for if nature is not kindly supported, she cannot free herself from such disorders; add to which, the languor arising from ne- cessary evacuations is sometimes fatal for want of pro- per strengtheners and nutritious restoratives. INTER- (9) INTERMITTING FEVER. AN intermitting fever (or ague) is one that returns after the patient is wholly free from it for one, two, or more days, with fresh and increased exacerba- tion. The causes. A viscidity of the arterial fluid, occa- sioning a quicker and stronger contraction of the heart; an obstruction, or unequal distribution of the vital heat; a predominant acid in the primæ viæ; so that the cause seems rather to originate in the nervous influence, for the bark will profligate this disorder, and the same drug is equally efficacious in the removal of hysteric passions. The diagnostics. An oscitancy, sensation of lassi- tude, rigor, quaking, paleness of the extremities, diffi- cult respiration, anxiety about the præcordia, nausea, vomiting, pain in the back; loins, and limbs, the pulse quick and small, the urine thin and crude; then follow heat, flushings, redness, strong pulse, intense thirst, violent pain in the head, and the urine red as in a con- tinual fever; afterwards the patient falls into a profuse sweat, the symptoms remit, the urine grows thick, with a sediment like brick-dust; sleep and debility succeed. The prognostics. Sometimes it changes its type, and is converted to a dangerous continual fever; but this is peculiar to plethoric habits. Sometimes it terminates (in cachectic habits, or if not treated scientifically) in a dropsy, jaundice, phthisis, or scirrous tumours of the abdomen; though these disorders may with more pro- priety be imputed to bleeding, than be numbered among the natural consequences of intermittents. If properly managed, it is to be subjugated with great facility. The cure. If plethoric, which is very rarely the case, bleed. If there is much nausea, furriness of the tongue, a bitter taste in the mouth, or frequent retchings, give A3 a puke (10) a puke immediately. The following repeated every morning, will be alone sufficient to remove most inter- mittents. Take of blue vitriol, Antimony tartarised, of each eight grains. Make into three powders. Let one be taken early in the morning, fasting,, in a large spoon about half full of water: let the patient strain, but drink nothing with it till he ejects some yellow or porraceous matter; if his sickness doth not then go off of itself, half a glass of brandy should be taken; if that should come up imme- diately, the repetition of it will settle his stomach, and he may then go about his usual business. If this method should be objected to, the bark may be administered as follows, with certainty of success. Take of red Peruvian bark, two scruples, Crude salt ammoniac, five grains, Syrup of orange peel, as much as will make it into a bolus. To be taken every third or fourth hour, during the ab- sence of the paroxysm, washing it down with a glass of port wine, or (which is a very elegant method of dis- pensing it,) Take of red bark, one ounce, Extract of liquorice, two drachms, Oil of sassafras, half a drachm, Mucilage of gum arabic, as much as will make it into an electuary. The size of a walnut to be taken three or four times a day, during the apyrexy. If the patient suffers under great debility, a chalybeate ought to be joined with the bark, as, Take (11) Take of red bark, an ounce, Green vitriol, a drachm and a half, Mucilage of gum arabic, enough to make it an electuary. Dose, the quantity of a nutmeg, three or four times a day, in the time of intermission. Should the bark be importunately objected to, either of the following formulæ will be found to answer ex- pectation: the first is most proper for them whose hot fits are the longest. Take of prepared kali, two drachms, Pure water, seven ounces, Spirit of cinnamon, an ounce and an half, Water of ammonia, half an ounce, Tolu syrup, an ounce. Of this mixture, let three large spoonfuls be taken every three hours, with a draught of cammomile tea. Or, Take of elecampane root, Flowers of sulphur, of each an ounce, Syrup of orange peel, enough to make an elec- tuary. Dose, the size of a walnut, thrice a day. As auxiliaries to expedite the cure, a tea-spoonful of one of the following bottles of drops may be given with either of the above medicines, twice, or thrice a day. Take of water of kali, six drachms, Water of ammonia, two drachms. Make into Drops. Or, Take (12) Take of compound tincture of gentian, six drachms, Diluted vitriolic acid, two drachms, as before. Or, Tincture of muriated iron, twenty drops twice a day. N. B. The flowers of sulphur (in costive habits) given in large quantities, as a table spoonful two or three times a day, will remove most agues. PLEURISY. A PLEURISY is an inflammation of the membrane that lines the ribs, or of the intercostal muscles; the first is called the true, the latter, the spurious, or bastard pleurisy. It attacks all parts of the pleura, and sometimes the mediastinum. It rarely, if ever invades children, or those who have a predominant acid in their stomachs. If owing to another disease, it is called symptomatic; otherwise idiopathic. The cause, is that which determines matter to the pleura; or a metastasis of matter from other disorders, or that of ulcerous tumors, absorbed by the veins; or whatever is the cause of an inflammation; as, expo- sing the naked body to the cold air after exercise; drinking cold water when hot; a blow, a fall, a con- tusion; neglect of usual exercise, or customary evacua- tions; carrying a weight disproportionate to the strength; inflammatory disposition of the blood; a plethora. The diagnostics. An acute continual fever, a hard pricking, serrine pulse; a violent fixed pungitive pain in the side, greatly exacerbated in inspiration: on hold- ing the breath, or in expiration, the pain is milder; a cough almost incessant; a dry furred tongue; the res- piration (13) piration small, frequent, and operose; great anxiety about the præcordia ; perpetual moaning, restlessness, agrypnia. The prognostics. If an hæmoptoe supervenes within three days, it is a sign that the disease will not be of long continuance: if later, it will be the more tedious; if a spitting doth not come on within fourteen days, the consequence will be an empyema and tabes. If it ap- pears mild on the fifth day, and is aggravated on the seventh, it generally proves mortal. The fifth day is often the last. If the expuition be of a dark brown co- lour, tough and excreted with difficulty, this, for ob- vious reasons, is a deadly symptom. The prognosis de- pends much on the respiration: if that is very anhelous, and the patient be really peripneumonic, though he seems hearty, speaks strong, and is in his perfect senses, yet in a few hours the shears of Atropus will perform their office. If a whitish viscous buff should appear on the surface of the drawn blood, or if it be a relapse, the case is dangerous. If a white light spitting is thrown off, and the fever is not very high, the heat equally distributed through- out the whole body, the thirst not very intense, the expuition performed with facility, the spirits not sunk, the dozes easy, and finish without starting; these are all good signs, and where they appear, the cure is not difficult. The cure. Begin with venæ-section from a large orifice, to be repeated as there is occasion, but not af- ter the disappearance of the white crust. Give plenti- fully, and as often as possible, of diluting liquids, blood warm, particularly Rhenish wine-whey, or any of those recommended under the article, FEVERS in general. The tartarised antimony powders, under that article, are not to be omitted. In the interim, viz. two hours after each powder, i. e. every fours hours, let one of the following draughts be given. Take (14) Take of spermaceti, (dissolved in a little of the yolk of an egg,) half a drachm, Pure nitre, a scruple, Pure water, an ounce, Tolu syrup, two drachms, Water of ammonia, thirty drops. Or, Take of acetated kali, half a drachm, Pure nitre, a scruple, Purified salt of amber, seven grains, Pure water, an ounce and half, Syrup of marsh-mallows, two drachms. If the form of a bolus is more agreeable, Take of pure nitre, Olibanum, of each a scruple, Camphire, ten grains, Balsam of Peru, ten drops, Oil of juniper, five drops, Syrup of marsh-mallows, enough to make them into a bolus. Or, Take of pure nitre, Rattle-snake root, of each a scruple, Opiate confection, enough to make a bolus. To facilitate expuition, and appease the cough, let one of the subsequent auxiliaries be used, viz. twenty drops of balsam of copavia on sugar, twice or thrice a day, which has no heating quality, as some suppose, but on the contrary, lowers the pulse; I have seen ad- mirable effects from it. Or, a tea-spoonful of volatile liquor of hartshorn, which is an excellent attenuant. Or, a tea-spoonful of spirit of nitrous æther, either of these to be given in water, two or three times a day. This linctus may be allowed at pleasure, to abate the violence of the cough. Take of conserve of roses, half an ounce, Juice of Seville oranges, Oil (15) Oil of olives, of each an ounce, Syrup of white poppies, two ounces. Make it a linctus. As topical applications are extremely necessary to re- move the pain, and discuss the inspissated fluids, the reader is here presented with various forms which have proved efficacious, though perhaps a vesicatory on the part pained, is as eligible as any of them. Take of water of ammonia, Oil of olives, of each half an ounce. Make it a liniment, with which the affected side should be often bathed. Or, Take of linseed oil, an ounce, Camphire, half an ounce, Oil of aniseed, a drachm. Make it a liniment. Or, apply the simple plaister, or the cummin cataplasm. Or, Take of fœnugreek, Cummin seeds, of each an ounce and half Linseed meal, an ounce, Honey, two ounces, Oil of olives, enough to make it a poultice. Or, cupping, with scarification. QUINSY. A QUINSY, or Angina, is an inflammatory fever, owing to a defluction upon, or some injury done to the thorax, fauces, or lungs, which occasions a dif- ficulty of deglution and respiration. It (16) It sometimes appears without any sign of a tumor, ex- ternal or internal, and is then owing to spasmodic con- striction, and requires the same treatment with the suf- focating catarrh. That which is the object of present consideration is, when there is a real tumor in some part of the organs of the fauces, tonsils or circumjacent muscles. It is usually divided into four species, viz. Cynanche, when the internal muscles of the larynx are affected without an apparent tumor; Pardcynanche, when the external muscles of the larynx are affected without ap- parent tumor; Synanche, when there is an internal tu- mor impeding respiration; Pardsynanche, when the ex- ternal muscles of the fauces are inflamed with a tumor: there are also other species of it, such as the watery, schirrous, suppuratory, gangrenous and convulsive, as well as inflammatory Angina. The cause. Stagnation of a vitiated fluid in the ves- sels, from whence arises a compression of the muscles, as must be the case in all inflammations. The obstruc- tion of insensible perspiration may occasion this. The diagnostics. Difficulty of swallowing, laborious respiration, rigidity of the neck, pricking pains about the cheeks, danger of suffocation, a violent fever, some- times with and sometimes without a tumor. The prognostics. If no swelling appears, it is dan- gerous. If the tumor is large and respiration very ope- rose, present help must be afforded; for if the patient is not soon relieved, suffocation will ensue. The cure. The regimen must be the same as in ar- dent or other inflammatory fevers; for we treat not un- der this head of the pituitous Angina. Let blood be drawn from the arm, the jugular, or the sublinguals, according to the strength of the patient. The part af- fected may be touched with the honey of roses, ren- dered (17) dered acrid. with vitriolic acid. A lump of sugar soaked in camphorated spirits of wine may be suffered to dis- solve slowly in the mouth. Use appropriate gargarisms, linctus; warm cataplasms, for warmth molifies and dis- cusses; vesicatories, clysters, lenient cathartics, and if nothing else will avail, bronchotomy, which may be performed with the utmost safety; were it otherwise, such cases as these would warrant the most hazardous enterprize that could afford the least gleam of hope. I shall now offer some medicines to the choice of the practitioner, the use of which has been attended with success. Seven drops of oil of amber on a lump of sugar, to be kept in the mouth without moving till dis- solved: this has often produced an amazing effect. Take of long pepper, an ounce, Winter's bark, Cloves, of each half an ounce. Boil in a pint of new milk, and let the vapor be re- ceived into the mouth through an inverted, funnel. Take of barley-water, half a pint, Rose-water, an ounce, Honey of roses, two ounces, Pure nitre, half an ounce. For a gargle, to be held in the mouth till it grows warm, and then to be spit out; to be used every three hours. Take of litharge plaister, enough to be spread on a piece of soft leather, that may reach from ear to ear. Take of pure water, four ounces, Honey, two ounces, Spirit of wine camphorated, half an ounce, Spirit of scurvy-grass, two drachms, Water of ammonia, a drachm and a half. For (18) For a gargle to be used every three hours: Take florentine iris root, an ounce, Flowers of sulphur, Long pepper, of each a drachm and half, Oil of wormwood, a drachm, Rectified spirit, enough to make a cataplasm, to be applied warm. Give the tartarised antimony powders. See FEVERS in general. Or, Take of prepared kali, Pure nitre, of each a scruple, Cochineal, five grains, Pure water, an ounce and half, Compound spirit of ammonia, twenty-five drops. A draught to be taken every three hours. Take of acetated kali, Pure nitre, of each a scruple, Volatile salt of hartshorn, seven grains, Pure water, an ounce and half Spirit of nutmeg, two drachms, Sugar, as much as will make it palatable, for a draught, to be taken every three hours. Twenty or thirty drops of either of the subsequent, may be used as auxiliaries, three or four times a day. Spirit of vitriolic æther, Spirit of nitrous æther, Volatile liquor of hartshorn. PERIP- (19) PERIPNEUMONY. A TRUE Peripneumony is an inflammation of the lungs; the parts affected are the bronchial or pul- monic arteries, or the laterial lymphatics; the blood be- ing either obstructed in the former, or propelled into the latter. The cause. Any thing that is the cause of an inflam- mation, which has been already assigned under the ar- ticles Fevers in general and Pleurisy. The diagnostics. A small, sometimes soft, always un- equal, undulatory and frequently dicrotic pulse; swel- ling of the eyes and cheeks; a little frequent and some- what tussiculous respiration; redness of the face, deli- rium. The prognostics. It terminates like all other inflam- mations, in health, another disease, or death. In health, if a plentiful yellow spitting comes on; or even if the expuition be sanguineous; if the respiration begins to be performed with greater facility. In another disease (as a vomica or abcess) if the in- flammatory matter cannot be resolved within fourteen days, as may be known by the cessation of pain, while the dyspnœa remains, the cheeks and lips reddening, with a soft, weak and undulatory pulse. In death, if both lobes of the lungs are affected at the same time; if a coma somnolentum supervenes, a pros- tration of the vis vitæ with grievous depression of the spirits; frequent shedding of tears; complaint of heat in the throat, coldness of the extremities, unabating de- lirium. The (20) The cure is various, according to the different state of the disease and symptoms. Rest of body, and a little dissipation of mind, are highly requisite; as also are baths, vapors, clysters, mild cathartics; medicines, such as in pleurisy, with which in every respect, the treat- ment should be nearly similar, phlebotomy excepted, which must be used sparingly, and with the utmost cau- tion. Boil elder flowers, mallow leaves, and flax-seed, in milk, and let the vapor be received into the fauces by means of a funnel. When the matter is resolved and absorbed by the re- fluent blood, great care must be exhibited, that it doth not settle on some noble part; for which purpose give attenuants, resolvents, demulcents, diluents, absorbents, diaphoretics, diuretics, or cathartics, pursuing that me- thod of expulsions which is pointed out by nature, I shall now, according to custom, propose some remedies, the efficacy of which has been often experienced. For common drink, let the compound decoction of barley be given, or the next. Take of barley decoction, a pint, Simple oxymel, two ounces, Pure nitre, half a drachm. The breast should be often bathed with the following embrocation, three or four times a day at least; I have seen marvellous advantage from it: Take of tincture of opium, Vinegar, of each an ounce, Make a fotus, to be used cold. Take of balsam of copaiva, an ounce. Let ten drops be taken on sugar, three or four times a day; whatever else is given, this is not to be dispensed with. A linctus may be used at pleasure, as, Take (21) Take of conserve of hips, half an ounce, Oil of sweet almonds, an ounce, Tolu syrup, two ounces. Take of spermaceti, (dissolved in the yolk of an egg) a scruple, Pure nitre, ten grains, Pure water, an ounce and half, Tolu syrup, a drachm, Compound spirit of ammonia, twenty-five drops. Make a draught to be taken every two hours. Take of acetated kali, half a drachm, Purified salt of amber, seven grains, Cochineal, five grains, Pure water, an ounce and half, Tolu syrup, a drachm. Make a draught to be taken every fourth hour. PHRENITIS. A PHRENITIS is an inflammatory fever; attended with a constant and fierce delirium. The cause. An inflammation of the brain, or its me- ninges, or of the sentum transversum. If it arises from a primary affection of the brain, it is called idiopathic; if the brain is secondarily affected, symptomatic. The diagnostics. The absurd behaviour of the pa- tient; incoherent, wild or unmeaning discourse; red- ness, rolling, and glaring of the eyes; throbbing, and an undulatory motion of the temporal artery, coma vi- gil, with an acute continual fever. The (22) The prognostics. The true phrenitis is generally mortal on the third, fourth, or seventh day at farthest. If it doth not exacerbate oh those days, it will terminate in a lethargy, or incurable mania. In old men, or origina- ting from an inflammation of the ilium, or lungs, it is mortal. White stools, or white urine are the harbin- gers of death. Æruginous vomiting, spitting at the bye standers, gnashing or grinding of the teeth or snatch- ing of the bed clothes, are the forerunners of a dissolu- tion. If accompanied with laughter, if a gentle sleep supervenes, or the delirium abates at times, a recovery may be expected. The cure. It is to be taken from an inflammation, in general. Open the jugular vein, or (which is prefer- able) the temporal artery. Give antiphlogistic eccopro- ticks, as tamarinds, salts, &c. diluting nitrous draughts, clysters two or three times a day; apply emollient fo- mentations to the anus; if it swells wash with rectified spirits of wine. A fotus should be frequently used to bathe the whole head with, as, Take of camphorated spirit, Compound tincture of lavender, Vinegar, of each an ounce. Bathe the feet and legs frequently with the fotus communis warm. After proper evacuations, apply ve- sicatories to the feet, which have often exceeded my expectation. Opiates. Take of tamarinds, two ounces, hail in a pint and half of water, strain, and then add Currant rob, Glauber's salt, Juice of lemons, of each two ounces. Of this mixture let a tea-cupful be taken every hour till a purging supervenes. Take (23) Take of salt of hartshorn, a scruple, Spermaceti, (dissolved in the yolk of an egg) fifteen grains, Purified salt of amber, ten grains, Pure water, an ounce and half. Let the draught be repeated according to the urgency of symptoms. Or, Take of pure nitre, half a drachm, Camphire, ten grains, Purified opium, three grains, Aromatic confection, enough to make a bolus. Take of camphire, a scruple, Æther, half an ounce. Let it be put into a spoon, and swallowed as quick as possible. PARA-PHRENITIS. A PARA-PHRENITIS is an inflammation of the di- aphragm. This disease is sometimes mistaken for another, which is nothing surprising, for it requires no small degree of sagacity and medical acumen, to dis- criminate an affection of the stomach, kidneys, colon, liver, or pancreas, from that of the midriff. The cause is the same as that of other inflammations. The diagnostics. An accute continual fever, attended with an inflammatory pain, which is greatly exacerbated by every inspiration, or coughing, or sneezing, or eva- cuation of the excrements or urine; a sensation of reple- tion in the stomach, nausea, deep, quick, small, suffo- cative, and painful respiration; perpetual but not vio- lent delirium, frequent laughter, risus Sadonicus, great anxiety (24) anxiety of the præcordia, difficult deglution of solids, convulsions, hiccoughs. The prognostics. This disorder is always extremely dangerous. If the diaphragm supperates, the pus either falls into the cavity of the abdomen or breaking up- wards, produces an empyema. In all other respects the prognostics are the same as in the pleurisy. The cure. Clysters may be administered every hour, even if the bowels became paralytic; for they will ea- sily and soon recover their natural tone without medical assistance. When pus is collected and matured, it must be evacuated. Endeavour to abate the inflammation by bleeding and an antiphlogistic regimen, proceeding ex- actly in the same method as you would treat a pleurisy, which see. MADNESS. MADNESS is a total privation of the due exercise of reason, from some fortuitous injury to the or- gans of cogitation. The cause. A preternatural accumulation of the vital heat, or nervous influence in the brain, with some im- pediment to its usual course from thence along its ner- vine conductors. It is justly called by Galen, intempe- ries ignea cerebri. Its principal seat seems to be in the cortical, while the usual determination of it to the me- dullary part of the brain is prevented; consequently the cerebellum not equally parcipitating of this enlarged quantity of heat, the exit of more than the customary quantity by the par vagum to the heart is precluded; for this disorder is sometimes attended with little or no fever. The (25) The diagnostics. A languid redness of the face, wild- ness and rolling of the eyes, ghastly staring, mischievous- ness, absurd discourse, a plethora. The prognostics. If attended with laughter and ra- ving, it is easier to be removed than if accompanied with sober, steady, studious fixedness of the thoughts on a particular object. There are few cases even if her- editary which will not yield to a proper method of cure. The cure. Elicit the vital heat from the cerebrum, and empty those vessels which perhaps by their turgid- ness occasion that pressure which prevents the usual in- flux by the par vagum. Open a vein; if a fever super- venes, it is a good sign, as I have often observed; this operation should be frequently repeated, for no persons can bear the loss of blood better than maniacs, nor is there any case in which it is so necessary to draw it off, and so many times. After due evacuations, apply vesi- catories, particularly to the head. Drastic cathartics should be given, and emetics can scarce be exhibited too often. Hence note, that disorders of the head by no means contra-indicate the use of vomits. In the declination of this distemper, the greatest care and attention must be paid to all the non-naturals, to preclude a relapse, which is not uncommon where these are neglected. The cold bath is then peculiarly ser- viceable, as is also the plentiful use of broth, which last is not improper, either in the beginning, increase, or state of this distemper. Take of tartarised antimony, seven grains. Let this powder be repeated every hour till it vomits. I have known six of them taken with out any sensible effect. Five grains at least should be given every day, and the use of the following draught continued for a considerable while: Take of prepared kali, two scruples, Pure water, an ounce and half, B Make (26) Make a draught, to be taken twice or thrice a day. See HYPOCHONDRIA. PRACTICAL OBSERVATIONS ON INFLAM- MATORY CASES. IT hath been observed by some ingenious physicians, that inflammatory disorders are by no means so com- mon to be met with as they used to be: to assign the premitive reasons would be no easy matter, for man- kind do not seem to be much more sparing in the indul- gence of their appetites, more averse from wine, or more discreet in their regimen than their forefathers were. May it not with greater propriety be attributed to the in- creased accuracy and precision wherewith practitioners discriminate diseases, who are not so apt as they were for- merly to impute every pain or flushing heat to an in- flammation. The rapid improvements made in the me- dical art within these few years, have occasioned even the abolition of several diseases, whose imaginary exist- ence exceedingly puzzled our ancestors. Another observation, which is equally just and me- lancholy is, that when inflammatory disorders appear, they have generally a fatal termination. Is it not pos- sible that this may, in some measure, be owing to a too hasty and frequent repetition of venæ-section? Na- ture will exert amazing efforts to relieve herself, when the vis vitæ is not much impaired; and I cannot help expressing my apprehensions, that in these cases, in which bleeding is absolutely necessary, it may yet be pursued so far as to incapacitate nature for carrying on the animal functions. For these ten years past I have not lost one patient by an inflammatory fever, yet never ordered blood to be drawn more than once in any case, maniacal ones excepted. As (27) As there are several other inflammatory disorders, which have not been noticed in the preceding pages, it may not be amiss to observe, that a similar, if not the same treatment, is equally proper for them all. Some indeed, as has been instanced in the peripneumony, re- quire a more sparing use of phlebotomy than others. It is to be feared, that to a to liberal use of the lancet, that mortification may be ascribed, which so often su- pervenes an inflammation, as that of the ilium, easy dis- covered by the hasty evanescence of the pain. When there is no inflammation or inflammatory disposition of the blood, nothing can exculpate the practitioner for drawing blood; this would be a wanton waste of the most useful and important of all fluids, and the most neces- sary for the support of animal life; but even in these ca- ses the utmost caution is requisite, lest a putrid disor- der should be manufactured from an inflammatory one. It is not an uncommon (though often an irretrieveable) error, to mistake an obstruction, or acrimony, or seri- ous tumor, for an inflammation, which, if real is—when the rea particles of the blood are forced into the lymphatics, and cannot possibly exist without its pathognomonic sys- tems, viz. violent and universal heat, parching thirst and restlessness, as well as pain in the inflamed part. Inflammatory disorders are far from being common, and many diseases are too often groundlesly ascribed to this cause: that the too precipitate use of the lancet has produced dreadful consequences, I have, in number of instances, been a sorrowful and unavailing witness to. How many have been hurried off the stage by being bled for a pain in the side, owing to an incipient ulcer in the lungs! There are various sorts of fevers, which mimic those of the ardent kind, in which venæ-section must be abstained from. I was in a country one au- tumn where one of these anomalous fevers raged, it spread only through a circle of six or seven miles dia- meter: it resembled, in every respect, an ardent fever, the pulse only excepted, which was neither hard nor full: every one who was bled died, and every one who was not bled recovered: it never shifted its type, though B2 it (28) it commonly continued seventeen days. Those who took the tartarised antimony seemed to be soon freed from all febrile symptoms, yet remained weak, uneasy, and greatly out of order, without being able to tell their com- plaint, as long as the rest. The antiphlogistic method was pursued by them all, nitre, prepared kali, and such like, were the medicines administered, and with suc- cess; yet phlebotomy once used always proved fatal. The peremptory axiom of the famous Dr. MEAD, viz. “in omni febre phlebptomia prius est instituenda,” is certainly not true, or warranted by experience. In plethoric habits, or in real inflammations, from what has been observed, the reader may easily per- ceive what method is requisite for the treatment of any inflammatory case, in whatever part the inflammation may be situated. When the pain is very intense, opiates may be safely and happily administered; of this I have given but few instances in the foregoing sheets, that no countenance might be given to the indiscriminate use of a medicine, where a perfect knowledge of the case, and the discreet direction of a skilful hand, are absolutely necessary. In painful spasmodic constrictions of the capillary vessels, narcotics are undoubtedly indicated: of all the various pretences to be their correctors, I believe none so well deserves that name as the prepared kali, ERUPTIVE FEVERS. THE SMALL-POX. THE Small-pox is a fever of the malignant and con- tageous kind, attended with a general eruption of particular pustules, affecting the human species only, and each individual but once. The variolous pustules in (29) in time become sanious, but those in the measles ap- pear red, dry, and branny, without suppuration. The cause. It seems to be connate with us, and to latitate until some violent exagitation of the blood, from the introduction of a variolous particle, raises the semi- nal ferment, and occasions the appearance of those eruptions. The diagnostics. A frequent and strong pulsation of the brachial and temporal arteries; redness of the eyes, pricking pains in the skin, severe pains in the head, back, and loins; a febrile heat, greatly increased in three or four days, with thirst, vomiting, palpitation of the heart, difficult respiration, tremblings, rigor, deli- rium, convulsions, restlessness, hoarseness, fixedness of the eyes, a ptyalism, purple spots; bladders full of clear water, commonly called the white hives; the pustules usually appear on the third and fourth day, and arrive at their state on the ninth or eleventh, in the distinct sort; in the confluent, they break forth on the fifth day, and continue till the fifteenth or twenty-first. The prognostics. When the pustules come out sud- denly, first red, then white; broad, round, few, dis- tinct, plump, and sharp at the top, there is little dan- ger. If preceded by convulsions in children, it is a good sign. If they come out irregularly, or imme- diately disappear, are exceeding small, confluent, or shew black spots, or a dint in the middle; if attended with a diarrhœa, (in adults) difficult respiration, dry husky cough, bloody stools or urine, continuing deli- rium, colliquative evacuations; these are all very bad symptoms, and most of them deadly. Adults suffer most. Gravid women generally miscarry. The cure. Phlebotomy can rarely be used to advan- tage in any disorder attended with cutaneous eruptions; however, if a lean, plethoric body should be invaded, and the pulse hard, venæ-section becomes necessary. The body should be kept soluble, the vis vitæ sup- ported; (30) ported; let the patient have a constant accession of fresh air in his chamber, a clean shirt every other day at farthest; which may in the worst cases be allowed without any hazard; for common drink, ap- ples boiled in water, or milk and water, equal parts; or wine-whey, or cyder whey, or vinegar-whey, or barley-water, accidulated with spirit of nitrous æther, or spirit of vitriolic æther, or the compound barley decoction; the more he drinks the better. In the con- fluent sort, there arises a ptyalism in adults, and a diarrhœa in children, either of which ought to be en- couraged. To prevent a secondary fever, give lenient cathartics, to be repeated as the strength will bear, at the distance of two, three, or four days, until five purges have been given. After the thirteenth day, the patient may drink plentifully of warm small beer. If the expuition is vis- cid and tough, or molests by its excess, (as it will some- times excoriate the parts) use appropriate gargarisms, syringings, or masticatories. The diarrhœa in adults, on the first eruption, should be restrained by opiates. To preserve the face from disfiguration, previous to the appearance of the eruptions, or while they are coming out, the extremities may be bathed with warm milk, or semicupia of the same may be used. The cooler the patient is kept the fewer the pustules will be. Emetics are of great service in the beginning. Clys- ters may be given occasionally: in cases when the pa- tient is very low, on the approach of a crisis, a good effect may be reasonably expected from versicatories. A narcotic may be administered every night in the con- fluent sort, and ought to be, if the patient is not coma- tose; such as, Take of pure water, an ounce, Tincture of castor, twenty-five drops, Tincture of opium, fifteen drops, Compound spirit of ammonia, Compoun (31) Compound tincture of lavender, of each thirty drops, Syrup of white poppies, half an ounce. A paregoric draught to be taken every night if neces- sary. A linctus is a very convenient and agreeable form to convey a medicine that may increase the ptyalism, and at the same time prevent its being troublesome.— The following is extremely desirable, and may be taken as often as is required, with equal pleasure and advan- tage: Take of conserve of hips, half an ounce, Tolu syrup, Oil of olives, of each an ounce, Vitriolic acid, enough to render it a gratefully acid linctus. If, after recovery, there seems to be a tendency to a phthisis, removal is necessary into a warm dry air, and the regimen should be pursued that is recommended un- der that article. To prevent pitting, let this liniment be applied to the face three or four times a day: Take of camphire, two scruples, Spermaceti, half an ounce, Oil of olives, an ounce, Make it a liniment. It is scarcely necessary to observe, that if an hæmop- toe should appear in the decline of the disease, the use of the bark is indicated. It is to be hoped, that in a little time the practice of inoculating children under three months old will be- come universal, and put an entire end to the ravages of this loathsome and dangerous disorder. The (32) The following medicines have been peculiarly ser- viceable in some very alarming cases: Take of prepared kali, a drachm and half, Pure nitre, half a drachm, Pure water, six ounces, Spirit of cinnamon, Juice of lemons, of each an ounce, Tolu syrup, half an ounce; Of this mixture three spoonfuls to be taken every sixth hour. Or either of the subsequent boles may be given every sixth hour: Take of compound powder of contrayerva, Mercury with sulphur, of each a scruple, Castor, ten grains, Tolu syrup, enough to make it a bole. Take of mercury with sulphur, a scruple, Snake-root, Castor, of each ten grains, Syrup of white poppies, enough for a bole. If a draught is more eligible, one of these draughts may be taken every six hours, viz. Take of acetaled kali, Aromatic confection, of each a scruple, Pure water, an ounce and half, Spirit of nutmeg, two drachms, For a draught. Or, Take of calcined antimony, a scruple, Pure nitre, ten grains, Purified salt of amber, five grains, Cochineal, four grains, Pure water, an ounce and half, Make it a draught. Or, Take (33) Take of kali tartarised, a scruple, Pure water, two ounces, Tolu syrup, a drachm, For a draught. SLOW, NERVOUS, & MILIARY FEVERS. THE Slow Fever is so called from the gentleness of its progress, and length of its continuance. The Nervous Fever receives its name from a sup- posed morbid quality in the nervous influence, or a re- laxed state of the nerves themselves, which is just as imaginary as the other. To say the truth, nervous dis- orders is a mighty handy and convenient expression to conceal ignorance. The Miliary Fever is so termed, from the resem- blance of its eruptions to millet seed. They all proceed from the same causes, and require the same method of treatment. The causes. A deficiency and unequal distribution of the vital heat; consequently, a declension of the powers of nature, a lentor, viscidity of the fluids; a relaxed state of the arterial system, or spasmodic con- strictions of the capillary arteries, some error in regard to the non-naturals. The diagnostics. Chills and flushings, lassitude, nausea, prostration of the strength and spirits, listless- ness, heat in the palms of the hands and soles of the feet, (a certain sign of bradypepsy) while all the rest of the body is cold, and emaciates fast: a sensation like cold water thrown down the back, the pulse quick, weak, and unequal, pale urine, coma, heat and dry- B3 ness (34) ness of the tongue, sometimes with, and sometimes without thirst; miliary eruptions, anxiety, tinnitus au- rium; cold, clammy, or colliquative sweats; convul- sions, delirium, subsultus tendinum. The prognostics. All the symptoms are exacerbated towards night, a tingling noise in the ears is generally the forerunner of a delirium: a copious spitting, or gentle breathing sweats are good signs; profuse sweats are bad ones; insensibility, twitchings of the tendons, involuntary evacuations of the excrements, urine, or tears, are preludes to the last catastrophe. The cure. All evacuations are inadmissible, vomits only excepted; sometimes very lenient clysters, such as new milk and sugar, may safely be administered, if nature inclines to stool. Give mountain wine whey, meat broths strong as the stomach will bear; jellies, panado, with spice, wine, or brandy in it: such things as these may be often offered, though ever so little is taken at a time; the medicines necessary are attenu- ants, restoratives, nervines, and cordials. If the sweats are profuse, let warm napkins be frequently ap- plied to the neck, breast, and abdomen; for though gentle sweats are of service, when they become pro- fuse, they only tend to the dissolution of the patient in a double sense: in this case red port wine and water may be allowed. The neck and breast should be exa- mined every day, for eruptions commonly appear in those parts first: their portent is good, and they indi- cate the use of cardiacs. Take of ipecacuanha, three grains, Antimony tartarised, one grain. Let this powder be taken every morning, out of a spoon half full of water: nothing should be drank either during the operation, or until the nausea goes off spontaneously. Many unexpected recoveries have been (35) been owing to this powder alone. The following also have been amazingly efficacious: Take of aromatic confection. Castor, of each a scruple, Precipitated sulphur of antimony, three grains, Syrup of ginger, enough to make a bolus. To be taken every fourth hour, washing it down with three spoonfuls of the following julep: Take of the camphire mixture, Musk mixture, of each four ounces, Volatile liquor of hartshorn, half an ounce. Or, Take of compound powder of contrayerva, Musk, of each a scruple, Tolu Syrup, as much as sufficient to make it a bole. To be taken every sixth hour, washing it down with this draught: Take of Salt of hartshorn, Aromatic confection, of each a scruple, Pure water an ounce and half, Spirit of nutmeg, half an ounce. The bark, when proper. PUTRID, MALIGNANT, AND PETECHIAL FEVERS. THESE may be classed together in the same man- ner with the last three, because they are each pro- duced by similar causes, and require very little, if any difference, (36) difference, in the method of treating them: to this class also belong the gaol or hospital fever, and the pesti- lence. The cause. A putrescent acrimony, or infectious miasmata, The obstruction of insensible perspiration is no uncommon cause of putrid fevers; for the reten- tion of those particles within the body which ought to have been thrown out of it, may, and often does, oc- casion a speedy putrefaction, especially when there is the least pre-disposition in the fluids to such a dissolution. The diagnostics. Pain in the temples or orbit of the eye; the eye, heavy, yellowish or somewhat inflamed; the face bloated, and of a cadaverous aspect; faintness, operose respiration, frequent sighing, erratic pains, the pulse small, sometimes quick, and sometimes the same as that of a person in perfect health; black tongue, bit- ter taste in the mouth, crude vapid urine; livid pete- chiæ, from the extravasation of grumous blood in the cellular membrane, vibices, aphthæ, furred lips and teeth, little thirst, tinnitus aurium lumbago, colliqua- tive evacuations. The prognostics. A mild diarrhœa is serviceable; the petechiæ florid, a smarting red rash, scabs on the nose or lips, watery vesicles; are all good symptoms. Black urine, or stools, small dusky spots, dun, or greenish; a lurid efflorescence, large livid blotches, black vibices, sweats profuse, cold or clammy; griping and bloody stools, coma and coldness of the extremities, are all symptoms of an approaching dissolution. The cure. The intestinal canal may be cleansed, and the drain kept open by small doses of rhubarb. The regimen necessary is much the same with that in the pre- ceding chapter, particularly with respect to wine, though Rhenish is generally the most eligible, but in case of colliquative evacuations, red port is preferable; give also freely of the vegetable and mineral acids, particu- larly (37) larly the muriatic, Peruvian bark, astringents, antisep- tics, camphire and opiates. Let vinegar be frequently thrown on a hot iron in the room, and a little of the bark of cascarilla be now and then burned in it. Vo- latile alcalis may be used sparingly; but throughout the whole stage of this disorder, withhold the lancet, as you tender the life of the patient. The formulæ subjoined have been peculiarly successful; Take of Red bark, half a drachm, Camphire, three grains, Syrup of saffron, enough to make a bole. To be taken every fourth hour, drinking after it three table spoonfuls of the following mixture: Take of pure water, six ounces, Spirit of horse rhadish, Vinegar, of each two ounces, Sugar, as much as you please. Or, Take of compound powder of contrayerva, two drachms, Tormentil root, Myrrh, of each one drachm, Make into six powders; one to be taken every fourth hour, with the subsequent draught: Take of pure water an ounce and half, Lemon juice, half an ounce, Cochineal, five grains, White Sugar, what you please. Or, Take of Red bark, half a drachm, Opiate confection, from ten grains to half a drachm, Syrup of saffron, enough to make a bole. To (38) To be taken every sixth hour, and washed down with the above draught. Or, Take of burk of eleutheria, half a drachm, Winter’s bark, Myrrh, of each a scruple, Syrup of Saffron, enough to make a bole. To be used as the former. The tartarised antimony powders and opiates, to re- strain the diarrhœa, if requisite, or Norris’s Drops. PUTRID SORE THROAT. THE Putrid Sore Throat is a disorder of the malig- nant kind, which has not been perfectly described or known till within these few years. The cause. A putrid diathesis of the fluids. The diagnostics. Fullness and soreness of the throat, a sensation of stiffness in the neck, redness of the arms, hands, or breast: frequent sighing, nausea, anxiety about the præcordia, languidness, great dejection, re- peated sneezings, agrypnia, thin crude urine, a pulse quick and small, bloated countenance, swelling of the maxillary and parotid glands and tonsils, ulcerations, sloughing of the ulcers. The prognostics. The prognostics depend on the pro- gress of the putrescent acrimony, and on the respira- tion. The cure. All evacuations are deleterious, espe- cially phlebotomy. It requires a similar treatment with other putrid fevers, but is the least rebellious of them all, for the cure is not very difficult. As it is some- times (39) times epidemical, the best orvietan, or preventive, per- haps, is to drink freely of red port; at a time when it was exceedingly rife, they who used this prophy- lactic escaped the disorder. Cordials and gargarisms seem the only necessary aids, as, Take of aromatic confection, half a drachm. Castor, a scruple, Pure water, an ounce, Spirit of nutmeg, two drachms, A draught to be taken every fourth hour. Or, Take of aromatic confection, a scruple, Snake root, Castor, of each ten grains, Syrup of saffron, enough to make a bole, To be swallowed every fourth hour. Take of compound barley decoction, an ounce, Tincture of myrrh, Red wine, Honey of roses, Vinegar, of each half an ounce, For a gargle, to be used occasionally, or every two or three hours. Or, Take of gum arabic, two ounces, Dissolve in one pint of pure water, for a gargle; to which may be occasionally added, as much vitriolic acid as is agreeable. If the ulcers spread or increase, add to the above solution four grains of muriatic mer- cury, dissolved in five drops of the muriatic acid. Be- ware of the use of nitre in this disorder. THRUSH. (40) THRUSH. APHTHÆ, or the Thrush, are little ulcerous tuber- cles, which affect the inside of the mouth, sto- mach, and intestines. The cause. A saline, viscid, or acrimonious lymph. The diagnostics. They appear first on the tongue, or in the corners of the mouth. The prognostics. If white, pelluced, thin, scattered, and superficial, they are of little consequence; if brown, opaque, black, thin, or run together, they forbode some danger. When they have passed through the bo- dy and appear at the anus with excoriation, apply me- lasses. The cure. Assist nature as in other fevers. They are often fatal to adults: whether they who escaped them in their infancy are the only persons liable to be attacked by them, is at least problematical. The treat- ment is the same with that of a miliary fever. The fol- lowing gargle is excellent for infants, viz. Take of gum arabic, two drachms, Lime water, an ounce and half, Tolu syrup, two drachms, It may be used every hour, and if swallowed can do no prejudice to the child. Take of pure nitre, a drachm, Three whites of eggs, Rose water, six ounces, Tolu syrup, an ounce, Let it be made a gargle, for adults, to be used occasion- ally; or the following, which wall answer the same pur- poses: Take (41) Take of gum tragacanth, a drachm, Pure water, seven ounces, Honey of roses, one ounce, Vitrolic acid, twenty-five drops. MEASLES. THE Measles require a treatment not much different from the small-pox. They are both natives of Africa. The cause. Infectious miasmata sui generis. The diagnostics. Small, dry, red spots, like flea-bites; they never supperate, but arrive at their state in four days; an almost perpetual cough, weakness, soreness, or running of the eyes, swelling of the eye-lids, running of the nose, convulsions. The prognostics. It is not a dangerous disorder if not rendered so by mismanagement. The cure. Nature is the best physician in this case; nor does she stand in need of any medicines to assist her. Venæ-sectlon appears to be highly improper, and is most certainly often productive of the most disagreeable consequences; I never ordered it in my life in this case, yet never lost one patient in the measles; nor to say the truth, did I ever hear of one that died who was not bled. If convulsions precede or accompany the erup- tion, they are by no means a bad prognostic; the tinc- ture of asafœtida may then be given with great advan- tage, fifteen or twenty drops three or four times a day. The linctus under the article small-pox may be used at pleasure, as in the small-pox, the little patient cannot be kept too cool. The drink may be cyder-whey, vine- gar-whey, butter-milk,, or for weakly children, thin broth. Medicines are seldom necessary during this dis- order; (42) order; but as soon as the eruptions begin to disappear, cathartics should be exhibited, as in the small-pox, which for obvious reasons, are necessary after all eruptive fe- vers. The subsequent drops are of great efficacy in re- moving the cough which so often remains after the measles. Take of balsam of copaiva, an ounce. Let ten drops be taken on brown sugar, morning and night. SCARLET FEVER THE Scarlet Fever is so called on account of the co- lour of the skin, or the large, red, vivid blotches in it. The causes. Viscidity, acrimony, an unequal distri- bution of the vital heat; the protrusive force of the heart overcoming the resistance of the solids, wherefore chil- dren are most subject to it. It seems to be in some de- gree infectious. The diagnostics. They appear from the definition. The prognostics. If attended with anxiety, dejec- tion, or oppression at the pit of the stomach, the liberal use of cardiacs is indicated. It is seldom dangerous if left to nature, without any officious interpositions. To drink plentifully of diluting liquids, and to be kept cool, is all that is requisite. Many children have perished by the use of the lancet, which is intended to remove that straitness and suffocating sensation so common in this disorder; these do not originate from repletion, but from depletion; a little tartarised antimony and cordials are the most eligible remedies. The (43) The cure. Let wine-whey be given freely. The patient should not be kept warm; let his linen be shifted every day. After the third day one of the following formulæ may be used: Take of calcined antimony, Acetated kali, of each a drachm, Pure water, seven ounces, Spirit of nutmeg, Tolu syrup, of each an ounce. A mixture, one or two spoonfuls to be taken every sixth or fourth hour. Or, Take of aromatic confection, two drachms, Calcined antimony, one drachm, Purified salt of amber, a scruple, Pure water, seven ounces, Spirit of nutmeg, two ounces, Tolu syrup, an ounce. A mixture, of which two spoonfuls may be given every fourth or third hour. Take of spirit of nitrous œther, an ounce. Let twenty drops be given in every draught of liquid that the patient takes. PHTHISIS. A PULMONARY Phthisis, or consumption, is owing to an ulcer in the lungs, whereby the whole body is gradually emaciated and consumed. The cause. That (whatever it is) which occasioned the stagnation of the blood in the lungs, till it is con- verted into purulent matter; this may be owing to a teneritude (44) teneritude of the arterial vessels, an acrid blood, debi- lity of the fibres of the viscera, long neck, straight breast, depressed scapulæ, an ulcer in the liver, spleen, pancreas, kidnies, mesentery, or uterus, a metastasis of matter, neglect of customary exercise. The diagnostics. A slight fever, generally exacer- bated towards evening; too great, but particular heat; flying stitches, hectic flushing, pain in the stomach or breast, pain in the side, the patient lying with most ease on the affected side; hereditary disposition, the age from sixteen to thirty-six; indigestion, frequent spitting; night sweats, particularly profuse towards morning, sen- sation like cold water thrown down the back; diarrhœa, a bloody, frothy, or fœtid expuition, wasting of the flesh, languor, lassitude, peevishness, great unevenness of tem- per, sudden starts and bursts of joy terminating in tears, incurvation and lividness of the nails, quick and inter- rupted respiration; a teazing and almost incessant cough, worst in the night, aversion from food, facies, hippo- cratica. The prognostics. An hereditary phthisis is the most dangerous. If the cough is very troublesome, the res- piration operose, the saliva stinking. The ancles swel- led, the body much wasted, the evacuations colliqua- tive, and the countenance Hippocratic, death seems to be approaching with hasty strides. A phthisis attended with a total obstruction of the catemenia, produced by bleeding, is absolutely incurable. A phthisis in which the vomica breaks suddenly, the expuition white and cocted, the appetite and digestion tolerably good, is easily curable. The cure. Bleeding is inadmissible. The non-na- turals require the strictest attention. New milk should be taken for breakfast and supper; if it purges it must be boiled; cow’s milk is preferable to that of asses; goat’s whey is too diluent, and I have seen several fatal effects from the use of it. Meat broths may be taken as (45) as strong as the stomach will bear, particularly of pork; jellies prepared from any animal substance should be taken as often as possible. Let the patient ride on horseback every morning, if too weak to sit alone, he must be supported by one that rides behind him, for riding in a morning is absolutely necessary. A warm, dry, clear air, the Bristol waters; Spa water, or for common drink, infusion of linseed, decoction of bran, or for change, sago, salep, or chocolate. Tea pre- pared from coltsfoot flowers, and sweetened with ho- ney, I have no small reason to recommend the use of; snails or earth worms boiled in milk are serviceable, as are shell fish of all sorts, wild fowls, generous wines and spices. Conserve of red roses may be eaten to the quantity of two or three ounces in a day, with vast ad- vantage. Acids are sometimes serviceable, stomachic plaisters, a Burgundy pitch plaister between the shoul- ders, to be kept on for some weeks; vesicatories, but above all things the dry vomit, as, Take of tartarised antimony, three grains, Ipecacuanha, ten grains, Make into three powders; let one be taken in a morn- ing fasting, twice or thrice a week, not drinking any thing during the operation. Or, if the diarrhœa is very violent, Take of Ipecacuanha, four grains. Blue vitriol, one grain, Let this powder be taken (as before) every morning. In an incipient ulcer of the lungs, when the pain in the side has been exceedingly troublesome, recourse has been often had to the lancet, which is the ready way to bring on an incurable phthisis. I appeal to the con- science of the practitioner, whether he has not fre- quently experienced this consequence. N. (46) N. B. When an ulcer in the lungs is formed, the urine discharged at night is very turbid the next morn- ing. The balsam of copaiva ought never to be omitted in the cure of this disorder; let twenty drops be taken on sugar in powder every night and morning. If the diarrhœa is not excessive, as it seldom is at the begin- ning of a phthisis, I have often found that the subse- quent mixture will carry of the hectic, which generally terminates in the appearance of a rash. Take of prepared kali, Calcined antimony, of each a drachm, Pure water, seven ounces, Spirit of nutmeg, two ounces, Compound spirit of ammonia, half an ounce, Tolu syrup, an ounce, Of this mixture, let two spoonfuls be taken every sixth or fourth hour. Or, Take of prepared kali, two drachms, Mint water, seven ounces, Tolu syrup, an ounce, A mixture. Three spooofuls to be taken twice or thrice a day, to which may be added (if the diarrhœa is exces- sive) half an ounce of tincture of opium camphorated. If the diarrhœa should prove, as it often does, the most troublesome and dangerous symptom, it should be restrained by opiates; as three, four, or five grains of the opiate pill, and as many of rhubarb, which may be taken at bed time, to be repeated occasionally; or, Take of asafœtida, Precipitated sulphur of antimony, Myrrh, of each a scruple, Pure opium hard, four grains, Simple syrup, enough for twelve pills. Two (47) Two every night, or oftener. A scruple of the astringent red gum may be used for the same purpose, or the same quantity of the tormen- til, or bistort root; but the boles and sealed earths are worse than useless. Take of blue vitrol, five grains, Dissolve in an ounce of tincture of cantharides. Of these drops let twenty be taken twice a day, increasing the dose one drop at a time, till it amounts to a tea- spoonful. They have often effected wonders; but with this, or whatever other medicine is used, let not the balsam of copaiva be neglected. I shall subjoin two more formulæ, from which also I have experienced the most desirable consequences: Take of red bark, six drachms, Extract of liquorice, two drachms, Oil of aniseed, forty drops, * Filings of iron, two scruples, Mucilage of gum arabic, as much as is suffi- cient to make an electuary. The size of a walnut to be taken night and morning. Take of gum ammoniac, a drachm, Precipitated sulphur of antimony, two scruples, Squills, ten grains, Filings of iron, one scruple, Simple syrup, enough to make into two pills. Number thirty-two: let two or three be taken night and morning. See COUGH, and the following. * Or nitre, two scruples, as the hectic is less or more. EMPYEMA. (48) EMPYEMA. AN Empyema is a collection of pus or matter in the cavity of the thorax. The cause. The rupture of a vomica: this proceeds from an inflammation, bruise, or wound (if closed too soon) of any of the five parts, viz. the lungs, pleura, diaphraghm, mediastinum, or pericardium. The diagnostics. Twenty days from the time that the inflammation began; from the signs of the disap- pearance of a vomica, a new pain, dry cough, sensa- tion of pressure on the midriff, lying with ease on one side only, viz. on that where the matter is congested, a slow fever, expuition of purulent matter, thirst, the face flushed, the eyes hollow, redness of the cheeks, swelling of the abdomen; on leaning forwards, danger of suffocation. The prognostics. If the pus is whitish, and of good consistence, the expuition easy, the respiration free, and the mind calm, these are all good signs; but if, after the rupture, there be an accumulation of pus, pu- trefaction of the fluids, sanious stools, and Hippocratic countenance, if will prove fatal. The cure. To determine the pus externally must be attempted at all events, by proper medicines or cutting: the operation is to be performed between the third and fourth rib, behind, numbered from below.* In the mean time keep the body open, and give terebinthi- nates, as, Take * I have known it often to succeed, though sometimes the patient dies tabid. After the operation use detergent interjections every day of barley water well acidulated, and keep open the wound some weeks with a leaden canula. (49) Take of common turpentine, Olibanum, of each what quantity you please. Form into a mass of pills of five grains each; three to be taken twice or thrice a day. Or, Take of red bark, an ounce, Balsam of copaiva, Spermaceti, of each half an ounce, The yolk of an egg, Honey of roses, as much as is sufficient to make an electuary. The size of a nutmeg to be taken twice or thrice a day. HAEMOPTOE. A SPITTING of blood is sometimes an idiophatic disease, to which some persons are subject at times for many years, without any manifest inconve- nience. The cause. Teneritude of the fibres of the lungs. The diagnostics, or concomitant symptoms, are sen- sations of soreness in the breast, of weight in the dia- phragm, a husky cough, pallid countenance, lank hair, flabbiness of the flesh, dislike to exercise. The prognostics. Bleeding generally ensures a se- verer return, or brings on an incurable phthisis. If that evacuation has not been premised, the cure is not difficult. The ingenious Monsieur Le Sage has, in his usual sprightly manner, graphically delineated a scene where- in the grim Monarch is represented with awful dignity, C conferring (50) conferring the doctoral cap on all those medical stu- dents who take a solemn oath never to deviate from the present method of practice, and ranking them among the number of his truest and dearest friends. In his time and country, the picture bore no very enlarged features; but in this enlightened age, and in a nation teeming with Philosophers, who will take nothing on trust, whatever deference may be due to a generally received opinion, it can certainly be no unpardonable crime to call the propriety of it in question; and if it is found unsupportable by experiments, to militate against it. Of this kind, it is presumed, is that too general one of the necessity of blood-letting in internal hæmorrhages, which I have often seen prove highly pernicious and productive of fatal consequences. Of what signification is it whether a person loses his life by bleeding from a natural or artificial orifice? I once knew a family, of which two brothers and two sisters were each at different times seized with an hæmoptoe; they were all bled five or six times, and not one of them survived many weeks after their respective attacks; another brother was taken in the like manner, who sus- pecting the effects of the lancet, applied to me, and al- though he at that time laboured under a confirmed lues, he was soon (without bleeding) restored to, and still continues in, perfect health. Innumerable instances have I been witness to of the most alarming hæmorrhages, which have all yielded to the use of vomits, and the method lain down below, without a single application of the lancet: if then, as is evident, phlebotomy is not necessary to the cure, is it not more eligible to preserve that important fluid, than to lavish it away without cause, and thereby de- stroy the health and shorten the lives of those who com- mit themselves to our care? The cure, I never failed of success with those who had not been bled. The first thing given was, always the dry vomit, as, Take (51) Take of tartarised antimony, Blue vitriol, of each two grains;* This powder should be taken in a spoon half full of water; let the patient strain, which straining he may provoke, if necessary, with his finger or a feather, but drink nothing until he throw up some yellow or porra- ceous matter, and if his sickness does not then go off, half a glass of raw brandy will settle his stomach, if that should be returned immediately, which is some- times the case, a repetition of the same will answer ex- pectation. Give twenty drops of the balsam of co- paiva, night and morning, for several weeks, to pre- vent a return, and the following electuary: Take of red bark, six drachms, Flowers of sulphur, three drachms, Pure nitre, one drachm, Precipitated sulphur of antimony, a scruple, Mucilage of gum arabic, enough to make an electuary, The size of a nutmeg to be taken twice or thrice a day. So long as the spittle is in the least tinged, the follow- ing mixture should be used, which may from the first invasion be drank at pleasure: Take of gum arabic, two ounces, dissolve in pure wa- ter a pint, Pure nitre, two scruples, Tolu syrup, an ounce. Of this mixture four large spoonfuls may be taken every two or three hours. A scruple of roach-allum may be given occasionally. Or the red astringent gum. The conserve of roses may be taken at pleasure.—See WEAKNESS OF THE SOLIDS. * The tartarised antimony may be given first, and as soon as the nausea commences, the vitriol immediately exhibited. C2 HÆMORRHAGES. (52) HÆMORRHAGES. ALL Hæmorrhages (the piles only excepted) require precisely the same treatment with the foregoing article, which see. In acute disorders, internal hæmor- rhages proceed from a plethora, but I never yet met with one instance of a chronical hæmorrhage in a plethoric habit. HICCOUGH. THE Hiccough is a convulsive motion of the sto- mach and midriff. The cause. An acrid irritating matter, adhering to the left orifice of the stomach; the diaphragm is affect- ed by consent of parts. Sometimes repletion may oc- casion it, and sometimes depletion. The diagnostic is sufficiently obvious. The prognostics. Sneezing generally removes it, or compression of the artery at the wrists; or frequent sip- ping of any liquid, or stopping both ears for a minute or two, or holding the breath, or a sudden fright, or fixing the eyes intensely on an object in an oblique di- rection. Proceeding from wounds, profuse evacua- tions, in asthmas, or at the close of a malignant fever, it is always a dangerous, and often a deadly symptom. The cure. Emetics and cathartics are indicated, if it arises from repletion; if from depletion, diaphoretics, diuretics, opiates, clysters, and fomentations; as the common fomentaton, or tincture of opium and vinegar, of each equal parts, to bathe the pit of the stomach with. Of the following formulæ the practitioner may select that which is best adapted to the case. In (53) In the decline of fevers, give a tea-spoonful of the diluted vitriolic acid in a glass of water frequently. Take of the musk mixture, five ounces, Tincture of castor, two drachms, For a draught. A tea-spoonful of these drops may be taken, and repeated pretty often, if necessary. Take of compound tincture of lavender, six drachms, Compound spirit of ammonia, too drachms, For a bottle of drops. Take of prepared kali, two scruples, Tincture of cardamoms, two drachms, Pure water, an ounce and half, Spirit of horse-rhadish, too drachms, A draught to be repeated as there is occasion. Take of vitriolated natron, o«e ounce, Pure water, seven ounces, Tincture of asafœtida, half an ounce, —opium, a drachm, A clyster. Take of salt of hartshorn, Aromatic confection, of each a scruple, Musk, fifteen grains, Oil of mint, five drops, Syrup of orange peel, enough for a bolus. Take of castor, Musk, of each a scruple, Oil of cinnamon, three drops, Purified opium, two grains, Syrup of saffron, enough for a bole. Either of the above boles may be given according to the urgency of the symptoms. ERYSIPELAS. (54) ERYSIPELAS. ERYSIPELAS, or St. Anthony's Fire, is an exter- nal inflammation, which generally affects the face, and sometimes the breast. St. Anthony was supposed, like many of our modern saints, to take great pleasure in adding to the miseries of mankind; but in these times, we readily exculpate said saint from having any hand in the infliction of this disorder. The cause. Those which produce an internal inflam- mation, or an acrid humor, heats and colds, errors in the non-naturals, an obstruction of any customary eva- cuation. The diagnostics. Swelling of the part, with pain and redness; inflammatory pimples; if pressed lightly by the finger, the appearance of a white spot. The prognostics. It is removeable without much dif- ficulty; is no ways dangerous, unless the eruptions are repelled by cold, and then very disagreeable conse- quences may ensue. The cure. Being a cutaneous disorder, venæ-section may be dispensed with, which cannot be necessary when any eruptions appear on the skin. It is a com- mon observation with ignorant practitioners, that the blood which they have let is exceeding bad, and it is much better such blood should be out of the body than in it; if this argument were worthy of refutation, it might be asked, whether drawing off a pint or two from a pipe of bad wine, would have any tendency to ameliorate the remainder? Dr. Sangrado's method was much more plausible, in taking away the whole mass, and refilling the vessels with the bland warm element. If the blood is bad, it must be mended in the body, and the use of proper alteratives is indicated; but to decrease the quantity of it is to lower the vital powers, to render nature (55) nature incapable of performing her necessary functions, and to preclude the good effects of those alteratives, which might afterwards be administered. Diaphoretics will greatly assist nature in expelling that which is offensive: diuretics are exceeding service- able in this disorder; mild cooling cathartics are also of considerable utility. As for example: Take of elder rob, an ounce, Pure nitre, half a drachm, Pure water, five ounces, A gently sweating potion to be taken at night going to bed. Take of spirit of nitrous æther, an ounce. Of these drops let a tea-spoonful be taken twice or thrice a-day. Take of vitriolated natron, ten drachms, Purified salt of amber, seven grains, Pure water, three ounces and a half. For a purging draught, to be taken in the morning. As external applications will expedite the cure, the reader is presented with several efficacious ones below; though perhaps wetting the parts two or three times a day with camphorated spirit of wine, is not inferior to any of them. Take of the internal elder bark, two ounces, boil in a pint and half of water to a pint; then add of Soft soap, an ounce and half, Make a fomentation, to be used night and morning. Or, the decoction of hellebore. Take (56) Take of camphorated spirit, an ounce and half, Compound tincture of lavender, three drachms, Oil of amber, one drachm, A liniment to be used morning and night. Or, Take of water of acetated litharge, forty drops, Rose water, five ounces, A lotion. Take of camphorated spirit, an ounce, To be applied three or four times a day; as soon as the parts are dry, rub on a little of the following liniment: Take of the ointment of white calx of mercury, an ounce and half, Essence of lemons, twenty drops, Make it a liniment. NEPHRITIS. A NEPHRITIS is an inflammation of the kidnies. The causes. The same as of other inflammations; whatever plugs up the extremities of the capillary arte- ries; a wound, a bruise, an abscess, a tumor, lying too long on one side, a calculus, whatever hinders the free passage of the urine; whatever forces the thicker parts of the blood into the urinary canals, as riding hard, running, leaping, or a plethora. The diagnostics. Difficulty of, or uneasiness in making urine, sensation of heat in making it, perpe- tual inclination to make it, total suppression of it, a fever, (57) fever, numbness of the thigh from an affection of the psoas muscle, bilious vomiting, costiveness. A neph- ritis is always attended with a fever; a calculus not al- ways. In a nephritis the pain is continual; in the cal- culus, or fit of the stone, the pain intermits. The prognostics are much the same as in other in- flammatory disorders. To persons in years, it is most commonly fatal; the patient often falls into a tabes dor- salis; sometimes a schirrus is formed; sometimes it is succeeded by a palsy, or incurable lameness, a dropsy also, and atrophy. If a calculus is formed from the concretion of the sabulus saburra too bulky to pass through the ureter, the case is helpless, unless it is ex- tracted by the knife; this operation has been performed, but never with success, as the author ever knew or heard of. The cure, as in other inflammations, venæ-section, diluting liquors, emollients, antiphlogistics, clysters, fomentations, lenient cathartics, semicupia: if the pain is very excrutiating, opiates; Dieuretics, nitre excepted, are improper at first; for common drink, the almond milk. Take of syrup of marsh-mallows, Oil of olives, of each an ounce, Compound spirit of ammonia, two drachms, Pure water, seven ounces, by agitation. Make an emulsion, three spoonfuls to be taken every fourth hour. Take of Venice turpentine, half an ounce, The yolks of two eggs, Pure water, five ounces, Linseed oil, three ounces, Oil of turpentine, Oil of aniseeds, of each a drachm, Syrup of marsh-mallows, two ounces, A clyster. C3 As (58) As soon as bloody water is evacuated, give honey and oil of olives, of each an ounce, for a draught, and let twenty drops of balsam of copaiva, or balsam of Peru, be taken on sugar thrice a-day. Take of Venice soap, four scruples, New milk, two ounces, Pure nitre, a scruple, Syrup of marsh-mallows, Alcohol, of each two drachms, Make a draught, to be repeated twice or thrice a-day. Take of pure nitre, a scruple, Purified salt of amber, ten grains, Pure water, an ounce, Tolu Syrup, a drachm, A draught to be taken every third hour. Take of Ointment of hog’s lard, an ounce, Oil of turpentine, two drachms, A liniment, with which the loins may be anointed two or three times a-day. Take of magnesia alba, Spermaceti, Rhubarb, of each two scruples, For six powders. Let one be taken every fourth hour, till the body is sufficiently open, Take of gum arabic, two ounces, Pure water, a pint, Acetated kali, Syrup of marsh-mallows, of each half an ounce, A (59) A mixture, of which let three spoonfuls be given every three hours. Take of Chio turpentine (dissolved in the yolk of an egg), half a drachm, Spermaceti, Acetated kali, of each two scruples, Pure Water, an ounce and a half, A draught to be taken every fourth hour. Take of gum arabic, Spermaceti, of each a drachm and half, Acetated kali, one drachm, For six powders, one of which should be taken every two hours. If the pain is exceeding great, as it often is, give three grains of pure opium. ULCER IN THE KIDNIES OR BLADDER. The cause of an ulcer in the above-mentioned is ei- ther a calculus, or something corrosive received into the stomach, venereal virus, scorbutic diathesis, contusion, inflammation, obstruction, or erosion. The diagnostics of an ulcer in the kidnies are bloody urine of a fœtid smell, with scales in it: sanious, or purulent urine. In this case rhubarb in small doses, frequently given, is an admirable medicine. Ulcers in the bladder are more dangerous, and often attended with unsupportable agonies. In an ulcer. of the kidnies, the urine is discharged without much diffi- culty or uneasiness; is reddish, often bloody, with car- uncles in it. In an ulcer of the bladder, the difficulty of (60) of making urine is very great, the pain dreadful; less blood, but large quantities of purulent matter accom- pany the urine, especially in women. The prognostics. In habits of body that are caco- chymic, phthisical, or to persons in years, they are al- ways dangerous and often mortal. The cure is the same. Lenient purges should be given, as cassia, rhubarb, manna, and tamarinds, for the alvine tube must be kept open; small mead, cooling ptisants, a milk diet, lime-water, and twenty drops of balsam of copaiva on sugar morning and night, should by no means be omitted. Injections of milk and lime- water. If the pain is excruciating (as in all other dis- orders without exception) the use of opiates is demanded; give two scruples of olibanum, and three grains of pure opium, made into a bole with balsam of Peru. Take of gum arabic, two ounces, Soap, one ounce, Gum guaicum, Jalap, of each two drachms, Balsam of copaiva, enough to make an electuary. The bigness of a nutmeg to be taken morning and night. Take of tincture of balsam of Peru, an ounce, A tea-spoonful to be taken twice a day. The solution of muriatic mercury. See LUES. Women declining into the vale of years are exceeding liable to internal latent ulcers, which greatly resemble ulcers in the bladder, with respect to the violence of the pain, and indeed every other symptom, the pus in urine excepted. The subsequent electuary has always an- swered my expectation in removing that troublesome complaint, and I would recommend it to those who are tormented (61) tormented with pain in parts contigious to the neek of the bladder. Take of elecampane, an ounce, Sweet fennel seeds, half an ounce, Black pepper, Balsam of peru, of each two drachms, Honey, enough to make an electuary. Dose, the size of a nutmeg morning and night. If the body is costive, add two drachms of jalap to it. Let her also take twenty drops of balsam of copaiva twice a- day, upon brown sugar. STONE. THE Stone, or human calculus, originates from a concretion of sabulous saburra, chiefly owing to the selenites in water; from the heat of the body, laxity of the fibres, or predisposition of the fluids to deposit this earthly matter; perhaps from a deficient attraction among their own particles to preserve its suspension: it is often formed into a hard friable substance. The causes. The water we drink seems to be the chief cause, which has more or less of an earth in it, and, if you please, something of a petrifying quality; claret, ale, and all those liquors which ferment strongly in the sto- mach, and consequently occasion the terrestrial parts of the urine to cohere together; the appulse of an acid gas, obstruction or coarctation of the urinary canals. Any extraneous substance in the bladder, which will soon form a nucleus. The diagnostics. A sensation of numbness, torpidity, or painful pressure in the thigh; nausea, frequent retch- ings; the urine thin, bloody, small in quantity, ex- creted with great uneasiness, or totally suppressed; pain in the glans penis, tenesmes. The (62) The prognostics. If both ureters are at once affected, if the urine is totally suppressed, the extremities cold, or the urine continues bloody after the fit is over, the disorder will be of long continuance, and most probably terminate in death. In ancient persons it is always very dangerous. The cure. This dreadful disease authorizes us to summon every possible and immediate medical assist- ance, as clysters, purges, antiemetics, oil of aniseeds, terebinthinates, fat broths, fomentations, opiates, the catheter, lithotomy. To prevent a return, equal quan- tities of lime-water and butter-milk should be drank at meals, and for a constancy, to the quantity of three pints in a day. Claret, malt, and all fermenting li- quors should be abstained from. Spirits of all sorts, (having passed the state of fermentation) diluted with water, are no ways prejudicial. Take of balsam of Peru, (dissolved in the yolk of an egg) two drachms, Decoction for a clyster, five ounces, Oil of olives, two ounces, Tincture of opium, two drachms, A clyster. This will always give immediate ease in the most racking pain. Or, Take of vitriolated natron, two ounces, Water, six ounces, Tincture of asafœtida, half an ounce, Tincture of opium, one drachm. A clyster. Take of balsam of Peru, Oil of aniseeds, of each two drachms, Mucilage of gum arabic, seven ounces, Tincture of jalap, half an ounce, A (63) A mixture; three spoonfuls to be taken morning and night, or as there is occasion. To preserve the patient from returns of this horrid distemper, Take of gum arabic, two ounces, Venice soap, one ounce, Grains of Paradise, Jalap, of each two drachms, Balsam of copaiva, enough to make an elec- tuary. Dose, the size of a walnut, morning and night. Se- veral have I seen who for many years had not been one moment free from pain, perfectly cured by this elec- tuary; a relation of what it has performed in a vast va- riety of cases, would be enough to shock the belief of the most credulous. Take of liquorice root, three ounces, Boil in a quart of water; half a pint to be drank twice a day. Take of tincture of balsam of Peru, an ounce, A tea-spoonful night and morning. OPTHALMY AND DISORDERS OF THE EYES. AN Opthalmy is an inflammation of the eye, or ad- nata, with redness, swelling, and discharge of a hot water, or matter. It is commonly divided into dry and moist; when slight, called Phlogosis; if there be some redness in the albugineous coat, Taraxis; when the eye-lids can scarcely be closed, Chumosis; if ac- companied with a profuse discharge of red rheum, Epi- phora, (64) phora, Suffusio, Phylctæna, Glaucoma, Hypopyon, Al- bugo, and Pterygium, &c. are all to be treated much in the same manner. The cause. Some irritation, or the same with that of other inflammations. The diagnostics. It is known by the red colour of the tunica conjunctiva: the other disorders of the eyes, by a distillation of bloody acrid rheum from their angles; a scalding water; a collection of matter, or water in vesicles under the cornea; filmes, motes, specks, &c. The prognostics. If it continue long, it sometimes turns to a glaucoma, or cataract, or gutta serena (which requires the internal use of medicines, as mercurials, &c.) In general, it is not difficult of cure. The cure. If the eyes are glued up in the morning, let them be bathed with warm milk. If the patient is plethoric, bleed; then give a gentle purge, such as, Take of vilriolated natron, an ounce, Purified salt of amber, seven grains, Pure water, three ounces, Syrup of buckthorn, half an ounce, A purging potion. Issues are exceedingly serviceable, vesicatories likewise applied to the temples, behind the ears, or to the nape of the neck; no small advantage will result from a seton, which should be cut perpendi- cularly, and not horizontally, as is the usual custom.— Sternutatories should not be omitted, as the compound powder of asarum. Or, Take of white hellebore root, a scruple, Florentine oris root, ten grains, Euphorbium, three grains. Of this powder let a pinch be taken, as if it were snuff, every night after getting into bed. If (65) If a hot water distils from the eyes, or if films, specks, &c. appear, the subsequent eye-water is, I believe, not to be excelled; the eye may be washed with it three or four times a day, and as much of it allowed to be worked in the eye, by frequent winking, as can be well borne. Take of white vitriol, fifteen grains, Spirit of wine rectified, Lime water, of each half an ounce, A collyrium. Or, Camphorated spirit, an ounce, A collyrium. Or, if that gives too much pain, Take of water of litharge acetated, seven drops, Rose water, an ounce, A collyrium, to be used three or four times a day. Or, Take of water of litharge acetated, sevem drops, Tincture of opium, Lime water, of each half an ounce, A collyrium. If the sight is very weak, and is daily impairing, put a drachm of allum into the white of an egg, let them be well whisked up together, and smear the eye-brow and eye-lid with it every night. If there be a scorbutic acri- mony in the fluids, Take of mercury with sulphur, an ounce and half, Gum arabic, half an ounce, Honey, enough to make an electuary. The dose, the size of a nutmeg morning and night. In (66) In opthalmies proceeding from a scrophula, (which by the way most opthelmies do) the bark is not only a certain but expeditious remedy, as, Take of red bark, an ounce, Extract of liquorice, two drachms, Mucilage of gum arabic, enough for an elec- tuary, The size of a walnut to be taken morning and night. When the edges of the eye-lids look red and raw, or discharge, Take of white calx of mercury, a scruple, Cerate of acetated litharge, an ounce, Smear them with a feather dipt in it night and morning. A cataract requires the operation, viz. depression or extraction of the chrystaline lens. If a gutta serena is curable, it must be helped by electricity, sternutatories, the dry vomit, the aluminous egg application, and such alteratives as mercurials and antimonials. CATARRHAL FEVERS. CATARRHAL Fevers are generally slow and mild, exacerbated toward evening, when the equilibrium of the atmosphere is destroyed; they are accompanied with pains in the joints, stoppage of the nose, deafness, head-ach, cough, and listlessness, &c. They are com- monly called colds. They produce, when neglected, innumerable disorders, as they originate from an abate- ment or obstruction of insensible perspiration, if that perspirable matter is retained in the circulation which ought (67) ought to have been thrown out of the body, it may soon putrify, and occasion fevers pessimi moris. Hence ob- serve how hazardous and frequently fatal (though little suspected) that custom must be of bleeding for a cold, when no plethora subsists. To attenuate viscidities, few medicines are preferable to the acetated kali. When cold is first taken, an opiate (which acts by effecting a temporary plethora) if not costive, will often remove it like an amulet, as, Take of tincture of opium, thirty drops. At bed time. Or, Take of Opiate pill, five grains, Tartarised antimony, one grain, A pill to be taken at going to bed. If the symptoms are very alarming, give two grains of the tartarised antimony well rubbed with ten grains of white sugar, for a vomit, drinking nothing during the operation. Either of the following are exceeding efficacious in the removal of a cold, and far preferable to bleeding: Take of prepared kali, a drachm and half, Pure water, seven ounces, Water of ammonia, Tolu syrup, of each half an ounce, A mixture. Let three spoonfuls be taken every fourth hour. Take of mercury with sulphur, an ounce and half, Crude antimony, Gum guaicum, of each two drachms, Honey, enough to make an electuary, The (68) The quantity of a nutmeg to be taken morning and night. N. B. Those who value their health, and are liable to colds, should lie with very light covering in bed.— One pair of blankets is at all times sufficient. COUGH, SUFFOCATING CATARRH, AND HOARSENESS. A COUGH is a convulsive motion of the diaphragm, generally owing to an irritation of the larynx. By chewing a hard crust, or piece of sea biscuit, on going to bed, the glands will be emptied of that acrid saliva wherewith they are distended, and consequently that teasing defluxion will be prevented, and that tickling sensation which is so troublesome in the night. A plais- ter of Burgundy pitch between the shoulders will won- derfully relieve a cough: it should be worn continually for some weeks. If the thyriod gland is swelled so as to render deglutition difficult, apply a poultice of bread and milk to the throat, and a vesicatory to the neck. The Suffocating Catarrh is an affection of the larynx, when the aspera arteria is irritated, and the glottis con- stringed, so as to endanger immediate suffocation. If plethoric, bleed: let the face be held over the steam of boiling milk; a bread and milk poultice be wrapped round the throat, and give an emetic,* antispasmodics, opiates, and agglutinants. A Hoarseness is an affection of the aspera arteria, caused by an effusion of a thin acrid lymph, or an abra- sion of its internal mucus. Half a pint of new milk, with *Take of antimony tartarised, ten grains, Pure water, an ounce. Of this let a tea-spoonful be taken every half hour, till the effect is produced. (69) with half a pound of suet dissolved in it, and drank warm, will almost instantaneously relieve, but is by no means a pleasant draught. Take of sulphurated oil, five drachms, Oil of aniseeds, one drachm. Of this bottle of drops, let ten be taken on sugar three or four times a day. It is an admirable medicine for a cough, as well as for hoarseness. To return to a cough. Nettle seeds mixed up with honey into an electuary, is no despicable remedy; the size of a nutmeg to be taken night and morning. Or a spoonful of the expressed juice of turnips twice a day, sweetened with as much sugar candy as will render it palatable. Or, two ounces of garlic, infused in a bot- tle of mountain wine, a glass-full morning and night. Or, (which exceeds every thing else) balsam of copaiva, an ounce; of these drops take twenty twice a day on sugar. Or, balm of Gilead. Or, if not costive, Take of tincture of opium camphorated, an ounce, A tea-spoonful night and morning, in a glass of water. Or any of the following medicines, the efficacy of which may be depended on: Take of flowers of sulphur, an ounce and half, Elecampane, six drachms, Balsam of copaiva, half an ounce, Myrrh, two drachms, Oil of aniseeds, a drachm, Tolu syrup, enough for an electuary, The bigness of a nutmeg twice or thrice a day. Take of asafœtida, Gum ammoniac, of each a drachm, Squills (70) Squills powdered, a scruple, Simple syrup, as much as is sufficient, Make twenty-four pills, two to be taken night and morning. Take of diluted vitriolic acid, twenty drops, Night and morning. If costive, Take of asafœtida, a drachm, Sulphur of antimony precipitated, two scruples, Socotrine aloes, one scruple, Squills dried, fifteen grains, Simple syrup, enough for pills, Twenty-four; two to be taken night and morning. Or, Take of asafœtida, a drachm, Filings of iron, Precipitated sulphur of antimony, of each half a drachm, Socotrine aloes, one scruple, Simple syrup, enough for pills, Twenty-four. Take of conserve of orange peel, half an ounce, Oil of olives, Tolu syrup, of each an ounce, Vitriolic acid, enough to make it gratefully acid, A linctus; a tea-spoonful to be taken at pleasure. Take of coltsfoot flowers, an ounce and half, Horehound, Hysop, of each half an ounce, boil a little in a quart of water, Extract of liquorice, two drachms, Make (71) Make a mixture, of which a tea-cupful may be drank twice a day, or oftener. Take of red bark, six drachms, Extract of liquorice, two drachms, Myrrh, one drachm, Mucilage of gum arabic, enough for an elec- tuary, Dose, the size of a chesnut, twice a day. PERIPNEUMONIA GNOTHA. THE Bastard Peripneumony, or Humoral Asthma, is a disease very different from the true Perip- neumony, and owing to a redundance of serum in the lungs, which are overflowed as it were, with a cold pi- tuita: this phlegm stagnating in the cellular membrane or extremities of the capillary branches of the pulmo- nary artery, produces effects very similar to those of a real inflammation, though the necessary discrimination is to be made with great facility. The causes. A deficiency of vital heat; diminution of the vis vitæ; redundancy of serum; teneritude of the muscular fibre, indolence, or inactivity, preceding dis- orders, profuse evacuations, whatever puts too speedily in motion that which stagnates in the lungs. The diagnostics. The patient is at first seized with a sudden coldness and rigour, and loses his strength very fast; pallid countenance, sensation of weariness, lassi- tude, shortness of breath, spasmodic constriction of the lungs, a slight hectic fever, ropiness of the saliva, anxiety about the præcordia, swelled ancles, increasing debi- lity, a teasing cough, anorexia. The (72) The prognostics. It is a very fallacious distemper. Sometimes it terminates (and very often, in cachectic habits) in sudden and unexpected death. It is always attended with danger, for there is no disorder of which more persons die; perhaps every one is peripneumonic for a few minutes at least before a natural death, be- cause the blood that is propelled from the right ven- tricle of the heart, from the declension of muscular mo- tion, cannot then pass through the anfractuous angus- tiæ of the lungs, without occasioning the anhelous res- piration. The cure. It is unnecessary to say that in this case phlebotomy would be deleterious. For common drink give the compound decoction of barley with large quan- tities of hydromel; vesicatories of no small dimensions are necessary, and should be frequently repeated. A seton should be made on the side of the sixth vertebra of the neck, in a perpendicular form; change of air is of considerable utility, though even to one no better than that which the patient was in before; acids may be given with advantage, for the generally received opinion that they are inimical to the lungs, is not con- firmed by experience; broths are useful. A tea-spoon- ful of the expressed jusce of garlic may be administered night and morning with great advantage. The dry vo- mit must not be omitted, as, Take of blue vitriol, Antimony tartarised, of each seven grains, For three powders; one to be taken twice or thrice a week in the morning, fasting; let the patient strain, without drinking any thing till some yellow or greenish matter is ejected, and then, if the nausea does not go off, take half a glass of brandy; if that should be thrown up, a repetition of it will soon settle the stomach. Take of balsam of copaiva, an ounce, A bottle of drops. Of (73) Of these let twenty be taken on sugar night and morn- ing. Whatever other medicines are used this ought not to be dispensed with. Diuretics are singularly service- able, and one that will give place to no other, is, Take of tincture of cantharides, an ounce, A tea-spoonful to be taken night and morning. Lenient cathartics are absolutely necessary, which should be repeated according to the strength of the pa- tient, as, Take of rhubarb, a drachm, Gamboge, fifteen grains, Calomile, ten grains, Simple syrup, enough for twelve pills, Two or three to be taken every morning, one at a time, at an hours distance each. Or, Take of asafœtida, a drachm, Tartarised antimony, half a drachm, Simple syrup, enough for pills, Twenty-four. Take of extract of cassia, an ounce, Four figs, Liquorice root, Senna leaves, of each two drachms, Boiling water, four ounces, Infuse and strain for a purging draught. Or the follow- ing, which is a very elegant one: Take of senna leaves, three drachms, Lemon peel, two drachms, Tartarised kali, ten grains, Compound decoction of barley, four ounces, D Let (74) Let it be poured boiling hot on the ingredients, and when cold strain for a purging potion. Take of rhubarb, five scruples, Precipitated sulphur of antimony one scruple, Balsam of copaiva, enough to make into pills, Number twenty-four; two to be taken once or twice a day. For persons upwards of fifty. Take of gum ammoniac, Precipitated sulphur of antimony, of each a drachm, Squills, a scruple, Simple syrup enough for pills, Twenty-four; two to be taken morning and night. See COUGH, and the following. N. B. In a confirmed Hydrothorax give Mr. Tick- el’s Anodyne Æthereal Spirit, with the above-mentioned rhubarb, or tartarised antimony pills, once or twice a week. Or, (which is the only certain remedy) the ex- pressed juice of artichoke leaves. See DROPSY. ASTHMA. AN Asthma is a difficult and laborious respiration, owing to the compression, coarctation, or obstruc- tion of the pulmonary vessels, and is either continual or periodical. The cause of a continual asthma is a compression of the veins, bronchial vessels, pulmonary vesiculæ or nerves; this may be occasioned by a hydrops pectoris, empyema, phlegmon, abscess, vomica, tubercles, po- lypus (75) lypus in the blood vessels, coagulation of the blood it- self, corpulence, gibbosity, adhesion of the lungs to the pleura, emphysematous tumors of them, inflamma- tion of the stomach, infarction of the bronchial glands. The cause of a periodical asthma is a compression of the vessels and bronchial vesiculæ, owing to a slow ha- litus, or acid gas, which impedes the course of the ner- vous influence along the par vagum, and in some mea- sure expels it, not leaving a sufficiency of vital heat to distend the bronchial vesiculæ to their usual extent; this appears sooner or later, as the fermentation in the stomach is sooner or later performed, as I have observed in numbers of instances. It commonly succeeds other diseases, as an intermittent, variolæ, the measles, ca- tarrh, peripneumony, cachochymy, hysterics, and un- necessary phlebotomy, or a sudden change of the non- naturals, especially of the air. It seems not to be an idiopathic disease. The proximate cause of both is a spasmodic constric- tion, coarctation, or irritation of the organs of respi- ration. The diagnostics appear from what has been observed above. A difficult respiration when the breath is drawn oftener and quicker than usual is called Dyspnœa. A frequent and large respiration, when the diaphragm and intercostal muscles are violently agitated with snorting or wheezing, is termed an asthma. The greatest diffi- culty of breathing, when the patient cannot fetch his breath without sitting upright in bed, and even not then without the vehement and operose working of the mus- cles of the breast and scapula, is nominated orthopnœa. The prognostics. A plethoric asthma is easily cured, requiring only the discreet use of phlebotomy, or cup- ping. A spontaneous diarrhœa is an exceeding good sign. If it is inveterate, or if the patient is advanced in (76) in years, the case is difficult. If pus is formed, it fore- bodes convulsions, a phthisis, or dropsy. If owing to another disease, it requires the same treatment with the respective disorder. The cure. The diet should be taken from those things which are easiest of digestion, and consequently ought to be of animal substance, which will not only digest with greater facility, but ten times sooner than any of the vegetable tribe. Milk should be taken for breakfast and for supper; broth, spoon-meats, and much the same regimen is requisite as in the phthisis. A clear, dry air, exercise, clysters, a seton cut in a perpendicular direction, issues, a Burgundy pitch plaister between the shoulders, perpetual vesicatories, frequent emetics, ca- thartics, the balsam of copaiva, and the dry vomit. See COUGH and PERIPNEUMONIA GNOTHA. The asthmatic pill: Take of asafœtida, a drachm, Precipitated sulphur of antimony, two scruples, Socotrine aloes, one scruple, Oil of aniseeds, twenty drops, Simple syrup, enough for pills, Twenty-four; two to be taken morning and night. Or, if very costive, Take of asafœtida, a drachm, Socotrine aloes, Filings of iron, of each two scruples, Simple syrup, enough for pills, Twenty-four; two to be taken morning and night. Or, the ammoniac pills in the last article. If opiates may be given with safety, viz. if the body is sufficiently open, to render the nights more tolerable, and to procure a truce, Take (77) Take of opiate pill, one drachm; Make into twelve or sixteen pills, one to be taken at bed-time. Or, Take of tincture of opium camphorated, an ounce, A tea-spoonful (more or less) in a glass of water, night and morning. Take of antimomy tartarised, three, four, five, or more grains, As the case requires, for a vomit; to be taken fasting, and drinking nothing after it for two or three hours; to be repeated every week or ten days. The following electuaries have been extremely ser- viceable: Take of flowers of sulphur, an ounce and half, Elecampane, an ounce, Balsam of copaiva, half an ounce, Oil of aniseed, a drachm, Tolu syrup, sufficient to make an electuary, Dose, the bigness of a nutmeg every morning and even- ing. Or, Take of red bark, an ounce, Extract of liquorice, three drachms, Tolu syrup, enough for an electuary, The size of a nutmeg to be taken twice or thrice a day. AUXILIARIES. Take of shavings of sassafras, Coltsfoot flowers, Maidenhair, of each equal parts. Of (78) Of this half an ounce may be made into tea, to be drank instead of common tea, sweetened with honey. Take of onions (or leeks) two ounces, Boil in a pint and half of water to a pint, strain, and let a tea-cupful, sweetened to the taste, be taken two or three times a day. Raw onions, with plenty of pepper and salt, may be eaten every day to great advantage. Take of conserve of squills, half an ounce, Tolu syrup, Oil of olives, of each an ounce, Vitriolic acid, twenty drops, A linctus, to be taken at pleasure. Take of tincture of cantharides, an ounce, Of these drops a tea-spoonful may be taken twice a day. Take of coltsfoot flowers, or leaves, an ounce, Boil in a pint and half of water to a pint; squeeze them dry. Let this pint be drank every day, very warm, holding the face first over the steam, while boiling hot, till cool enough to drink. N. B. Half an ounce of horehound may be added. See FLATUS, and PERIPNEUMONIA GNOTHA. CEPHALALGIA. CEPHALALGIA is a sensation of pain in the head. Cephalæa is an inveterate (and supposed hereditary) pain in the head. Hemicrania (79) Hemicrania is a pain in the middle of the head.— They are all owing to the same causes, and require the same method of cure. The causes. Little acrid particles of blood or lymph, which vellicate or distend the membranes or nervous fibrillæ; strong liquors drank too profusely, spasms, staying too long in the heat of the sun, immoderate ex- ercise, intense study, fermentation in the stomach, acid gas, or halitus, a deficiency of heat in the encephalon, a plethora, costiveness. The diagnostics is sufficiently obvious. The prognostics. If symptomatic it is to be profligated by the removal of that disease which is the occasion of it. The more superficial the easier it is to be cured; the deeper, the sharper, and if of long continuance, with the more difficulty. If accompanied with a verti- go, noise in the ears, strabismus, or deafness, if not removed, it will end in a lethargy; if with æruginous vomiting, in a mania. A defluxion of blood or pus from the nostrils often cures it. Turbid urine indicates a continuance of the malady. If the pain strikes into the orbits, is accompanied with giddiness, and the pa- tient be advanced in years, the cure is very problem- atical. The cure. If it proceeds from the stomach, give an emetic, if from a plethora, (which a chronical head- ache rarely, if ever does) bleed or cup. If from a re- dundance of acrid serum, with costiveness, which is an usual concomitant, if not the procatarctic cause, aloetic purges are the surest and most expeditious remedy.— Vesicatories, setons, cephalic plaisters, sternutatories, diaphoretics, and opiates, are ail indicated, and may be made use of according to the discretion of the practi- tioner. A blister may be laid over the whole head, and kept on till it comes off of itself, which will be on the fourth or fifth day. For common drink valerian tea is excellent. (80) excellent. Sitting for a few minutes with the feet im- mersed in warm water will sometimes yield instanta- neous relief. Ginger is the most excellent of all ner- vines; in this and all other disorders affecting the nerves, it may be given to two scruples, twice or thrice a day: few fits will withstand its power. Slight electrical shocks will often remove it. If external, which may be known by increasing on pressure, dissolve a drachm of camphire in half an ounce of æther, and pouring a little into the palm of the hand, let it be applied to the pained part. If an old and crabbed case, give the dry vomit, as, Take of blue vitriol, Antimony tartarised, of each two grains and a half. Let this powder be taken in half a spoonful of water in the morning, fasting, without drinking any thing du- ring the operation; but when yellow or greenish matter is thrown off from the stomach, half a glass of brandy may be taken to remove the nausea; if that is rejected, as it will be if there is more corrupted bile to be thrown up, a repetition in a few minutes after will soon settle the stomach. Plaisters of Burgundy pitch may be ap- plied to the temples, or behind the ears, a fomentation for the whole head of equal quantities of tincture of opium and vinegar, will often give ease; or equal quan- tities of camphorated spirit, compound tincture of la- vender and vinegar. An errhine may be given to snuff up the nose, of brandy and vinegar equal quantities; or of camphorated spirit. Sternutatories ought not to be omitted, as white hellebore root, or asarabacca leaves. A pinch of either (in powder) to be taken as if it were snuff, every night after getting into bed. If the pain is very excruciating in the night, thirty or forty drops of tincture of opium may be taken at bed time, and the next morning a draught given, composed of an ounce of aloetic wine, and half an ounce of cin- namon water. Habitual (81) Habitual head-achs, arising from constipation of the bowels, soon yield to the following pills: they are in- deed a noble medicine, and too much cannot be said in their praise. The author has ordered them many thou- sands of times, and they never disappointed his expect- ations. Take of socotrine aloes, one drachm, Precipitated sulphur of antimony, Filings of iron, of each half a drachm, Simple syrup, enough to make into pills, Number twenty-four; two to be taken night and morn- ing, if they do not open the body too much. Or, Take of socotrine aloes, Filings of iron, of each a drachm, Precipitated sulphur of antimony, Calomel, of each a scruple, Simple syrup, enough to make into pills, Thirty-two; two to be taken every night. Take of prepared kali, half an ounce, Water, a pint, A tea-cupful night and morning. If the patient is not costive, and the pain returns pe- riodically, give the bark. EPILEPSY. AN Epilepsy is a sudden prostration of the vis vitæ, with a violent concussion of the muscles, and loss of the senses, both external and internal. It is called catalepsy, caducus, catoche, morbus sacer, comitialis, and Herculeus. D3 The (82) The causes. A bad conformation of the encephalon; corruption or erosion of the meninges; quicksilver, by what means soever conveyed to the brain; an increased flux of serum into the head, hydatides on the corpus callosum, violent exercise, profuse venery, strong think- ing, a fright, all vehement affections of the nervous system, excruciating pain, hysterics, irritation from worms, toothing, an acrid humour, the infection of the variolæ, the obstruction of some secretion; various sorts of vapors, as the steams from liquors in a state of fer- mentation, or an acid gas. The diagnostics. A sensation of weight in the head, or of pressure over the eyes; of heaviness in the joints, frothing at the mouth, foolishness, tinnitus aurium, for- getfulness, a thin and crude urine, gnashing of the teeth, a deprivation of all feeling; paleness of the coun- tenance, inordinate motion of the tongue, shrieks, clenched hands, sudden fall to the ground, dimness of sight; from the violence of the paroxysm, an ejection of food, mucus, lymph, or bile; involuntary discharge of urine, semen, or excrements; on recovery, no re- membrance of what has passed; impaired intellects. The prognostics. It is either idiopathic or symptom- atic. If hereditary, and a delirium supervenes after the fits, it is incurable. From the frequency of the fits arise loss of memory, dulness, stolidity, palsy, apoplexy, and death itself. An involuntary excretion of the fœ- ces, the fits being of long duration, and the brain, pri- marily affected, are signs that the cure will not be affected without great difficulty. If the cause is in the solids, it is irremoveable From the injuries which the nerves suffer, there follow contractions, deformity, and dis- torsions. In children, when a quartan supervenes, the fits go off. If owing to worms they are easily curable; if to spasms, and properly treated, they are not very refractory. The cure. In the paroxysm, let a loud noise be made in the ear, and apply water of pure ammonia to the nose, (83) nose, or blow up the nostrils a little white hellebore, or black pepper; bathe the temples and wrists with vine- gar; if the mouth can be opened, put into it fifteen or twenty drops of oil of amber on powdered sugar, or give a drachm of tincture of castor in half an ounce of strong cinnamon water. As I never saw a plethoric epileptic, I never ordered the use of the lancet for any one, nor can I think it by any means allowable. Purges are of- ten proper, and of considerable utility, even twice or thrice a week; so are chalybeate waters, issues, setons, blisters, the cold bath, alkalis, anthelmintics, anti-hys- terics, cardiacs, nervines, opiates, lancing the gums, the trepan, electricity, and the dry vomit. The diet should be of animal food for dinner, with milk constantly for breakfast and supper: vegetables of ail sorts are to be avoided, wines also, and malt liquors; spirits diluted with water may be drank with safety.— Gentle and frequent exercise is absolutely necessary, change of air and amusements are not to be neglected. Take of blue vitriol, Antimony tartarised, of each seven grains, For three powders, one of which should be taken at least twice a week, in the morning fasting: let the pa- tient strain, without drinking any thing, till he throws up some yellow or greenish matter, and if his sickness doth not go off, take half a glass of brandy; if that should be puked, another half glass will perfectly settle the stomach. Nothing can be more mild, safe, or gentle, than one of these vomits, and I have known great numbers of persons, by whom the repetition of them was more eagerly requested than opiates have been by those who were in pain. I shall now subjoin all the medicines which I ever used that proved efficacious in the removal of this dis- order, and many hundreds of cases I have been for- tunate enough to succeed in. Let it be added that the dry (84) dry vomit was never omitted, excepting in those cases which were owing to worms, or spasms, and then the following pills and drops have never once failed to an- swer expectation. Of the rest the most proper must be left to the choice of the prescriber. Take of socotrine aloes, Filings of iron, of each a drachm, Simple syrup, enough for pills, Number twenty-four; two to be taken night and morn- ing (if not too opening) washing them down with a glass of water, in which put two tea-spoonfuls of these drops: Take of tincture of asafœtida, two ounces, For a bottle of drops. Take of white hellebore, a scruple, Ginger, ten grains, Euphorbium, two grains, Of this snuff let a pinch be taken every night, after getting into bed. If laxative, Take of red bark, an ounce, Valerian root, six drachms, Ginger, half an ounce, Mucilage of gum arabic, enough for an elec- tuary, Dose, the quantity of a walnut night and morning, or oftener. Take of valerian root, an ounce, Red bark, six drachms, Factitious cinnabar, half an ounce, Filings of iron, a drachm and half, Mucilage of gum arabic, enough for an elec- tuary, Dose, (85) Dose, the size of a walnut morning and evening, wash- ing it down with two tea-spoonfuls of the following drops, in a glass of water: Take of volatile tincture of valerian, an ounce, For a bottle of drops. Take of ginger, half an ounce, To be divided into six powders, one to be taken twice a day. Take of madder, half a drachm, A powder, to be taken night and morning. See CE- PHALALGIA. FLATUS. FLATULENCIES are of all disorders the most com- mon, and have, perhaps, the least attention paid to them, notwithstanding that few persons are free from some disagreeable circumstances owing to wind, for the too rapid escape of the aereal acid from vegetables eaten, proves the source of some of the worst and most crab- bed chronic cases. The causes. An acid gas arising from a too speedy fermentation in the stomach. It is not easy to imagine what a variety of bad consequences are produced from the detention of elastic air in the bowels. Many of these disorders are by the common people called the spleen in men and the mother in women. The diagnostics. Breaking wind upwards, downwards; incessant eructations, pain in the stomach, rumbling noise in the bowels, loss of appetite, heart-burn, sour breath, (86) breath, sensation of pent-up wind, borborygmy; acid or nidorous belchings; bad taste in the mouth, tumor at the pit of the stomach; swelling of the abdomen, or the right epigastre; pain in the left side, dyspnœa, head- ach, sensation of fulness after eating; nausea, especially in the morning, obstructed bile, costiveness, passing of worms or slime, spasms of the urinary vessels, some- times a diarrhœa, ash-coloured excrements; in females, generally an obstruction of the catamenia. It is almost an inseparable concomitant of all bilious or gravelly com- plaints. The prognostics. If of long continuance, it will re- quire some time, but no great difficulty, to remove. If the wind is not determined downwards, the disorder, though seemingly cured, will, return. In sanguinous habits, or if attended with an habitual diarrhœa, it is most troublesome to manage. The cure. The predominant acid in the stomach is to be corrected and destroyed by alkalis, emetics, and eccoprotics; the wind is to be expelled by proper carmi- natives, nervines, and cardiacs; the alvine tube to be kept open by aloetics, or antimonials; if accompanied with a diarrhœa, give the bark, with opiates; ginger, cas- tor, opiate confection, tincture of asafœtida, and such like. A milk diet, at least morning and evening, is very adviseable. Abstinence from fruit, vegetables, malt, and other fermenting liquors, is indispensably ne- cessary; animal food, and spirits diluted with water, may be used safely, and the warmer any liquor is drank the better. Pains, sickness, and common disorders of the stomach, are soonest removed by half a pint of boil- ing water taken as hot, and as fast as it can be supped. Obstinate fixed pains in the sides and loins, of many standing, have soon yielded to the following carmina tive: Take of bay berries, six drachms, Grains of paradise, too drachms, Socotrine (87) Socotrine aloes, Filings of iron, of each two scruples, Oil of turpentine, two drachms, Simple syrup, enough to make an electuary, The bigness of a nutmeg to be taken night and morning. This, though not a pleasant, is a most powerful me- dicine, the wonderful efficacy of which I have experi- enced in a great many thousands of instances. Elastic air pent up in the vessels, is often the cause of these fixed pains, as well as of rheumatic complaints (which may be known to be the cause by their being worse in bed), and of vagrant spasms. In such cases, some chaly- beate water, with half as much boiling water poured on it, should be drank to the quantity of half a pint, two or three times a day. If attended with a diarrhœa. Take of opiate confection, an ounce, Red bark, six drachms, Grains of paradise, three drachms, Filings of iron, one drachm, Syrup of ginger, enough for an electuary, The quantity of a nutmeg to be taken twice or thrice a day. The following tincture is well deserving a place in the shops. Take of bay berries, two ounces, Grains of paradise, an ounce, Ginger, half an ounce, Proof spirit, a pint, Digest without heat for three days, strain and sign the carminative tincture. Take (88) Take of the above carminative tincture, Volatile tincture of valerian, of each an ounce, Two tea spoonfuls to be taken night and morning. Or, Take of the above carminative tincture, an ounce and half. Tincture of asafœtida, an ounce, Of these drops, let two tea spoonfuls be taken night and morning. If costive, Take of socotrine aloes, a drachm, Precipitated sulphur of antimony, Asafœtida, Filings of iron, of each half a drachm, Simple syrup, enough for pills, Number twenty-four; two to be taken night and morn- ing, washing them down with two tea-spoonfuls of either of the above drops. Or, if not very costive, Take of asafœtida, a drachm, Precipitated sulphur of antimony, Socotrine aloes, of each half a drachm, Simple syrup enough for pills, Number twenty-four; two to be taken night and morn- ing, taking after them a tea spoonful of the following drops in a glass of water. Take of chian pepper, or Long pepper, powdered, half an ounce, French brandy, a gill, Digest without heat for three days, and filtre. Drops, Take (89) Take of caraway seeds, three drachms, Galangal, one drachm, Of this powder, a tea-spoonful may be taken occasion- ally (when much oppressed with wind) in a glass of wa- ter, with a tea-spoonful of the last-mentioned drops. To restore the overstrained fibres to their proper tone, after the stomach and bowels are well cleared, Take of diluted vitriolic acid, half an ounce. Of these drops let twenty or thirty be taken thrice a day. It might not be amiss to propose the following ques- tions to every patient in all chronical complaints, viz. have you any thing of the heart-burn; any sourness or heat in your stomach? Does water ever rise in your mouth in the morning; do you feel a nausea or sick- ness at your stomach in the morning? are you oppressed with wind in your bowels? Do you find ease in dis- charging it? Does it ever rise up in your throat, or seem to fly between your shoulders? Have you any pain in your left side? do you feel a sort of weight or pressure over your eyes? Have you a sensation of ful- ness after eating, a fluttering about your heart? Any swelling at the pit of your stomach, or pain on the right side of it, or under the blade bone of your right shoulder? Do you not feel a faintness and sinking with- in you? Are you costive? Do you find any difficulty or uneasiness in making urine? Does it seem hot? Do you ever void any worms or slime? Any difficulty of breath- ing? A single affirmative to either of those questions will warrant the use of one of the above formulæ, mu- tatis mutandis, according to the circumstances of the case; a due combination of such antispasmodics, car- minatives, and anti-acids, keeping open the intestinal canal; or restraining the alvine discharge, if excessive; will, to the no small surprise of the practitioner, in a vast variety of chronic cases, soon restore the unhappy sufferer (90) sufferer to a perfect state of health, by removing the cause of the disease, as the writer of this has joyfully experienced in many thousands of instances every year, for these twenty years past. HYPOCHONDRIA. THE Hypochondriacal affection, melancholly, or lowness of spirits, is a sort of delirium without a fever. This disorder is commonly supposed to originate from the imagination, because it is intensely fixed on one particular object; but, in fact, it is entirely owing to a laxity of the muscular fibres throughout the whole vascular system. The cause. A deficiency of the vital heat in the cerebrum (a cause diametrically opposite to that which produces the phrenitis, though the effects are similar,) this may be expelled therefrom by that, whatever it is, which dissipates the finer fluid parts, and fixes the rest, as agrypnia, profuse venery, an acid gas, any excessive evacuation, particularly that of insensible perspiration; grief, disappointment, fear; the immoderate use of sal- lads, fruits, vegetables of all sorts, sugar, fermenting liquors, vinous or malt; indigestion, flatulencies, a se- dentary life, severe studies, want of exercise, indolence. The diagnostics. The absurdity of the patient’s be- haviour, inactivity, dislike to motion, anorexia, bor- borygmi, costiveness, oppression from wind, frequent sighing, anxiety about the præcordia, great dejection, prostration of the vital powers, internal sinkings, load at the stomach, palpitation of the heart, taciturnity, wild incoherent discourse, ridiculous notions, the mind being fixed on one object. The prognostics. An appearance of the piles is a good sign. It is sometimes very tedious, but seldom very (91) very difficult to cure. If improper methods are used, such as bleeding, &c. it often terminates in madness, blindness, an epilepsy, or apoplexy. The cure. Draw off the patient’s attention from his favourite object as much as possible. Exercise must be taken, generous wines may be drank freely, as moun- tain, red port, or Madeira: or, which is more eligible, spirits diluted with water. The most nourishing diet is necessary, as milk, meat broths, particularly of pork; strong soups, jellies, sago, vermicelli, flummery, salep, eggs; all sorts of shell fish, as lobsters, crabs, oysters, &c. flat fish, as turbots, skait, dories, plaice, &c. soups made of lampries, or cray-fish; every species of wild fowl, especially grouse, partridges, and pigeons; any animal food taken in large quantities, and often repeated. He should abstain from vegetables, fruit, and malt liquors. In this, or in any other case arising from weakness of the solids, bleeding is inadmissible, it would be preposterous practice indeed to bleed an hy- pochondriac. Let the patient drink the chalybeate waters, use carminatives, very mild cathartics, corro- borants, aromatics, fœtids, perfumes, volatiles, sternu- tatories, aloetics, emetics, mercurials, blisters, setons, steel, the cold bath, infusion of horse-rhadish, valerian tea and ginger. See FLATUS and EPILEPSY, under which articles there is scarce one prescription that is not of considerable utility in this malady. Begin the cure with the dry vomit, as, Take of tartarised antimony, Blue vitriol, of each seven grains, For three powders; one to be taken on an empty sto- mach twice a week. Either of the under-mentioned pills may be given to vast advantage, as gentle cathar- tics; they have been often proved: Take of extract of black hellebore, Aloe pills, of each a drachm, For (92) For twenty-four pills; two to be taken night and morn- ing, or occasionally. Take of asafœtida, a drachm, Socotrine aloes, Filings of iron, of each half a drachm, Simple syrup, as much as is sufficient, Pills, number twenty-four; two to be taken morning and night. Or, Take of socotrine aloes, a drachm, Filings of iron, Precipitated sulphur of antimony, of each half a drachm, Mucilage, enough for pills, Twenty-four; two morning and night. Take of red bark, six drachms, Compound powder of myrrh, Ginger, of each half an ounce, Tartarised iron, a drachm, Tincture of cantharides, enough to make an electuary. Of which (if not costive) the size of a chesnut may be taken morning and night. Take of volatile tincture of valerian, an ounce, Of these drops two tea-spoonfuls may be taken in a glass of mountain wine twice or thrice a day. Take of compound powder of assarabacca, White hellebore root, of each a scruple. Of this snuff let a pinch be taken every night at bed time. Errhines seem to deserve a much higher rank in practice than they have hitherto obtained. Take (93) Take of diluted vitriolic acid, an ounce, Of these drops give twenty-five thrice a day. APOPLEXY. AN Apoplexy is a sudden abolition of the external and internal senses, and of all voluntary motion, with sometimes a full pulse and large respiration. There are four species or degrees in it. The first is, when the patient breathes, during the paroxysm, in a manner very little different from that in perfect health. The second, when the respiration is intermitting, an- helous, and inordinate. The third, when the breath cannot be fetched with- out great struggling, and nature is obliged to exert all her efforts to carry on a most operose respiration. The fourth, when respiration for some time totally ceases. The cause is that which wholly impedes the efflux of the nervous influence into the cellular coats of the or- gans of sense and motion. One would imagine that the ancients were acquainted wtth the real cause of it, from the derivation of its name Apoplexia, from Apopletto to strike. The above effect may be produced from a plethora, and too great an accumulation of blood in the ventricles of the brain, but much more commonly pro- ceeds from a deficiency thereof, and a redundance of viscid serum; as also may be reckoned among the pre- disponent causes, a large head, thick neck, corpulence, spasmodic contractions of the vessels, osseous protube- rances (94) rances within the cranium, acrimony of the lymph, ir- regularity of the non-naturals, a too liberal use of nar- cotics, frequent ebriety, extravasated blood; inordinate venery, especially of persons in the decline of life; the affections of the mind, an acid gas, blows, bruises, and mercurial vapours. The diagnostics. Preceeding the paroxysm, dimness of sight, loss of memory, a sudden and acute pain in the head, swelling of the jugulars, vertigo, an unusual cold- ness of the extremities, supine indolence, drowsiness, oscitancy, tremblings, a strong pulse, and redness of the face. The reader may observe that the signs are given indiscriminately of the sanguineous* and serous apoplexy. In the paroxysm, deprivation of all sense and motion; the eyes are closed as if he was dead; snoring, an unequal interrupted respiration, insensi- bility. The prognostics. The fourth degree is always fatal, because the conductors from the cerebellum are affected. If the pulse is weak, respiration difficult, the patient old, or has been seized before in the same manner, loud snoring, cold sweats, frothing at the mouth; these are all symptoms of a fatal tendency. An apoplexy often terminates in a palsy. A strong pulse is a sign of reco- very; if succeeding phlebotomy, the patient will un- doubtedly do well. The cure. Let the patient be laid on his back, with his head raised. If plethoric, bleed; which will pre- sently relieve by removing the cause. Hippocrates with great justice asserts that venæ-section always kills or cures in an apoplexy: the reason is evident, because it is always owing to too much or too little blood. Pro- per means to be used are sternutatories, emetics, vesi- catories, particularly to the feet, cathartics, and corro- borants. * I never yet saw one sanguineous apoplexy. In (95) In the fit, if cachochymic, as is most commonly the case, he should be rubbed with warm flannel, or bathed with rectified spirit, and instead of phlebotomy use er- rhines. Bleeding is too generally performed in fits of all sorts, though there are very few instances in which they do not originate from a laxity of fibres and defi- ciency of blood. Those who are so busy with the lan- cet, ought to be reminded, that there is yet no repeal of the sixth commandment. Take of white hellebore, Long pepper, of each a scruple, Euphorbium, seven grains, Let some of this powder be blown up the nose, through a quill, or some tobacco smoke, or a little of the fol- lowing errhine: Take of camphorated spirit, Brandy, if each an ounce, Water of ammonia, half an ounce, An errhine and fotus. A fomentation also for the head may be used of spirits of wine, compound tincture of lavender, and oil of am- ber, equal parts. A clyster should be injected as soon as possible, as, Take of tobacco, Rue, of each a handful, Penny-royal, Coloynth, of each two drachms, Boil in ten ounces of water, strain, and administer it warm. As soon as possible give the following purge or vomit: Take of senna leaves, Tamarinds, of each an ounce, Rhubarb, (96) Rhubarb, three drachms, Volatile salt of amber, a scruple, Macerate in twelve ounces of boiling water. Of the colature, give two ounces every hour till it pnrges suffi- ciently. Or, Take of tartarised antimony, Vitriolated mercury, of each five grains in powders. An emetic, drinking nothing during the operation. To prevent a return, let him take two tea-spoonfuls, twice a day, of volatile spirits of valerian, with one of the subsequent electuaries, or pills: Take of valerian, an ounce, Ginger, six drachms, Red sulphurated mercury, two drachms, Syrup of orange peel, enough for an electuary, Dose the quantity of a nutmeg, twice a day. Take of red bark, an ounce, Castor, Galangal, of each two drachms, Syrup of orange peel, sufficient for an electu- ary, as before. Take of socotrine aloes, Long Pepper of each a drachm, Simple Syrup, enough for pills, Twenty-four; two to be taken morning and evening. PALSY. (97) PALSY. A PALSY is a laxity or immobility of a particular part, sometimes with a deprivation of the sense of feeling. If the whole side is affected, it is called Hemiplegia. The cause. A sudden shock, from some impedi- ment to the course of the vital heat along the nerves from the cerebrum, medulla oblongata, or spinal mar- row, which lacerates the cellular tunic of the muscles, destined for voluntary motion; this may be occasioned by a redundance, (though I never met with such an in- stance) but is more commonly owing to a deficiency of the nervous influence, and consequently of blood. The diagnostics. Flaccidity of the parts, a diminished sensation in, or incapacity of moving them; distortion of the muscles, tremors, wasting of the part, involun- tary tears, despondency. The prognostics. A partial palsy in young persons is easily curable; in children from dentition will disap- pear of itself. In those who are advanced in years, or if universal, or if succeeding an apoplexy, or if it is attended with a marasmus, in these cases little hope is to be indulged. A fever or spontaneous diarrhœa, are favourable symptoms. The cure. The regimen must be indicated from the cause. If (as has been always the case with every pa- ralytic that I have ever seen) there is a laxity of the muscular fibres, and weakness of the soiids, let the spina dorsi be rubbed with a warm flannel, even to an inflam- mation, and be bathed with oil of amber night and morn- ing, from which method alone, and a large vesicatory, to the os sacrum and lumbar region, I have recovered many who had lost the use of the lower extremities. Apply a tight ligature to the part affected; if the leg, a straight stocking should be worn. Give Venice soap E at (98) at first in pretty large quantities, and ginger and mer- curials. Let the intestinal canal be kept open, and vesi- catories be laid on the affected parts, or one of the fol- lowing topics be used: Take of cantharides, an ounce and half, Rectified spirit, a pint, Digest warm for three days; a fomentation to be used twice a day. Or, Take of spermaceti ointment, an ounce, Oil of amber, half an ounce, Oil of pepper, a drachm, Euphorbium, nine grains, A liniment, as before. The cold bath should be repair- ed to every morning; let the patient be just covered with water, and be taken out immediately, without a second dip. The warm bath is pernicious. Chalybeate waters should be drank, and electricity be tried, which I have sometimes known to be effectual, but oftener to fail. Emetics are extremely serviceable, particularly the dry vomit. See EPILEPSY. The following medi- cines have answered the Author's expectation: Take of horse-rhadish scraped, Mustard-seed bruised, of each two ounces, Galangal sliced, half an ounce, Infuse in a quart of boiling water close stopped till cold; a tea-cupful to be taken twice a day. Take of cassumunar, Ginger, of each an ounce, Oil of turpentine, half an ounce, Honey, enough for an electuary, Of which let the bigness of a nutmeg be taken thrice a day. Take (99) Take of Tincture of guiacum, two ounces, Of these drops give two tea-spoonfuls in three quarters of a tea-cupful of new milk night and morning. The cold bath should not be omitted every morning till well. A tea-spoonful of tincture of cantharides, and twenty drops of tincture of muriated iron, twice a day. DROPSY. A DROPSY is a tumor of the abdomen, from an extravasation of serum in its cavity, or a stagna- tion thereof in the vessels, whereby they are distended and often ruptured. This may happen in many other parts of the body, as for instance, the hydrocephalus internus, hydrops pectoris, ovariorum, &c. When the lymph is contained in little vesicles in distinct cells, like a bunch of grapes, these are called Hydatides. There are three sorts of this disorder. Anasarca, or Leucophlegmatia, when the lymph stagnates in the whole habit of the pinguedinous sub- stance, or cellular membrane. Tympanites, when the turgescence of the abdomen is owing to the rarefied vapour, ichor, or putrefied fat; this is to be known by the tightness of the skin; the belly, if struck, sounds like a drum, from whence its name; no fluctuation of water can be perceived. In this case the paracentesis is sometimes fatal, (nothing issuing but pus) and sometimes succeeds. Ascites, when the lymph is collected in the duplica- ture of the peritonæum, or cavity of the abdomen: this is to be known by the quashing of water, to be felt on pressure of the hypogastre. E2 The (100) The cause. Whatever occasions a stagnation of the fluids in their vessels, the lymphatics to burst, and the lymph to fall between the membranes; as acute dis- eases, tumours, schirri, hard drinking, stoppage of the necessary or usual evacuations, profuse bleeding, espe- cially of the corpulent, who can never well bear the loss of blood; many fat persons have been bled into dropsies. The diagnostics. Swelling of the ancles, insteps, or feet; afterwards of the abdomen, dyspnœa, heavi- ness, thirst, lassitude, torpor, costiveness, a slow hec- tic fever, leanness, no sweat; the urine crude, or red, white, and small in quantity, excreted with difficulty, sometimes totally suppressed, anorexia, a teazing cough. The prognostics. If taken in time, it is easily cura- ble; in the worst stages a cure is not to be despaired of if the patient will for four or five weeks persist in an entire abstinence from all liquids, a lump of sugar soaked in brandy excepted, which may be taken two or three times a day; if this is suffered to dissolve gra- dually in the month, it will sooner appease the most in- tense ragings of thirst than copious draughts of water. Many have recovered of this disorder in the most hope- less state, by that means, with the use of proper evacu- ants. If attended with a teazing cough, difficult respi- ration, quick pulse, prostration of strength, high-co- loured urine, total suppression of it, obstinate costive- ness, intolerable thirst, (and the patient will indulge it) abscesses, lurid spots on the thighs, the body ema- ciated, the countenance pallid, and of a cadaverous as- pect; these are the harbingers of death. The cure wholly consists in evacuating the waters which are gathered, and in preventing their collection for the future. To this end conduce cathartics, diu- retics, detergents, emetics, (particularly the dry vomit) diaphoretics, and (the sooner the better) the paracen- tesis: after these, corroborants, stomachics, chalybeats, and astringents. In (101) In every stage of this disease, the region of the abdo- men should be bathed with sweet oil every night and morning, and twenty drops of the balsam of copaiva be taken on sugar twice or thrice a day. The purges from which I have experienced the most extraordinary effects are: Take of rhubarb, two drachms, Gamboge, Precipitated sulphur of antimony, of each half a drachm, Vitriolated quicksilver, a scruple, Simple syrup, enough for pills, Number thirty-two; the dose two or three morning and night. Or, Take of rhubarb, a drachm and a half, Gamboge, half a drachm, Calomel, a scruple, Simple syrup, enough to make into pills, Twenty-four; two to be taken night and morning. Take of gamboge, a drachm, For three powders, one of which should be taken in the morning fasting, twice or thrice a week. As to diuretics, no small service may be expected from the broom ashes, and the tincture of cantharides, which are far superior to any of that tribe in this case. An ounce of the expressed juice of florentine orris root, taken twice a day, has cured several dropsicals, as I have been told by a brother Physician; I never tried it. Of the expressed juice of artichoke leaves a tea-cupful three or four times a day has certainly been effectual. Emet- ics are sometimes wonderfully efficacious; they ought not to be of the mildest sort. What I have usually given is, Take (102) Take of vitriolated quicksilver, five grains, Antimony tartarised, four grains, Let this powder be taken fasting, and nothing be drank during the operation. If the thighs are much swelled and hard, apply a warm fomentation of strong brine every night. From the above sylloge, the scientific practitioner may select that which will sufficiently answer his most sanguine expectations; nor need he question the safety with which any of them may be administered, any more than that of the following narcotic diaphoretic, which has performed apparent miracles: the patient should lie between two blankets instead of sheets, and the quan- tity of water which it will cause him to evacuate by the skin, is such as is beyond all belief, and that without the least diminution of the vis vitæ; though the removal of a load from a man’s shoulders can scarcely be sup- posed to weaken him. This Herculean medicine is, Take of purified opium, Ipecacuanha, of each four grains, Vitriolated quicksilver, two grains. A powder to be taken at bed-time. In an anasarca, use oil to the belly, and the balsam of copaiva inwardly. If the legs are much swelled, they should be retained in an horizontal position for the chief part of the day, and straight stockings be worn. A gentle emetic every other morning, such as five grains of ipecacuanha, and the subsequent electuary and drops, I have found sufficient for a cure: Take of conserve of squills, an ounce and half, Magnesia alba, an ounce, Rhubarb, three drachms, Simple syrup, Enough (103) Enough for an electuary; the bigness of a nutmeg to be taken twice a-day. Take of gamboge, half a drachm, Spirit of ammonia, an ounce and half, Of these drops let a tea-spoonful be taken night and morning, or oftener, as occasion requires. When the cure is nearly effected, to restore the fibres to their proper tone, it may not be amiss (as on restoration from the dropsy also) to use Take of red bark six drachms, Filings of Iron, one drachm, Mucilage of gum arabic, enough for an electuary, Dose, the size of a nutmeg, twice or thrice a day. In a tympanites, (as also in a dropsy) a salivation has sometimes succeeded. See FLATUS. Perhaps it would be more eligible to use aloetic purges, corroborants, and stomachics only, and leave the rest to nature. JAUNDICE. THE Jaundice is a copious effusion of the bilious fluid, throughout the whole habit of the body. The cause is most commonly an obstruction of the bile, from viscidities, or calculous concretions in the biliary duct, or in the liver itself, a schirrus of the liver; or a too profuse secretion of bile. The diagnostics. Of an overflowing of the bile, a yellow colour of the skin, especially in the tunica albu- ginea of the eyes, a bad appetite, thirst, bitter taste in the mouth, bilious vomiting, pain in the stomach or bowels, (104) bowels, tumor at the pit of the stomach after eating, in- creasing in size and hardness; pain or swelling of the right hypochondre, periodical colics, borborygmi, list- lessness, itching in the skin, the urine and fæces in- tensely yellow. Of an obstruction of the bile the diagnostics are white or cineritious stools: obstinate constipation; the colour of the skin black, nidorous eructations. The prognostics. If recent, it is easily cured; a black turbid urine indicates the profligation of the disease: the yellower the skin the easier, the blacker the harder it is to be removed. From a schirrus in the liver, calculi in the vesica fellea, or if inflations of the hypochondres supervene, great danger is foreboded. In a state of pregnancy it is of little consequence: parturition cures it. It sometimes terminates in a dysentery. The cure. Venæ-section is unnecessary. The diet should by no means be vegetable. A couple of raw eggs fasting ought not to be omitted, and if repeated three or four times a day, great advantage will result in every stage of this disorder. As to medicinal assistance, begin with the dry vomit, if there is no reason to sus- pect the existence of a calculus in the gall bladder, though even then it may be administered with safety, but the patient will suffer more pain; a clyster, there- fore or cathartic, may be preferable. Avoid chaly- beates at first, for an incurable schirrus of the liver may be the consequence of their premature use, though they are the best of medicines in some stages of this disorder. For children the following is equally safe and efficacious: Take of chalk, ten grains, Rhubarb, five grains, Filings of iron, one grain; This (105) This powder may be repeated night and morning, or as there is occasion. If a clyster is thought necessary, an ounce of soft soap, in seven ounces of the decoction for a clyster, is an excellent one. I have been told that an ounce of the expressed juice of dandelion will cure the yellow jaundice, if taken twice or thrice a day; I never tried it. The balsam of copaiva is of considerable utility.— Either of the subsequent medicines may be depended on, to answer all the ends which can be desired; one of the electuaries may be made use of first, the chaly- beate pills to perfect and confirm the cure. The choice must depend on the circumstances of the case, and skill of the prescriber. Take of turmerick, Venice soap, of each an ounce, Columba root, a drachm and half, Rhubarb, half an ounce, Oil of juniper, two drachms, Simple syrup, enough for an electuary, Dose, the size of a nutmeg, twice or thrice a day. Or, Take of conserve of orange peel, Venice soap, of each an ounce, Magnesia alba, six drachms, Rhubarb, two drachms, Tolu syrup, enough for an electuary, The size of a nutmeg night and morning. Take of socotrine aloes, a drachm, Asafœtida, Precipitated sulphur of antimony, Filings of iron, of each half a drachm, Simple syrup, enough for pills, Number twenty-four; two to be taken morning and night. E3 Take (106) Take of columba root, Rhubarb, of each a drachm, * Precipitated sulphur of antimony, half a drachm, Tincture of cantharides, enough for pills, Thirty-two; two or three to be taken night and morning. Take of gum guaiacum, a drachm and half, Quicksilver pills, Camphire, of each a drachm, Simple syrup, enough for pills, Number thirty-two; two to be taken night and morn- ing. Or, the powders at the close of this article. Rhubarb alone, if skilfully administered, will remove almost any jaundice. Or, Take of rhubarb, any quantity, Soap, enough for pills, size of a pea. Two, three, or four, night and morning, enough to keep the body gently open. In habitual bilious colics, opiates may be given at discretion. The patient is often seized with a violent pain in the stomach and right side, a nausea succeeds, with vehement retchings, till the calculus passes through the ductus choledochus into the duodenum, and he is then in a moment as well as if nothing had happened, until another calculus obstructs the passage, and then the same tragedy is acted over again. I have seen per- sons to whom these fits have returned thrice in twenty- four hours. The following medicines have relieved them: Take * Or, filings of iron, half a drachm, and five grains of tartarised antimony. (107) Take of prepared kali, two drachms, Calcined antimony, one drachm, Pure water, seven ounces, Sugar, as much as you please. Of this mixture let three spoonfuls be taken thrice a day, with two tea-spoonfuls of the subsequent drops: Take of volatile tincture of valerian, two ounces. Or, Take of columba root, a drachm and half, Grains of Paradise, Rhubarb, of each half a drachm, Make into six powders, one to be taken night and morn- ing. See JAUNDICE. VENEREAL DISORDERS. A CLAP is a flux of matter from the glands called lacunæ, situated in the internal parts of the urethra in men, and of the pudenda in women, the fluid which oozes from the secretory glands in their natural state, was designed to lubricate the passage, and line it with a viscous mucus, which might sufficiently defend the extremities of the nerves from being irritated by the salts or acrimony of the urine. When this mucus is abraded and carried off by the attenuated discharge, oc- casioned by the venereal virus, which irritates their ori - fices, the urine causes an intolerable pungent, smarting, or burning sensation. Hence this disorder is called by the French Chaudpisse. The cause originates from an acid virus, or infectious miasmata, acquired by impure coition: these insinuate themselves into the minute mouths of the lacunæ, and consequently increase their diameter, whence a copious running of thinner matter than usual must issue. Cow- per’s and the prostrate glands are often affected. This (108) This distemper is by no means a native of Europe, but was first imported by Christopher Columbus to Na- ples from America, and spread through that city with prodigious rapidity. Somewhat more than a year after his return from his first voyage, the French army sat down before Naples, in the year 1492. The Neapo- litans being distressed by a scarcity of provisions, thought it necessary to discharge the most useless persons from their town, amongst whom were the courtezans, who were received by the besiegers with their usual polite- ness to that sex; the horrid ravages which this disorder soon after made in the camp obliged the French to raise the siege; upon this account it obtained the name of the French disease, and will in all probability ever retain it, notwithstanding the umbrage France has taken at it, and the repeated efforts she has made to shake off the opprobrium. It was then a new disorder, and certainly was never known in Europe before; for whatever has been ad- vanced to the contrary might easily be refuted; the physicians were puzzled, the people were alarmed, for it was supposed to be equally as infectious and fatal as the pestilence; neither monasteries nor nunneries were exempt from it, nor even the holy fathers of the con- clave; it was to be catched (heaven bless us!) by being in the same room with an infected person, or walking on the same side of the way in the street—but, how- ever, with due deference to the characters of those times, it cannot be taken without contact. So deplo- rable was the situation of affairs then, that thousands were deserted, and left to rot without the least assistance. But it being foreign to my design to enter into the history of diseases, I shall only observe, that there is no distemper which is better understood in this enlightened age, nor any one that is with more certainty, or with greater facility, to be cured, even in all its stages, and without that nauseous (though formerly reputed neces- sary) process of salivation. The (109) The diagnostics. Three or four days (generally) after the infection is received, the running comes down with a titillating sensation; difficulty in making urine; smart- ing or scalding; sometimes the cavernous bodies of the penis are puffed up, appear like a spunge, and are of an astonishing bulk; the matter yellow or green, which last is the worst colour it can be of, because it indicates an incipient gangrene; phymosis, when the prepuce cannot be brought back; paraphymosis, when it is tucked down behind the glans and cannot be brought forward to cover it; chordee, or great pain when the penis is erected; frequent stimulations to venery. When the infectious matter has crept into the lymphatics, and from thence is conveyed into the blood, a dry pox is the consequence: though perhaps the miasmata are of a nature quite different from those which produce a clap: yet if the running is stopped too soon in the latter, the symptoms of the former will undoubtedly appear, which are as follows: buboes in the groin, chancres, crystallines, a swelled testicle: warts, mariscæ, fici, rhagades, condylomata, blotches; green seedy excres- cences, on the neck, breast, shoulders; ulcers in the head, eyes, nose, or fauces; mortification, nocturnal pains, tingling in the ears, gummi, nodes, tophs, a rash, scurf, crusts, scabs, caruncles and carnosites in the urethra, total suppression of the urine, bloody urine: atrophy, or wasting of the flesh; erratic pains in the sides; difficulty of breathing, especially when lying on the back; clavus hystericus, corona veneris; softness and rotteness of the bones. This affection of the bones is not unjustly ascribed more to the too liberal use of quicksilver than to the venereal virus: thus it may be observed that the nose falls when the salivation is at its heighth. Many symptoms mimic venereal complaints, which are entirely owing to the lodgments of quicksilver in the minutest vessels; sulphur clogs and chokes this active mineral. I have known numbers who thought that they laboured under a confirmed pox (when they were actually freed from the venereal venora) who have been not only relieved but perfectly cured of all their complaints (110) complaints by the use of an electuary composed only of flowers of sulphur and honey; dose, the bigness of a walnut night and morning. The prognostics. If the running is imprudently tied up before the infection is extirpated, a confirmed pox is the consequence, as is often the case also from the use and frequent repetition of drastic cathartics; for the natural elasticity or springiness of the fibres from such an irritation, will squeeze the infection into the blood. The miasmata will sometimes float about in the fluids for several weeks, before there is any appearance of those dreadful consequences which will sooner or later in good earnest take place. It is easily cured in any of its stages, by due care and proper medicines. It is curable with much less difficulty in men than in wo- men. The old method of giving a calomel bolus at night and a purge next morning, is justly exploded, for it tears the constitution to pieces, is at best a precarious, and often a fallacious procedure; by this means many a pox has been manufactured from a very trivial injury. Salivation is not necessary even in the worst cases, nor is there any one to be cured by it who is not much more easily cured without it. When eruptions appear, with all the indications of a pox, what can be more ri- diculously absurd than to melt down those salts into the blood that they may pass off by the salival glands, when nature so plainly points out the method by which they ought to be expelled. The solution of muriated quick- silver hereafter-mentioned, with a proper liniment to open the pores and increase their diameter, will enable her to throw them off by perspiration; salivation is only the effect of an alteration made in the fluids, which al- teration is as easily made without producing that dis- agreeable and nauseous consequence; nor will it always succeed, for I have known many who have been sali- vated (111) vated four, yea, five times, without success, yet have found no difficulty in curing the same persons afterwards by much milder methods. The cure. In a recent injury the intestinal canal should be kept gently open; bleeding and violent purg- ing are equally improper and useless; there need be no alteration of the usual method of living, nor are the ef- fects of the inflammation, as it is called, in the least to be dreaded. I have known several, who have been drunk every night ’till the cure was completed, without suffering any other inconvenience than an increase of the smart in making water, which must be the conse- quence of an increased running, an event in every other respect by no means undesirable. Of the * stronger quicksilver ointment let the size of a small hazle nut be used night and morning, to be rubbed on the perinæum, between the testicles and fundament, and the inside of the thighs. If injections are permit- ted, a tea-spoonful of oil of olives may be used night and morning. Or a scruple of calomel in an ounce of mucilage; a tea-spoonful of this also may be used twice a day, two grains of muriated quicksilver dissolved in six ounces of mucilage, which in most cases, used as a lotion, would alone be sufficient for a cure; however, without any injection, if the quicksilver ointment is made use of, and one of the following formulæ is given internally, such a method is as safe, certain expeditious, and radical, as any in the power of medicine; this I have experienced in some thousands of instances. N. B Nitre is often prejudicial, and sometimes great- ly increases the uneasiness in making water. Take * Or, which is neater, of white calx of quicksilver, three drachms, ointment of hog's lard, half an ounce, (112) Take of gum arabic, two ounces, Red sulphurated quicksilver, half an ounce, Julap, three drachms, Oil of sassafras, one drachm, Balsam of copaiva, enough for an electuary, Dose, the size of a nutmeg, morning and night. Or, Take of gum arabic, an ounce and half, Quicksilver, with sulphur, an ounce, Gum guaiacum, Jalap, of each two drachms, Balsam of copaiva, sufficient for an electuary. The bigness of a nutmeg to be taken twice a day. Or, Take of rhubarb, four scruples, Calomel, one scruple, Simple syrup, enough for pills. Twenty-four; two at night only. Or, Take of muriated quicksilver, five grains, Muriatic acid, five drops, Rhubarb, a drachm, Simple syrup, enough for pills, Twenty-four; two to be taken every night and morn- ing. Take of muriated quicksilver, ten grains, dissolve in muriatic acid, ten drops, then add compound tincture of lavender, an ounce, For a bottle of drops; twenty to be taken in a glass of white wine,‡ or milk,‡ or water gruel,‡ or water, morning and night, with two scruples of gum arabic in powder. The ‡ These disguise the disagreeable taste best. (113) The author scarcely thinks it worth his while to ob- serve that he was the first person (as far as he knows) who gave the muriated quicksilver inwardly: the above solution he invented after innumerable trials in the year 1753, and has used it ever since; he has ordered it some thousands of times, and is fully persuaded that if it is properly managed, there is no stage of this disorder, in which it will not prove efficacious, nor has it ever once deceived him. The only secret in the manage- ment of this medicine, is to give it in such a manner that it may act beyond the primæ viæ and not run off by stool; there is then no desirable effect which may not be expected from it. One motion in the twenty-four hours is natural, one may be produced by the drops; but if the patient should have more than two in a day, let the dose be diminished to fifteen, ten, seven, or even five drops. A CONFIRMED POX. Chrystallines need only be snipped, and the acrid lymph will be evacuated. A proper application to heal them with is, Take of ointment of elemi, half an ounce, Red nitrated quicksilver, a drachm, To be applied twice a day. Buboes, if soft, white, or flabby, disperse by rub- bing in the stronger quicksilver ointment, as before- mentioned, every night and morning, at the same time taking inwardly the above drops. If the buboes are red, hard, and look angry, let the bread and milk cataplasm be applied to them till they break; the last prescribed ointment is an excellent dres- sing, or the gum plaister; they may be kept open with a pea, like an issue, as long as it is thought necessary. Some indolent tumors of this sort require opening. Warts, (114) Warts, rhagades, &c. cut off, and apply a caustic; if this is not permitted, use the stronger quicksilver oint- ment. Or touch with these drops night and morning, A scruple of muriated quicksilver dissolved in an ounce of water. Caruncles try to break with a wax candle, if that doth not succeed, then with an armed probe apply, Take of ointment of elmi, Red nitrated quicksilver, of each half an ounce, Water of kali, twenty drops, A liniment. At the same time let not the stronger quicksilver ointment be omitted, but be rubbed externally on the perinæum twice a day. Carnosities require the same method of treatment with caruncles. Phymosis, Paraphymosis, Chordee, Swelled præpuce, Chancres, Soak the penis in warm milk night and morning, Avoid the least ap- plication of mercurial ointment to it. And, Take of water of acetated litharge, twenty-five drops, Rose water, three ounces, A lotion to be used frequently. Chancres may be touched night and morning with a lotion of a scruple of muriated quicksilver, dissolved in an ounce of water, and dressed with, Take of the strongest quicksilver ointment, Tar ointment, of each equal parts. Crusts (115) Crusts, scabs, blotches, and ulcers in the throat, if venereal, give the above solution of muriated quicksilver, and let a little of the subsequent powder be sprinkled on a hot iron, and the fumes be received in the fauces by means of an inverted funnel, twice or thrice a day. Take of red sulphurated quicksilver, two drachms, Frankincense, two scruples, Camphire, seven grains, A suffiment. And, Take of muriated quicksilver, two grains, Muriatic acid, two drops, Rose water, six ounces, A gargle to be used night and morning. If owing to the relicts of the quicksilver (which is a very common case), give the sulphur and honey. A swelled testicle. Give immediately five grains, at least, of vitriolated quicksilver, and, Take of camphire, Oil of olives, Oil of aniseeds, of each half an ounce, A liniment to be used every two or three hours. Or, Take of water of litharge acetated, two scruples, Pure water, five ounces, A lotion, in which let a piece of linen rag be dipped and laid on the testicle; when dry, to be again repeated, or kept constantly wetted, and the bread and milk poul- tice at night; if it is not resolving on the next morning, give a bolus of half a drachm of compound extract of colocynth, with ten grains of the quicksilver pills. The warm (116) warm bath will hasten its removal. It should be sus- pended pretty tight by a bag truss, till well. Take of rhubarb, a drachm, Calcined quicksilver, a scruple, Simple syrup, enough for pills, Twenty-four; two to be taken every night, or one night and morning. Or, if laxative, Take of gum guaiacum, one drachm, Pure opium, half a drachm, Calcined quicksilver, fifteen grains, Simple syrup, enough for pills, Number thirty-two; two to be taken every night. Or, Take of muriated quicksilver, ten grains, Spirit of nitrous œther, an ounce, Of these drops let twenty be taken night and morning, in a glass of water. Take of winters bark, Mezereon, of each an ounce, Boil in a gallon and half of water to a gallon; when the boiling is almost finished, add an ounce of prepared kali to every pint. Of this apozem let half a pint be drank twice or three times a day, which, with the above drops or pills, will remove nocturnal pains, nodes, tophs, &c. If the nocturnal pains are very grievous, rub on the shins some of the stronger quicksilver ointment every night, and give two of the following pills every other (or every) night, viz. Take of colocynth, two scruples, Purified opium, one scruple, Precipitated sulphur of antimony, Vitriolated (117) Vitriolated quicksilver, of each ten grains, Simple syrup, enough for pills, Number twelve. Cuticular eruptions will soon vanish, if rubbed over with the following liniment, morning and night; Take of hog's lard, an ounce, Precipitated sulphur, two drachms, White calx of quicksilver, two scruples, Water of kali, a drachm, Oil of sassafras, twenty drops. See SCORBUTIC ERUPTIONS. The sarsa and china root are said to possess wonder- ful virtues; but the author, after a long series of fair trials, was so unfortunate as not to be able to discover them. GLEET. A GLEET is a drain of matter from the urethra. The causes. An ill-cured clap; salivation; profuse venery; a strain; laxity of the fibres. The diagnostics. From the abrasion of the mucus, heat of urine; indifference to coition; pain in the back or loins; general debility; hanging down of the testi- cles; lowness of spirits; loss of appetite; at going to stool the discharge of a glairy matter, in colour and consistence like the white of an egg; the colour of that which oozes is sometimes brown and sometimes yellow, of which last colour it may continue to be (if of long duration, or in those who have been frequently injured) without any remaining infection. The (118) The prognostics. If white or ropy, or thin and glairy, or if flocci appear in the urine, it is easily cured. If of long standing, it will require some time to muzzle it. There is no case so obstinate, but may be cured by some of the subsequent medicines. It has been the malleus medicorum, yet I never met with one (though I have had great numbers who were deemed incurable) with whom I did not succeed. The cure. The patient should abstain from all vege- tables, acids, and sugar, if the case be inveterate, all fermenting liquors; malt or vinous spirits, diluted with water, are harmless. The most proper regimen is— rising early in the morning; gentle exercise; the cold bath, just plunging over head and ears (every morning) and coming out immediately without taking a second dip, or remaining one moment in the water; any ani- mal food, particularly pork, pigeons, partridges, growse, flat fish, shell fish, eggs, jellies: for breakfast and sup- per, milk. From the medicinal classes; detergents, astringents, corroborants, chalybeates, balsamics, fotus, injections, and dry vomit. Isinglass chewed to the quantity of half an ounce a day, and the saliva swal- lowed, is an excellent auxiliary. The glans penis should be frequently washed: much depends on clean- liness. The following formulæ are such as have proved successful, and I never used any other; Take of gum arabic, two ounces, Olibanum, two drachms, Filings of iron, one drachm, Cantharides, a scruple, Balsam of copaiva, Enough for an electuary. The bigness of a chestnut to be taken night and morning. Take of red bark, an ounce, Gum guaiacum, Olibanum, of each half an ounce, Tincture of Cantharides, Enough (119) Enough for an electuary. Dose, the size of a nutmeg twice a day. If costive, Take of conserve of orange peel, an ounce and half, Gum guaiacum, half an ounce, Rhubarb, two drachms, Oil of cloves, one drachm, Tincture of cantharides, Sufficient for an electuary. The size of a walnut to be taken night and morning. Or, Take of socotrine aloes, Filings of iron, of each a drachm, Cantharides, nine grains, Simple syrup, enough for pills, Twenty-four. Two to be taken every night, Or, if the body is too open, Take of purified opium, twelve grains, Cantharides, seven grains, Filings of iron, Asafœtida, Precipitated sulphur of antimony, of each half a drachm, Simple syrup, Enough for pills, twenty-four, two every night. Take of tincture of Peruvian balsam, Compound tincture of benzoin, of each an ounce. Of these drops let two tea-spoonfuls be taken twice or thrice a day. The testicles and parts adjacent should be bathed with a fotus of brandy and vinegar, equal parts, at going to bed (120) bed, and on rising in the morning. Vinegar and water, or vinegar alone, is an excellent injection. Or, Take of acetated ceruse, four grains, Calomel, a scruple, White vitriol, five grains, Rose water, eight ounces, For an injection. A tea-spoonful to be used night and morning. Or, Take of muriated quicksilver, two grains, Muriatic acid, too drops, Rose water, eight ounces, For an injection as before. Or, † Take of blue vitriol, a scruple, Boiling water, an ounce and half, Dissolve in a copper vessel, and make an injection as before. DIARRHŒA. A DIARRHŒA is an immoderate, or too frequent discharge of the excrements. If the matter ex- creted is undigested food, it is called a lientery. If crude, of an ash-colour, or whitish, it obtains the name of cœliac passion. If the fœces are sufficiently digested and aqueous, it is then a diarrhœa. The cause of a lientery is whatever impedes ferment- ation in the stomach, or irritates its villous coat. Cœliaca † This Herculean remedy requires some eare and nicety in the ma- nagement of it, viz. to lower it with water to such a point as to give little or no pain at first. (121) Cœliaca arises from an obstruction of the lacteals, or deficiency of bile. A diarrhœa is from a redundance of serum, which may be owing to consent of parts, as a humid cerebrum, dentition, balbution, &c. from a too large quantity of food taken, at least such a one as is disproportionate to the powers of the digestive or chylopoietic organs; a morbific quality, lubricity of the intestines, laxity of the muscular fibres, deficiency of heat, sometimes from an effort of nature to relieve herself by making a push at the bowels, and thereby carrying off a morbid colluves. The diagnostics. They in general appear from what has been said, to which may be added bilious, black, slimy, or viscid excrements; tenesmus; spumous, greasy, or aqueous dejections; sometimes like pieces of putrified flesh; anorexia, faintness, lassitude, prostration of the vis vitæ, frequent gripings, borborygmy, swelled legs, an emaciated habit, cold sweats, spasms, a slow hectic. The prognostics. If of long duration, it weakens and excoriates the viscera, from whence arise debility, dy- sentry, atrophy, inspissation of the fluids, universal lax- ity of the solids, and accumulated acrimony. Critical evacuations without much pain ought not to be checked: let a few doses of rhubarb be given to expel the noxious saburra and assist nature in her intentions. In a long continued series of moist weather, it is epidemical, from the exhaurition of the vital heat; in old age it is dange- rous. Supervening a pleurisy or peripneumony (Hip- pocrates justly observes) formidable: it is bad, says the same author, if the stools are very aqueous, white, yellow, or frothy, worse if black, livid, little and glutinous.† The cure. Let the patient be removed to a clear dry air; for the most healthy bodies are liable to this disor- der on visiting a moist climate. Exercise should be F taken, † These are what nurses call death stools. (122) taken, particularly riding on horseback in the morning; for diet, animal food, broths, jellies, and rice milk; the cold bath. For common drink, dcoction of harts- horn; clysters are of considerable service, especially in case of a tenesmns: as, Take of starch, a drachm and half; dissolve in six oun- ces of water, then add Oil of olives, an ounce, Tincture of opium, a drachm. Astringents must be given, opiates ought not to be neglected, nor the dry vomit. Begin the cure with an emetic, viz. a scruple of ipecacuanha, and one grain of blue vitriol; then a linient cathartic; after which, if the pain still continues, an anodyne. The reader will find a sufficient number of prescriptions, which have been successful, subjoined. Take of rhubarb, a scruple, Toasted nutmeg, fifteen grains, Prepared kali, ten grains, Syrup of orange peel, enough for a bole; To be repeated occasionally. Take of compound powder of chalk, with opium two drachms, Toasted nutmeg, Mastich, of each a drachm, For six powders; one to be taken twice a day, drinking after it four sponfuls of the following mixture: Take of the chalk mixture, seven ounces, Strong cinnamon water, two ounces. Or, Take of tormentil root, Red astringent gum, of each a drachm, For (123) For six powders; one to be taken twice or thrice a day. Take of the compound powder of chalk, with opium, two scruples, Filings of iron, three grains, Syrup of white poppies, enough for a bole. To be taken at bed time. Take of conserve of red roses, an ounce and half, Compound powder of gum tragacanth, an ounce, Syrup of white poppies, enough for an electuary, Dose the size of a nutmeg, three or four times a day. Take of opiate pill, myrrh, Mastich, of each two scruples, Simple syrup, enough for pills, Number twenty-four; one to be taken twice or thrice a day. Unripe blackberries kept in powder are worthy a place in the shops; half a drachm may be taken twice or thrice a day, or the same quantity of extract of log- wood. When the diarrhœa is subjugated, to recover the appetite and restore the tone of the fibres, Take of red bark, an ounce, Aromatic powder, three drachms, Filings of iron, Galangal, of each one drachm, Syrup of orange peel, enough for an electuary, The size of a nutmeg to be taken night and morning. Take of tincture of catechu, six drachms, Compound Tincture of lavender, two drachms, A bottle of drops; a tea-spoonful night and morning. F2 Or, (124) Or, Twenty drops of the muriated tincture of iron, Night and morning. DYSENTERY. A DYSENTERY is a flux of blood from the bowels. The causes. An acrid blood, erosion of the intes- tines, abrasion of their mucus; long continuance of a diarrhœa, somewhat acrimonious eaten or drank, hy- percatharses. The diagnostics. Bloody dejections, with films, slime, pieces of flesh, phlegm, bile or pus; tormina in the sto- mach and bowels; faintness, spasms, tenesmus, hippo- cratic countenance. The prognostics. If it is imprudently stopped too soon, such a method is productive of the worst conse- quences; if attended with a hiccough, syncopes, or in old persons, great danger is foreboded; from a gangrene or schirrus of the intestines, or meseraic glands, it is fatal. The cure. For diet, rice milk, fat broths, and in the summer time, berries of all sorts may be eaten at pleasure, particularly strawberries. The expressed juice of the solanum is said to be a specific in this disorder, with what truth I know not; the cerated glass of anti- mony has been strongly recommended: I have seen in- stances wherein it has succeeded, but more wherein it has failed. The buds of birch powdered and mixed up with conserve of red roses, is a medicine that will sel- dom disappoint expectation; this has for many years been (125) been sold at a guinea a gallipot, and is still used in the navy. The conserve of roses itself is no despicable re- medy, for I have often known it to answer alone, when taken to the quantity of two or three ounces in a day. Begin the cure with a dose or two of salts; after which a little rhubarb may be given; then give three or four grains of ipecacuanha, and two grains of tartarised antimony every morning; with any of the following formulæ: Take a sheet of white paper, cut into slips, boil in a pint and half of milk to a pint, to be taken at twice. N. B. This never deceived me. For common drink, two ounces of gum arabic may be dissolved in a quart of water, sweetened to the taste. Two scruples of the compound powder of chalk with opium, should be given every night. Take of conserve of red roses, two ounces, Yellow wax, half an ounce, Filings of iron, Galangal, of each a drachm, Syrup of orange peel, enough for an electuary, The size of a nutmeg to be taken twice or three times a day. Or, Take of red bark, six drachms, Tormentil root, Red astringent gum, of each two drachms, Syrup of ginger, enough for an electuary, Dose, the size of a nutmeg, thrice a day. Take of compound powder of gum tragacanth, two ounces, Spermaceti, half an ounce, Balsam of copaiva, enough for an electuary, The (126) The bigness of a nutmeg to be taken morning and night Take of red astringent gum, four scruples, Colomba root, two scruples, Purified opium, ten grains, Simple syrup, enough for twenty-four pills, Two to be taken night and morning, or oftener if occa- sion. CHOLERA MORBUS. THE Cholera Morbus is a disorder of the stomach and bowels, always accompanied with vomiting and purging. The cause. An acrid bile, which may be vitiated by various means; as by eating more than can be digested; by taking too copious a draught of cold water; by con- tinuing too long in the cold bath; by a deficient secre- tion of the pancreatic juice; by profuse evacuations, or feeding voraciously on fat or fruit. The diagnostics. It is most common in autumn; retching, nausea, purging, griping, spasms, contrac- tions of the hands and feet, bitter taste in the mouth, green colour of that which is ejected, and dejected, sometimes it is black; tremors, cold sweats, facies Hip- pocratica. The prognostics. If the inclination to go to stool abates first, it is a good symptom. Syncopes, a dicro- tic or rebounding pulse, proclivity to evacuate, super- seded by faintness, tumor at the pit of the stomach, all these signs denote great danger; in ancient persons death. The (127) The cure. Give plentifully of thin broths to facili- tate vomiting; the custom is not yet relinquished of ad- ministering a puke, though it seems to be needless; broth also may be thrown up in clysters. Or, Take of white poppy seeds, Cucumber seeds, of each half an ounce, boil in ten ounces of water to seven, Oil of castor, two ounces, Nitre, four scruples, Acetated ceruse, a scruple, For a clyster. For common drink, give a decoction of a crust of bread well toasted, till broth can be prepared, or coffee. Apply a bit of cotton dipped in the following mixture to the pit of the stomach: Take of camphire, a scruple, Tincture of opium, two drachms, Oil of nutmegs, cloves and mint, of each twenty drops: Or, bathe the pit of the stomach frequently with bran- dy, or camphorated spirit. Take of calcined antimony, Rhubarb, of each a scruple, Purified opium, two grains, Simple syrup, enough for a bole. To be taken as soon as the patient has had plentiful evacuations upwards and downwards, and begins to grow faint, washing it down with the following draught: Take of peppermint water, an ounce and half, Spirit of cinnamon, half an ounce, See COLIC and VOMITING. TENESMUS (128) TENESMUS. A TENESMUS is a continual desire of going to stool without voiding any thing more than an acrid mu- cus; the part affected is the rectum, or its sphincter. It is rarely an idiopathic disease. The cause. A laxity of the fibres; spasmodic con- striction; a paralytic affection of the sphincter ani; abrasion of the mucus of, ulcer, or acrid irritating fluid in the rectum; hæmorrhoides, worms, stone, diarrhœa, dysentery. The diagnostics. A pungent pain in or about the rectum; frequent inclinations to go to stool, without correspondent evacuations; violent straining without voiding any thing but a viscid or bloody mucus; sensa- tion of lassitude, faintness. The prognostics. If idiopathic, and the patient is not subject to a prolapsus ani, it is by no means formi- dable or rebellious; if it proceeds from an ulcer in the strait gut, or if it is symptomatic in a diarrhœa or dysen- tery, or accompanied with syncopes, it portends great danger, and demands immediate assistance. The cure. Use emollient fomentations and clysters: let the body be kept as still as possible, and in an easy position. Take of gum arabic, an ounce, dissolve in seven ounces of whey, to which add A drachm of tincture of opium, For a clyster. Or, Take of new milk, five ounces, Sweet oil, two ounces, Tincture of opium, a drachm, For a clyster. Or, (129) Or, the starch clyster in diarrhœa. Take of flowers of sulphur, Rhubarb, of each a scruple, Purified opium, two grains, Simple syrup, enough for a bole, To be repeated as there may be occasion. Take of conserve of red roses, an ounce and half, Spermaceti, Elecampane, of each half an ounce, Rhubarb, a drachm, Syrup of white poppies, enough for an electuary, The size of a nutmeg to be taken morning and night. PILES. THE Piles are a painful and sometimes periodical tu- mor in the lower part of the rectum; if they dis- charge blood, they are called the bleeding piles; if not, the blind piles: according to the size and shape, they are nominated verucal, uval, moral, or vesical. The causes. A plethora, a cacochymy; violent ex- ercise, particularly hard riding; neglect of usual eva- cuations, laborious efforts in parturition; constipation of body, straining hard at stool, lentor; viscidity, or acrimony of the fluids. The diagnostics. Swelling of the anus, great pain at going to stool, voiding of blood, sensation of a pungent pain: heat, or weight and pressure in the anus. The prognostics. They sometimes, though rarely, inflame and become gangrenous; sometimes grow ul- cerous, and bring on a fistula. If they continue long F3 without (130) without being resolved, they are extremely troublesome and even render life burthensome. If they happen pe- riodically, and are always attended with a discharge of blood, they are salutary critical evacuations, and to stop them may prove dangerous, unless the bleeding is very profuse and occasions faintness, weakness, or loss of appetite. The cure. Due regard must be paid to the cause from whence they spring, and the concomitant symp- toms with which they are attended. If owing to a ple- thora bleed; or order a diluting sparing regimen, with the liberal use of fruit, vegetables, cucumbers, and such like. But if they appear in a cachectic habit, it is needless to say that all these things should be avoided, and those only proposed which are easiest of digestion. Note,—The viands which digest soonest, and afford the most laudable nutriment, are milk, eggs, partridge, chicken, shell fish, jellies, and pork; there is no vege- table that digests so soon as animal substance: the bones of birds will be converted into a mucus in the stomach in less time than even bread, as I have found by fre- quent experiments. Nature never designed that man- kind should use a vegetable diet only, and it is astonish- ing that Dr. Cheyne should recommend it to hypo- chondriacs, and to persons subject to the gout; though indeed he retracted what he had wrote on this head be- fore he died. The means necessary for the relief of patients in this disorder, are fomentations, liniments, astringents, atten- uants, resolvents, sulphureous medicines, and opiates. For the bleeding piles. Take of expressed juice of yarrow, —of plantain, each five ounces, Sugar, as much as you please, Of (131) Of this mixture let four spoonfuls be taken night and morning. Or, syrup of elder berries. If the patient is costive, Take of electuary of senna, an ounce, Precipitated sulphur, seven drachms, Jalap, one drachm, Syrup of buckthorn, enough for an electuary, Dose, the size of a nutmeg, morning and night. If he is of a lax habit, Take of compound powder of chalk, Olibanum, of each a drachm, Simple syrup, enough for pills, Number twenty-four; two to be taken once or twice a day. A fotus may be used, of an ounce and a half of lime water, with half an ounce of tincture of opium. Or, half an ounce of the spermaceti ointment, with seven grains of hard opium: this ointment, or the above, should be applied two or three times a day to the rec- tum and the blind piles, when painful. Take of quicksilver, with sulphur, an ounce and half, Precipitated sulphur, half an ounce, Rhubarb, a drachm and half, Honey, enough for an electuary, The bigness of a nutmeg to be taken night and morning. The parts may be touched three or four times a day with hog’s lard, or oil of amber, or camphorated spirit. The following electuary is not only excellent in this disorder, but I have seen amazing effects from it in the cure of a fistula. Take (132) Take of flowers of sulphur, Elecampane, of each an ounce, Sweet fennel seeds, half an ounce, Black pepper, two drachms, Balsam of copaiva, or honey, enough for an electuary, Dose, the size of a walnut, twice or thrice a day. HEART-BURN. THE Heart-burn is a painful sensation of heat and sourness about the left orifice of the stomach, which is called cardia, from whence its name, viz. Cardialgia. The cause. An acid acrimony, arising from a too rapid fermentation in the stomach; the corrosive steams of this acid effect the plexus of the nerves on the upper orifice of the stomach. The diagnostics. Acid eructations, a hot burning pain at and above the scrobiculus cordis, an involun- tary flux of tears, nausea; vomiting soon after meals, of a greasy inflammable pituita; spasms in the stomach and bowels; the rising of water in the mouth, particu- larly in the morning; sickness soon after rising from bed; borborygmi, flatus. The prognostics. It is never dangerous, but extremely troublesome, especially after riding or smoaking; those who are subject to it are free from inflammatory fevers; it is sometimes a tedious while ere it can be eradicated, though always curable; if it is suffered to continue long, it may occasion a cephalalgia, vertigo, epilepsy, and convulsions of all sorts. The (133) The cure. The spasmodic or rheumatic pain in the stomach requires the use of aromatic heating medicines, as a scruple of camphire, in half an ounce of æther; this noblest of all antispasmodics should be taken in a spoon, without mixing any thing with it, or swallowing any thing immediately after it; the tincture of guaia- cum, half an ounce in six ounces of water; opiates, aloetic purges, chalybeates, and the dry vomit. See FLATUS. The gout in the stomach is soon removed by the above-mentioned solution of camphire in æther, the guaiacine tincture; drinking moderately of spirits or Madeira wine, or the liberal use of opiates. Periodical pains are to be removed by the bark, or if they do not yield to that, by the dry vomit. Whatever ferments speedily in the stomach should be avoided, as vegetables, fruit, sugar, wines, malt and all liquors that have not passed the state of fermentation; Madeira is said to be the only wine which will not fer- ment in the stomach. The dinner should be made of animal food, and nothing but water drank with it; the breakfast and supper should be milk, A draught of milk and water will generally relieve the pain, when- ever it is violent. The cure may be perfected by the occasional use of chalk or magnesia troches, oyster shells, bole, terra lemnia, red coral, crabs eyes or claws, egg shells, burnt hartshorn, liquorice, chalk, or lime stones, the oils of nutmeg, cloves, or cinnamon. Take of gum arabic, two ounces, Prepared kali, six drachms, Pure water, a pint and half; When the gum is dissolved and the salt, add four ounces of spirit of cinnamon; of this mixture three or four spoonfuls may be taken twice or three times a day. Of (134) Of the aloetic wine two tea-spoonfuls may be taken morning and night. Or, thirty drops of water of kali, in a glass of water. Take of socotrine aloes, Filings of iron, of each a drachm, Simple syrup, enough for pills, Number twenty-four; two to be taken morning and night. In very obstinate cases an emetic should be premised, then a purgative of two ounces of the aloetic wine; after which, either of the above formulæ will complete the cure. COLIC THE Colic is a severe pain in the belly, affecting the epigastre or hypochondres; the part affected is the glut colon, sometimes the ilium. The causes. Distention from flatulencies, acid gas, irritation of the villous coat of that intestine, crudities, costiveness, ruptures, solution of continuity, scybals, acrimony of the bile. The diagnostics. A violent pain in the abdomen, at one time affecting the whole of it, another time deter- mined to one point; sometimes shifting from place to place, sometimes fixed, while the belly swells as if it would burst; the patient is costive, makes but little urine; a fever and strong pulsation in tue abdomen are its usual concomitants, with vomiting, rugitus, or rol- ling noise in the intestines, but always a vehement and tensive pain. In the bilious colic yellow or greenish matter is ejected, the eructations are nidorous, the thirst is more intense, and the fever higher than in the flatulent colic. The (135) The Colica Pictonum infests the hands and feet. For this the balsam of Peru has been found an excel- lent remedy; the dose thirty or forty drops, to be re- peated as there is occasion. The Stone Cholic must be treated with a view to its cause. See STONE. The Hysteric Colic is not dangerous. See HYSTER- ICS. The prognostics. If the pain is mild, or if it inter- mits, and the constipation of body is not very refracto- ry, it is easily cured. If the pain is fixed, and there be no passage downward; if it is attended with intoler- able restlessness, vomiting, fainting, hiccoughs, cold sweats, and delirium, there is no small danger. It not unfrequently terminates in a palsy, jaundice, epilepsy, or dropsy. If owing to an inflammation of the bowels, and the pain suddenly vanishes. it will prove fatal, for the parts are then sphacelated. The cure. The concominant fever is of less conse- quence than it is often imagined to be, being only symptomatic, and when the cause is removed, will cease of course. In general phlebotomy is unnecessary, and superinduces much worse disorders, for those just men- tioned (when colics terminate thus unfavourably) are not little obliged to the lancet for their existence. Clysters are peculiarly serviceable, because they are soonest conveyed to the affected part, and expedite the discharge by stool. The use of opiates (as in all pain- ful disorders) is indicated. Semicupia are highly bene- ficial. In the Bilious Colic, tartarised antimony, clysters, aloetic, or rhabarbine purges and anodynes are to be used. See JAUNDICE and FLATUS. In Hysteric Colic, cordials, diaphoretics, anti-hyste- rics, clysters, and chalybeates, are indicated. In (136) In the Stone Colic, carminatives are of little service: regard must be paid to its original cause. See STONE. In the Flatulent Colic begin with a purgative clyster; if attended with a high fever, and the patient is really plethoric, draw off six or seven ounces of blood. Then, Take of common water, six ounces, Oil of olives, two ounces, Vitriolated natron, an ounce and a half, Tincture of opium, a drachm, For a clyster. Or, Take of balsam of copaiva, (dissolved in the yolk of an egg) half an ounce, Mountain wine, six ounces, Linseed oil, two ounces, Purified opium, five grains, A clyster. Or. Take Colocynth, a scruple, Purified opium, ten grains, Vitriolated quicksilver, Precipitated sulphur of antimony, of each five grains, Simple syrup enough for pills, Eight; two every hour till the pain ceases. Take of wine of aloes, two ounces and a half, Syrup of buckthorn, half an ounce, A draught to be taken immediately, Or, Take of Tincture of senna, two ounces and a half, Syrup of roses, half an ounce, Purified salt of amber, ten grains, A draught. If (137) If the pain continues after the draught begins to work, use the above pills, one occasionally. I have known electricity often remove the colic: to say the truth, I never knew it tried without giving im- mediate relief; it has sometimes returned, but a repe- tition of the same has had the same effect as before. Ten or fifteen grains of allum often repeated, are said to cure an habitual colic. ILIAC PASSION. THE Iliac passion is an inversion of the peristaltic motion of the intestines; consequently in this case nothing can pass downwards. It is called Volvulus and Miserere mei. The causes. The introsusception of a superior part of an intestine into a lower; or a contra; induration of fœces in the rectum into scybals; vomiting irritation, a rupture, acrid bile. The diagnostics. A most acute pain in the small, sometimes in the large guts; generally about the um- bilical region; above it, a tumor; difficulty in making urine: the anus so fast closed by a spasm, as to become totally impervious; it comes on slowly, while the tu- mor in the belly grows bigger and harder; vehement straining, ejection of excrements by the mouth, difficult respiration, cold sweats, hiccoughs, frigidity of the extremities, syncopes, subsultus tendinum, idiotcy. The prognostics. This terrible disorder is incident to persons of all ages; to old persons it is fatal; hiccoughs and convulsions are the forerunners of death; so is a sudden disappearance of the pain, being the sign of a mortification. The (138) The cure. I have relieved some after the fœces came up at the mouth, by cold pediluvia. Let the patient be taken out of bed, and being supported by two persons, throw water as cold as can be procured on the feet, then dash it on the legs, and in a few seconds more on the thighs; after wiping them dry, replace him on the bed, and in a quarter of an hour, if a stool is not produced, repeat the same manœuvre; if the second operation fails success it is not to be expected. If it proceeds from a hernia reduce the intestine, if possible. If plethoric, which is seldom the case, a little blood may be taken away. Inject, if it can be done, a clyster of tobacco smoke, it is an Herculean remedy; then give a clyster of seven ounces of oil, with a drachm of colocynth boiled in it. Some give five ounces, or even half a pound of live quicksilver, for a dose; if void- ed by stool the patient will recover; if retained as it often is, it expedites his end; I have found it in the sig- moid flexture of the colon. For several nights after re- covery a paregoric will be necessary. The following simple draught has been exceeding serviceable: Take of tincture of aloes, an ounce, Syrup of white popies, Oil of olives, Vinegar, of each half an ounce, Spermaceti, two drachms; A draught, to be taken every three hours. Take of vitriolated natron, two ounces, Pure water, six ounces, Tincture of asafœtida, Tincture of opium, of each two drachms, A clyster. Take of colcocynth, two scruples, Purified opium, one scruple, Vitriolated (139) Vitriolated quicksilver, Precipitated sulphur of antimony, of each ten grains, Simple syrup, enough for pills, Twelve; two to be taken occasionally. APPETITE BAD. WHEN the appetite is depraved, or the stomach deprived of its usual appetence for food, or when a nausea is felt at the sight or smell of victuals, a per- son is said to labor under an anorexia. Apepsia is when the digestive organs are incapable of elaborating the aliment into chyle, or a lost digestion. Bradypepsia is when digestion is performed slowly and with great difficulty, or a diminished digestion. Dyspepsia is when the food cannot so properly be said to be digested as converted into a morbid colluvies not fit for nutriment, and may therefore be called a Depraved Digestion. They all proceed from the same causes, and require the same method of cure. The causes. A laxity of the muscular fibres of the stomach, a glutinous pituita; a deficiency of the secre- tions, particularly that of saliva or the gastric fluid; grief, fear, the mind being intensely fixed on one ob- ject, hard drinking, former voracity, profuse excre- tions, want of sleep or exercise, deficiency of heat in the stomach, severe studies. The diagnostics. Frequent retchings, paleness, bor- borygmi, tension of the scrobiculus cordis, nidorous eructations; (140) eructations; after long continuance without food no inclination to eat; at the sight of victuals nausea; after eating vomiting and swelling at the pit of the stomach, sensation of coldnes in the stomach. The prognostics. It often terminates in a marasmus, dropsy, jaundice, or cachexy, and the patient dies ta- bid. It is always of bad consequence if of long conti- nuance, for the patient gradually grows worse while the disorder increases in obstinacy. There are but few cases which are irremediable. The cure. The patient should humour his stomach by eating whatever he feels the least inclination for, and of that a little at a time, and often. For diet, see PHTHISIS, HYPOCHONDRIA, IMPO- TENCY, and WEAKNESS OF THE SOLIDS. The chalybeate waters are useful, or if from frequent acts of intemperance and ebriety, the Bath waters; acids, bitters, change of air, exercise, sleeping soon after meals, gentle cathartics, astringents, aromatics, but above all the dry vomit. Take of ipecacuanha, five grains, Blue vitriol, one grain; Let this powder be taken in the morning fasting, three times a week, without drinking any thing during the operation. Take of aloetic pills, a drachm, Precipitated sulphur of antimony, Filings of iron, Myrrh, of each half a drachm, Simple syrup, enough for pills, Number thirty-two; two to be taken twice a day. If not costive, Take (141) Take of conserve of wormwood, an ounce and half, Galangal, Zedoary, of each half an ounce, Syrup of orange peel, enough for an electuary, Dose, the size of a nutmeg, twice a day. Take of aloetic pills, too scruples, Snake root, a drachm, Long pepper, half a drachm, Oil of cinnamon, twenty drops, Simple syrup, enough for pills, Number thirty-two; two to be taken morning & night. A tea-spoonful of the compound tincture of gentian may be taken thrice a day, or tincture of orange peel, or of the diluted vitriolic acid. See FLATUS. BULIMUS. BULIMUS, or canine appetite, is so called from the constant propensity that is felt to eat, and the vo- racity with which the food is devoured. The causes. A digestion too quick, a too liberal use of acids, immoderate evacuations, worms, acrimony of the gastric fluid. The diagnostics. are sufficiently obvious. The prognostics. It is often succeeded by a Bulimia; that is when the same inclination to eat remains without the power, and after the patient does eat, he faints. If not cured, it terminates in a lientery, a cachochymy, or atrophy. The (142) The cure. Let fat meat and fat broths be the principal diet; sweet wines or new beer, the chief li- quids that are drank. Give emetics, particularly the dry vomit, and aloetic cathartics. If it proceeds from worms, Take of quicksilver, with sulphur, Tin of each two drachms, For six powders; let one be taken morning and night. Take of socotrine aloes, Filings of iron, Asafœtida, of each two scruples, Oil of wormwood, enough for pills, Number twenty-four; two to be taken twice a day. Take of socotrine aloes, Filings of iron, of each a drachm, Calomel, Colocynth, of each a scruple, Simple syrup, enough for pills, Thirty-two; two to be taken night and morning. Take of Mutton suet, four ounces, New milk, eight ounces, For a draught, to be drank warm. Opium may be given occasionally, not in less doses than three grains. See WORMS. VOMITING. (143) VOMITING. THE cause of vomiting is a convulsive or inverted motion of the stomach, owing to some irritation of the nerves of its left orifice, which may be occasioned by consent of parts, as sailing, tickling the throat, &c. to a laxity also of its muscular fibres, acid acrimony, or redundance of bile. The diagnostic is obvious. If idiophatic, no part is affected but the stomach. If symptomatic, reference must be had to the primary disorder. The prognostics. It is often a critical expulsion of an acrid morbific matter, and should then be promoted by an emetic and broth. If of more than two days conti- nuance, (at times) or if the patient is always sick after eating, it ought to be prevented, or it will terminate in an anorexia, marasmus, or paralytic affection of the stomach. The cure. Give a gentle emetic, or five or seven grains of ipecacuanha, every morning fasting, for a few days, letting it work itself off without drinking. Its prevention is to be secured by anti-emetics, nervines, cardiacs, and opiates. Repeated applications of cam- phorated spirit to the pit of the stomach; fomentations and stomachic plaisters may be used: it would not be amiss to apply them under the left shoulder rather than to the pit of the stomach. Preparations of mint are of great utility, either the essential oil, or an infusion of the leaves in the distilled water of the same. If it pro- ceeds from an acid acrimony, give plentiful draughts of broth, and a drachm of the magnesia alba occasionally. A scruple of colomba root as often as is necessary. See COLIC, CHOLERA MORBUS, FLATUS, and AP- PETITE BAD. Take (144) Take of prepared kali, two scruples, Conserve of wormwood, half a drachm, Let this be washed down immediately with two ounces of lemon juice, or vinegar, or a draught composed of an ounce of lemon juice, and one ounce of peppermint water. Take of bay berries, half a drachm, Grains of Paradise, Galangal, of each ten grains, Oil of cinnamon. Oil of mint, of each three drops, Purified opium, two grains, Syrup of orange peel, enough for a bole, To be taken at bed time. A tea-spoonful of compound tincture of lavender may be taken occasionally, or of colomba, or of casca- rilla. SYNCOPE. SYNCOPE, or fainting, proceeds from an obstruc- tion of the efflux of the nervous influence along the par vagum. The causes. Weakness, intense pain, hunger, thirst, anorexia, profuse evacuations, excess of external heat, passions of the mind, hysteric affections, uterine furor. The diagnostics. Paleness, cold sweats, low flutter- ing pulse, trembling, cessation of motion and sense. The prognostics. It is always dangerous, excepting in hysterical paroxysms, and then it is of little conse- quence. (145) quence. From excessive evacuations, or after convul- sions or supervening the ravages of a fever, it is often fatal. The cure is to be effected by nervines, cardiacs, ster- nutatories, volatiles, opiates, the aromatic confection, ginger, a generous diet, and the cold bath. See EPILEPSY, FLATUS, and WEAKNESS of the SOLIDS. Take of the chalk mixture, seven ounces, Spirit of cinnamon, two ounces, Compound tincture of lavender, Syrup of tolu, of each half an ounce, A julep, of which give three or four spoonfuls as there is occasion. It is a most excellent cordial. Take of volatile tincture of valerian, an ounce and half, Compound tincture of lavender, half an ounce. Two tea-spoonfuls of these drops to be taken in a glass of water two or three times a day. POISONS. IF Poisons have been taken internally, give immedi- ately three grains of blue vitriol, and five grains of the yellow emetic quicksilver, with frequent and large doses of sweet oil afterwards, and two scruples of kali every three hours. For the bite of a mad dog. Apply a cataplasm of pickled herrings to the part affected: or a caustic with the following dressing, half an ounce of gum elmi, and two drachms of the red nitrated quicksilver. Use musk, alkalis, mercurials, and immersion in salt water. G Take (146) Take of camphire, a drachm and half, Precipitated sulphur of antimony, Vitriolated quicksilver, of each half a drachm, Simple syrup, enough for pills, Number thirty-two; one to be taken morning and night. N. B. I fear all the above, and the famous Orms- kirk medicine too, are equally useless, if the dog be really mad. For the bite of a viper. Bathe the part affected with warm oil often. Sting of an insect. Apply a piece of allum wetted to the part frequently, or balsam of Peru and Hungary water, of each equal parts; or of oil of olives and oil of turpentine equal parts, or camphorated spirit, tincture of myrrh, of each equal parts; or of water of ammonia and oil of amber, of each equal parts, or, an aqueous solution of opium. PALPITATION OF THE HEART. A PALPITATION of the heart is a preternatural systole of that viscus. The causes. It is often owing to a plethora, to poly- pous concretions, sometimes to a deficiency of nervous influence, or influx disproportionate to the elasticity of the muscular fibre, indolence, ebriety, acid gas, spasms, acrimony of the fluids. The diagnostics. A fluttering pulse, temporary stop- page of the breath, a preternatural pulsation on the left side, to be felt by the hand, and sometimes to be heard. The (147) The prognostics. If it is owing to fleshy excrescencies or grumous clots, it is incurable: if from a plethora, it is to be removed by bleeding only; if from an acid halitus, easily curable by alcalis and cardiacs. If of long continuance, it often terminates in an apoplexy. The cure. It must be treated according to the cause it proceeds from. If the patient is not plethoric, avoid all evacuations and use one of the subsequent remedies; A scruple of camphire, dissolved in half an ounce of œther, For a draught. Take of compound tincture of lavender, Tincture of castor, of each half an ounce, Of these drops let two tea-spoonfuls be taken twice or thrice a day. Take of gum arabic, two ounces, dissolve in Pure water, a pint, Tincture of cantharides Oil of turpentine, of each half an ounce, Two or three spoonfuls of this mixture to be taken night and morning. SPASMS, OPISTHOTONOS, CONVULSIONS. SPASMS owe their origin to an irregular or unequal influx of the vital heat into the affected muscles; or great deficiency thereof. They require the use of vesi- catories, emetics, and antispasmodics, such as gum am- moniac, asafœtida, valerian, musk, blue vitriol, or which is second to none of them, a scruple of camphire in half an ounce of æther. G2 Painful (148) Painful spasms demand the liberal use of opiates. In the opisthotonos and the locked jaw, purified opium may be given, even to the quantity of seven or eight grains for a dose, washing it down with seven or eight ounces of the musk julep, or two grains frequently repeated, i. e. every hour, till the end is answered. Convulsions of all sorts in children yield to the fol- lowing: Take of prepared kali, a drachm, Tincture of asafœtida, half an ounce, Peppermint water, an ounce and half, Let a tea-sponful be given three or four times a day. DIABETES. A DIABETES is a preternatural discharge of urine. The causes. An obstruction of insensible perspiration, dilatation of the renal glands, to great attenuation of serum, laxity of the fibres, hard drinking. The diagnostics. If of long standing, or supervenes on the departure of a fever, it is dangerous: proceeding from weakness of the solids, it is difficult of cure: in old persons seldom removeable. The cure. For diet, see PHTHISIS and HYPOCHON- DRIA. Astringents, chalybeates, balsamics, mineral acids, agglutinants and corroborants are proper in this case, as also is the cold bath. A vesicatory applied to the os sacrum has an admirable effect. For common drink, the decoction of hartshorn may be given, with an ounce of infusion of roses in every pint; or lime-water, or (149) or the Bristol waters, or allum whey, which will some- times effect a cure alone: it may be prepared by putting two drachms of roch-allum powdered in a pint of boiling milk: half a pint to be drank twice a day. If costive, let aloetics be given. The dry vomit is of considerable utility. The following have been all found serviceable. See DIARRHŒA. Take of mastic, a drachm and half, Balaustines, Olibanum, of each half a drachm, Simple syrup, enough for pills, Number thirty-two; three to be taken twice or thrice a day, Take of compound tincture of lavender, an ounce, Vitriolic acid, half a drachm, Of these drops, let a tea-spoonful be taken thrice a day. Or, of Tincture of cantharides, A tea-spoonful, morning and evening. Take of gum arabic, an ounce, Red bark, six drachms, Red astringent gum, half an ounce, Tincture of cantharides, enough for an elec- tuary. Dose, the size of a nutmeg, twice a day. WORMS. (150) WORMS. WORMS are of three sorts, teretes, or the round worm, whose seat is in the stomach; tænia, or the tape worm, which is to be found in most of the in- testines; ascarides, or the small worm, seldom to be met with but in the rectum. The cause. Ova received with the food. The diagnostics. Inflation of the abdomen; violent pain and spasms in the stomach and bowels; itching of the nose or anus; fœtid breath, voracity, the excre- ments greasy, or greenish, or slimy; coma, nausea, moistness of the mouth and slavering in the night, grind- ing of the teeth, faintness, cold sweats, delirium, con- vulsions; shocks, similar to electrical ones; flushing heats, flying pains, anxiety, alternative swelling and subsidence of the veins, the pulse weak and intermit- ting, thirst, paleness, vagrant stitches, epileptical pa- roxysms, paralytical strokes, which go off spontaneously on the removal of the cause. The prognostics. If they remain long in the intesti- nal canal, they produce a variety of unaccountable dis- orders: strange and incredible are the effects which are occasioned by these detestable vermin; few persons are wholly free from them, particularly females. If after they are destroyed they are not conveyed out of the body, a putrid acrimony may be the consequence; small doses of cathartics should be continued for some time after they are killed, not only for the above reason, but to cleanse the bowels from the adhering ova. The cure is to be effected by aloetics, chalybeates, oils, oleous clysters, prepared kali, or oil of wormwood, which may be applied to the navel, or plaister of aloes and galbanum may be smeared over with it, and applied to the umbilical region for children. New milk in a decoction (151) decoction of quicksilver, two ounces to a pint for four doses: flowers of sulphur mixed up with honey, the size of a nutmeg to be taken night and morning; red sulphurated quicksilver is an excellent anthelmintic, as also are the filings of pewter, which may be given to adults to the quantity of a drachm, fasting, or the same quantity of tin. The following pills are equal to any thing in efficacy: Take of socotrine aloes, Filings of iron, of each a drachm, Calomel, a scruple, Simple syrup, enough for pills, Number twenty-four; dose, two morning and night. Or, Take of quicksilver with sulphur, an ounce and half, Seeds of santonicum, half an ounce, Honey, enough for an electuary, The size of a walnut to be taken night and morning. Or, if of a laxative habit, Take of red hark, an ounce, Coralline, half an ounce, Mucilage of gum arabic, enough for an elec- tuary, Dose, the bigness of a chestnut morning and night. See WORM FEVER. SCURVY AND SCORBUTIC ERUPTIONS. THE Scurvy is a cachochymic diathesis of all the fluids. The causes. An acidity, an acrimony, or (at Sea) putrefactive quality in the blood, often introduced by a moist (152) moist air, obstructed perspiration, putrid water, poor- ness of blood, that part of salted provisions which has not taken salt, (for salt itself, so far from producing the scurvy, is an excellent antiscorbutic) eating too plenti- fully of fruit. Surfeits, as they are called, and scorbu- tic eruptions, originate from the too liberal use of vege- tables. Few persons are entirely void of all scorbutic complaints. The sea scurvy is a disorder that requires treatment very different from this we are treating of, though the effects are somewhat similar; for vegetables and acids are the most expeditious remedy for seamen, especially on shore; but they ought to be totally ab- stained from, by those who never use the sea, and are troubled with cuticular eruptions. Scorbutic eruptions are so common, that the author has met with some thou- sands of these cases in a year, and never one that he did not succeed in the cure of; but lest his invariable order to abstain from all vegetables and acids should startle the reader, he begs leave to observe, that so far from being singular in this point, he has heard the same advice given by the greatest and best Physicians of this or any age or country; it were needless to add that he means Dr. Fothergill. The diagnostics. An acute pain in the head, a sen- sation of dulness, erratic pains in the limbs, blackness of the skin, sponginess and putrefaction of the gums, oozing of blood from them; rottenness of the teeth, fœ- tid breath, an unequal pulse, diarrhœa and dysentery; frequent shiverings, a palpitation not seldom fatal; swellings in the joints, vitiated appetite, borborygmi, tormina in the bowels, sometimes costiveness; the urine pale, red, or gravelly; nausea, hiccoughs, livid spots on the skin, sometimes converted to foul ill-con- ditioned ulcers, crusts, scabs, scabies, cuticular erup- tions, which itch intolerably, appearing in general, first on the thighs, then on the arms and hands, sometimes scattered on the breast or over the whole body; red an- gry pimples, carbuncles, vesicles full of a hot acrid lymph, elephantiasis, contractions, stiffness of the joints, vertigo, (153) vertigo, convulsions, lowness of spirits, frequent sigh- ing, dyspnœa. See LEPROSY. The prognostics. This is a distemper which is ex- ceeding crabbed and refractory, has been always reck- oned very difficult to cure, and dangerous. If not scientifically treated it frequently terminates in a dropsy, atrophy, hypochondria, or apoplexy. As the old me- thod of treating it has been hitherto somewhat unfor- tunate, the author can with some justice, as well as confidence, recommend a new one, which has never yet baulked his expectations. The cure. When eruptions appear they are most for- cible pleaders against bleeding; the lancet is in these cases always pernicious. A milk diet is proper, at least for morning and evening; for dinner, animal food, with plenty of salt, but no vegetables. For regimen, see HYPOCHONDRIA and WEAKNESS OF THE SOLIDS. Give lenient cathartics, errhines, the chalybeate waters, aluminous waters, salt water, bitters, balsam of copaiva, but above all, the dry vomit. I shall now communicate to the reader all the various medicines I have used, the efficacy of which has been proved by a most extensive and successful experience. Take of aloetic pills, Precipitated sulphur of antimony, Gum guaiacum, of each two scruples, Simple syrup, enough for pills, Number twenty-four; two to be taken morning and night. Take of muriated quicksilver, ten grains dissolve in Muriatic acid, ten drops, then add Antimonial wine, an ounce, Of these drops let twenty (or if they purge, fifteen) be taken twice a day, G3 Take (154) Take of quicksilver with sulphur, an ounce and half, Gum guaiacum, half an ounce, Crude antimony, Snake root, of each two drachms, Syrup of orange peel, enough for an electuary. Dose, the size of a nutmeg, night and morning. If not costive, Take of red bark, on ounce and half, Winter's bark, half an ounce, Mucilage of gum arabic, enough for an elec- tuary, The size of a nutmeg to be taken twice a day. To cleanse the skin entirely from any remaining eruptions, defœdations, or from gingivous tumors. Take of sharp pointed dock roots, two ounces and a half, Extract of liquorice, two drachms, Winter's bark, half an ounce, Boiling water, a quart. Let them stand for twelve hours, then strain. Of this mixture let a tea-cupful be taken in the morn- ing, (fasting) and at night. If a dentifrice is thought necessary, Take of French bole, Burned allum, Myrrh, of each a scruple, To be used every morning. Or, Take of florentine-orris root, Burned allum, Lac (155) Lac, of each a drachm, Honey, acidulated with spirit of vitriol, enough for a mixture. As Scorbutic Eruptions are generally attended with a most troublesome pruritus, especially in bed, let the parts affected be anointed night and morning with the tar ointment; or if that, though powerfully efficacious, is objected to on account of the smell, Take of ointment of white calx of quicksilver, an ounce, Water of kali, Essence of lemons, of each twenty drops, To be used night and morning. Or, Take of white calx of quicksilver, two scruples, Cerate of acetated litharge, an ounce, Oil of rosewood, ten drops, An ointment, to be used night and morning. Or, Take of ointment of white hellebore, ounce, Water of kali, twenty drops; An ointment, as before. Or, the Neapolitan ointment. Take of the diluted vitriolic acid, Water, of each four ounces; A lotion, to be used night and morning. Or, Take of muriated quicksilver, ten grains, Muriatic acid, ten drops, Rose water, two ounces, As before. A liniment, to wash the eruptions night and morning, with a rag dipped in it. One (156) One of the above ointments, particularly the tar oint- ment. Or, Take of calomel, two scruples, Tar ointment, an ounce, To be rubbed in night and morning, and then wiped off with a dry cloth; should always be used when there are eruptions on the skin, and one of the above-men- tioned prescriptions be taken inwardly at the same time, particularly the mixture or drops, which will effectually free the patient in a few days from this disagreeable disorder. It will wonderfully expedite the cure if the following powder be used by way of snuff; a pinch of it to be taken every night after getting into bed: Take of white hellebore root, a scruple, For a sternutatory powder. ITCH. THE Itch is a cutaneous disorder, too well known to need description. The cause. An infectious miasma sui generis. The hypothesis of its being wholly owing to animulcules is highly problematical. The diagnostics. These are to be discriminated from scorbutical eruptions by their minuteness; from vene- real ones by not blotching; and from both, by their principally infesting the parts between the fingers; with a sensation of heat that invariably accompanies the itch- ing. The prognostics. It is attended with no danger. It is never difficult to cure in any habit. The (157) The cure. See SCORBUTIC ERUPTIONS, under which article the reader may find several elegant and efficacious liniments, either of which will answer his expectations in the cure of the itch, (particularly the solution of muriated quicksilver, the tar ointment, or the ointment of white precipitate) and of all cuticular eruptions, whatever cause they arise from: they will also cure red faces, freckles, morphew, grubs, tetters, ringworms, or any defœdations of the skin. The tar ointment with calomel should be used for a day or two morning and night, and then one of the others twice a day also, till the skin is perfectly clean: taking, during the use of the latter, the mixture recommended under the article SCURVY. Bleeding and purging are useless and improper in this as well as in all other cutaneous disorders. If internals are requested, though they are seldom necessary, either of the subsequent ones may be given with propriety and advantage: Take of vitriolic acid, half an ounce, Three or four drops to be taken in a glass of water night and morning. Take of quicksilver, with sulphur, an ounce and half, Calcined antimony, two drachms, Syrup of orange peel, enough for an electuary, The size of a nutmeg to be taken morning and Night. Or, Take of flowers of sulphur, an ounce and half, Nitre, two drachms, Honey, enough for an electuary; Dose, the bigness of a chestnut, night and morning. For children, Take (156) Take of vitriolic acid, five drops, Rose water, fifteen drops, Ointment of hog's lard, an ounce, Essence of lemon, fifteen drops, A liniment, to be used night and morning. For adults, Half an ounce of vitriolic acid, in a pint of water, A lotion, to be used twice or thrice a day. Take of muriated quicksilver, ten grains, Muriatic acid, ten drops, Camphorated spirit, two ounces, A lotion, to wet the parts with, night and morning. Or, The decoction of hellebore, Or, Take of white calx of quicksilver, a drachm, Ointment of hog's lard, an ounce and a half, Water of kali, a drachm, Essence of lemon, fifteen drops, A liniment, to be used night and morning. See SCOR- BUTIC ERUPTIONS. LEPROSY AND ELEPHANTIASIS. THE Leprosy is a cutaneous disorder, which appears in whitish dry scabs, and often spreads over the whole body. Sometimes one leg only is affected, which swells to an enormous bulk, then called Lepra Græco- rum and Elephantiasis. The (159) The causes. Obstructed perspiration, weakness of the solids, poverty of blood, an ill-cured itch, the re- mains of which will often lurk, appearing and disappear- ing, though not totally, for many years, and at length will break forth in this dry scurf, gradually enlarging. The diagnostics. Sometimes it is confined to the palms of the hands only, with fissures which run parallel to each other; sometimes to a little below the elbows; one while on the face only; another in white hard scales on the neck, generally appearing most on the thighs, or on the hands and arms; intolerable itching; the elephant’s leg. The prognostics. The Leprosy confined to the skin, without any remarkable tumor, is easily curable; the Elephantiasis not without much difficulty and time. The cure. For the Leprosy give the most nourishing diet, as eels, &c. and use precisely the same method as that recommended under SCURVY and SCORBUTIC ERUPTIONS, which see. For the Elephantiasis give the solution of muriated quicksilver in antimonial wine, under SCURVY. Let the whole leg be wrapped up in a cloth, on which the following liniment is to be spread, to be renewed night and morning. Take of tar ointment, an ounce, Water of acetated litharge, half a drachm, Camphire, a scruple, Calomel, two scruples, A liniment. EVIL. (160) EVIL. THE Struma, Scrophula, or King’s Evil, is so called from an imaginary cure performed by the Royal touch. The cause. An acrid blood, hereditary disposition, the venereal virus conveyed in semine. Those who are of habits exaltedly scorbutic, or in whom the itch has not been perfectly cured, (strange as it may seem) may beget a sciophulous offspring. Weakness of the solids. The diagnostics. Glandular tumors, serpiginous ul- cers, erosions of particular parts, contractions, distor- tions, sinuous abscesses. The prognostics. This disorder is not easily extirpated. If the tumors in the neck are not dissipated or opened, a glandular consumption generally ensues. Fistulous abscesses in scrophulous patients are rarely, if ever curable, unless by the following: Take of muriated quicksilver, two grains, Muriatic acid, two drops, Rose water, five ounces, Lint dipped in this to be applied night and morning. The cure. For regimen see PHTHISIS. The bark is the most noble remedy in strumous cases, when the patient is not of a costive habit. Burnt spunge is often used to advantage, and madder; sea-water also, but the dry vomit is inferior to no other remedy. The following I have given with manifest utility. Take of muriated quicksilver, ten grains, Muriatic acid, ten drops, Antimonial wine, an ounce; Of (161) Of these drops let an adult take twenty in a glass of wa- ter, morning and night. Take of quicksilver, with sulphur, two ounces, Crude antimony, two drachms, Honey, enough for an electuary; Dose, the size of a nutmeg night and morning. Externally apply the tar ointment with calomel twice a day. Or, Take of muriated quicksilver, ten grains, Pure water, an ounce and half, Tincture of cantharides, half an ounce, For a lotion, till the tumors lessen; if not, apply a poul- tice of bread and milk till they break, and then dress with Take of calomel, two scruples, Tar ointment, an ounce, To be applied morning and night. Or the above solu- tion in rose water. FALLING DOWN OF THE ANUS. THE falling down of the fundament is owing to a laxity of the fibres of its sphincter, or to a paralytic affection of them. It is easiest to be reduced by the pa- tient himself, lying on his back, writhing himself from side to side, crossing his legs, &c. with the application of sweet oil. When it is reduced, let a warm flannel be applied and frequently repeated; some of the following powder may be thrown on a red hot heater in a close- stool, and the anus be placed over it. If it cannot be reduced apply dephlogisticated air. Take (162) Take of aromatic powder, Mastic, of each a drachm and a half, White amber, Balustines, of each a drachm, A suffiment. The subsequent drops have proved of considerable utility: Take of Rectified spirit, half an ounce, Oil of turpentine, two drachms, Vitriolic acid, one drachm, Twenty to be taken twice or thrice a day. Take of Tormentil root, Dragons' blood, Mastic, of each a drachm, Simple syrup, enough for pills, Number twenty-two; three to be taken night and morn- ing. The red astringent gum will be of considerable ser- vice. See DIARRHŒA and DYSENTERY. STRANGURY. A STRANGURY is a partial suppression of urine, while the efforts to discharge it are attended with pain. The causes. Irritation, too long detention of urine, obstruction of it, spasms, paralytic affection of the de- trusores urinæ. The (163) The diagnostics. Frequent desires to make water, its coming away with difficulty and uneasiness; but little made at a time with great pain; sensation of heat and smart when the dribbling is over; pruritus. The prognostics. If symptomatic, it is easily helped, as from blisters in fevers, &c. If idiopathic, it is dan- gerous; in old persons frequently mortal; it often ter- minates in an incurable ischury. The cure. Let the patient abstain as much as possi- ble from liquids, and take food that is balsamic and light of digestion, and make use of agglutinants, as linseed tea, fomentations, emollient clysters, lenient cathartics, oleous injections, mild diuretics, cardiacs, opiates, warm semicupia, cold pediluvia, or the catheter. If it pro- ceeds from spasms give half an ounce of æther with a scruple of camphire in it. If from a paralytic affection of the detrusors, Take of red bark, an ounce and half, Compound powder of tragaeinth, half an ounce, Mucilage of gum arabic, enough for an elec- tuary. The size of a nutmeg to be taken every two hours. In other cases the following remedies have been at- tended with success: Take of oil of olives, five drachms, Camphire, two drachms, Oil of aniseeds, one drachm. With this liniment let the pubes and perinæum be anointed every hour. Let two ounces of horse-rhadish scraped be boiled in a pint of ale, thrown into a close-stool, and the vapour be received. Take (165) Take of gum arabic, two scruples, Nitre, one scruple, Camphire, five grains, Oil of aniseeds, four drops, Aromatic confection, enough for a bole, To be repeated as there is occasion; or the balsam of Peru mixture, under the article STONE. If the pain is vehement give two or three grains of purified opium. URINE SUPPRESSED. A DYSURY is when the patient feels inexpressible difficulty in making water. An Ischury is a total suppression of urine. The causes. An inflammation, abrasion of the mucus that lines the urethra, deficient secretion of it; ulcers, diarrhœa, gonorrœa, vesicatories, acid food, hard riding, hard drinking, the stone. The diagnostics. On an attempt to make water the pain begins; after it is evacuated, a violent smarting and sensation of heat; most severe at the extremity of the urethra. The prognostics. Proceeding from another disease, reference must be had to the original cause. If consti- tutional, the case is difficult. An Ischury in old persons, or when the water cannot be reduced by the cathether, is generally mortal; the last resource is immersion of the feet in cold water. A (166) A few cases I have met with of persons not much ad- vanced in years, where there has been no inclination to make water, nor has there been any in the bladder; fre- quent nauseas have been the only other symptom of want of health. On dissection the kidnies have been found wasted. The cure. The patient should use diluent liquors, whey, aluminous waters, agglutinants, blomange broths, jellies, balsam of copaiva, gum arabic, decoction of marsh-mallow roots, new milk warm, absorbents, and such as are proposed under STRANGURY, which see. See also the balsam of Peru mixture, under the article STONE. URINE, INCONTINENCE OF. IF the patient cannot hold his water, let a blistering plaster be applied to the os sacrum, of the same size and shape, to be kept on four or five days, or till it comes off of itself, and, Take of red bark, six drachms, Red astringent gum, two drachms, Tincture, of cantharides,, enough for an electuary. Dose, the size of a nutmeg night and morning. Or, for an adult, A tea-spoonful of tincture of cantharides, Night and morning, in milk. LETHARGY. A LETHARGY is an involuntary drowsiness, or continual propensity to sleep. The (167) The causes. A deficiency of vital heat in the cere- brum, foggy food, excess of pituita, indolence, using sleep after dinner, omitting customary exercise, lentor, viscidity of the fluids, spasms. The diagnostics. They are obvious from what has been already observed, to which may be added a me- mory much impaired. The prognostics. In young persons, if they are in- vaded in the summer time, it is easily cured; in winter if the patient is attacked, and feels a great prostration of strength, it is dangerous. In old persons, if the urine is white, it is scarcely curable. The cure. Removal into a clear dry air is necessary. The diet should be as in HYPOCHONDRIA, which see. Bleeding often renders it incurable. A bladder may be filled with hot water, and laid on the head, which should be rubbed with warm flannel, or use some of the applications recommended under the article HEAD- ACH. Touch the palate with a feather dipped in boil- ing water. The proper remedies are sternutatories, acrid clysters, stimulants, aromatics, volatiles, chaly- beates, vesicatories, the dry vomit, and plasters to the head when shaven, as, Take of galbanum, two drachms, Pellitory, Long pepper, Castor of each a drachm, Balsam of Peru, sufficient to make a plaster. Take of salt of hartshorn, Purified salt of amber, of each a scruple, Lisbon wine, two ounces, A draught to be taken every night. Take of volatile tincture of valerian, Tincture of guaiacum, of each an ounce, Of (168) Of these drops let two tea-spoonfuls be taken twice or thrice a day. Take of socotrine aloes, Filings of iron, Asafœtida, of each two scruples, Precipitated sulphur of antimony, Vitriolated quicksilver, of each one scruple, Simple syrup, enough for pills, Thirty-two; two or three to be taken night and morn- ing. IMPOTENCE. IMBECILITY is an inaptitute for coition: Impotency is a total incapacity of that action. The causes. A deficiency of vital heat, or some im- pediment to its proper efflux from the spinal marrow; weakness of the solids, profuse venery, ill-cured claps, gleets of long continuance, gravelly disorders anorexia, mastupration, frequent bleedings. The diagnostics. Flaccidity and hanging down of the testicles, coldness of the glans penis; few, weak, or no erections; pain or weakness in the loins, wandering stitches in the sides and groins, cephalalgia, vertiginous disorders, involuntary emissions without erections, hy- pochondria. The prognostics. If idiopathic, the cure is difficult; in old men, impracticable; if the patient is young, and has no other complaint of any consequence; or if it pro- ceeds only from indiscreet excesses, it is easily curable; if accompanied with a gleet, let that be first muzzled before the cure is attempted. The (169) The cure. Great regard must be paid to the non-na- turals. The patient should keep his mind constantly employed, to prevent as much as possible the incursion of venereal desires or thoughts. He should rise early in the morning, take a great deal of exercise, stopping short only of fatigue. The less fluids that are drank the better, the whole quantity ought not to exceed two quarts in the twenty-four hours. Let the diet be of shell-fish of all sorts, particularly lobsters, crabs, or oy- sters; of flat fish also, as scait, turbot, dories, and plaice, especially the skin of the latter; or of any wild fowl, the most eligible of which are pigeons, partridges, and woodcocks; add to which eggs, lampries, eels of all sorts, which are by no means inferior to vipers; cavear, strong meat soups, any animal (but no vegetable) food, par- ticularly pork, calf’s head, with the skin on; calves’ and neats’ feet, or trotters. Milk is the best breakfast and supper. Brandy and water the most proper to drink at dinner. All agglutinants, chalybeates, and aromatics are useful; opiates also, which powerfully increase the secretion of semen. The testicles should be bathed night and morning with equal parts of alcohol and vine- gar ’till they cabbage; nor is it a matter unworthy of at- tention, always to wipe the glans dry after making urine. See WEAKNESS of the SOLIDS. Sterility is owing to the same causes, and requires the same method of treatment. To give prolificity to the semen, by determining a sufficient quantity of the nervous influence to it, nothing equals the oil of cloves, by means of which many have proved fathers, after all previous efforts had for many years been fruitless: this, therefore ought not to be omitted in any medicines that are given, calculated for that purpose. It may not be amiss to observe in this place, that the balsam of Peru has an effect directly opposite to that of the said oil. The following formulæ powerfully stimulate to con- jugal intercourses, furnish ability equal to desire, and seldom fail to render those intercourses prolific. Take (169) Take of oil of Cloves, half an ounce, dissolve in The yolk of an egg, then add, Tincture of cantharides, an ounce and half: Of these drops let two tea-spoonfuls be taken night and morning. Take of socotrine aloes, Filings of iron, of each two scruples, Purified opium, ten grains, Cantharides, six grains, Oil of cloves, ten drops, Simple syrup, enough for pills, Sixteen; two to be taken every night. Take of aromatic powder, Cloves, of each a scruple, Ambergris, Musk, of each five grains, Purified opium, Cantharides, of each one grain, Oil of cloves, five drops, Syrup of orange peel, enough for a bole; To be taken every night for a month, keeping the body soluble, during which time the patient should have no connection with his wife. Take of oil of cloves, six drachms, Oil of nutmegs, one drachm: Of these drops, ten may be taken on sugar night and morning- Take of oil of cloves, ten drops, Mucilage of gum arabic, half a drachm, Pure water, an ounce; A draught to be made according to art, and taken morning and evening. See GLEET. H GOUT. (170) GOUT. THE Gout is a chronical disease, most commonly af- fecting the feet. If it attacks the knees, it is cal- led Gonagra; if the hands, Chiragra; if the elbow, Onagra; if the shoulder, Omagra; if the back or loins, Lumbago. The causes. Irregularity with respect to some of the non-naturals, immoderate venery, feeding frequently and immoderately on fat, great fatigue, a moist cold air, a contusion, tartarous wines, fermenting liquors; acid gas, as appears from the sour sweats and acid eruc- tations so common in arthritic paroxysms; fruit, vege- tables; the passions of the mind, indolence. The diagnostics. A most intense pain, as though a wedge were fixed between the joints; or as if the part were in a press; sometimes it seems stretched to such a degree, that the unhappy patient is ready to think that it will burst every moment: when this is the case, it is seldom more than six hours before the pain abates and welcome sleep succeeds. Sometimes the sensation is similar to that which would be brought on if the parts were gnawn by carnivorous animals. Those who have been long tormented with it, have often a cretaceous matter issue from the bursting of the small vessels, which is an induration of the nervous filaments, and is actually chalk; for the nerves seem to be originally con- stituted of a chalky earth, lengthened into fibres by animal glue. The prognostics. If hereditary (which with humble submission to Doctor C. it certainly may be) it is most difficult to relieve. It is generally supposed to be incu- rable, as all disorders are said to be which we know not how to cure. The fits may undoubtedly be rendered mild- er, and perhaps be totally prevented by pursuing the subsequent method; it has succeeded in the removal of many (171) many inveterate gouts, though they were of long stand- ing and had been every year exacerbating. The cure. Let the patient live wholly on animal food or use a milk diet, and for change take meat broths; he may drink plentifully of two milk-whey; but must ab- stain from all vegetables, claret, and malt liquors; spi- rits diluted with water will not hurt him. Exercise is absolutely necessary, and too much cannot be taken, nor can it be too often repeated, if it does not proceed to fatigue. The mind should be kept as calm and com- posed as possible; amusement and a little dissipation of thought is necessary. If the gout seizes the stomach, give immediately half an ounce of æther with a scruple of camphire in it; let it be taken alone in a spoon, without swallowing any liquid for some minutes after it; if the sensation it occasions is disagreeable, he may rinse his mouth with a little cold water, and spit it out. It is an admirable remedy, and never deceived me. To fix an erratic gout, and bring on a regular fit, give asafœtida inwardly, and bathe the great toe and metatarsus with water of ammonia. If the fit comes on in good earnest, Take of camphire, fifteen grains, Purified opium, Ipecacuanha, of each three grains, Precipitated sulphur of antimony, Vitriolated quicksilver, of each two grains, Aromatic confection, enough for a bole, To be repeated as occasion requires. Let this be washed down with the following draught: Take of tincture of guaiacum, six drachms, Pure water, eight spoonfuls. H2 After (172) After taking this bolus and draught, the patient should lie between flannel sheets. Let the draught be repeated every night for some time, with the addition of two drachms of elixir of aloes, if costive, and that the gout is incurable is a proposition that will no longer be taken for granted. The alvine canal should be kept open with aloetics and quicksilver; all bitters and alkalis are useful; nor is it amiss to bathe the feet every night in warm water with a handful of salt in it. As to the application of leeches, or opening the saphœna when the fit is coming on, I never saw any good effect from it, nor can a gouty person be bled without great hazard and danger. As to burning cotton on the part affected, notwithstand- ing the authority with which it comes recommended, I could never persuade any person to try the experiment. If topics are desired, quick-lime and honey for an epi- them seems to be the most eligible one. Or, Take of vitriolic acid, forty drops, Hog's lard, an ounce, A liniment, to be applied often to the part affected. Or a vesicatory. To prevent a return let one of the subsequent medi- cinee be given and continued for some months; they are adapted to the various circumstances of different patients, and the choice must depend on the skill of the practitioner. Two tea-spoonfuls of the tincture of guaiacum, or, One of water of pure kali, May be taken night and morning. Take of gum guaicum, Camphire, of each a drachm, Precipitated sulphur of antimony, Vitriolated (173) Vitriolated quicksilver, of each a scruple, Simple syrup, enough for pills, Number thirty-two; two, or three to be taken every night. Take of aloetic pills, a drachm and half, Filings of iron, half a drachm, Precipitated sulphur of antimony, Vitriolated quicksilver, of each a scruple, Simple syrup, enough for pills, Number thirty-two; two to be taken night and morn- ing. Take of germander, Ground pine, of each an ounce, Lesser centaury, six drachms, Gentian root, half an ounce, Syrup of ginger, enough for an electuary. The size of a walnut, to be taken twice or thrice a-day. Take of red bark, an ounce, Winter's bark, three drachms, Mucilage of gum arabic, enough for an electuary, Dose, the size of a nutmeg, thrice a day. Take of cammomile flowers, Ginger, of each an ounce, Galangal, two drachms, Grains of Paradise, Oil of mint, of each one drachm, Syrup of orange peel, enough for an electuary, The bigness of a nutmeg, to be taken morning and night. In emaciated habits, two drachms of the tartarised iron may be added to either of the above electuaries. RHEUMATISM. (174) RHEUMATISM. THE Rheumatism is a painful disorder, the seat of which is in the membraneous part of the body: it is sometimes mistaken for the gout. The causes. A viscidity of that mucus which is de- signed to lubricate the joints and facilitate their motion, heats and colds, moist air, relicts of the venereal dis- order, large quantities of quicksilver taken, scrophulous diseases, acrid serum, deficiency of vital heat. The diagnostics. Wandering pains, a fixed pain in the shoulder, hip, loins, arm, leg, knee, thigh, breast, side, or head, the part seldom red, the pain felt most when the part is in motion, or the pain being most se- vere at night, when the patient begins to grow warm in bed. N. B. This is the case, when the cause is elastic air. Sometimes it is attended with a fever, then called the hot rheumatism, preceded by chills and rigor; persons in years feel the attack in their head and bowels. The prognostics. If idiophatic, the chronic rheuma- tism is curable with great facility, however difficult so- ever it may be thought to be; the author has a right to speak, with some confidence on this subject, for he has certainly had the management of as many rheumatic cases as any human being, without finding any of them rebellious to the method hereafter proposed. If impro- perly treated it is very apt to return periodically. If symptomatic, the cure of it depends on the removal of the primary disorder. Bleeding in the chronic rheu- matism, protracts the cure. The cure. If attended with an ardent fever (then called the acute rheumatism) let it be treated in just the same manner as an ardent fever; when there is a re- mission (175) mission give the bark, which by the way, will remove any rheumatic disorder, if exhibited scientifically, and in large quantities, with proper combinations. The lancet has been esteemed necessary in a chronic rheu- matism, but it is never really so; for if it should yield a temporary relief, such a relief is purchased at a vast expence. The diet should be the same as in the gout, which see. Let the part be kept warm, bathed with oil of turpentine night and morning, or a blistering plas- ter be laid on it. Buckbean tea, though nauseous, is no bad auxiliary. The dry vomit will greatly expedite recovery, and in many cases effect a cure alone. Take of tartarised antimony, ten grains, For three powders. One to be taken every other morn- ing, fasting. Take of tincture of guaiacum, six drachms, Tincture of aloes, one drachm, Oil of turpentine, half a drachm, To be taken in eight spoonfuls of milk or water every night till well. Four or five of these draughts are gene- rally sufficient for a perfect cure. Or, Take of socotrine aloes, seven grains, Purified opium, three grains, Simple syrup, enough to make two pills, Both to be taken at bed-time, and repeated as there is occasion. Or, Take of colocynth, two scruples, Purified opium, one scruple, Vitriolated quicksilver, Precipitated sulphur of antimony, of each ten grains, Simple syrup, enough for pills, Twelve; two to be taken at night. Or, Take (176) Take of calomel,* Conserve of arum, Camphire, of each a scruple, Simple syrup, enough for a bole, To be taken at bed-time. To prevent its return, Take of flowers of sulphur, two ounces, Gum guaiacum, half an ounce, Precipitated sulphur of antimony, two scruples, Oil of turpentine, three drachms, Honey, enough for an electuary, Dose, the size of a nutmeg, morning and night. This electuary will succeed also in the cure of most cases alone. Take of tincture of guaiacum, two ounces. Of these drops let two tea-spoonfuls be taken morning and night. Take of red bark, an ounce and half, Extract of liquorice, half an ounce, Oil of aniseeds, two drachms, Tincture of Benjamin, enough for an electuary, Dose, the size of a chestnut, twice a day. Take of red bark, an ounce, Gum guaiacum, half an ounce, Oil of sassafras, two drachms, Filings of iron, one drachm, Syrup of orange peel, enough for an electuary, Dose, the size of a nutmeg, twice or thrice a day. HIP- * Procured from Apothecaries Hall. (177) HIP-GOUT. THE Sciatica, or Hip-Gout, is so called because the pain is confined to the parts about the hip. The cause. Inspissation of the mucus in the aceta- bulum, which may be occasioned by the same causes which produce the rheumatism. The diagnostics. Intense pain, as though the thigh were dislocated; it is most common with those who have not yet arrived at the years of puberty; sometimes very old persons are attacked with it; it rarely invades those of middle age; atrophy of the thigh, lameness. The prognostics. If idiophatic, it is not dangerous; if not scientifically treated at first, it may require some difficulty and time to remove; if symptomatic, reference must be had to the primary disorder; the lameness, if of long standing, is rarely curable. The cure. The regimen and medicines requisite are much the same as those just mentioned in the rheuma- tism. Vitriolated quicksilver is greatly and justly ex- tolled as an alterative in this case. It will generally yield, in a few days, to one large spoonful of volatile tincture of guaiacum, every night, in six spoonfuls of water. Some recommend whipping the part with net- tles; much more eligible topics are to be found below. Take of gum guaiacum, two drachms, Purified opium, half a drachm, Tartarised antimony, Vitriolated quicksilver, of each ten grains, Simple syrup, enough for pills, Number thirty-two; two, or three to be taken every night. Or, Take of rhubarb, a drachm, Camphire, half a drachm, H3 Calomel, (178) Calomel, twelve grains, Simple syrup, enough for pills, Number twenty-four; two to be taken morning and night. Take of camphire, Barbadoes tar, Oil of turpentine, Oil of aniseeds, of each half an ounce, A liniment, to be used twice or thrice a day. Or, Take of black soap, Honey, of each an ounce, With the white of an egg, make an ointment, as before. Take of litharge plaster, with gums, an ounce, Plaster of cantharides, two drachms, Euphorbium, one drachm, A plaster. Or, the common blistering plaster (which may be applied to the head of the fibula, if the part, or knee be swelled,) or a Burgundy pitch plaster. See RHEUMATISM. DEAFNESS. DEAFNESS must be treated according to the pri- mary disorder from which it arises, as epilepsy, lues, fevers, &c. The more plentiful the excretion of cerumen is, the easier to be cured. The methods pro- per to be taken are such as follow: purges, diaphoretics, vesicatories, setons, syringings, sternutatories, and the dry vomit. Electricity will sometimes cure it, so also will wearing their own hair in those who have been used to a wig. The (179) The common cause of deafness is a deficient, or too viscid secretion, or a constipation of the wax in the ears. A tea-spoonful of warm water poured into the ears, and suffered to continue for a minute or two in them, every night, will often produce extraordinary and unexpected effects. This is a more expeditious solvent of the ceru- men than upwards of seventy other different menstrums that were tried. Let a pinch of the following snuff be taken immediately after: Take of white hellebore root, a scruple, Euphorbium, two grains, A sternutatory powder. If the warm water will not remove deafness, after using it some weeks, nothing that is put into the ears will do it. If an insect has penetrated into the ear beyond the reach of extraction, let it be killed by dropping some of the following mixture warm into the ear: Take of tincture of aloes, half an ounce, Oil of wormwood, thirty drops, Oil of savin, twenty drops. CHOREA SANCTI VITI. ST. Vitus’ Dance is an involuntary yet irresistable motion of several muscles. The patient uses many ridiculous and antic gestures: what is very odd, those muscles only are affected which are destined for spon- taneous motion, for the heart, diaphragm, lungs, and stomach are never injured by this whimsical disorder. The cause. An unequal distribution of the nervous influence. This is often owing to an obstructed men- struation, chlorosis, acid gas, irritation from worms, weakness of the solids. The (180) The diagnostics. It is most common to females be- fore puberty; tremors, convulsions, distortions, conti- nued contraction of the antagonist muscle; working of the eyes, stiffness of the limbs, hopping about upon one leg, catchings of the hands, twisting of the fingers, ly- ing down and rising upright for many times together, various grotesque and unintended gesticulations. The prognostics. Menstruation generally cures it.— I have seen many extraordinary cases of this sort, but never met with one that was difficult to cure. When of long continuance it sometimes degenerates to an epi- lepsy. The use of the lancet (which ought by no means to be allowed in this disorder) sometimes super-induces an opisthotonos, and often an incurable phthisis. The cure. For regimen see WEAKNESS OF THE SO- LIDS, which is an inseparable concomitant of this dis- temper. Begin the cure with the dry vomit, which should be continued twice or thrice a week till the pa- tient is recovered: besides this, the following pills and drops will greatly expedite the cure. Take of socotrine aloes, a drachm, Filings of iron, two scruples, Precipitated sulphur of antimony, one scruple, Simple syrup, enough for pills, Number twenty-four; two to be taken every night, or oftener. Take of tincture of asafœtida, an ounce, A tea-spoonful to be taken night and morning. To complete the cure, let chalybeate waters be used, and the cold bath every morning, half a drachm of gin- ger may be given with great advantage twice a day.— The balsam of copaiva is of considerable utility, as also is the volatile tincture of valerian. The subsequent mixture I have seen the most desirable effects from: Take (181) Take of prepared kali, two drachms, Cinnamon water, seven ounces, Water of ammonia, half an ounce, Balsamic syrup, an ounce, Of this mixture let two spoonfuls be taken morning and night. WEAKNESS OF THE SOLIDS. IN all habits of body where there is a constitutional deficiency of vital heat, there must exist a laxity of the muscular fibre, with some of its usual concomitants, viz. habitual chilliness, flabbiness of the flesh, pallid countenance, thin lank hair, bad appetite, lowness of spirits, cuticular eruptions, flatulencies, bilious disorders, obstinate costiveness, or diarrhœa. Whatever malady such persons may labour under, bleeding is inadmissible, and must be highly improper; for such an operation will certainly prove injurious, and perhaps, (as is too often the case) fatal to the patient; purging may be of considerable utility to such persons, because they have generally a redundance of serous fluids, though never of the flat red particles. Weakness of the solids re- quires peculiar attention to the regimen and diet, for that which is received into the stomach by pounds and quarts, is much more consequential and may as well be adapted to the state of the case as that which is taken by grains and drops. For such persons a clear dry air is extremely requisite, at some distance from trees; nor is it an unimportant matter for them to take frequent walks in a garden well stored with aromatic herbs, such as rue, lavender, mint, rosemary, &c. or those herbs may be kept growing in the house, but by no means suffered to lie in it when dry or dead. Sleep should not be allowed to excess, and the less time that is spent in bed, when not sleeping, the better. The excretions must be duly regulated, for a great deal depends on a proper (182) proper regard to the evacuations: care should be taken to adjust this affair with as much nicety as possible, and to trim the balance between deficiency and excess. To such persons few things are of more importance than pleasing conversation, diversions, and a constant en- deavour to preserve a calmness and composure of mind. Gentle exercise, gradually increased, must not be neg- lected; particularly swinging, during a continuance of a moist atmosphere. The most nutritious diet is to be recommended, such for instance, as milk, which is the best breakfast and supper for all weakly persons with- out exception; no person need be apprehensive of any bad consequences from its curdling on the stomach: it is most eligible to take as it comes from the cow, unless it purges; then it must be boiled. Of broths (all which are useful) that which is made of pork is preferable; the author has seen amazing effects from it. Eggs, if they do not gripe, are very desirable, and all sorts of animal, with little (or no) vegetable food; especially shell fish, and flat fish, every species of which affords the most plenteous and the most laudable nourishment: next to these may be mentioned wild fowl, particularly par- tridges, growse, and pigeons; for change, chicken, calves feet jellies, neats feet, trotters, beef tea, soups of all sorts, cavear, and blomange. A little should be taken at a time, but often repeated: a jelly may be al- ways at hand, and cannot be too frequently had recourse to, if the stomach will bear it, for that must be con- stantly humoured, and nothing should be refused that the least inclination is felt for. Spirits diluted with wa- ter are chiefly, if not wholly to be drank; unless Ma- deira wine should be found more agreeable to the palate; if beer is allowed, it ought to be very strong and very old, but not stale. As a teneritude of the fibres, or their want of due elasticity, is owing to a deficiency of vital heat, which is greatly abated by an acid gas or vapor, persons of this frame should abstain from all those things which increase this sour halitus by fermenting too rapidly in the sto- mach, (183) mach, such as sugar, fruit, vegetables, claret, and all liquors that have not passed the state of fermentation. The medicines proper to be administered, are aro- matics, bitters, chalybeates, astringents, the bark, fœ- tids, detergents, cardiacs, mineral acids, and above all things else, frequent repetitions of the dry vomit. See PHTHISIS, FLATUS, HYPOCHONDRIA, EPILEPSY, and IMPOTENCY. PAINFUL DISORDERS. PAIN IN THE HEAD. See CEPHALALGIA. PAIN IN THE EARS. PAIN in the Ears is sometimes caused by the tooth- ach, sometimes owing to an imposthume. If idio- phatic, and attended with a tinnitus, apply plasters of Burgundy pitch, or blisters behind the ears; use warm cataplasms, sternutatories, setons, cathartics, or opiates. TOOTH-ACH. THE Tooth-ach is generally owing either to a tumor of the gingivæ, of the circumjacent muscles, or to the caries of the tooth; it may also originate from a viscidity, or acrimony of the fluids. It is common in scorbutic habits, and to those of weak solids. If it comes periodically, let the bark be taken; opiates, if necessary, may be given internally; oil of castor held in the mouth will often give immediate ease, so also will electricity. If the gums are much swelled, they may be ripened by a cataplasm of figs; smoaking tobacco will sometimes (184) sometimes discuss the tumor; sternutatories are exceed- ing useful, and so are vesicatories; warm cloths should be frequently applied, and plasters of Burgundy pitch to the temples. A tea-spoonful of tincture of opium, or brandy, poured into the ear of the affected side sel- dom fails to remove the pain, especially if a little vine- gar be previously held in the mouth. If the tooth is carious, extirpation is the quickest and most efficacious remedy: if that is not permitted, Take of purified opium, Camphire of each two grains, Oil of cloves, Oil of pepper, of each two drops, A pill, to be put into the tooth. PAIN IN THE FACE. IF the pain is over all one side of the face, or if both the maxillæ are affected, use a gargarism of brandy and vinegar, equal parts, and bathe the part outwardly with warm oil: if this method has not the desired effect, dissolve a drachm of camphire in half an ounce of æther, pour a little of it into the hand, and apply to the affected part. Take of prepared kali, two drachms, Calcined antimony, two scruples, Pure water, seven ounces, Balsamic syrup, one ounce, A mixture; three spoonfuls to be taken night and morning. PAIN (185) PAIN OF THE NECK. THIS is commonly called a Crick, and is soon helped by drawing sparks from the part when the patient is placed on an electrical stool; by the frequent appli- cation of warm cloths, or by ironing the part, or moisten- ing it with a saturated solution of camphire in æther, or compound water of acetated litharge. PAIN IN THE BREAST. See PHTHISIS. PAIN IN THE SIDE. See FLATUS. PAIN IN THE STOMACH. See HEART-BURN. PAIN IN THE BACK OR LOINS. TAKE of balsam of copaiva, an ounce. Of these drops let twenty be taken on brown sugar, night and morning. Take of Spa water, half a pint, Boiling water, the same quantity, A draught, to be drank immediately, and to be repeated twice or thrice a day. Half an ounce of tincture of guaiacum, To be taken every night, in six ounces of water. See NEPHRITIS and RHEUMATISM. PAIN (186) PAIN IN THE LIMBS. SEE RHEUMATISM. If in the Shins, give three or four grains of purified opium, with three grains of precipitated sulphur of antimony every other night, anointing them every night with the stronger blue oint- ment. WHITE-SWELLING. APPLY a blistering plaster to the knee, let it be wrapped up in it, and the plaster be kept on four days. This should be repeated every fortnight or three weeks, ’till the patient is well, giving the dry vomit twice or thrice a week. I never met with but one in- stance wherein this method failed of success in curing this formidable disorder. HERNIA. A RUPTURE is either intestinal, omental, watery, flatulent, carnous, or varicose. The two first are owing to a prolapsus of the gut ilium, or the caul into the scrotum, groin, or navel. In infants it is easily cu- rable, in adults with some difficulty. Give an emollient clyster, apply an emollient fomen- tation, reduce and retain with proper ligatures or a truss: the patient avoiding flatulent food for some time, and all violent motions of the body. Let the part be bathed night and morning with alcohol, or with lime-water. Keep the patient on his back as long as possible: I have known those who by resolutely continuing in this pos- ture for five or six weeks, have been perfectly freed from a Hernia of many years standing, though pretty much advanced in years. The (187) The watery Hernia to be known by a pellucid tumor of the testicles, is to be cured by hydragogues, diuretics, discutient cataplasms, or puncture. The strangulated Hernia also requires the hand of a surgeon. GANGRENE AND MORTIFICATION. A GANGRENE is the death of a particular part, owing to the total impediment of any communi- cation of a fluid from the arteries. It commonly affects the adipose membrane only; a Sphacelus or Mortifica- tion invades all parts, the bones not excepted. The causes. Stagnation of the fluids, ligature, or compression of the veins, cold, inflammation, wounds, bruises, luxations, fractures (especially if bound too tight) ruptures. The diagnostics. A sensation of a dull pain; a pale, ashy, brown, livid, or green colour: no resistance to the touch. Those of a mortification are insensibility, a cadaverous smell, perfectly black colour, that blackness spreading, an eroding mortiferous corruption. The prognostics. A Gangrene may be cured. A sphacelus must be extirpated. A Gangrene of the brain, bowels, or bladder, is mor- tal: of the mouth, lip, nostrils, or genitals, difficult of cure; in dropsicals, phthisicals, and scorbutics, a Gan- grene is the fore-runner of death. A mortification, if it attacks the upper parts, or brings on agrypnia, delirium, faintings, borborygmi, hiccoughs, spasms, pains which go off suddenly; cold sweats, or coma, forebodes the hasty approach of a dissolution. The (188) The cause. If a gangrene proceeds from frost, rub the parts with snow or cold water, afterwards applying, Take of compound tincture of aloes, Water of ammonia, Oil of turpentine, of each equal parts, For a liniment. To stop the progress of a mortification, there is no external application comparable in efficacy with the oil of olives: let the part be bathed with it as hot as it can be borne twice or thrice a day. I have seen incredible effects from it, even with persons greatly advanced in years. If any thing in nature will prevent a sphacelus from spreading, I believe this will. Internally give the bark, chalybeates, the blue vitriol, and opiates. Take of the opiate pill, a drachm; Make into sixteen pills; one to be taken every hour, if necessary. SCHIRRUS AND CANCER. A SHIRRUS is an induration of a glandular part, owing to a previous inflammation. The causes. That which occasions an inspissation of the fluids in the glands. If the margins of a Schirrus are inflamed so as to pro- duce an erosion of the neighbouring vessels, it is called a Carcinoma, or Cancer. A recent Schirrus, the resolution of should be at- tempted by quicksilver and blisters; if these succeed not, extirpation is necessary; if that cannot be com- plied (189) plied with, palliatives are all that can be expected, such as milk diet, the balsam of copaiva, and thirty or forty drops of spirit of nitrous æther, in every draught of li- quor that the patient takes. A cancer resists every internal means (hitherto known) of cure. I never saw any good effects from the cicuta. If extirpation is not permitted, give twenty of the following drops night and morning: Take of muriated quicksilver, ten grains, Muriatic acid, ten drops, Spirit of nitrous æther, an ounce: Drops. Muriated quicksilver may be sprinkled on the fore. To alleviate the pain, the tar ointment with calomel, applied twice a day, is, I verily believe, superior in efficacy to any other topic. I have known great num- bers whose lives have been rendered comfortable by the use of it, who before had suffered the most excruciating agonies. The same above-mentioned palliatives are requisite. If the part is extremely offensive, use a carrot poul- tice. If a cure is expected, it must be obtained from the hands of a surgeon. I have seen lately several cancers of the lip yield to the above drops and ointment. BURN. APPLY oil, or lime-water, or spread some of the calamine cerate thin on a piece of thin leather. To prevent an unsightly scar, alter the above cerate has been (190) been renewed every day, for four or five days, use a liniment (once a day also) composed of equal parts of soft soap, honey, and oil of olives. SPRAIN. FROM the situation a part must be in when sprained, nothing can be more absurd than the usual method of resting it: it should be kept as constantly in motion as possible, and it will be well in the tenth part of the time that will be requisite for the cure, if spared, which any one may be satisfied of, who will make the trial. If any fotus is used, equal parts of vinegar and brandy is the most eligible. ŒDEMA. AN Œdematous tumor is soft, whitish, cold, indo- lent, and doth not resist the touch. If a topic is necessary, I know none preferable to, Take of alcohol, an ounce, Oil of turpentine, two drachms, Water of ammonia, one drachm, A liniment, to be used three or four times a day. Or, Compound water of acetated litharge. ULCER IN THE LEGS. OF all the disorders incident to poor people, this is the most common; at least, I have seen such numbers among the infinite variety of persons who have applied to me for assistance, that I can safely aver, I have (191) have cured more ulcerated legs than any man in his Ma- jesty’s dominions; nor did I ever meet with one case that did not yield to the method hereafter proposed. The causes. A scorbutic acrimony, depauperated blood, sedentary life, poor living, moist air, damp ground. Hence it is no wonder that there are so few of the weavers in the North of Ireland free from this troublesome complaint; for they live chiefly upon po- tatoes, or oaten bread, and sit at their looms three or four feet beneath the surface of the earth. After recommending a milk diet, the only medicines which I ever ordered inwardly, were my solution of the muriated quicksilver (See CANCER,) twenty drops to be taken in a glass of water morning and night. Or, if obstinately costive, Take of gum guaiacum, Socotrine aloes, of each a drachm, Precipitated sulphur of antimony, Vitriolated quicksilver, of each a scruple, Simple syrup, enough for pills, Number twenty-four; two to be taken every night. Externally, Take of calomel, two scruples, Tar ointment, an ounce, An ointment, with which the ulcer is to be dressed twice a day for two or three weeks, and then, to com- plete the cure, let a bandage be bound over the ulcer as tight as it can be borne. And, Take of spermaceti cerate, six drachms, Red lead, two drachms, A liniment, to be applied night and morning. Or, Take (192) Take of muriatic quicksilver, two grains, Muriatic acid, two drops, Rose water, six ounces, A lotion; lint dipped in this to be applied night and morning, and wetted with it before it is removed. The sore may be sprinkled now and then with calo- mel, or the red nitrated quicksilver. CONTRACTIONS. CONTRACTION of the tendons, particularly that of Achilles, is a common cause of lameness, espe- cially in children, though this case is often overlooked. The use of many limbs (when long lost) has been re- covered when the patient could not touch the ground with his heel, by the following simple liniment. Take the yolk of a new laid egg, carefully cleared from the white, beat it up with six spoonfuls of spring water, let the thigh and leg be bathed with it morning and night, for some weeks. The effects are equally amazing and incredible. PARALYTIC AFFECTION OF THE LEGS. APPLY a large vesicatory to the os sacrum and loins. Electricity, much exercise, strait stockings, liberal use of the flesh brush, dry vomit, cold bath. See PALSY. DISORDERS (193) DISORDERS PECULIAR TO FEMALES. CHLOROSIS. THE Green Sickness, as it is commonly called, is a distemper that attacks females generally before pu- berty, and sometimes (if there is no eruption of the ca- tamenia) long after. It is also termed Febris alba and Morbus virgineus. The causes. A deficiency of the vital heat, a predo- minant acid in the stomach, a lentor of the blood, vi- tiated quality of it. An over proportionate quantity of serum, pining, inactivity, dyspepsia, too profuse secre- tion of the succus pancreaticus, vegetables, fruit, sugar, deficiency of bile. The diagnostics. A sallow, pallid, or livid counte- nance: laxity of the muscular fibres, inflated eye-lids, swelling of the ancles, and sometimes of the abdomen; indolence, aversion from exercise, especially running or walking fast; the respiration difficult and anhelous; pica and malacia, cephalalgia, a palpitation of the heart, green stools, sour breath. The prognostics. This chronical disorder is some- times of long continuance, without producing any re- markable ill consequences: sometimes sehirrosities pro- ceed from it: it is rarely difficult of cure; menstruation often carries it off. Feeding on chalk, tobacco pipes, and such like, is not the cause, but the effect of this disease. The cure. The regimen should be the same as in Weakness of the Solids. First give an emetic, the pro- perest is a grain and half of blue vitriol, not drinking I any (194) any thing to work it off; the best time to take it is in the morning fasting; afterwards, uterine cathartics and corroborants, especially chalybeates; the cold bath may be used to advantage. Exercise is necessary. Some bleed in the Saphœna; but to lessen the quantity of that important fluid in such cases, as has already been observed, is inexcusable indiscretion. From the subsequent tribes an efficacious formulæ may be easily contrived. The gums, as ammoniac, galbanum, sagapenum, opoponax, guaiacum, asafœtida, olibanum, myrrh, ben- jamin, styrax, mastic, frankincense. Aromatics, as winter’s bark, cinnamon, ginger, ze- doary, all piperines, cloves, nutmegs, and such like. Bitters, as gentian, galangal, centaury, aloes, camo- mile, carduus benedictus, which yields a pleasant bitter in a cold infusion, round birthwort, orange peel, &c. Emmenagogues, as savin, castor, dittany of Crete, borax, penny-royal, rue, mugwort, white bryony root, stinking orrach, black hellebore, salt of amber, vitriol- ated, or tartarised iron, calomel, balsam of copaiva, or compound powder of myrrh. Take of tincture of muriated iron, half an ounce, Twenty drops, night and morning. See MENSES SUP- PRESSED. WHITES. THIS is a disorder females of all ages are subject to. The (195) The causes. A laxity of the glandular fibres of the lacunæ, suppression of the menstrual discharge, sprains of the loins, hard labor, hypercatharsis, profuse bleeding, blows, falls, weakness of the solids. The diagnostics. A constant oozing from the os ex- ternum uteri of a white matter, sometimes thin, yellow, or brown: fœtid, sensation of heat in making urine, syncopes, anorexia, pain in the back and loins, increased by exercise, atrophy, Hypocratic countenance. The prognostics. It is not very easy of cure. Wo- men are generally troubled with it a great while before they apply for assistance: to this natural bashfulness they owe more bad consequences than they ever suspected. It is often productive of many dreadful disorders, which might with great facility have been prevented; as con- sumptions, procidentia uteri, dropsy, internal ulcers, &c. The cure. The most nourishing diet is necessary, as milk, meat broths, shell fish, and such like. For her breakfast, two drachms of isinglass may be boiled in milk. The dry vomit is of considerable service, as also are lenient cathartics, magnesia, which alone is some- times efficient, agglutinants, lime water, and Spa water. The most proper astringents are tormentil root, aroma- tics, roch allum, acetated ceruse, and chalybeates.— Twenty drops of the balsam of copaiva may be taken twice a day, or a tea-spoonful of tincture of cantharides, which has an excellent effect. Take of gum arabic, two ounces, Red astringent gum, Olibanum, of each half an ounce, Balsam of copaiva, enough for an electuary, Dose, the size of a chestnut, night and morning. I2 Take (196) Take of conserve of red roses, two ounces, Yellow wax, half an ounce, Rhubarb, two drachms, Filings of iron, Galangal, of each a drachm, Tincture of cantharides, enough for an elec- tuary, The size of a nutmeg to be taken twice a day. Take of blue vitriol, a scruple, dissolve in Boiling water, an ounce; An injection, to be used warm, twice a day. See GLEET. HYSTERICS. HYSTERIC Fits, notwithstanding the various shapes they appear in, are too well known to need any description. The causes. An unequal distribution of the vital heat, owing in some measure to the peculiar conformation of the uterus and its adjacent parts; suppression, or defi- ciency of the menstrual flux, sometimes to its profusion: delicacy of constitution, luxury, want of exercise, strong inclination to venery, fluor albus, want of blood, acid gas. The diagnostics. Syncopes, catchings, rising of a halitus in the throat, sometimes so as to endanger suffo- cation, convulsions, clavus hystericus, quick respira- tion, laughing, screaming, crying, the hands strongly closed, bawdy expressions, colic, cephalalgia. The prognostics. If the patient has been long trou- bled with them, they often terminate in a perpetual causeless (197) causeless timidity; madness, or all the horrors of the hypochondriacal affection, to which this disorder is very similar. It is by no means dangerous, or if scientific- ally treated, difficult of cure. The cure. All evacuations are deleterious, the dry vomit excepted, which succeeds wonderfully, if fre- quently repeated, and its propriis viribus sufficient to effect a cure; but if objected to, the practitioner will find various formulæ, which have proved efficacious, subjoined. Chalybeate waters are highly necessary; opiates are sometimes so. The cold bath. If the head is affected, let it be shaved, and a blister laid over it. See HYPOCHONDRIA, EPILEPSY, and FLATUS. Take of prepared kali, two scruples, Pure nitre, a scruple, Purified salt of amber, seven grains, Penny-royal water, an ounce and half, A draught, to be taken every night, for some weeks. Take of ginger, half an ounce, For six powders. One to be taken night and morning. Twenty drops of the oil of amber may be taken night and morning. If costive, Take of socotrine aloes, Filings of iron, Asafœtida, of each two scruples, Oil of amber, twenty drops, Simple syrup, enough for pills, Number twenty-four; two to be taken night & morning. Take of galbanum, half an ounce, Camphire, half a drachm, Oil of amber, twenty drops, A (198) A plaster to be applied to the navel. If laxative, Take of aloes, half a drachm, Purified opium, Camphire, of each a scruple, Simple syrup, enough for pills, Number twelve; one to be taken at night, or oftener. Take of red bark, six drachms, Valerian, half an ounce, Filings of iron, a drachm, Conserve of sloes, an ounce, Syrup of ginger, enough for an electuary, Dose, the size of a walnut twice or thrice a day. MENSES SUPPRESSED. AN obstruction of the menstrual flux is either total or partial, when there is a small drain, and the colour not florid, nor the appearance regular at the stated times. The same method of cure is requisite. The cause. A deficiency of blood. Some have sup- posed that an universal plethora may be a concomitant of this disorder; to speak my own sentiments, I verily believe that it is never the case; a partial plethora, in- deed, or which is the same thing, an unequal distribu- tion of the vital heat, often may and doth accompany it. The diagnostics. Anorexia, pale or bloated counte- nance, fluor albus, cephalalgia, vertigo, palpitation of the heart, pain in the loins and thighs, swelling of the ancles, hysterics. The prognostics. If it is total, the cure is difficult, but by no means impracticable, as some moderns sus- pect, (199) pect, (unless succeeded by a phthisis) or from salivation; in pinguedinous habits, it is of little consequence; if partial, easily procured; if symptomatic, the primary cause must be removed. The cure. The dry vomit is of admirable efficacy. For regimen, see WEAKNESS of the SOLIDS. If once the blood is sufficient in quantity there is no fear of the obstruction being removed. Balsam of copaiva, is an excellent auxiliary. See CHLOROSIS. One remark may not be amiss, viz. that if no extraordinary incon- venience attends the too little or too great discharge of this sort, it is best not to interfere by the use of medi- cines, but leave nature entirely to herself. Take of socotrine aloes, a drachm, Filings of iron, two scruples, Precipitated sulphur of antimony, half a drachm, Calomel, a scruple, Oil of savin, twenty drops, Simple syrup, enough for pills, Number thirty-two; two to be taken every night, or oftener. Take of compound tincture of savin, Tincture of black hellebore, of each an ounce, Of these drops let two tea-spoonfuls be taken twice a day. See FLATUS. MENSES IMMODERATE. THE menstrual discharge is sometimes so profuse as to super-induce a large tribe of the most formidable disorders. The (200) The cause. Weakness of the solids; consequently a want of elasticity in the fibres of the mouths of the ute- rine, or vaginal arteries, and deficiency of vital heat. The diagnostics. Laxity of the muscular fibre, thin, light, lank hair, flabbiness of the flesh, pallid counte- nance, syncopes, anorexia, swelled ancles, cachexy. The prognostics. If after abortion, parturition, or if the patient is above fifty years of age it must be very profuse to prove dangerous. If the age is about thirty, and it is succeeded by a spontaneous total suppression, it is always fatal. If of long continuance, and always immoderate at the periodical returns, and the patient under forty, it cannot be restrained too soon. The cure. It is surprising that all practitioners who have wrote on this subject, propose phlebotomy, by way of revulsion forsooth: such practice cannot be too much execrated. A vomit is a more speedy, more effectual, and far safer remedy. For regimen, see WEAKNESS of the SOLIDS. The exercise should be very gentle. The medicines necessary are agglutinants, astringents, corroborants, and sometimes opiates. A cloth dipped in vinegar, may be laid on the abdomen, or loins. Take of gum arabic, two ounces, dissolve in pure water, a pint, Of this mixture let a tea-cupful be taken two or three times in a day, or as often as there is occasion. Give a scruple of roch allum every half hour till it vomits; afterwards as much of the red astringent gum, as often as is necessary. She may eat of conserve of red roses to the quantity of an ounce in a day. To prevent a return, Take of red bark, an ounce, Mastic, half an ounce, Filings (201) Filings of iron, a drachm, Mucilage of gum arabic, enough for an elec- tuary. The size of a nutmeg to be taken night and morning. Take of alcohol, six drachms, Oil of turpentine, two drachms, Vitriolic acid, one drachm, Of these drops, twenty or thirty may be taken morning and night. Take of olibanum, a drachm and half, Cinnamon, half a drachm, Venice turpentine, enough for pills, Number twenty-four; three to be taken night and morning. If costive, Take of conserve of red roses, an ounce and half, Yellow wax, half an ounce, Rhubarb, two drachms, Galangal, Filings of iron, of each one drachm, Syrup of ginger, enough for an electuary, Dose, the size of a nutmeg, twice a day. FALLING DOWN OF THE WOMB. THE Falling down of the Womb is owing to a re- laxation of its ligaments, or to some violence used in labour. The (202) The cause. Falls, strains, shocks, fluor albus, the forcible (though needless) plucking away the placenta, weakness of the solids. The diagnostics. Great pain when sitting still, or at stool, difficulty of making urine, sometimes convulsions and mortification. The prognostics. If the patient is pregnant, the case is always dangerous; if the part is not reduced, it may turn gangrenous; if the ligaments are broke, scarcely curable. The cure. Let the patient try to reduce it herself, by the means prescribed under Falling down of the Fun- dament. Or, lay a crown piece, with a small piece of wax candle, lighted, on the middle of it, on the abdo- men: put a tumbler glass over it and the pressure of the air will soon restore it to its proper place. If she is with child, let the abdomen be supported by a bandage. She should be kept lying on her back (with her hips raised and her legs crossed) as long as possible. Use clysters, astringent injections, fomentations, suffiments, and pessaries. See the drops in the last article. DISORDERS PECULIAR TO PREGNANCY. NAUSEA and Vomiting. Give frequently twenty drops of diluted vitriolic acid in a tea-cupful of strong mint tea; or if necessary, opiates. See VOMIT- ING. Diarrhœa. See that article. Costiveness from the pressure of the fœtus. Admi- nister fat oily clysters. A powder composed of two parts (203) parts magnesia and one of rhubarb; of this let half a drachm be taken occasionally. Heart-burn. Two scruples of chalk and one of gum arabic may be taken as often as necessary, if not cos- tive; if that is the case, give as much magnesia, drink- ing half a pint of broth after every dose. Syncopes. Use cardiacs, volatiles, opiates, strong soups, and jellies. Longing. Whatever is craved may be given with safety, and ought by all means to be procured as soon as possible. Swelling of the ancles, legs, thighs, or breast. Use lenient cathartics, absorbents, diuretics, diaphoretics, opiates, rest; if the legs, they cannot be kept too much in a horizontal position. Pain in the loins. If from the weight of the fœtus, let the abdomen be supported by a bandage. Cardiacs and rest are necessary. Oedematous tumors of the os externam. Scarifica- tion. Dysury. Agglutinants: the catheter. Dyspnœa. See COUGH. Bearing down. See ABORTION. Flux menstrual or hæmorrhoidal, treat as at other times. False conceptions, or moles, leave to nature. If any thing is given, it should be taken from the emmena- gogue tribe. Pretty violent exercise may be used. ABORTION. (204) ABORTION. THIS and every other disorder to which a woman during the state of her pregnancy is liable, is chiefly, if not entirely, owing to a deficiency of heat and blood; which may easily be gathered from the consideration of the expence she is at for the nutrition of the fœtus, and the formation of its appurtenances; if two ounces of blood were drawn every day from a person ever so healthy for forty weeks together, let it be left to com- mon sense to determine whether such an one can stand in need of supernumerary venæ-section during that time. It is upon this account that their faces appear so thin, their noses pinched in, and various disorders attack them which originate from a deficiency of blood. If a woman with child is bled, says Hippocrates, a miscar- riage is endangered; the larger the fœtus, the more certain and expeditious will be the abortion. Expe- rience confirms the truth of this observation of the di- vine old man. I knew many ladies who used phlebo- tomy during their pregnancy, and miscarried; but on the omission of it, went out their full time and were delivered of healthy children. That all do not miscarry who are bled is true, and indeed nothing is more to be wondered at than the inexhaustible resources of nature, by which she can recover herself from the consequences of such ill-timed evacuations. To use phlebotomy be- cause her periodical visits disappear, is absurd and peu- rile, for it cannot be a manly argument that we ought to lavish away that fluid which nature demonstrates her want of by her care to preserve it. Bleeding, in a word, is always hazardous and improper during preg- nancy, and not seldom brings on convulsions and death. To this rash and inexcusable imprudence it is owing that such numbers of women who even go their full time, die in child-bed. The (205) The causes. Weakness of the solids, bleeding, blows, falls, frights, disappointment in that which was longed for. The diagnostics. Pain in the back, loins, and thighs, bearing down; cephalalgia, nausea, quick pulse, flat- ness of the breasts, syncopes, dribbling of the waters from the uterus, flooding. The prognostics. If nature is not counteracted, or disturbed by unnecessary interposition, there is seldom any danger of the mother. If the fœtus is dead (which may be known by syncopes, cold sweats, flushings, ri- gor, or the fœtus falling from side to side) nothing but mild emmenagogues should be given once or twice a day. It may continue in the uterus three or four weeks without any ill consequence, and it scarce ever exceeds that time before nature will effect its expulsion. The cure. Prevention is all we are capable of in these cases. Where there is a proneness to miscarry, from a laxity of the muscular fibres, or if she has miscarried before, it will be necessary to use the same regimen as that recommended under WEAKNESS OF THE SOLIDS, and to keep an issue constantly open. I knew a lady who miscarried twice, then opened an issue, and while it continued had three living children; she then suffered it to dry up and again miscarried; it was cut again shorty after, and she bore five strong healthy children; her issue then dried up spontaneously, after which she miscarried three times successively. The reader is left to make his own observations on this remarkable case. I have often seen amazing effects from the following: Take of French bole, Mastic, of each three drachms, Yellow wax, two drachms, Cyprus turpentine, enough for a plaster, To be applied to the loins, and worn during the time of gestation. Take (206) Take of chalk mixture, six ounces, Spirit of cinnamon, two ounces, A mixture, of which let three spoonfuls be taken morn- ing and night. Take of cannella alba, a scruple, Ginger, ten grains, Aromatic confection, half a drachm, A bole, to be taken every night. Take of red bark, an ounce, Winter's bark, three drachms, Cloves, one drachm, Oil of cinnamon, twenty drops, Mucilage of gum arabic, enough for an elec- tuary, Dose, the size of a nutmeg, morning and night. PARTURITION. THE usual time of delivery is forty weeks after im- pregnation. It has been generally supposed that about the eighth month of pregnancy, the head of the fœtus growing specifically heavier than the body, falls down on the os internum, with the face towards the mother’s back, which was before towards her belly.— This tumble, as the French call it, appears to me to be wholly imaginary, for I never dissected a woman in any state of pregnancy, that the posture of the fœtus was not the same as at the time of delivery, when the birth is natural. The fœtus receives no nourishment but by the um- bilical cord, notwithstanding the numerous arguments which that ingenious and truly excellent anatomist Heis- ter, (207) ter, has used to prove, that it swallows the alimentary liquor before expulsion; a sufficient refutation of all which is, that from the consideration of its posture, and incapacity of breathing, it is impossible. Tn a natural birth, nothing more is necessary than to support and prevent the laceration of the perinæum, leaving the rest to nature. In breech presentations, it is needless to alter the posture of the fœtus, but in all other preternatural positions, search for and extract it by the feet. If the placenta follows not immediately, use no violence; the woman may be ordered to bed: there are frequent instances of its continuance in the uterus for twelve, twenty, yea eight and forty hours, without the least ill consequence. What nature will perform in such cases is scarcely within the limits of credibility: when the head of the fœtus has been left, she has affected the expulsion of it without any assist- ance, and what is still more extraordinary, a living child has been produced from a pelvis, where there have not been more than two inches between pubes and sacrum. It would be far more eligible for practitioners to watch, wait upon, and gently operate with, than even to attempt to hurry, or disturb nature in any of the efforts she may make to relieve herself. In difficult labours, let an emmolient clyster be ad- ministered. If attended with a suppression of urine, the catheter should be introduced: sternutatories may be used to advantage; sometimes emetics and opiates; strong cardiacs ought not to be omitted. Take of balsam of copaiva, half an ounce, The yolk of two eggs, Linseed oil, six ounces, An excellent clyster. Take (208) Take of myrrh, a scruple, Purified opium, two grains, Syrup of saffron, enough for a bole, To be repeated as there is occasion. Take of penny-royal water, six ounces, Spirit of penny-royal, two ounces, Compound tincture of lavender, half an ounce, Of this mixture, three spoonfuls should be given every hour, or every half hour, with one of the following powders: Take of borax, a drachm and half, Myrrh, half a drachm, Make into six powders. To procure an easy labour. A tea-spoonful of the compound tincture of savin, taken every night for a month before the expected time, is a most certain, safe, and efficacious method, as I have experienced in a prodi- gious number of cases. Flooding. Let a cloth, dipped in vinegar, be applied frequently to the abdomen and loins, and be left on till it is dry. See MENSES IMMODERATE. Fever in child-bed. Let her be kept cool and re- ceive constant supplies of fresh air. Give the tartarised antimony in small doses with castor, and cardiacs. Suppression of the lochia. Give a scruple of com- pound powder of myrrh, two or three times a day. AFTER- (209) AFTER-PAINS. AFTER-PAINS are most severely felt by those wo- men who have had more children than one. The causes. A too quick contraction of the mouths of the uterine arteries; a distention of the ligaments, elastic air, retention of pieces of the coagulated blood. The diagnostics. Spasmodic constriction of the loins; shooting pains in the groin, abdomen, or thighs. The prognostics. They are not dangerous, nor diffi- cult to remove; if they cause a suppression of the lochia, use emmenagogues. The cure. Some give half an ounce of oil, not with- out a good effect. That which is given to drink should be supped very warm. The abdomen ought to be swathed pretty tight. Opiates may be given with safety. Take of spermaceti, half an ounce, The yolks of two eggs, Tincture of opium, Oil of juniper, of each one drachm, Penny-royal water, seven ounces, A mixture; of which let three spoonfuls be given every three or four hours, till the pains go off. Or, Take of galbanum, Myrrh, of each half a drachm, Purified opium, ten grains, Balsam of Peru, enough to make twelve pills, One to be taken every hour till the pain vanishes. SORE (210) SORE NIPPLES. DRESS them twice a day with the following lini- ment: it will not disappoint expectation. Take of spermaceti cerate, Balsam of Peru, of eacb two drachms, A liniment. DISORDERS PECULIAR TO CHILDREN. THE disorders peculiar to children are exceeding few which require any assistance. If they are kept very cool (except in winter) fed sparingly and often; have their bodies sufficiently open; be suffered to sleep little in the day time, and almost continually played withand dandled: in a word, let them not be gorged with victuals, and receive sufficient exercise, and nature will do her own business, without any interference, in all disorders that I know of, excepting those mentioned below. When children have any other complaints, the best advice I can give is, to do nothing. Frequent friction with the hand, and almost perpetual motion on the arm, are the best of all prophylactics. My intention in the seventh edition of my work was to have given more particular and diffusive direc- tions for the management of children, but am well pleased to find that intention superseded by Dr. Under- wood’s excellent Treatise on the Diseases of Children, a work worthy of the highest commendation, and which I most warmly recommend to the perusal of my reader. There is one thing indeed, in which I cannot agree with him, viz. the necessity of bleeding in the measles and hooping cough. I have only to say, I never once attended (211) attended a child in either of those disorders, which died, that had not previously been bled. This necessity, there- fore appears to me to be problematical. However, if there are any other errors to be met with in this author, I am persuaded that his work is as remarkable for their trivialness and paucity as Dr. B’s Domestic Medicine is for their magnitude and number. RETENTION OF THE MECONIUM. IF the child has no discharge by stool within six hours after its birth, let a tea-spoonful of oil of olives be given to it, or a few grains of manna, or an oleous clys- ter, or a tea spoonful of rhubarb wine, to be repeated as there is occasion. HYDROCEPHALUS. HYDROCEPHALUS, or the watery head, the best remedy for, if any, is a perpetual blister. It must not be opened; if it is, the child will be irreco- verably lost. HYDROCEPHALUS INTERNUS. THIS disorder is commonly called the dropsy of the brain, because on dissection there is found below the corpus callosum a bag of water generally as large as a goose egg, or two or three ounces of water extravasated on each side of the falx. It greatly resembles the worm fever, these particular diagnostics excepted, constant moaning, shrieking, intolerance of light, enlargement of the pupil, strabismus, and frequent lifting of the hand to the head. It is always mortal. The cause (if not preceded by a blow, or pulling the hair) is un- known. (212) known. I was once in a town where this distemper was exceeding rife. It never attacks any one after the age of puberty. As all attempts are vain, it is pity to give the patient the least painful sensation: blisters are entirely useless. They often live in this pitiable and shocking state till the fifteenth or seventeenth day after the first invasion. The only prospect is from quick- silver. CONVULSIONS. IF symptomatic, the removal of the primary disorder which occasions them is the first object. Those that are most common generally yield to the following: Take of peppermint water, an ounce and half, Prepared kali, two scruples. Balsamic syrup, half an ounce, A tea-spoonful night and morning, or three of four times a day as there is occasion. If primary, Take of tincture of asafœtida, half an ounce, Give ten drops every two or three hours. Take of new milk, an ounce, Peppermint water, half an ounce, Tincture of asafœtida, half a drachm, For a clyster. The above clyster may be given with vast advantage in all convulsive disorders in children. Note. (213) Note.—The prepared kali has all the good effects of absorbents, besides keeping open the alvine tube and urinary canals, it entirely precludes their use. In a diarrhœa, chalk may be used, which is the best of the whole tribe. SCROPHULA. HAVING already treated of the Evil, I should not have resumed the subject, but on account of re- commending a medicine which has perfectly cured infi- nite numbers of scrophulous children. Yet a very emi- nent* Physician has asserted in print, that quicksilver is of no service: I asked him, if he had used it for any length of time? His reply was, not at all, but several Physicians had asserted the same. I think my assertion, which arises from trials, and invariable success in those trials, demands as much attention. Take of muriated quicksilver, ten grains, Muriatic acid, ten drops, Rose water, half an ounce. Of these drops, let three be given to a child from two to four years old every night, or even four drops, if they do not purge (for they must not run off by stool) and the use of them continued for several months, till quite well. I have seen the most astonishing and incre- dible cures performed by them. Glandular tumors in the neck, &c. will sometimes be discussed by the tar ointment, rubbed in morning and night. If they lessen not in five or six days, Take of camphire, half an ounce, Oil of olives, six drachms, Aniseed, one drachm, A * Dr. F. the ingenious author of the Treatise on Bath Waters. (214) A liniment, to be used three or four times a day. Or, Saturnines. If it still continues to swell, or begins to look red, apply a poultice of bread and milk only, repeating it three or four times a day, and let one be laid on at bed time, to be kept on all night. This process to be con- tinued till it breaks, and for a day or two after; then dress, as you will find under the article Evil, which see. TOOTHING. IN six or seven months after birth, children com- monly begin to shew signs of dentition. It is often accompanied with some very untoward symptoms, as violent pain, symptomatic fever, convulsions, partial palsies, and severe diarrhœa. I have seen children lose the use of an arm, of a leg, and sometimes of both, till the tooth was through, and then recover immediately, without any medical assistance. The signs of cutting their teeth are, swelling of the gums, slavering, loose- ness, restlessness, and symptomatic fever. Though opiates are improper for such tender frames; yet in this case (if in any one) they may be allowed, as it is always attended with some danger; no small care is requisite to assist nature through this troublesome pro- cess. Among the many ill effects which a liberal use of Godfrey's Cordial (too often made use of by indolent nurses) or any other opiate, produces in children, may be reckoned costivenes, which is the worst habit of body a child can be subject to. Rub the inflamed gum hard and often with a lump of sugar, even till it bleeds, or give a child a piece of liquorice root to mumble, or divide the gum with a gum lancet, to facilitate the passage of the tooth. There (215) There are few disorders to which children are liable, that are not either caused by, or attended with a predo- minant acid in their stomach and bowels, partly owing to the quick fermentation of the milk in their stomachs, but chiefly to that pernicious ingredient, sugar, in their victuals; this is evident from the sourness of their breath and stools, and the green colour of the latter. Magnesia alba should be given them, not sparingly, if costive; chalk, powdered, if laxative; which two are the only medicines necessary for them while they are suckled. Perhaps it may not be amiss to observe, that five or six months are long enough for any child to suck with the least advantage to itself, or without manifest detri- ment to the mother. WORM FEVER. AS this Fever is only symptomatic, bleeding is un- necessary and improper. A few grains of nitre; or salt of wormwood may be given two or three times a day. If the fever remits, give the bark, than which there is scarce a better vermifuge. For common drink, water sweetened with honey, and acidulated with lemon juice. Of all the various medicines which are used in this case, perhaps none will prove more successful than the following powders: Take of scammony, ten grains, Calomel, three grains, A powder, to be given occasionally. Or, Take of mercury with sulphur, two drachms, Rhubarb, half a drachm, Tartarised antimony, two grains, For (216) For six powders; one to be taken twice a day. Take of Indian pink roots, an ounce, Divide into three parts; of one part make an infusion, by boiling water; two or three tea cupfuls to be taken at once, and repeated occasionally. N. B. This disorder is not uncommon with adults, especially females. TUSSIS CONVULSIA. THE Hooping, or Chin-Cough, as it is called, is dangerous, on account of those spasms of the lungs wherewith it is always attended, and from whence that matter is ejected, when the children hoop and strain, and not from the stomach, as is vulgarly supposed. Take of antimony tartarised, five grains, Water, an ounce, Balsamic syrup, two drachms, A mixture; a tea-spoonful to be taken every half hour, till it pukes, and repeated every other morning. Ten drops of the balsam of copaiva, on sugar, twice a day, ought not to be omitted. Spermaceti, dissolved in broth, is useful; so also is an electuary, composed of nettle-seeds and honey; the asafœtida, were it less nau- seous, is inferior to no medicine. They should be kept as warm as possible. The exercise of swinging is peculiarly serviceable to them. Oil of amber, or garlic, rubbed on the spina dorsi every night, will have a won- derful effect, or a Burgundy pitch plaster, to be worn constantly between the shoulders. See COUGH. Emetics (217) Emetics, eccoprotics, antacides, antispasmodics, as valerian, gum ammoniac, castor, musk, &c. are all of considerable utility, and opiates, if not costive. As a plethoric child is a prodigy indeed, I cannot conceive what phlebotomy has to do in this or any other disorder to which children are liable; whatever their ailments are, the lancet may well be dispensed with. I have seen many, too many instances, in which their lives have been sacrificed to the use of it. Take of prepared kali, two scruples, Peppermint water, an ounce and half, Balsamic syrup, half an ounce, A tea or pap-spoonful to be taken night and morning. WATERY GRIPES. IN this disorder not more than two doses of rhubarb ought to be premised, before recourse is had to astringents, such as the compound powder of chalk, with opium, which is second to none; it may be given from three to five grains, twice or thrice a day. Chalk may be freely given, and any alcalis. The inmost peel of a walnut powdered, and given at pleasure, is excel- lent; or powder of unripe blackberries. In the decline of this and the foregoing disease, large quantities of the bark, in decoction, should be used, to confirm and per- fect their health and strength. SCALD HEAD. LET the head be shaved, if it can be performed with any tolerable convenience, and apply the tar oint- ment, with calomel, rubbing it well in night and morn- ing. K Take (218) Take of tobacco, two ounces, boil in Water, a pint, Till about an ounce is evaporated; then strain, and add a drachm of water of kali. Let a cloth be dipped in this mixture, warmed, and the head be moistened with it each time, previous to the application of the ointment, and the cruel operation of plucking out the roots of the hair will be totally unnecessary. During the cure, small quantities of antimonials and mercurials, combined, will be found extremely ser- viceable, or the solution of muriated quicksilver, or the mixture under SCURVY, which see; but none of them are absolutely necessary. The above topics may be safely trusted to alone. CUTICULAR ERUPTIONS. THESE are very common with children, and are no very unpromising prognostic. They indicate a proper attempt of nature to throw off something that is offensive, consequently they ought to be promoted, and by no means to be repelled by any evacuations what- ever. Bleeding or purging would be equally injurious. In this case animal food, with plenty of salt, is neces- sary. My eldest son, at the age of four years, had a violent eruption all over his body, which soon disap- peared without any medicines, by the liberal use of salt and gravy. No diet is so proper for children as that of animal substance; and the healthiest children I ever saw were those who had been used to it from the time that they were four or five months old. The meat should be minced small, but not be deprived of its most nutritious juices, by being previously & filthily mouthed by the nurse. If children had nothing given them but milk, or half cow’s milk and half water, till they began to teethe, without either bread or sugar, and afterwards were (219) were indulged in the use of animal, with very little ve- getable food, we should rarely find any disorders among them. Vegetables require too operose a process for their tender organs to elaborate into nutritious chyle. See SCURVY, and the mixture and liniment under that article. RICKETS. THIS is a disease that affects the bones of children; the head is sometimes enlarged to an enormous size; the wrists and ancles seem protuberant, and as the bones increase in size, the child grows weaker; indeed every fibre is distended beyond its proper dimension, for the solids are by no means a match for the fluids.— It is chiefly, if not wholly, owing to the sloth and nas- tiness of the nurse. Those children who are much dandled and danced, kept clean, and frequently in mo- tion, carried sometimes on one and sometimes on the other arm, will be for ever strangers to this disorder. For the cure, emetics and rhabarbine purgatives be- ing premised, give chalybeates, the bark, change of air, plenty of exercise, which is absolutely necessary, and let the child be plunged into cold water every morn- ing; but never give it a second, much less a third dip, as is the foolish custom of some. For regimen, see WEAKNESS OF THE SOLIDS. N. B. All drops should be taken in a glass of water, unless otherwise expressed. K2 AS  (221) AS a promise is sacred, however unfairly extorted, it would be unkind for the reader to impute the insertion of the following petit piece to the vanity of the author: TO THE AUTHOR OF THE ART OF HEALING. LONG had Philosophy lain hid in night, Till sapient NEWTON rose, and all was light: So Physic hobbled on, with crippled pace, Veil’d in dark terms, or covered with grimace, Till MARRYAT laid her open to the view, With Truth adorn’d her, and with Reason too. SHARMAN HARROLD. ANTRIM, August 24, 1766. THE END.  (223) INDEX. A PAGE. ABORTION, to prevent—204 After-pains—209 Ague—9 Albugo. See OPTHALMY Anasarca. See DROPSY Angina. See QUINSY —Pectoris. See FLATULENCIES, HUMO- RAS, ASTHMA, and DROPSY Anorexia. Apepsia. See APPETITE BAD Aphthæ—4O Apoplexy—93 Appetite Bad—139 Ardent Fever—6 Arthritis. See GOUT Ascites. See DROPSY Asthma—74 B Bastard Peripneumony—71 Bloody Flux. See DYSENTERY Borborygmi. See FLATULENCIES Bradypepsia. See APPETITE BAD Bulimus 224 INDEX. PAGE. Bulimus—141 Bulimia—ib. Burn—189 C Caducus. See EPILEPSY Cancer—188 Canine Appetite—141 Cardialgia. See HEART BURN Catalepsy. See EPILEPSY Catarrhal Fevers—66 Catarrh Suffocating—68 Catoche. See HEART BURN Causus. See ARDENT FEVER Cephalalgia—78 Cephalæa—ib. Chiragra. See GOUT Cholera Morbus—126 Chlorosis—193 Chorea Sancti Viti—179 Chumosis. See OPTHALMY Colic Bilious—134 —Flatulent—136 —Of Painters—135 Clap. See VENEREAL DISORDERS Cœliaca. See DIARRHŒA Colds. See CATARRHAL FEVERS Coma Vigil. See FEVERS —Somnolentum. See LETHARGY Consumption—43 Contractions—192 Convulsions—147 —in Children—212 Cough—68 —Hooping—216 Cuticular Eruptions—153 —in Children—218 D 225 INDEX. D PAGE. Dance of St. Vitus—179 Deafness—178 Dentition. See TOOTHING Diabetes—143 Diarrhœa—120 Disorders of the Eyes—63 —Breast. See COUGH, ASTHMA, FLATULENCIES, & BASTARD PERIPNEUMONY —Painful—183 —Peculiar to Children—210 —Females—193 —Pregnancy—202 —Venereal—107 —Windy. See FLATUS Dropsy—99 Dysentery—124 Dyspepsia. See APPETITE BAD Dyspnœa. See ASTHMA Dysury. See URINE SUPPRESSED E Elephantiasis—158 Empyema—48 Ephemera. See FEVERS Epilepsy—81 Epiphora. See OPTHALMY Eruptive Fevers—28 Erysipelas—54 Evil—160 —in Children—213 F Fainting. See SYNCOPE Falling down of the Fundament—161 —Womb—2Ol Fevers 226 INDEX. PAGE. Fevers in general—1 —Ardent—6 —Intermitting—9 —Malignant—35 —Miliary—33 —Nervous—ib. —Petechial—35 —Puerperal—208 —Putrid—35 —Scarlet—42 —Slow—33 —White. See CHLOROSIS Fistula. See PILES Flatus—85 Flooding—208 Fluor Albus. See WHITES G Gangrene—187 Glaucoma. See OPTHALMY Gleet—117 Gonagra. See GOUT Gonorrhœa virulent—107 Gout—170 Gravel. See NEPHRITIS Green Sickness. See CHLOROSIS Gripes Dry. See COLIC —Watery—217 Gutta Serena. See OPTHALMY H Head-Ach—78 Hæmoptoe—49 Hæmorrhage—52 Hæmorrhoids. See PILES Heart-Burn—132 Hemicrania 227 INDEX. PAGE. Hemicrania. See CEPHALALGIA Hemiplegia. See PALSY Hernia—186 Hiccough—52 Hip-Gout—177 Hoarseness—68 Hooping-Cough—216 Humoral Asthma—71 Hydrocephalus, or Watery Head—211 —Internus, or Dropsy of the Brain ib. Hydrops. See DROPSY Hydrothorax. See PERIPNEUMONY GNOTHA Hypochondria—90 Hypopyon. See OPTHALMY Hysterics—196 I Iliac Passion, or Twisting of the Guts—137 Imbecility—168 Impotency—ib. Intermitting Fever— Ischury. See URINE SUPPRESSED Itch—156 J Jaundice—103 K King’s Evil—160 L Labor Difficult—207 Lepra Græcorum. See LEPROSY Leprosy 228 INDEX. PAGE. Leprosy—158 Lethargy—166 Lientery. See DIARRHŒA Locked Jaw. See SPASMS, &c. Looseness. See DIARRHŒA Lues, or Pox—113 Lumbago. See GOUT M Madness—24 Malignant Fever—35 Measles—41 Melancholy. See HYPOCHONDRIA Menses Suppressed—198 —Immoderate—199 Miliary Fever—33 Miserere Mei. See ILIAC PASSION Morbilli. See MEASLES Morbus Comitialis —Herculeus —Sacer See EPILEPSY —Virgineus—193 Mortification—187 N Nephritis—56 Nervous Fever—33 Nipples Sore—210 O Odontalgia, or Tooth-Ach—183 Œdema—190 Omagra Onagra See GOUT Opisthotonos—147 Opthalmy 229 INDEX. PAGE. Opthalmy—63 Orthopnœa. See ASTHMA P Painful Disorders—183 Pain in the Back—185 —Breast. See PHTHISIS —Ears—183 —Face—184 —Head. See CEPHALALGIA —Limbs—186 —Loins—185 —Neck—ib. —Side. See FLATUS —Stomach. See HEART-BURN —Teeth—183 Palpitation of the Heart—146 Palsy—97 Paralytic Affection of the Legs—192 Para-Phrenitis—23 Parturition—206 Peripneumony Gnotha—19 —Bastard—71 Petechial Fever—35 Phlogosis Phylctnæ Pterygium See OPTHALMY Phrenitis—21 Phthisis—43 Piles—129 Plague. See PUTRID FEVER Pleurisy—12 Poisons—145 Pox—113 Procidentia Ani—161 —Uteri—201 Psora. See ITCH Putrid 230 INDEX. PAGE. Putrid Fever—35 —Sore Throat—38 Q Quinsy—15 R Retention of the Meconium—211 Rickets—219 Rheumatism—174 Rupture. See HERNIA S Scald Head—217 Scarlet Fever—42 Schirrus—188 Sciatica. See HIP GOUT Scorbutic Eruptions—151 Scrophula—160 & 213 Scurvy—151 Singultus. See HICCOUGH Slow Fever—33 Small Pox—28 Spasms—147 Sphacelus. See Mortification Spina Ventosa. See WHITE SWELLING Sprain—190 Sterility. See IMPOTENCE Stone—61 Strangury—162 Struma. See EVIL Suffocating Catarrh—68 Suffusio. See OPTHALMY Syncope. See FAINTING Synochus. See ARDENT FEVER T 231 INDEX. T PAGE. Taraxis. See OPTHALMY Tenesmus—123 Thrush—40 Tinea. See SCALD HEAD Tooth-Ach—183 Toothing—214 Tussis Convulsiva, or Hooping-Cough—216 Twisting of the Guts. See ILIAC PASSION Tympanites. See DROPSY V Variolæ, See SMALL POX Venereal Disorders—107 Volvulus. See ILIAC PASSION Vomiting—148 U Ulcer in the Bladder—59 —Kidnies ib. —Legs 190 Urine Suppressed—164 —Incontinence of—165 W Watery Gripes—217 Weakness of the Solids—181 Whites—194 White Swelling—186 Windy Disorders. See FLATUS. Worm Fever—215 Worms—150 Y Yaws. See POX and SCORBUTIC ERUPTIONS.