''!feaiK'::-:'..::r.:::'.r«aKtf ^.^i.nrUtr.rt; ■„:■■',' ...;■;'•;;;♦*•.:;:■.■ ■ ■ f:i*w:-'''" f*-': -can! •" '•■ • ■"•' /..'-HKJWtl";f-*.!-' ••' ';-'";;:i*i- :',:'.!:;:.'"..• '.{23 f liitfcwf'd..' fe Siwii"--:' .....iwi )$$■>{■:;■ :....... ''■■■':-'^^Kl^rK ,,r.y.,. KTJ •-*•"•- ■■'W^^tifcL ■:.Va':*^;^-«Sfrjs«ap ifitri: i:a;-;. JU&I! tetr. int^-.-i;:.-..- CARPENTER'S FAMILY •Medicine Chest Dispensatory^ CONTAINING A SELECT CATALOGUE OF DRUGS, CHEMICALS, AND FAMILY WITH THE PROPERTIES AND DOSES OF EACH ARTICLE MOST APPROVED OF IN DOMESTIC MEDICINE. 2To tohfcft in ^enteir, A CONCISE DESCRIPTION OF DISEASES, WITH DIRECTIONS For the Treatment of such as are unattended with serious consequences-showing also the best unmediate measures to be adopted, in those disorders and accidents which' aredestrucuvetolife, when the physician is not at hand, or until his assistance can be procured. / PHILADELPHIA:^^ Geo. W. Carpenter's Chemical Warehouse', Wo. 301 Market street. 1835. QV less" Entered according to the Act of Congress, in the year 1835, By GEORGE W. CARPENTER, In the Clerk's Office of the District Court of the United States in and for the Eastern District of Pennsylvania. Meall, Printer, Philadelphia PREFACE. In submitting the following pages to the public, I feel it my duty to state, that I have been assisted by a medical gentleman of this city, in the introduction and composition of this work; and that I am indebted to this source, entirely, for that portion of the work which treats of diseases and the various applications of reme- dies. I consider it my duty, thus publicly to acknowledge the fact, as I wish to guard against the imputation of appropriating to myself what justly belongs to others. My chief object is to intro- duce, and put in extensive circulation, a work which, I think, will be found highly useful for heads of families, especially those who reside in the country, and at a distance from medical aid. To planters who have a large number of domestics—to owners of vessels—and, in short, to every individual, a source of valuable information in the treatment of the various diseases to which the human frame is liable. When we contemplate the condition of man—his constitution — the various diseases to which he is liable—and the relief which, in numerous cases is instantaneously produced by the judicious application of proper remedies, we are surprised that heads of families should be without a medicine chest, and a treatise upon the use and application of simple remedies. We believe the principal cause of this is the expense of the chest, and cost of a 4 Preface. book; for it will be doubted whether any one would not avail himself of either, could they be procured without expense. How- ever high an estimate money may command, unless applied to the uses for which it is intended, its intrinsic worth is entirely lost; for its only value is to afford us the means or facilities in getting what is useful or agreeable to us ; in the abstract, or independent of this, it is entirely worthless; and if we do not avail ourselves of the advantages it gives us while we possess it, we are quite as well without it. Health is infinitely more valuable than the diamond : in fact, there is no earthly comparison to be brought in competition with it. , To put money in the scale, as equivalent to health, is an insult to reason. Those in health may think light of this, but go to the bed of the ago- nizing patient, wasting and expiring under the protracted stages of disease, and ask him the question. Although his possessions were equal to the resources of India, what would be his feelings, and what consolation would it afford him? Give him but the possession of health, notwithstanding he appreciated it so little while he possessed it, he will at once sacrifice what can afford him no relief or comfort. And yet the disease for which he is willing to make so great a sacrifice, might probably have been ob- viated, and his life yet prolonged, by the early and judicious ap- plication of some simple remedy of the medicine chest. Such are the errors of judgment and inconsistency of man, that in his vari- ous researches for general knowledge and information, he should entirely overlook and forget that which is of most importance to him. It is of essential use to every man, to make himself ac- quainted, as far as practicable, with the diseases to which he is liable, and the most simple means of guarding against and check- ing the progress of disease. It is not expected that he should be- come proficient in the arduous and profound science of medicine, or to treat with success the diversified and complicated diseases Preface. 5 to which the human frame is liable. This would require years of study, and an unremitting application to the subject. It is, how- ever, of essential importance, and within the reach of all who are disposed, to acquire at least some acquaintance with the symptoms of the diseases of common occurrence, and of the structure and functions of the human body; and to become familiar with the properties and doses of the various remedies which are made use of to preserve and restore health. A degree of restraint, however, should be observed on all occasions where a physician is advisa- ble, and an immediate submission be made to his superior know- ledge and experience. A physician should on all occasions be preferred and consulted where it is practicable ; but there are occasions of very frequent occurrence, where the knowledge of individuals could be called into immediate and successful operation before a physician could be reached ; particularly in cases of accident, or sudden illness in travelling, or in distant parts of the country ; and also in cases of insufficient importance for the attention of a physician. In some cases, even where the physician is in attendance, his success is aided by the facilities he receives from those who have some knowledge of the diseases and the mode of administering the re- medies. When it is for a moment considered our liability to accidents from the most trifling causes, how suddenly disease sometimes oc- curs, and moreover the difficulty often experienced in procuring Medical Aid at the instant it may be required, it becomes, no doubt, a matter of surprise how so important an article as a Medi- cine Chest, with a proper assortment of Medicines, should have been overlooked, when other articles, far less useful, are consu dered as indispensables. At no period had the anxiety for the preservation of life been so strongly demonstrated, as during the awful visitation of the 6 Preface. late Epidemic ; thousands who theretofore considered themselves secure had been taught the solemn axiom, that " in the midst of Life we are in Death" and had been brought to the conviction of the duty they owed to themselves, their families, domestics, and dependants, in having a remedy at hand in time of need. They witnessed their fellow-being this moment in health, and the next in all the coldness of death ; they learned that a timely application of proper means saved, and that delay proved destruc- tive ; but it is not the Cholera alone that comes like a thief in the night; there are numerous diseases which assail us even more suddenly, and which require the promptest attention: apoplexy, fits, convulsions, the rupture of blood vessels, accidents from various causes, may all prove as rapid in their termination as did that of Cholera. A Selection of Medicines, however, is of very little utility, unless those who possess them have also the knowledge essential for the administration of them ; too large or too small a Dose may be equally injurious; the one by acting too violently, whilst the other, from its inefficacy, may cause a loss of valuable time, and render the life of the patient precarious. The above Work forms a catalogue of those articles more ge- nerally used for Medical and Domestic purposes ; the Catalogue is arranged alphabetically, the dose for an adult, and the proper- ties follow the name of each article.—By this arrangement, and the variety of articles named, every one will be enabled to make a collection agreeable to his own experience and inclination, and however varied the selections of different persons may be, instruc- tions will be found to answer all their views. A Table for regulating the doses according to the age of the patient, will follow the Pkeface. The most approved methods of fumigating infectious chambers ; the best means for obviating the effects of poison ; the British Royal Humane Society's plan Preface. 7 for restoring suspended animation ; the treatment of apoplexy, &c, observations on bathing and hydrophobia, a concise descrip- tion of the most celebrated Mineral Waters with their Medical Qualities, and a glossary of the Medical Terms used in the Work, are superadded, as information with which every one should be acquainted. An Appendix containing a brief but intelligible description of diseases, with directions for the treatment of such as are unat- tended with serious consequences, as before stated, will be add- ed, which, it is hoped, will answer the purposes intended. WEDIOll^ CHESTS. Medicine chests should be made of different sizes, and the con- tents so proportioned as to suit the sizes of families and the num- ber of domestics. Another consideration should be kept in view; whether residing in the city where a chest can, in a short time be replenished, or whether in the country where such facility does not exist, and where of course a larger chest would be required, and the quantity as well as the number of articles should necessa- rily be increased. In order to have chests adapted to all the various conditions of life, I have put up five sizes of chests of particular description and construction, and denominated them Carpenter's Medicine Chests, varying in numbers from 1 to 5, so as to distinguish them and pro- perly to characterize them according to the numbers—thus, No. 1, is adapted for a family residing in the city. No. 2, for a large family in the city or a small family in the country. No. 3, for a large family at a considerable distance in the country, or for a plantation where a large number of domestics are employed. No. 4, for a practising physician, containing a full assortment of medicines, &c. No. 5, for sea, suitable for large vessels and packet ships. These chests will be all filled with fresh and choice medicines, in ground stoppered heavy flint glass bottles, of various sizes, neatly labelled in gold, and which will be put at a very moderate price. The following are descriptions of each chest. Carpenter's Medicine Chests No. 1, Adapted for a Family residing in the City. This is a neat Mahogany case, finely firished with brass moun- tings, lock and key, handles, &c, and forms a neat and appropri- ate piece of parlour furniture. On opening the lid the following bottles are displayed :— 4, Four ounce salt mouth bottles, containing Calcined Magnesia, Flour of Sulphur, Cream of Tartar, Epsom Salts. 5, Two ounce Tincture bottles, containing Syrup of Rhubarb, Sweet Spt. of Nitre. Hive Syrup. Sulphuric iEther. Castor Oil, 4, One ounce salt mouth bottles, containing Powd. Ipeeacuanha, Calomel, Powd. Rhubarb, Powd. Jalap, o 10 8, One ounce Tincture bottles, containing Laudanum, Tincture of Lavender Comp. Paregoric, Syrup of Squills, Essence of Peppermint, Elixir of Vitriol. Antimonial Wine, Under which is a drawer which contains the following articles. 4, Two ounce Fancy Porcelain Jars, containing Blistering Ointment, Simple Cerate, Basilicon, Mercurial Ointment. Also in which are neat separate divisions made for, and containing the following articles. 1 Pair of Scales and Weights, Small Glass mortar and pestle, Graduated Glass Measure, Small Glass Cup to take doses of medi- Kmall Spatula, cine from. Carpenter's Medicine Chest Dispensatory, containing a full description of ah the Medi- cines, and a concise description of the treatment of the diseases. This chest will cost from $20 to $30, according to the finish, and the variation of the cost between bottles labelled in gold or in the ordinary manner, and whether also, of cut glass or plain. Carpenter's Medicine Cliest: No. 2, Adapted for a large family in the city or a small jamily in the country. This is also a neat Mahogany Chest, handsomely finished, with brass mountings, lock and key, handles, &c. On opening the lid the following articles are displayed:— 5 Four ounce salt mouth bottles, containing Calcined Magnesia, Epsom Salts, Cream of Tartar, Red Bark. Flour of Sulphur, 7, Two ounce salt mouth bottles, containing Powd. Rhubarb, Susrar of lead, Calomel, Tartar Emetic, Powd. Jalap, Carbonate of Iron. Ipecacuanha, 5, Four ounce Tincture bottles, containing Castor Oil, Sweet Spt. of Nitre, Syrup Rhubarb, Antimonial Wine. Hive Syrup, 7, Two ounce Tincture bottles, containing Laudanum, Syrup of Squills, Paregoric, Solution of Quinine, Sul. iEther, Elixir of Vitriol. Essence of Peppermint, 8, One ounce salt mouth bottles, containing Powd. Aloes, Lunar Caustic, White Vitriol, Powd. Nitre, Powd. Opium, Sulphate of Quinine, Blue Vitriol, Salt of Tartar, 11 Under which is a drawer containing the following articles. 4, Four ounce Covered Porcelain Jars, containing Simple Cerate, Blistering Ointment, Mercurial Ointment. liasilicon. 1 pair of Scales and Weights, Spatula, Graduated Glass Measure, Small Glass Measure Cup, Small Glass Mortar and Pestle, 1 Copy Carpenter's Medicine Chest Dispen'y. 4, Tin Canisters with lids, containing Chamomile Flowers, Senna and Manna. Also, neat and appropriate divisions, containing r of Scales and Weights, Spatula, uated Glass Measure, Small Glass ] I Glass Mortar and Pestle, 1 Copy Carpenter This chest will cost from 30 to 35 dollars. Carpenter's Medicine Chest: No. 3, For a large family residing at a considerable distance in the country, or for a plantation where a large number of domestics are employed. This being a larger chest, is generally made of pine, poplar or cherry, neatly stained and varnished, or can be made of maho- gany, if desired, at a few dollars more expense. On opening the lid the following bottles are displayed. 6, Eight ounce Tincture bottles, containing Castor Oil, Sweet Spts. of Nitre, Syrup of Rhubarb, Soap Lin ment, Spts. of Camphor, Lead Water. 7, Four ounce Tincture bottles, containing Essence of Peppermint, Solution of Quinine, Laudanum, Syrup of Squills, Paregoric, Hive Syrup. Antimonial Wine, 10, Two ounce Tincture bottles, containing Elixir of Vitriol, Spts. of Hartshorn, Spts. Lavender, Compound, Huxham's Tincture of Bark, Hoffman's Anodyne. Black Drop, Tincture of Asafcetida, Sulphuric .Sthcr, Tincture of Guaiac. 6, Eight ounce salt mouth bottles, containing Red Bark, Calcined Magnesia, Powd. Jalap, Cream of Tartar, -----Rhubarb, Flour of Sulphur, 7, Four ounce salt mouth bottles, containing Powdered Aloes, Sugar of Lead, Calomel, White Vitriol, Ipecacuanha, Powdered Squills, Tartar Jtmetic, Under which is a drawer containing the following. 4, Half ounce salt mouth bottles, containing Sulphate of Quinine, Pulv. Antimonialis or James' Powder, Acetate or Sulphate of Morphia, Powdered Nitre. 12 6, Four ounce canopy Porcelain Jars, containing , Citrine Ointmei Basilicon Ointn j Turner's Ceratt 6, Tin Canisters, containing Gum Arabic, Arrow Root, Adhesive Plaste Neat and appropriate divisions, containing IVeights, Glass Mortar Glass Cup, Glass Measure, Carpenter's M This chest will cost from 35 to 40 dollars. Mercurial Ointment, Citrine Ointment, Simple Cerate, Basilicon Ointment, Blistering Ointment, Turner's Cerate. Epsom Salts, Gum Arabic, Glauber Salts. Arrow Root, Senna and Manna, Adhesive Plaster, spread Scales and Weights, Glass Mortar and Pestle, Spatula, Glass Cup, Graduated Glass Measure, Carpenter's Medicine Chest Dispensatory. Carpenter's Medicine Chest: I\o. 4, Adapted for a Practising Physician in the Country. This being a large Chest, is generally made of pine, poplar or cherry, neatly stained and varnished, or can be made of mahogany, if desired, at a few dollars additional expense. This Chest contains a neat and general assortment of medicines for a Practising Physician, and will be found a highly useful ar- ticle. On opening the lid, the following articles are displayed at one glance. 7, Twelve ounce Tincture bottles, containing Ol. Ricini, OR Castor Oil, Sp. ^th. Nit. "• Sweet Spts. Nitre, Syr, Scillae. " Syrup of Squills, Sp. Camphorse, " Spirits of Camphor, Mel. Scills Com. " Hive Syrup, Tinct. Cinchon. Com. " Huxham's Tincture of Bark. 8, Eight ounce Tincture bottles, containing Ess. Menth. Pip. OR Essence of Peppermint, Tr. Opii " Laudanum, Tr. Opii Cam. " Elixir Paregoric, Vin. Antimon, " Antimonial Wine, Sp. Cornu. Cervi, " Spirits of Hartshorn, Sol. Quinae, " Solution of Quinine, Sp. Lavend. Com. Spirits of Lavender, Compound, /Ether Sulph. " Sulphuric ^Ether. 9, Four ounce Tincture bottles, containing Bals. Copaiva, OR Balsam Copaiva, Sp. ^ther. Sul. Com. " Hoffman's Anodyne, Tr. Benzoin Com. " Turlington's Balsam, Tr. Guaiac. « Tincture of Guaiac, Tr. Assafcetid, " Tincture of Assafoetida, Tr, Myrrhse. « Tincture of Myrrh, Tr. Sapon. Com. " Soap Liniment, Tr. Gentian. Com. " Compound Tincture of Gentian Aqua Plumbi, " Lead Water. 13 12, Two ounce Tincture bottles, containing Tinct. Digitalis, Acet. Opii, Sp. Ammon. Ar. Vm. Rad. Colchic. Tr. Opii. Narcot. Depr. Acid. S. Arom. Tr. Meloe Vesic. Tr. Kino, Tr. Cubebae Tr. Iodin, Tr. Rhei, Tr. Valerianae Tincture of Digitalis, Black Drop, Aromatic Spirits of Ammonia, Wine of Colchicum Root, Denarcotised Laudanum, Elixir of Vitriol, Tincture of Cantharides, Tincture of Kino, Tincture of Cubebs, Tincture of Iodine, Tincture of Rhubarb, Tincture of Valerian. 14, One ounce Tincture bottles, containing Ol. Anisi, Ol. Carui, Ol, Cinnamoro. Ol, Caryophil. Ol, Copaiva. Ol, Cubebae Ol. Juniper. Ol, Lavindul- 01. Limonis, Ol. Menth, Pip, Ol. Sassafras, Ol, Santonic. Ol. Terebinth. 01. Sabinae. Oil Oil Oil Oil Oil Oil Oil Oil Oil Oil Oil Oil Oil Oil of Aniseed, of Can-away, of Cinnamon, of Cloves, of Copaiva, of Cubebs, of Juniper, of Lavender, of Lemons, of Peppermint, of Sassafras, of Wormseed, or Spts- of Turpentine, of Savine, 14, One ounce salt mouth bottles, containing Iodine, Potass. Hydriod. Hydrar. Chlor. Opii Pulv, Pulv. Antimonialis, Fol. Digitalis Pulv, Pulv, Nit, Potas, Caryophil. Pulv. Zinci Sulph, Cupri Sulph. Pulv, Gallar. Argent. Nitrat. Fefri Sulph. Secale Cornut. Hydriodate of Potash, Corrosive Sublimate, Powd. Opium, James' Powder, Powd. Digitalis leaves, Powdered Nitre, Powdered Cloves, Sulphate of Zinc, Blue Vitriol, Powdered Galls, Lunar Caustic, Sulphate of Iron, Ergot. 15, Quarter ounce salt mouth bottles, containing Acet. Morphiae, Sulph. Morphiae, Piperine, Strychnine, Acid. Prussic, Veratrine, Kreosote, Ol. Croton. Elatine, Proto-Iodur. Mercury, Deuto do do Iodide of Lead, Lupuline, Ol. Cantharid, 01. pip. Nig. 7, Twelve ounce salt mouth bottles, containing Magnes. Usta, Pulv. Cinchon. Potas. Bitart. Sulph. Subl. Pulv. Jalapse, Pulv. Rhei, P. Sal. Rochel, Calcined Magnesia, Powdered Bark, Cream of Tartar, Flour of Sulphur, Powdered Jalap, Powdered Rhubarb, Rochelle salts. 8, Eight ounce salt mouth bottles, containing Pulv. Aloes. OR Powdered Aloes, Ipecac, pulv. " Powdered Ipecacuanha, Sodae, Bi-carb. " Super Carbonate of Soda, Acid. Tartaric. " Tartaric Acid, Creta. ppt. " Prepared Chalk, Ammon. Carb. " Carbonate of Ammonia, Potas. Carb. " Salt of Tartar, 14 9, Four ounce salt mouth bottles, containing Acaciae, pulv. OR Powdered Gum Arabic, Sodae Subbor. " Borax, Hyd. Sub. Mur. " Calomel, Quinae Sulph. " Sulphate of Quinine, Colocynth. pulv, " Powdered Colocynth, Camphora, " Camphor, Scillaa, pulv. " Powdered Squills, Spigelian, pulv. " Powdered Pink Root. Serpentarite pulv. " Powdered Snake Root. Under which is a drawer containing the following 6, Eight ounce canopy top jars, containing Unguent. Hydrarg. OR Mercurial Ointment, Unguent. Res. Flav. " Basilicon do Cerat. Simp. " Simple Cerate, Ung. Cantharides, " Blistering ointment, Mass. Hydrarg. " Blue Mass, Ung. Hyd. Nit. " Citrine ointment. 6, Tin canisters, containing Fol. Sennae, OR Senna, Manna " Manna, Magnesise Sulph, " Epsom Salts, Linteum, " Lint, Emplast. Adhes. " Adhesive plaster, Acacias Gum, " Gum Arabic. Also, neat and appropriate divisions, containing Scales and Weights, Wedgwood mortar and pestle, Spatulas—2 sizes. Graduated Glass Measure, Glass Mortar and pestle, Carpenter's Medicine Chest Dispensatory. The above chest will cost from 90 to 100 dollars. Chest No. 4 intended for physicians is also made of a very small size suitable for carrying out in a gig or sulky ; the most prominent and important articles are put up in small quantities, sufficient for each day's practice. The bottles are neatly put up and handsomely labelled, price $15.00 to 20.00, according to finish. Carpenter's Medicine Chest: J\o. 5, For Sea Voyage. The above chest is intended for a ship, the size can be propor- tioned and varied to suit the vessel, length of voyage, &c. This being a large chest, is generally made of pine, poplar or cherry, neatly stained and varnished, with lock and key, brass handles, &c. it can also be made of mahogany if desired, at a few dollars more expense. On opening the lid the following articles are displayed, viz. 7, Twelve ounce tincture bottles, containing Castor Oil, Balsam Copaiva, Soap Liniment, Spts. of Camphor, Sweet Spts. of Nitre, Essence of Peppermint. 8, Eight ounce tincture bottles, containing Laudanum, Syrup of Squills, Elixir of Vitriol, Turlington's Balsam, Tincture of of Myrrh, Paregoric Elixir, Goulard's Extract of Lead, Solution of Quinine. 15 8, Eight ounce salt mouth bottles, containing Powdered Jalap, Powdered Aloes, Sulphate of Quinine, Ipecacuanha, Powdered Rhubarb, Powdered Nitre, Sugar ol Lead, Powdered Alum. 6, Four ounce salt mouth bottles, containing Red Precipitate, Dover's Powder, Calomel, White Vitriol, Caustlc> Blue Vitriol. 6, Pint ointment Jars, containing Blistering Ointment, Mercurial ointment, Citrine ointment, Basilicon do 1 timers Cerate, Simple Cerate, 4, Two ounce salt mouths, containing Calomel pills, Blue pills, Lee s pills. Corrosive Sublimate. Under which is a drawer containing the following : 10, Tin canisters, containing Cream of Tartar, Flour of Sulphur, Epsom Salts, Adhesive plaster, Chamomile, Patent Lint, Tapioca, Pearl Barley, Flaxseed, Senna and Manna. Sundry articles, 2 Lancets, Glass mortar and pestle, lpint Syringe, Graduated Measure, 2 Bougies, Penis Syringes, 3 2 Catheters, Spatulas—2 sizes. Scales and Weights, Carpenter's Medicine Chest Dispensatory Composition Mortar and pestle, CARPENTER'S IMPROVED MEDICAL SADDLE BAGS. This very convenient appendage for the country practitioner, is made of a new construction, it contains 29 square bottles made of extra weight, and ground in a superior manner, expressly for the purpose. The bottles are neatly labelled with gold, and filled with choice medicines—on lifting the bear-skin cover, on either side, the bottles aie all displayed similar to the wing of a medicine chest, as follows, 4, Four ounce salt mouth bottles, containing Magnes. Usta. Jalap pulv. Rhei pulv. Aloes pulv. 4, Four ounce Tincture bottles, containing Ess. Menth. pip. Mel. Scil. C Ol. Ricini, Syr. Scillae 7, Two ounce salt mouth bottlas, containing Pulv. Scil. M. Pulv. Ipecac. Acet. plumb. Quinine, Calomel, Pulv. Doveri, Camphors, 16 6, Two ounce tincture bottles, containing Tinct. Opii. Sp. Nit. Dul. Tr. Opii. Cam. Aqua Ammoniae, Vin. Antimon. Black Drop. 8, Half ounce salt mouth bottles, containing Pulv. Opii. Ei-grot, Morphine, Vin. Colchici. Tart. Antim. Red precipitate, P. Nit. pot. iEther Sul. 3, Tin canisters, containing Blistering ointment, Blue Mass. Basilicon ointment, There is a pocket on each side of the bag for Surgical instruments or other articles. The price of the above is $25.00, including medicines—or $15.00 for the bags and bottles unlabelled. Different practitioners have their own peculiar remedies, and those who wish any of the bottles varied as to the labelling, can have any alteration made which they may point out. G. W. Carpenter having incurred considerable expense, in get- ting brass bottle moulds made expressly for the medicine chests and saddle bags above described, and taken especial care in having the bottles made of extra weight and otherwise superior in quality, he hopes those who may wish a medicine chest will send their orders direct to him, and they can rely upon getting an article superior in quality to those generally made, and as low as chests of like character can be had from any establishment in the United States. He also has the above chests made with wings in a more compact manner, and very neat and ornamental; the wing chests are seve- ral dollars more expensive. It is an established law in the order of things to which an exception is very rare, and to which no man can dissent, that where particular attention is paid to a particular object, by a particular individual, he must be more proficient in that branch to which his attention has been so applied, than any of those who have given it but a very partial and imperfect atten- tion. He must also possess decided advantages in the prosecution and success of the under- taking. The community also finds it comportable with their interest to seek such an indi- vidual, when they wish an article in his line, in preference to making application to those who have given little attention to it, or are engaged in the business in a very partial and im- perfect manner. They do this on account of getting it more expeditiously, of a better quality and at a lower price. This will apply immediately to the medicine chests, to which I have given especial attention, and entered into the business on an extensive scale, will have them made in large quantities, and will be prepared to supply these articles on the best terms which they can possibly be put up for, of the same style and quality; and 1 hope those who wish to provide themselves with this very important and almost indis- pensable family requisite, will at least examine the chests which I have prepared before they purchase elsewhere. 17 DESCRIPTION OF WEIGHTS AND MEASURES. -:o: The following is an explanation of the characters marked on the Weights and Measures. ?j one ounce. 5ss half an ounce. 3j one drachm. 3ij two drachms. 3ss half a drachm. 9i a scruple. B ss half a scruple or two grains The grain weights are stamped with punch marks, indicative of the number of grains they are equivalent to ; and the following is their order, according to the table of Apothecary's weights. 20 grains - - - one scruple. 3 scruples ... one drachm. 8 drachms ... one ounce. 12 ounces - - - one pound. Note.—A teacup full is estimated to contain about four fluid ounces, or one gill. A wine glass full, two fluid ounces. A tablespoon full, half a fluid ounce. A teaspoon full, a fluid drachm. 3 IS Exhibiting the Doses of Medicine adapted to different ages. :o:- In prescribing a medicine the following circumstances should always be kept in view. Age, Sex, Temperament, Habit, Climate, state of Stomach, and Idiosyncracy. AGE. For an adult, suppose the dose to be one, or say one drachm. Under 1 year will require only/2 th, or say 5 grains. C( 2 do. do. 5th or 8 grains. u 3 do. do. 0th or 10 grains. a 4 do. do. ^th or 15 grains. a 7 do. do. Jd or 20 grains. a 14 do. do. 2 or 30 grains. (C 20 do. do. f ds or 40 grains. Above 21 the full dose of 1, or 1 drachm. At 65 years the inverse gradation of the above. SEX. Women require rather smaller doses than men : and the pecu- liar stale of the constitution must never be overlooked. 19 TEMPERAMENT. Stimulants and purgatives more readily effect the sanguine than the phlegmatic, and consequently the former requires smaller doses. HABITS. The knowledge of these is essential, for those in the habitual use of stimulants and narcotics require larger doses to effect them when labouring under diseases; whilst those who have habituated themselves to the use of saline purgatives are more easily effected by those remedies. CLIMATE. Medicines act differently on the same individuals in summer and winter, and in different climates. STATE OF STOMACH AND IDIOSYNCRASY. The least active remedies operate very violently on some indi- viduals, owing to a peculiarity of stomach, or rather disposition of body, unconnected with temperament; this state can only be dis- covered by accident or time, but when it is known, it should al- ways be attended to by the practitioner. In prescribing, the practitioner should always so regulate the intervals between the doses, that the next dose may be taken be- fore the effect produced by the first is altogether effaced; for by not attending to this circumstance, the cure is always commencing but never proceeding. It should, however, always be kept in mind that medicines, such as the mercurial salts, arsenic, &c, are apt 20 to accumulate in the system, and danger may thence arise, if the doses too rapidly succeed each other. The action, also, of some remedies, Elaterium and Digitalis for example, continues long after the remedy is left off, and therefore much caution is requi- site in avoiding too powerful an effect by a repetition of them even in diminished doses.—A- T. Thompson. 21 select catalogue of DRUGS, CHEMICALS, AND FAMILY MEDICINES, With the properties and doses of those most approved of and used in Domestic Medicine. Acid Acetic. Rubefacient Stimulant Escharotic.—This article is the essen- tial ingredient of all vinegars. It is used as an exhilarant; with aromatics, camphor, &c, it constitutes the aromatic. For the re- moval of warts, corns, &c, it is applied with a camel's hair pencil once a day ; in using it, care must be taken that it does not ex tend beyond the excrescence. Acid Acetous. [see distilled vinegar.] Acid Citric, CRYSTALLIZED lemon-juice. Cooling Antiseptic and Febrifuge.—This acid is principally em- ployed for making a substitute for Lemonade, and for making sa- line draughts. Where it is saturated with an alkali, one drachm of this acid, dissolved in two ounces of water, forms a solution, equal in strength to lemon-juice, and may be used for all purposes for which fresh lemon-juice may be required. It is an important part of the composition of Carpenter's citratcd Kali, a valuable 22 and convenient preparation for extemporaneously making the sa- line draught, or neutral mixture. Lemon-juice is recommended to obviate the effects of some narcotic poisons ; but as regards opium, it is questionable if it be not rather injurious than other- wise. Acid Muriatic. SPIRITS of salts. Refrigerent and Antiseptic.—Dose, 10 to 20 drops, well diluted with barley water or gruel. Acid Nitric. Chiefly used in the arts. One part of nitric and two of mu- riatic acid, constitutes the aqua regia, the liquid employed for dissolving gold. It is also considered to be useful for destroying contagion.—(See article on Fumigation.) Acid Nitric, (diluted). Antiseptic, tonic, antiscorbutic, antisiphilitic.—Dose, 20 to 40 drops, well diluted with water, twice or thrice a day. If this acid be further diluted, to a strength of acidity similar to lemonade, and sweetened with sugar or treacle, it will be an excellent beve- rage in fevers, particularly in Typhus fever. A lotion formed of from one and a half to three fluid drachms of this acid to a pint of water, has frequently been found serviceable, when applied to ulcers of an unhealthy and fetid character; it is also used in simi- lar cases, where there is a tendency to mortification. It is ob- served that the diluted acid here introduced, is after the London Formula, as follows:—" Nitric acid (fort.) I fluid ounce ; distilled water, 9 fluid ounces.'1'' •23 Acid Nitrous. AQUA fortis. Principally used in the arts, particularly by dyers to heighten and fix many colours, especially that of cochineal. Acid Nitro Muriatic. Employed principally for barley lotions and fomentations in chronic affections of the liver, skin, &c. (See article on bathing.) It is also used internally ; the dose in this case is two or three drops sufficiently diluted with water. Acid Oxymuriatic. This acid is not much used in medicine, but very extensively in the arts, particularly for bleaching linens, paper, &c. Acid Oxalic, OR ACID OF SUGAR. Poison.—Rarely used as a medicine. Employed by curriers for bleaching leather, &c. It bears a strong resemblance to, and is often mistaken for epsom salts. " Nothing can be easier than to distinguish them ; for upon testing a minute portion of the acid, which may be done with perfect safety, it will be found strongly sour, whereas the salt in question is bitter."—(U. S. Dispensa- tory.) If lime water be added to the solution of oxalic acid, it will immediately turn it white; but when lime water is added to a solution of epsom salts, no change is produced. 24 Hydrocyanic or Prussic Acid. This acid has been administered with advantage in consump- tion, for allaying the cough and diminishing the irritability of the system which usually attends that formidable disease. Sometimes it is used, extremely diluted with water, as a wash in cutaneous diseases. The dose of medicinal hydrocyanic acid, is from 1 to 6 drops dissolved in distilled water, or rubbed up with mucilage of gum arabic or almond emulsion. It requires to be administer- ed with the greatest caution, and to be watched in its operation ; and should never be had recourse to, unless under the direction of a medical attendant. It is a rapidly fatal poison, when injudi- ciously taken or administered. When resorted to as a lotion, from 30 minims to a fluid drachm may be mixed with a fluid ounce of water. Acid Fyroligneous. This acid, in a diluted state, has been used as an application to gangrene, and ill conditioned ulcers. It acts on the principle of an antiseptic and stimulant. It is applicable to all the purposes for which vinegar is employed, and simply by dilution with water will form vinegar of any strength. It is not injured by weather or climate, and will preserve animal matter, cooked or raw, for weeks in the hottest weather. Mr. John Ramsay (Edinburg Philosophi- cal Journal, iii. 21,) has made several interesting experiments on its use for this purpose. Herrings and other fish, simply dipped in the acid, and afterwards dried in the sjiade, were effectually preserved ; and, when eaten, were found very agreeable to the taste. Herrings slightly cured with salt by being sprinkled with it for six hours, then drained, next immersed in pyroligneous acid for a few seconds, and afterwards dried in the shade for two 25 months, were found by Mr. Ramsay to be of fine quality and fla- vour. Fresh beef, dipped in the acid in the summer season, for the short space of a minute, was perfectly sweet in the following spring. Professor Silliman states that one quart of the acid added to the common pickle for a banel of hams, at the time they are laid down, will impart to them the smoked flavour as perfectly as if they had undergone the common process of smoking. When required for fumigation, or its antiseptic qualities, it is used undi- luted. One part of the acid and seven parts of pure water, form the distilled vinegar used by the chemist, &c. ; and is applicable to all medicinal purposes. One part of the acid and four parts of watei form the strongest pickling vinegar, and is applicable to pickling and preserving meat, fish, game, and every other purpose for which very strong vinegar is required. One part of the acid and six parts of water, is equal to the best pickling vinegar, and is proper for pickling most kinds of vegetables, for salads, table, cu- linary, and family use. In diluting the acid with water it is only necessary to stir them well together. For medicinal purposes, distilled water is preferable ; for other uses cold soft water is the best. This acid is frequently used in the place of common vine- gar, for inhaling in recent sore throats, hoarseness, &c.; and the following is the most usual way of applying it. One part of the acid is put into a teapot, (if an inhaler cannot be procured,) and six parts of boiling water are poured upon it. The lid of the tea- pot is then to be closed and covered with a cloth. The spout of the vessel should then be introduced into the mouth, and the acid vapour inhaled. The effect is greatly increased if held over a lamp or candle. The strength of concentrated pyroligneous acid is designated by numbers, corresponding with the degree of strength, thus :— No. 6 is six times the strength of common vinegar ; No. 8 is eight times ; and so on in numbers from 1 to 12. No. 8 is tho most 4 26 convenient, and best adapted for the use of the medical profession f one pint of which, added to seven pints of water, is equivalent to a gallon of distilled vinegar of the shops, and is much preferable. Acid, Sulphuric. (oil of vitriol.) Used extensively in the arts. The arts of bleaching and dyeing cause its principal consumption ; it is also used in fumigating in- fectious chambers. (See article on Fumigation.) For medicinal purposes it is used in a diluted state, as under the following head. Acid, Sulphuric, (diluted). Tonic, refrigerant and astringent.—" It is much less used in the United States than the elixir of vitriol, which possesses nearly the same medical properties."—U. S. Dispensatory.—(See Elixir of Vitriol.) Acid, Tartaric. This acid possesses the same properties and dose as citric acid ; but being much cheaper is usually substituted for that article. When dissolved in water and sweetened, it forms a good substi- tute for lemonade. What we call soda powders, consist of 25 grains of tartaric acid, and half a drachm of carbonate of soda, put up in separate papers. When used, the acid and salt are dis- solved in separate portions of water, and the solutions mixed and drank in a state of effervescence. Tartaric acid is also a constituent in the gentle aperient called Seidleitz powders. (See Seidleitz powders.) Tartaric acid, when powdered and dried at a gentle heat, and then mixed in due proportion with the bicar- bonate of potash, or of soda, forms a good effervescing powder ; 27 a tea-spoonfull of which, stirred into a tumbler of water, forms the dose. The mixture must be kept in well stopped vials. Alkanet Root. This root imparts an elegant red colour to oily substances. It is used in compositions for furniture, &c.; and is said, also, to be used in the preparations of spurious port wine. Almonds. Jordon or sweet, and bitter.—A confection prepared from the sweet almond is used for making the almond emulsion, which is taken to allay cough. As prussic acid has been so highly extolled in consumption, quere—If an emulsion formed from the bitter al- mond would not be a more desirable way of administering that acid, as the bitter almond is known to contain prussic acid in its natural state, and combined with mucilage, oil, &c, which would render it more manageable ? Almond Meal Is used instead of soap by persons whose skins are irritable. Almond Paste. A cosmetic for softening the skin. Aloes, Socotorine. Powder—cathartic, anthelmintic, emmenagogue.—" The medi- um dose is 10 grains ; but as a laxative, it will often operate in the quantity of 2 or 3 grains; and when a decided impression is required, the dose may be augmented to 20 grains. In conse- 28 quence of its excessive bitter and nauseous taste it is most con- veniently administered in the shape of pill."—IT. S. Dispensato- ry. Aloes act on the lower intestines, for which reason they should not be taken by persons liable to piles. (See Decoction of Aloes compound.) The socotorine is decidedly the most superior quality of aloe3; and although considerably higher in price, should be preferred. Aloes, Hepatic. This aloes is said to have derived its name from the supposed resemblance of its colour to that of the liver. It has none of the aromatic odour of the socotorine, and is often exceedingly un- pleasant. Aloes, Cape. Inferior much to the socotorine or hepatic, and not so certain in its effects. Alum, Burnt. Astringent.—Used in gargles and lotions. Alum is very fre- quently used in dentifrices ; but in consequence of the excess of sulphuric acid it contains it tends greatly to destroy the enamel of the teeth. It is frequently applied as an escharotic to wounds containing proud flesh, and to chilblains which resist the usual mode of healing. Alum, in doses of from one to two drachms in the course of 24 hours, is said to have proved effectual in remov- ing the painter's cholic; but laxative enemata were also em- ployed. 29 Alum, Common. Alum is sometimes used for making whey, which is a useful beverage in fever; it is made by boiling about a quart of milk with about 3 drachms of alum, and then straining; a small piece shaken up with the whites of three eggs forms a curd, much used as a cataplasm for inflammation of the eye, and what are commonly termed black eyes. It is placed in a fold of fine mus- lin, and affixed by a bandage. Alum has the property of render- ing woollen cloth indestructible by fire ; for this purpose the cloth is immersed in a strong solution of alum, and then dried. Alcohol Is spirit in its purest form ; chiefly used in the arts, and in pharmacy for dissolving resinous substances. When alcohol is indicated as a diffusible stimulant, brandy is usually given. It is sometimes ordered in low fevers, mortification, &c. Amber. This article was held in high estimation among the ancients as a medicine, but at present it is only employed in pharmacy. In pharmacy it is used to prepare succinic acid, and oil of amber for the arts. (Vide Oil of Amber.) In the arts it is turned into ornaments, and employed in making varnishes. When put to the latter use it requires to be subjected to roasting, whereby it is rendered soluble in alcohol and the fat oils.—U. S. Dispensa- tory. 30 Ammonia, Muriate of. SAL-AMMONIAC Employed both internally and externally; but in this country it is very little used as an internal remedy. Externally applied, it operates in two ways ; by the cold produced during its solution, and by the stimulus created by the salt. It acts in the former way when it proves beneficial in the form of lotions applied to the head in mania apoplexy, and violent head-ache ; and on the latter principle, in the cure of indolent tumours, contusions, chilblains, and other local inflammatory injuries. For external use it may be dissolved to the extent of one ounce in nine fluid ounces of water ; a fluid ounce of alcohol being added to the solu- tion.—JJ. S. Dispensatory. In England it is one of the ingredients in the freezing mixture used for cooling wine in hot weather. The following is the form of making it. Take 12 ounces of powdered muriate of ammonia and an equal quantity of nitre ; put them into a stone jar, and pour upon them 2 pints of cold water. If a thermometer be now introduced, it will be found to sink considerably below the freez- ing point; so, if a decanter of wine be immersed in the liquid for a few minutes, it will be found, on withdrawing it, that the wine has been greatly reduced in temperature. Ammonia, Carbonate of. VOLATILE SALT. Antispasmodic, antacid, stimulant, diaphoretic, and in large doses emetic.—As a stimulant, it is exhibited principally in ty- phus fever, and very frequently in connexion with wine whey. Its principal advantage in this disease is its power to increase the 31 action of the heart and arteries, without unduly exciting the brain. It is employed with a view to the same effect, and as an antacid, in certain states of atonic gout, and in the derangement of the stomach, supervening on habits of irregularity and debauch- ery. As an external application it is rubefacient; and may be employed in several ways. Reduced to fine powder, and mixed with some mild ointment, it is useful in local rheumatism. One part of it incorporated with three parts of extract of belladonna forms a plaster very efficacious in relieving local and spasmodic pains. The dose, as a stimulant, is from five to ten grains every two, three, or four hours, dissolved in water or in the form of pill. It is applied to the nostrils in fainting fits, and is used by the most celebrated biscuit bakers and confectioners to give lightness to their manufacture. The saline draught, formed by dissolving 10 or 12 grains of the carbonate of ammonia into two table-spoonsful of water, and then pouring into the solution one table-spoonful of lemon juice, is an excellent medicine for checking vomiting in cholera mor- bus, or when the stomach is under spasmodic excitement. It should be taken whilst effervescing, and if two or three doses prove ineffectual, 10 or 15 drops of laudanum may be added to the draught. Carbonate of ammonia is given with considerable suc- cess in measles in the following form :—dissolve two drachms in half a pint of water, to which add an ounce of the syrup of capil- laire—a table-spoonful to be taken every four or five hours. Anise Seed. Aromatic and Carminative.—They enter into several cordials. The infusion of an ounce, or an ounce and a half in a pint of water is given in cases of flatulence, to the extent of a wine-glassful; and one or two tea-spoonsful to an infant when wind or griping pain& are present—fennel seed in this country is usually preferred. 32 Antimonial Powder. A medicine resembling the celebrated powder of Dr. James in its effects, but more liable to nauseate and sicken the stomach. Its properties are febrifuge and sudorific. Dose, 3 to 6 grains every 6 or 8 hours; in large doses it is purgative or emetic. It is truly observed by Drs. Wood and Bache in their dispensatory, that " the estimation in which this preparation is held is very various." The causes principally ascribed to its inefficacy is the variation in its chemical preparation. The United States Medical Convention expunged it from the Pharmacopoeia of 1830, on ac- count of its uncertain effects: much testimony, however, is on record of its beneficial effects. Drs. Cheyne and Stoker* recom- mend the internal use of small doses of James' powder, or anti- monial powder, where there is an habitual tendency to inordinate sanguineous determinations to the head. Doctor Eberle states, that in one instance of this kind he found the daily use of two grains of James' powder, mornings and evenings, of unequivocal benefit.f The same author also recommends a few grains of an- timonial powder, in connection with blue pill, to be taken occa- sionally at night, where there is reason to expect hepatic torpor or derangement. Dr. Duncan characterizes it as one of the best antimonials we possess. The old history of the beneficial effects of antimonial powder is as follows :—In secret catairh, if a dose of it be taken at bed- time, and after it a basin of warm whey, it will generally afford relief by inducing perspiration. When fever is suspected, the dose repeated twice or thrice a day will also be attended with be- * Dublin Hospital Reports, Vol. i. p. 315. t Dublin Medical Essays, anno 1806. Transactions of the association of Fellows and Li- centiates of the queen's College of Physic, Dublin, Vol. ii. t hberle's Practice of Medicine, 2d Edit. Vol. ii,p. 24, 33 neficial results. In eruptive diseases, such as measles, small pox, scarlet fever, &c., it is a remedy of the highest value ; but it is also requisite here to remark, that in all cases for which it is re- quired, the bowels must be first attended to ; for until they are freed, very little advantage can be expected to accrue from the mere action of the skin. As a general rule, the skin will not yield to sudorifics perfectly, until the bowels are evacuated. Four grains of antimonial powder, two grains of calomel, and eight of the colocynth pill, divided into three pills, is an excellent sudori- fic and purgative in slight attacks of catarrh. Arrow-Root, (Indian.) A light and nutricious food for invalids and children, when pure and unadulterated. A desert-spoonful is sufficient for making half a pint of the jelly. The powder should be first put into a basin, and then so much cold water added as will form a soft paste ; half a pint of boiling water should then be gradually poured upon it, observing to keep them briskly stirred. It should then be poured into a saucepan and boiled for a few minutes, after which it will be fit for use. A small quantity of wine, sugar, lemon peel, orange or lemon juice may be added to suit the palate. When it is required for invalids affected with relaxation of the bowels, such as occur to consumptive persons, a desert or table- spoonful of the tincture of rhatany is an excellent substitute for wine. When required for children, milk instead of water may be used. The following is the form for preparing the effervescing arrow-root, so highly recommended by several leading physicians in London and Paris. Blend a tea-spoonful of arrow-root with as much cold water as will form a smooth paste ; then pour as much barley water upon it as will dissolve it, observing to stir briskly whilst it is being added. Next dissolve 30 grains of the bi-carbonate of soda in half a pint of milk, and sweeten with sugar 34 to taste ; this is to be mixed with the arrow root. Lastly, pour a table-spoonful of lemon juice to the above mixture and drink it in a state of effervescence; a tea-spoonful of brandy is sometimes added to the lemon juice. The above is extremely useful when the stomach is irritable, and will not bear solids of any descrip- tion. Arrow-root is extensively prepared in England from the potato, and in the island of Portland from the roots of the arum muculatum, or wake robin. These kinds are very inferior to the genuine arrow-root, which also varies considerably in quality. To be good, arrow root should be perfectly free from smell and unpleasant flavour. Asarabacca. Used as an errhine for the purpose of increasing the discharge and exciting the membranes of the nose in head-ach, and chro- nic diseases of the eyes. "The powdered root snuffed up the nostrils in the quantity of one or two grains, produces much irri- tation, and a copious flow of mucus, which is said to continue sometimes for several days. The leaves are milder, and generally preferred. They should be used in the quantity of three or four grains; repeated every night until the desired effect is experi- enced. They have been strongly recommended in head-ache, chronic opthalmia, and rheumatic and paralytic affections of the face* mouth, and throat."—U. S} Dispensatory. Asbestos, or salamander's wood. As its latter name implies, it is indestructible by fire at the most intense heat; it also resists the action of the strongest acids and is therefore used in the oxymuriatic fire-box, to absorb the acid necessary for igniting the match. Cloth has been made of 35 the fibres of this substance, which resists the action of fire ; and these fibres are also frequently used in the same way as cotton to form what is called the perpetual wick for lamps. Assafoetida- Antispasmodic, stimulant, carminative, an efficient expectorant, and feeble laxative.—Dose, 5 to 20 grains. The medium dose is ten grains, which may be given in pill or emulsion. (Vide assafoeti- da mixture.) It is a medicine very serviceable in those hysteri- cal affections to which delicate females are liable. About 5 grains, with an equal quantity of aloes, form a combination ex- tremely useful in such cases ; particularly where the bowels are liable to constipation. About half a drachm of the gum with a drachm of rhubarb, divided into 18 pills, constitute a very useful remedy in those affections of the stomach attended with flatulence, indigestion, &c Two of these pills may be taken an hour before dinner, or at bed-time, occasionally. Five grains of assafoetida, with one of opium, form a most excellent antispasmodic pill, to be taken at bed-time in asthma. Assafwtida Mixture- This mixture, from its whiteness and opacity, is frequently called " milk of assafoetida." It is more prompt in action than the pill, and is very often employed as an enema. It is made in the following form : " Take of assafoetida 2 drachms, water half a pint. Rub the assafoetida with the water, gradually added, until they are thoroughly incorporated." The dose is from one to two table-spoonsful, frequently repeated. In hysterical pa- roxysms, and other kinds of convulsions, the mixture may be given in the form of enema, in the compliment of from 2 to 4 fluid ounces. 36 Balsam of Copaiva. Stimulant and diuretic—-Dose, 20 to 30 drops, three times a day, in jelly, mucilage, brown sugar, or the yolk of an egg. The balsam of copaiva is a medicine of great value in checking the diseased secretions of the urinary passages. It is taken in doses specified, for the removal of fluor albus, gleet, &c.; and of late it has been used with peculiar advantage in these diseases when combined with sarsaparilla and cubebs. I have combined these articles in proper proportions, and put them up in a neat and con- venient form; which can at any time be obtained under the title of Geo. W. Carpenter's Compound of Sarsaparilla, Cubebs, and Co- paiva. The Resin of Copaiva, (which is the balsam reduced by evapo- ration to the consistency of an extract,) and which has been pro- posed as a substitute, is nearly inert; as the volatile oil is driven off during the process of inspissating it. The Solidified Copaiva, when properly prepared, is a valuable article; and possesses all the properties of the balsam. It is made of proper consistence for forming into pills, in which state it can be taken with more facility than the fluid balsam. Tt should be made in pills of 4 to 5 grains each; two of which to be taken three or four times a day. Balsam Canada, OR BALSAM OF FIR. Used in the manufacture of varnish for engraving, &c. It is sometimes given in the same diseases for which copaiva is pre- scribed ; also used externally for cuts, and fresh wounds. Balsam of Peru. Stimulant, tonic, and expectorant.—It is frequently applied with advantage to foul and fetid ulcers, and is sometimes dropped into 37 the ear, combined with three times its quantity of castor oil, for deafness, and fetid discharge ; but the ear should be previously syringed with a solution of soap. It may be used once a day. Balsam of Tolu. Stimulant and expectorant.—Principally used in the form of tincture, and syrup. (Vide same.) Bark, Peruvian. (pale,) Powder. (yellow,) Powder. (red,) Powder. (bruised for decoction,) Tonic, stomachic, febrifuge, astringent.—Dose in powder, 10 grains to 1 drachm. In decoction, 1 ounce to 2 ounces. It is, however, observed that bark in substance has fallen into con- siderable disuse, since the discovery of the chemical called " the Sulphate of Quinine," which is found to agree better with the stomach—does not contain any of the fibrous particles of the bark, and possesses all it3 properties in the most concentrated state. (Vide Sulphate of Quinine.) The Sulphate of Quinine has in a great measure, of late, given way to a much cheaper, and also equally as efficacious a composition—"the Precipitated Extract of Bark," prepared by G. W. Carpenter, containing qui- nine, cinchonine, the new organic alkali, chiniodine, and all the entire principles of Peruvian Bark except the ligneous fibre, and possessing all the febrifuge properties of quinine, in the same doses and at about one third the expense. (See Carpenter's Essays on Materia Medica, 2d Ed., 6p.) The decoction of bark is made by boiling an ounce of the 38 bruised bark in a pint of water for 10 minutes, in a covered ves- sel, and the liquor then strained through a linen cloth whilst hot. (Vide Infusion of Bark.) Bark, Canella. An aromatic bitter, acting as a local stimulant, and gentle tonic; and producing on the stomach a warming, cordial effect, which renders it useful as an addition to tonic or purgative medi- cines, in debilitated states of the digestive organs. It is used on the continent very extensively ; and in the West Indies it is em- ployed by the negroes as a condiment, and has some reputation as an antiscorbutic. The best form of taking it is the tincture. It is one of the ingredients in the compound called usquebaugh; a liquor used with advantage by persons of gouty habit, or those who are liable to spasm or cramp in the stomach. The following is a good form for making usquebaugh:—Take of allspice, anise seed, and carraway seeds, of each 3 ounces; mace, cloves, and nutmegs, of each 2 ounces; coriander seeds, 8 ounces; canella bark, 3 ounces; saffron, 2\ ounces ; sugar 2\ pounds; rectified spirits of wine or proof spirits. 5 gallons ; let them stand for a fort- night, then filter and bottle. Bark, Cascarilla. Aromatic and Tonic.—This bark is employed where a pleasant and gently stimulant tonic is desirable, as in dyspepsia, chronic diarrhea and dysentery, flatulent cholic, and other cases of de- bility of the stomach and bowels. It may be given in powder or infusion. The dose of the former is from a scruple to half a drachm, which may be repeated several times a day. When burnt in a room, it emits a most agreeable perfume ; persons, when smoking, mix it in small quantities with their tobacco, but it is said, when thus employed, to occasion vertigo and intoxication. 39 Bark, Oak. Chiefly used externally as a styptic astringent and antiseptic, when it is applied in fine powder, or mixed with water in the form of a poultice to gangrenous and fcetid ulcers. A decoction of the bark is often prescribed as an injection in fluor albus and other diseases of debility affecting females. It may also be advan- tageously used as a bath, particularly for children, where a com- bined tonic and astringent effect is desirable, and the stomach is not disposed to receive medicine kindly. Barley, Pearl. Barley water is used by invalids as an article of beverage, and is either taken alone, or combined with a small quantity of lemon juice. It is useful in affections of the bladder, and in most other diseases; and as it contains a minute quantity of nourishment it is esteemed an auxiliary in assisting the effect of medicine. The i most approved form of making barley water is as follows:—Take two ounces of pearl barley, water four pints and a half; first wash the barley well, then boil it for a few minutes in half a pint of the water, which is to be thrown away : then add the remaining four pints of water, boiling, which should be kept boiling until two pints only are left—strain for use. Equal parts of barley water and new milk, with a {ew drops of the tincture of fennel, is much used in England for the food of infants who are nursed by the bottle. The tincture of fennel is not officinal in this country ; but the tincture of cardamom, which is, may be substituted. Basilicon Ointment. Digestive and detergent.—Used as a gently stimulant applica- tion to blistered surfaces, indolent ulcers, burns, scalds, and chil- 40 blains. It is an excellent application to ulcers, which follow burns, in disposing them to heal. Blue or Mercurial Pill. This medicine is frequently prescribed by the profession to the extent of 3 or 5 grains twice a day in cases in which it is necessary to produce salivation, but as great caution is needful in the ad- ministration of it in such cases, both as to the proper time for its use, and the fitness of the constitution to undergo its effects, it can only be safely taken under the direction of a practitioner. In affections of the liver, such as torpidity, or want of proper action in that organ, in which a suffering of bile for the regular process of digestion is not secreted, from 3 to 5 grains of the blue pill may be taken once or twice a week at bed-time; and to assist the operation, it may be combined with 8 or 10 grains of the com- pound extract of colocynth, or a seidlitz powder may be taken early in the following morning. Four or five grains of blue pill and 8 or 10 grains of rhubarb is also an excellent purgative in bilious affections. Five grains of the blue pill and 10 grains of Dover's powder, mixed and formed into three pills, and taken at bed-time, will, on the first appearance of dysentery, oftentimes put a stop to the complaint; but it will be well also to take on the following morning a mild purgative, such as castor oil or rhubarb. " The blue mass may be frequently administered with advan- tage suspended in water, by the intervention of a thick mucilage, and it forms an excellent addition to the chalk mixture in diarrhea, particularly that of children, where the biliary secretion is defi- cient, or otherwise deranged."—U. S. Dispensatory. Blue Vitriol, or Blue Stone. An application for fungus, or proud flesh. It is also used inter- nally as a prompt emetic when poison has been taken, in doses of 41 from 2 grains to 10 dissolved in 4 ounces of water, large draughts of warm water thereto succeed the use of it. It is a powerful styptic, and for that purpose is employed for stopping hemorrhage from leech-bites, &c. It is also employed in solution as a stimu- lant to ill conditioned ulcers, as an escharotic for destroying warts, fungus, and callous edges. It has been administered in intermittent fevers, epilepsy, and other spasmodic diseases; but it should never in these cases be resorted to, except under the di- rection of a physician. Bole, American. Levigated.—It is much used for dentifrices. Borax, Crude. -----Refined. Rarely used internally. It is applied as a gargle or wash for thrush in the mouth ; in which case half an ounce may be dis- solved in half a pint of distilled water, and sweetened with honey. This will also be found an excellent gargle in sore throat, relaxa- tion of the uvula, &c. A small piece of borax dissolved gradually in the mouth affords relief in the apthory affection, to which old people are more particularly subject. Borax is used extensively in the arts, especially as a flux for metals. Buchu Leaves. Lithonlriptic, tonic, astringent.—The plant from which these leaves are procured, is a native of the Cape of Good Hope, where it is esteemed as a very valuable medicine for rheumatism, fluor albus, gleet, affections of the bladder and kidneys. The mode of using the leaves by the inhabitants of the cape, is in the form of 6 42 infusion, which is made by pouring half a pint of boiling water on half an ounce of the leaves, and allowing them to stand for four hours in a closely covered vessel, then straining through linen ; about a wine-glassful of this infusion is taken twice or thrice a day. The leaves are also used in the same manner as chamomiles, ' as a fomentation to the parts affected with rheumatism or palsy. Since this medicine has been introduced, the testimony of some eminent practitioners has been advanced in its favour. The buchu requires considerable care in preparing it for the patient, and in order that physicians may have a uniform prepa- ration of this valuable medicine, made in a careful manner, with proper proportions and specific dose adapted to the disease, the author is pleased to announce his compound fluid extract of this plant, which he recommends to the medical profession as a con- centrated preparation, and the most convenient form in which it can be exhibited, and which will obviate the necessity of preparing the decoction. Among various highly satisfactory accounts of the value of the buchu in diseases of the bladder, obstruction of urine, chronic gonorrhea, gleets of long standing, &c. &c. is a valuable and interesting communication by Dr. Ephraim M'Dowell, a highly distinguished physician and member of the Royal College of Sur- geons in Ireland, published in the Transactions of the King and Queen's College of Physicians. (Vide Carpenter's Compound Fluid Extract of Buchu.) Burgundy Pitch. Used as a stimulant plaster for the chest, in affections of the lungs and their membranes : but it is not so certain in producing the necessary excitement as the warm plaster. Calomel. Alterative, antisiphilitic, purgative, and antiscorbutic. It is 43 a curious circumstance with regard to this article, that it assists the operation of other remedies quite different in their effects, and assumes, according to its combination, the action of the ingre- dient with which it is united ; with diuretics, as squills, foxglove, &c, it is diuretic ; with purgatives, as rhubarb, aloes, &c, it is purgative ; with camphor, assafoetida, &c, it is antispasmodic ; and in combination with antimonials, it increases their sudorific effect. Dose, as an alterative, or to excite salivation, half a grain to a grain, three or four times a day, to be increased considerably in urgent cases ; when large doses are given with this view, it is often necessary to combine them with opium ; as a purgative, from 5 to 15 grains, or with a view to excite its purgative effects, from 3 to 6 grains may be given either alone at bed-time, and car- ried off in the morning by a seidlitz powder, or some other mild purgative, or combined with the compound extract of colocynth, as directed under that article or with about 15 or 20 grains of rhu- barb, where there is a redundance of bile. Calomel has the pe- culiarity that its cathartic action is not increased in proportion to the dose; 3 or 4 grains of calomel, however, purges some indi- viduals. In these persons large doses, (though they do not pro- portionably increase the evacuation, often occasion excessive spasmodic pain in the stomach and bowels. Children, from the large quantity of mucus contained in the intestines, require larger doses, in proportion, than adults ; from 2 to 5 grains may be given to a child of 2 or 3 years old, and this quantity even, often fails to act on the] bowels, unless assisted with castor oil, senna tea,"or some other cathartic. The safest course to adopt with children of from 1 to 4 or 5 years old, (where calomel is indicated,) is to give 1, 2 or 3 grains over night, according to the age, either com- bined with rhubarb, or merely taken in a jelly ; and to assist the operation, on the following morning a dose of senna tea or cas- tor oil. 44 Calomel, Howard's, OR HYDROSUBLIMATE OF MERCURY. This preparation was first made by Howard, Jones & Co, of London, and it has been found less liable to produce griping, being milder in its operation, and equally effectual as the common calomel, and has been almost invariably prescribed by the London physicians. It is certainly better adapted to persons who have delicate bowels, and to children ; the dose may be given the same as common calomel. The English calomel has generally been preferred, but is not superior to that prepared by Farr & Kunzie of Philadelphia. Calamine Powder, OR PREPARED CARBONATE OF ZINC. Applied chiefly as an absorbent to infants, when chafed or ex- coriated. Camphor. Antispasmodic, diaphoretic, narcotic, antiseptic. The medium dose is from 3 to 10 grains. Externally, when combined with oil or spirit, it forms an excellent stimulant and anodyne embro- cation for sprains, bruises, chilblains, rheumatic and gouty pains, &c. (Vide Tincture of Camphor.) Camphor enters into the composition of sealing-wax, varnish, &c. Cardamom Seeds. A warm aromatic. Cardamom is employed in this country chiefly as an ingredient in compound preparations. (Vide Grains of Paradise.) 45 Carraway Seeds. The same properties as anise seeds, and used in the same manner. Carbonate of Potash. (Sub-carb.) Antacid and diuretic. Dose from 10 to 30 grains, properly di- luted. If a scruple be dissolved in 2 table-spoonsful of water, and then mixed with 1 table-spoonful of lemon juice, they form an agreeable saline draught. (Vide Salt of Tartar.) Carbonate of Soda. Properties and dose as carbonate of potash. Carrageen, OR IRISH MOSS. The fucus crispus, commonly known by the above names, has long been highly esteemed by the peasants on the western coast of Ireland, as a dietetic remedy in various diseases, more espe- cially for consumption, dysentery, rickets, scrofula, and affections of the kidneys and bladder ; dissolved by being boiled in water, it forms a thick mucilage, more pure and agreeable than that pro- duced from any other vegetable, and the jelly made from it is found to agree better with the stomach, than any of those prepared from animal substances. A decoction of the moss, made by boil- ing half an ounce in a pint and a half of water or milk, until re- duced to a pint, is recommended as food for children affected with scrofulous and rickety diseases, for such as are delicate and weakly, and for infants brought up by hand, or after weaning. As 46 an article of diet for invalids, generally, it is highly nutritious, bland and easy of digestion. The decoction in water is also taken for the relief of cough, at any time in the course of the day when it is troublesome; and it is for this purpose simply sweetened with honey or sugar, syrup of squills, or the honey of roses, as the case may indicate. It must, however, be admitted, that experience in the virtues of this moss, in cough, does not justify the expectation that it will supercede the Iceland moss, the bitter principle of which renders it so valuable as a tonic, as well as a demulcent. The author has combined with the carrageen, Iceland moss, slippery elm, hoarhound, &c. and prepared an extract from them, which has proved highly useful in colds, coughs, dyspepsia, dys- entery, and affections of the breast and lungs. (Vide G. W. Car- penter's Extract of Carrageen, Iceland Moss, &c.) Cassia Pulp Is produced from the fruit of the cassia fistula. It is gently laxa- tive, and may be advantageously given in cases of habitual cos- tiveness. In doses sufficient to purge, it occasions nausea, flatu- lence and griping. In this country it is very rarely prescribed except as an ingredient in the confection of senna. (See same.) The dose of the pulp as a laxative is from one to two drachms, as a purge one or two ounces. Castile Soap. Used in combination with other articles as a purgative and diu- retic. Dose, 5 to 10 grains. One drachm of castile soap and 10 drops of the oil of juniper, divided into 12 pills, (of which 2 may be taken night and morning,) are often serviceable in slight cases of gravel. 47 Castor Oil. COLD EXPRESSED. Purgative.—An excellent medicine for females during preg- nancy, and for children ; being less stimulant than most other purgatives, it may be given in safety where other purgatives would be injurious. As it operates speedily, it is particularly serviceable in affections of the bowels, cholic and dysentery. Dose, i an ounce to 1^ ounce, floating on warm milk, coffee, water, or any of the medicated waters. Some persons can take it more readily when beaten up with the yolk of an egg. Castor oil and Daffy's elixir, or the tincture of rhubarb, in the proportion of 6 drachms of the former to 2 of either of the latter medicines, is an excellent remedy for griping pains in the bowels. An ounce of castor oil and about 15 drops of the essence of peppermint may be also advantageously taken for the same purpose. It is sometimes desiiable to combine castor with almond oil, for very young infants; equal parts are used for this purpose, and a tea- spoonful of the mixture may be repeated every two or three hours until it operates : and to render it carminative 4 or 5 drops of the spirit or essence of anise may be added to an ounce of the mix- ture thus formed. A few drops of castor oil dropped into the ear every night at bed-time, has been found serviceable in deaf- ness arising from an accumulation and thickening, or even a de- ficiency of the wax. There is, no doubt, a very active purgative oil in the hull or skin of the castor oil bean ; for as the beans are more or less sub- jected to increased heat or pressure, so is the oil increased in ac- tivity. The hulls or skins forming the residuum, after the ex- pression of the bland oil, is worthy of further experiments with a view of obtaining this oil. 48 Catechu. Same properties and doses as gum kino. (Vide Infusion of Catechu.) Caustic, Lunar. Escharotic.—Used for warts and fungus. In the hands of the practitioner it is employed internally in epilepsy, and externally for lotions. Cayenne Pepper Is a powerful stimulant, and produces, when swallowed, a sense of heat in the stomach, and a general glow over the body, without any narcotic effect. Its most important application is to the treat- ment of malignant sore throat, and scarlet fever; in which it is used both internally and as a gargle. The gargle may be pre- pared by infusing half a drachm of the powder in a pint of boiling water, or adding half an ounce of the tincture to 8 fluid ounces of rose water. (Vide Tincture of Cayenne Pepper.) The dose of the powder is from 3 to 6 grains, which may be given in the form of pill. It is frequently combined with calomel or blue pill to obvi- ate the griping effects. Chalk, (prepared). Antacid, absorbent.-Vose, a scruple to a drachm, combined with cinnamon water, in relaxation of the bowels, arising from acidity; but it is always best preceded by a purgative. The 49 chalk mixture is a convenient form for administering chalk, and is much employed for the above purposes. Laudanum and kino or catechu, are very often added to increase its astringency. The dose of the chalk mixture is a table-spoonful, frequently repeated. Chalk, French. Used for marking woollen cloth, removing grease, &c. Charcoal, (levigated.) Antiseptic and absorbent.—Dose varies from 10 grains to a drachm, or more, taken twice or thrice a day in milk. It has been employed with advantage in certain forms of dyspepsia, attended with fetid breath and putrid eructations, in doses of about 10 grains, and it has been exhibited in dysentery with the effect of correcting the fetor of the stools. When combined with crumbs of bread, and water, or, what is better, the grounds of porter or yeast, it is applied as a poultice to ulcers, which have a foul and putrid discharge, or which indicate a disposition to mortification. Doctor Stephenson, of Philadelphia, gives a favorable account of the use of charcoal in bilious derangements : he says it is an ex- cellent aperient and tonic, and extols it in pulmonary and hepatic disease, when great debility, accompanied with hectic fever, ren- ders the use of other medicines hopeless. It has been, also, uni- versally successful as a remedy in obstinate constipation; but in such cases large doses must be administered. In consequence of the absorbent and antiseptic properties of charcoal, it is invalua- ble in domestic economy. Meat imbedded in it in close vessels, is kept perfectly sweet for many months, and water intended for long voyages is equally preserved by the addition of its powder. The charcoal for medicinal purposes should be carefully pre- pared and kept in well stopped bottles. 50 Chloride of Lime, OR BLEACHING POWDER. A chemical preparation, recommended by D. G. LabaraqueV Pharmacian of Paris, for disinfecting the atmosphere of foul efflu- via, staying the progress of decomposition in animal matter, and destroying contagion. It has since been found to possess all the properties described by him. It is used dissolved in water ; and for the convenience of those who wish to employ it, is kept at most establishments in the form of solution. The solution pre- pared, (according to the directions of the London College, which is the most convenient for family preparation) is made by dissolv- ing 2 ounces of the chloride of lime in 3 fluid ounces of distilled water, and then filtering through paper. Six quarts of water may be added to a wine glass full of this liquid or solution, and it is then fit for use; or it may be prepared for immediate use simply by dissolving a pound of chloride in a bucketful of water. To prevent infection from small pox, measles, cholera morbus-, scarlet and typhus fevers, sprinkle the diluted liquid about the chamber of the sick ; soak the linen of the patient in it, and after- wards rinse it in water; put a wine-glassful into the water of the night-chair or bed-pan. If death take place, wash the body with it occasionally, and it will retard putrefaction ; it will also preserve bodies from exhaling an unpleasant odour before inter- ment, which is of much importance in the summer season. To destroy all offensive and putrid effluvia, arising from drains>, sewers, &c, pour into them half a pint of the liquid or solution, mixed with a bucketful of water, or prepared in the manner be- fore directed. In short, all places which may be deemed infec- tious, from having been the receptacle of cases of virulent dis- ease, may be more or less disinfected by its use, after they have undergone the ordinary process of cleansing. 51 Tainted meat, fish, game, Sfc, will be divested of all smell; and fresh meat may be kept much longer in the warmest weather, without the slightest injury to its quality or taste, if sprinkled with or dipped into the diluted liquid at intervals, and suspended in the air. Fruit trees, flowers, and vegetables will be freed from insects, by watering them with the diluted liquid. The solution has been successfully used by many surgeons of repute, as an application to ill conditioned ulcers, carbuncles, and other cutaneous erup- tions ; and as a gargle in putrid sore throats. It has also been applied to burns and scalds with decided benefit, where destruc- tion of parts seemed inevitable. When applied to ulcers, their surface may be covered with lint, dipped in the solution. Chloride of lime may also be advantageously applied to the purpose of purifying offensive water, a property which makes it invaluable, particularly on long voyages. When used for this purpose, from one to two ounces of the chloride may be mixed with about 65 gallons of the water. After the purification is ef- fected the water must be exposed for some time to the air, and allowed to settle before it is fit to drink. Bathes of the solution, properly diluted, are said to have re- moved inveterate cases of itch. The chloride of lime is also used for preparing the chlorine gas, which has been so highly extolled by Doctor Cattereau, a French physician, and Doctor Elliotson of London, for the relief of pulmonary consumption. The most simple plan is that sug- gested by Doctor Wallace of London, which is " to put half an ounce of the dried chloride of lime into a saucer, and to pour upon it half an ounce of the diluted sulphuric acid ; as soon as the acid comes in contact with the chloride of lime the gas begins to es- cape, and if the saucer be placed on a table in the centre of the room, the gas will in a few minutes be diffused throughout the 52 atmosphere." The mixture of the gas with the atmosphere ap- pears to be a better mode of using it than that at first recom- mended. It is not so liable to produce cough or uneasiness in the chest; symptoms easily brought on when the lungs or bronchial passages have become diseased. The experiments of Mr. Simeon, (in the Annales de Chemie,) prove that chlorine is the best anti- dote to the poisonous effects of prussic acid. Chlorine destroys the virus of organic poisons ; and, quere, that which produces hy- drophobia. Chloride of Soda, (solution of.) It is used for the same purposes as the above, but it is more generally prescribed for gargles, lotions, &c. It has been admin- istered with success in the malignant stages of measles, small pox, fever, &c, to the extent of from 10 to 25 drops, in a wine- glassful of water, repeated every 3 or 4 hours. As a disinfecting agent, chloride of soda is even more valuable than the chloride of lime ; but its comparative expensiveness will restrict its use to disinfecting operations on a small scale. The concentrated li- quid chloride of soda, is in extensive demand. (See Carpenter's Essays, page 175.) Chamomi le Flowers. Tonic and Stomachic. They are used in the form of infusion, com- monly called chamomile tea. Dose, a wine-glassful twice or thrice a day, in cases of indigestion, &c. They are also used either alone or in combination with poppy heads for fomentations. Cinnamon. Aromatic and Cordial. 53 Cloves. The same. Cochineal. Chiefly used in medicine for its colour; also in pickles, dyes, &c. Cocoa. The various preparations of the cocoa nut having obtained con- siderable reputation as articles of diet for invalids, as well as af- fording most grateful beverages in health, it has been deemed pro- per to give them a place in this catalogue. The nut, from which they are prepared, is of a farinacious nature, combined with a pe- culiar kind of oil and aroma, and so well blended naturally, that it has been thought to contain alkaline properties. It is a bland, sweet, and nourishing food, and when it is desirable to support the constitution, without producing excitement, (which tea and coffee are liable to do), it is esteemed by the faculty as one of the best beverages for breakfast, lunch, &c. A French physician has asserted that one ounce of chocolate contains more nutriment than a pound of beef, and the experience of many other physicians, amongst whom may be enumerated Hoffman, Cullen, Quincy and Baillie, has determined that in hectic, scorbutic and melancholic disease, it is generally preferable to every other diet. Water is undoubtedly the best solvent for it, although milk is more agree- able, and therefore, more generally used. As it is of a lubri- eating character, advantage has often been derived from the use of it in gout, stone, gravel, and diseases of the alimentary canal. 54 Colocynth, OR BITTER APPLE. (For its medicinal properties, see Extract.) It is used in sub- stance for keeping moths from woollen cloths, furs, &c, for which purpose it is thrown carelessly in the different folds, and scattered about the shelves and drawers. Colchicum, OR MEADOW SAFFRON. This plant has for many years formed the chief ingredient in the vaiious patent medicines for the cure of gout and rheumatism, and is now much used by practitioners for those diseases, and fre- quently with most decided advantage. It nevertheless, as a me- dicine, produces most unpleasant symptoms, and requires to be continued very cautiously ; the bowels should be well freed pre- vious to the use of it. The preparations used in practice are made for the most part from the seeds and root, but the most popular is the vinous tincture. (See Wine of Meadow Saffron.) The dose of the dried bulb is from 2 to 8 grains, which may be repeated every four or six hours, till the effects of the medicine are ob- tained. Columbo Root. Tonic. The infusion, made by pouring half a pint of boiling water upon half an ounce of the bruised root, which should stand for two hours in a covered vessel, is an excellent and agreeable bitter for indigestion, &c. Dose, 2 ounces, two or three times a day. Drs. Wood and Bache, say, that the remedy which they 55 found most effectual in the permanent cure of a disposition* to the accumulation of flatus in the bowels, was an infusion made with half an ounce of columbo, half an ounce of ginger, a drachm of senna, and a pint of boiling water; and given in the dose of a wine-glassful, three times a day. Conserve of Roses. Used chiefly as a vehicle of other medicines. Coriander Seeds. Warm and carminative. They may be employed in the same way, and for the same purposes, as anise seeds. Corrosive Sublimate. Poison. This is the most powerful of the mineral preparations, operating very quickly on the system, and if not properly regu- lated, produces very violent effects. Its administration should be left altogether to the physician. It is much used in veterinary practice for blisters, washing, &c. Cream of Tartar. Cathartic, diuretic, and refrigerant. " In small doses, it acts as a cooling aperient, in large ones, as a hydragogue cathartic, producing copious watery stools ; and from this latter property, as well as its tendency to excite the action of the kidneys, it is very much used in dropsical affections; when exhibited in these dis- eases, it is frequently prescribed in combination with jalap. Its solution in boiling water, sweetened with sugar, and allowed to cool, forms an acid, not unpleasant refrigerant drink, advanta- 56 geously used in some febrile affections, and very much employed as a domestic remedy. The beverage called Imperial is a drink of this kind, and is made by dissolving half an ounce of the salt in three parts of boiling water, and adding to the solution four ounces of white sugar, and half an ounce of fresh lemon peel. The dose is a drachm or two, as an aperient; and from half an ounce to an ounce, as a hydragogue cathartic, generally mixed with molasses. As a diuretic in dropsical cases, it is best given in divided doses to the amount of an ounce or more in 24 hours, largely diluted with water.— U. S. Dispensatory. Croton Oil. Drastic purgative. Dose, 1 drop, mixed with crumb of bread, and made into pills. This is one of the most active purgative me- dicines in use ; it is seldom prescribed except in severe cases ; it acts speedily on the bowels, generally in a few minutes after taking it. In obstinate constipation of the bowels, after other pur- gatives have failed in producing an evacuation this medicine should be tried. For extreme costiveness of body, 1 drop com- bined with a drachm of the extract of colocynth compound, and divided into 12 pills, will be found a useful form of medicine. One or two of these pills may be taken as occasion may indicate. Cowhage Is possessed of powerfully vermifuge properties, and acts mecha- nically by penetrating the worms. " It has been chiefly employ- ed against the round worm; but all the,different species which in- fest the alimentary canal have been expelled by its use." The usual mode of preparing it is to dip the pods into syrup or mo- lasses, and scrape off the hairs with the liquid, which is in a pro- 57 per state for administration when it has attained the consistence of thick honey. The dose of this preparation is a table-spoonful for|an adult; a tea-spoonful for a child 3 or 4 years old, to be given every morning for three days, and then followed by a brisk cathartic. Cubebs Are gently stimulant, with a special direction to the urinary or- gans. They are much used in gonorrhea, gleet, and leucorrhea, and as a grateful stomachic and carminative in diseases of the di- gestive organs. They are extolled in gonorrhea, and have been of late used in conjunction with buchu leaves and copaiva for this disease. Dose, of the powder, from half a drachm to three drachms twice or thrice a day, in brown sugar, treacle, &c. (Vide Tinct.) Daffy's Elixir. (Vide Tincture of Senna, compound.) Dover's Powder. Anodyne, diaphoretic. As its action is to determine to the skin, it is often given in severe colds ; but in this case it should be preceded by a purgative, and followed by copious dilutions of some tepid fluid, as water, barley water, gruel, &c. It is also used under the same regulations in rheumatic affections, gout, &c; in fact, it is applicable to all cases not attended with much fever or pain in the head, or sick stomach, in which there is an indication for profuse diaphoresis, especially in painful affections, or those connected with unhealthy discharges. Dose, 5 to 15 grains at bed-time, given diffused in water, or mixed with syrup, jelly, sugar, &c. 8 58 Eau de Cologne. Composed of various essential oils dissolved in alcohol—used externally as a cosmetic. Elecampane Is tonic and gently stimulant; and has been supposed to possess diaphoretic, diuretic, expectorant and emenagogue properties. By the ancients it was much employed, especially in the complaints peculiar to females; and it is still occasionally resorted to in cases of retained or suppressed menstruation. In this country it is chiefly used in chronic diseases of the lungs, and it is sometimes benefi- cial where the affection of the chest is attended with weakness of the digestive organs, or with general debility. It has also been highly recommended both as an internal and external remedy in tetter psora, and other diseases of the skin. The usual modes of administration, are in powder and decoction; the dose of the for- mer is from a scruple to a drachm. The decoction may be pre- pared by boiling half an ounce of the root in a pint of water, and given in the dose of one or two fluid ounces.—U. S. Dispensa- tory. Elixir of Vitriol, Astringent, cooling, tonic. Dose 10 to 30 drops in a wine- glass of water, three or four times a day ; used also for gargles in the proportions of from a drachm to a drachm and a half, in half a pint of water, barley water, &c. It is a most useful medicine for checking internal hemorrhage, spitting of blood, and pro- fuse perspiiation arising frem debility, hectic fever, &c. It is pre- scribed occasionally with advantage, to allay excessive thirst, art- sing from irritation in the stomach, for which reason, it is fre- quently taken by persons who have been hard drinkers j it has 59 also proved successful in checking vomiting where opium and other remedies have failed, and has, therefore, been given for this purpose in cholera morbus. Epsom Salt. Cathartic. Dose, as a purgative, from an ounce to an ounce and a half, well diluted in gruel or water; as a laxative, one or two tea-spoonsful dissolved in a wine-glass of water, once or twice a day ; to which may be added 10 or 15 drops of elixir of vitriol, to make it more cooling and agreeable. Epsom salts is found too cold for some stomachs, in which cases a tea-spoonful of the es- sence of ginger should be added to each dose. Ergot of Rye, OR SPURRED RYE. Emenagogue. Used also in difficult and tedious labours ; but only under the direction of the accoucheur. When used as an emenagogue, about half an ounce is infused in half a pint of water, and two or three table-spoonsful of the infusion are taken three or four times a day. The dose of the powder to a woman in labour is 15 to 20 grains, to be repeated every twenty minutes till its peculiar effects are experienced, or till the amount of a drachm has been taken. Of an infusion made in the proportion of one drachm of the ergot, to 4 fluid ounces of water, one third may be given for a dose, and repeated with the same interval. The use of ergot should not be continued for any great length of time. Essence of Bergamot. A perfume. 60 Essence of Lemon. A perfume. Essence of Orange Peel. Do. Essence of Orange Flowers. Do. Essence of Ambergris. Do. Essence of Bitter Almonds. Do. Essence of Musk. Do. Essence of Ginger. Do. Essence of Peppermint, Pennyroyal, Cinnamon, Dill, Anise seed, and Fennel, For making the carminative and cordial waters, bearing these names. (Vide Waters.) If from 10 to 15 drops of any of these essences be mixed with a wine-glassful of water, the combination will be sufficiently strong for ordinary purposes, and will supercede the necessity of having the distilled waters, which are always liable to become injured by keeping. Ether. Stimulant, antispasmodic, externally cooling. Dose, 30 drops 61 to a tea-spoonful in water. It is chiefly given in hysterics, asthma, and spasmodic affections; when applied to the temples for head- ach, in consequence of the coolness it produces, it gives almost instantaneous relief. Ether evaporates rapidly, and requires to be kept in a stopper bottle ; it should also be taken without delay when it is poured out. Ether is sometimes used with advantage for deafness, in which case the vial containing the ether is put into hot water, and a tube being affixed to the mouth of the vial, the vapour is conveyed to the ear. Dr. A. T. Thompson has found it to give immediate relief when dropped into the ear in ear-ach. The vapour of ether is applied as above directed to re- lieve certain nervous affections of the eye-lids. Ether is some- times singularly efficacious in flatulency. Ethiops Mineral. Used in scrofula and affections of the skin. Dose, 10 to 30 grains in honey or sugar. It is a very uncertain preparation. Extract of Aloes, (aqueous.) Cathartic, anthelmintic, and emenagogue—acting chiefly upon the lower intestines; but from the manner in which it is prepared it is found not to irritate in the same degree as aloes in its usual state. Dose, 5 to 10 grains, in pill. Extract of Bark. (For properties, vide Bark.) Dose 10 to 30 grains, being equiv- alent to about a drachm of the powdered bark. The precipitated extract of bark, prepared by G. W. Carpenter, is now generally preferred, and in numerous cases the administration of this pre- paration has been followed by the happiest results even when the 62 sulphate itself was found to be inefficacious. The dose is the same as the sulphate of quinine. (See advertisement.) Extract of Boneset, Carpenter's Compound Fluid. EUPATORIUM PERFOLIATUM. This preparation is combined with peruvian bark, Colombo, centaury, and other vegetable tonics, and is a valuable prepara- tion in intermittent fevers, general debility, indigestion, loss of appetite, dec. The valuable tonic and diaphoretic properties of the eupatori- um are well known to every practitioner of medicine, who has had any experience in his profession. Its usefulness as a febrifuge and tonic in curing intermittent and other fevers, are well known to every person who lives in the vicinity of its production, where large quantities are annually collected, dried, and sent to distant cities. It is said to have been employed in the earliest periods by the Indians in intermittent fevers, as the chief remedy on which they relied, and has proved highly successful in the hands of me- dical men of eminent standing of the present day. Distinguished authors of the latest period ascribe to it valuable properties as a tonic in dyspepsia, indigestion, and general debility of the con- stitution arising from various causes, particularly after fevers. The valuable properties of peruvian bark, Colombo and centau- ry, selected as adjuvants in this preparation are too well known to the faculty to attempt a description; and their combination in this preparation, in which all their active properties are concen- trated and united in equitable proportions, must at once convince them of the character of this medicine and its valuable properties as a tonic and febrifuge. Its usefulness and convenince will no doubt be fully appreciated by physicians in the country, who have not the convenience of an 63 apothecary to compound their preparations, and whose engage- ments will not allow their attention to it, and consequently in many cases must be under the necessity of confiding in those who are entirely ignorant of, and unqualified to prepare their medi- cines. To such, this medicine cannot but be a great desidera- tum. Dose of the extract, a tea-spoonful 3 or 4 times a day. Extract, Carpenter's Compound Tonic. This article is a compound of some of the most active vege- table alkalies, being composed of cornine, qninine, piperine, capsi- cine, Sfc. Sfc. It has proved more efficient than any preparation yet employed in the treatment of intermittents, arresting the par- oxysms in cases which resisted quinine and other remedies in large doses. For an account of the cornine, see Dr. Morton's valuable paper in the Philadelphia Journal of the Medical and Physical Sciences. For an account of the piperine, see G. W. Carpenter's paper in the American Journal of the Medical Sciences. (Vide advertisement.) Extract of Colocynth, (compound.) Purgative.—This extract is an energetic and safe cathartic, and so highly has it been esteemed by some leading practitioners in London, as being applicable to a majority of complaints, that it is said they keep varied forms of prescriptions, containing this com- pound, ready written. 5 or 10 grains taken at bed-time, may be used in ordinary constipation of the bowels. 2 or 3 grains of calomel and 10 grains of the extract mixed (divided into 3 pills) is an excellent purgative in bilious affections. It is also frequent- ly combined with blue pill, in the proportion of 5 grains of each, made into 2 or 3 pills, and taken at bed-time for the same purpose ; but it is desirable occasionally to take a seidlitz powder the fol- lowing morning to assist the operation, when torpidity of the liver exists, or when plethora is to be diminished. 64 Extract of Dandelion. Aperient, diuretic, deobstruent.—Dose, 20 to 80 grains, 3 times a day, dissolved in cinnamon or mint water. It has been found of considerable service in cases of consumption and dropsical affec- tions. It is much used by the French. Extract of Dulcamara, Carpenter's Compound Fluid. A most effectual remedy in all cutaneous diseases, particularly scaly eruptions of the skin, pimples or blotches on the face, biles, tetter, ringworms, &c. Also a valuable purifier of the blood ; and has been successfully used in chronic rheumatism, white swelling, mercurial and syphilitic diseases. Dulcamara has long been known as a valuable alterative, with the peculiar power of considerably increasing the secretions of the skin ; hence it has been pronounced by some of the most distin- guished writers on Medical Science, as valuable in diseases of the skin, particularly those of a scaly character, as lepra, psoriasis, and ptyriasis. At the suggestion of several of the faculty, George W. Carpenter has unitod with the dulcamara, sarsaparilla and several other vegetable tonic and alterative medicines, and extracted the active principles of each by the most effectual processes, and com- bined the whole, which he now has the pleasure of offering to the medical profession under the above title, and feels confident he will receive the sanction and support of the faculty, in its intro- duction and general use; and is persuaded it will be pronounced by those who are disposed to test its properties and qualities, as a valuable accession to our remedial agents, and an important ad- dition to the materia medica. It has a greater power in expelling humours of the skin, and transferring those deep seated to the surface ; in tetter and ring- 65 worms, the application of Carpenter's solution of kreosot, used externally as a wash, and the extract of dulcamara used internally to remove it from the blood to the surface, where it may be di- rectly reached by the kreosot: and which will act with immediate effect, and will seldom fail to cure those diseases in the worst form. The dose of the extract, for adults, is one tea-spoonful three times a day, which may be gradually increased to two tea-spoons- ful ; if it produces nausea, or unpleasant effects, the dose must be diminished. The effects of the medicine will be much rriore cer- tain, if care and attention is paid to diet, so as to avoid stimula- ting food and drink. Extract of Gentian. Tonic, stomachic.—Dose, 5 to 20 grains, in pills, either alone or combined with an equal quantity of rhubarb. Extract of Hops. (Vide Hops, and Tincture of Hops.) Extract of Iceland Moss, Carrageen, Slippery Elm, Hoarhound, S?c. Carpenter's Comp. Fluid- A valuable remedy in colds, coughs, dyspepsia, dysentery, di- arrhea, catarrh, and affections of the breast and lungs. The Lichen Islandicus has long been well known to the faculty as a valuable medicine in pulmonary affections and is highly re- commended by the best authors for its demulcent, nutritious and tonic properties. The carrageen, or Irish Moss, has but lately been in use here ; it has been long of great repute on the coast of Ireland, where persons of delicate health resort to use it. It has the confidence of the faculty in that vicinity, and the enco. 9 66 mium on it as a domestic article, and the cures attributed to it in- all diseases of the lungs, &c, are numerous. The carrageen ap- pears to possess qualities similar to iceland moss, but without its unpleasant flavour, and the quantity of nutritious jelly which a few sprigs produce is truly surprising. The prevalence of con- sumptive diseases in this moist climate, which often arises from neglected colds, renders this simple restorative of peculiar interest. Slippery Elm bark is also well known as an excellent demulcent and is especially recommended by all medical authors as a valua- ble remedy in dysentery, diarrhea, pulmonary affections, &c. Hoarhound is also employed as an auxiliary, which is equally well known and recommended for its valuable tonic properties and its usefulness in catarrhs, colds, coughs and affections of the breast and lungs. I feel satisfied that this medicine will receive the sanction of the faculty wherever it may be introduced, and that it will be extensively used and recommended by them, in all cases where demulcent, nutritious, and mild tonic properties are required"; and hence in dyspepsia, dysentery, diarrhea, debility of the bowels and digestive organs, in coughs, colds, pulmonary affections, &c. Dose for grown persons two tea-spoonsful 3 or 4 times a day— for children one tea-spoonful repeated in the same manner. Extract of Jalap, For properties see Jalap. Extract of Pink Root, Carpenter's Comp. Fluid. (SPIGELIA MARILANDICA.) The most effectual worm-destroying medicine yet discovered. The Pink Root is considered by all who are acquainted with its properties to be one of the safest and most effectual remedies. There is however considerable of that which is sold almost worthless, containing but 67 a small portion of the root; it also requires considerable care and attention in extracting its properties, which is imperfectly done by those unacquainted with pharmaceutical preparations. Under these circumstances, G. W. Carpenter has thought it ad- visable to prepare an extract of the spigelia, combined with seve- ral of the vegetable remedies most approved of, for the convenience of the faculty, particularly those in the country, and he feels as- sured he will be supported by them in the introduction of this ar- ticle, whose composition is known and can be prescribed by them in safety and confidence; and will be the means of putting down the various nostrums introduced by the ignorant and inexperienced and which are productive of serious evils to the community. This article will be carefully prepared of uniform strength, and can be administered with safety to persons under any circumstances. DIRECTIONS. This extract must be taken before meals. No restriction in diet need be observed, nor fear of taking cold. Lessen the dose as occasion may require ; a mild purgative will be necessary where the patient is costive. A child under 1 year old may take half a tea-spoonful once or twice a day, from 1 to 2 years old, one tea- spoonful morning and night; 2 to 6 one tea-spoonful morning, noon, and night; 6 to 10 a pap-spoonful morning and night; grown persons a table-spoonful, morning and night. Extract of Sarsaparilla, Carpenter's Com. Fluid. Alterative, antiscorbutic, diuretic, demulcent.—Sarsaparilla has of late years been much used as an alterative in scrofulous affec- tions and other cutaneous diseases; and is considered, by the most eminent practitioners, as the very best medicine for re-estab- lishing the constitution, after it has undergone the effects of mer- eury, or has been seriously injured by a long continuance of one of the most baneful maladies to which human nature is liable, 63 particularly under that state which is denominated the secondary symptoms, which, if not speedily eradicated, will produce serious injury, and lay the foundation of such derangement in the consti- tution as will probably last for the remainder of existence, and extend the evil to the offspring of those who have been thus af- fected. Sarsaparilla is administered in powder, syrup, decoction, and extract. As the medicinal properties reside entirely in the bark, the powder which contains the woody fibre, ground with the bark, requires too large a bulk for the dose to be admissible in debilitated stomachs. The syrup, in consequence of the quan- tity of sugar it contains, cannot hold in solution any useful quan- tity of the extractive, and is liable to acidity in weak stomachs, thereby inducing further derangement of the digestive organs. The decoction, when properly made, (which cannot be so well done in private houses) is undoubtedly a useful mode of taking the medi- cine ; but as it will not keep for more than two or three days, it has also its objections. The fluid extract has none of the above mentioned disadvantages ; it contains all the properties of the root in a concentrated state—will keep for any length of time, and will enable the patient to make the sweetening drinlc of any strength required. Dose of fluid extract, a fluid drachm or tea- spoonful, which is equivalent to a drachm of the root, to be taken in 4 ounces of water, 3 or 4 times a day.—(Vide G. W. Carpen- ter's Compound Fluid Extract of Sarsaparilla.) Fevtr Root. Cathartic, diuretic, and in large doses emetic.—The fever wort, fever root, or wild ipecac, as this plant is variously called, though not very abundant, is found in most parts of the United States, preferring a limestone soil and shady situation. Its flowers ap- pear in June. The whole plant has a bitter taste ; but the root is most active, and is the only officinal part. The bark of the root 69 is the part which has been usually employed. In the quantity of 20 or 30 grains, it ordinarily acts upon the bowels, and may be given alone, or in combination with calomel at the commence- ment of fevers. The extract may be given in half the dose.— U. S. Dispensatory. Figs Are nutritious, laxative, and demulcent.—In the fresh state they are considered, in the countries where they grow, as a wholesome and agreeable aliment. As they are obtained in this country, they are apt, when eaten freely, to produce flatulence, pain in the bowels, and diarrhea. Their chief medical use, is as a laxative article of diet in cases of constipation. They occasionally enter into demulcent decoction ; and when roasted or boiled, and split open, may be applied as a suppurative cataplasm, to parts upon which an ordinary poultice cannot be conveniently retained.—U. S. Dispensatory. Flaxseed or Linseed. Demulcent, emollient.—Used chiefly in infusion, which is made as follows. Macerate one ounce of flaxseed and half an ounce of liquorice root in 2 pints of boiling water for 4 hours, then strain. This is a good cough medicine in slight cases, but will be found more useful, if half an ounce of gum arabic be dissolved in it. It is also useful in affections of the kidneys and bladder, and may be taken ad libitum. Flaxseed or Linseed Meal. This forms an excellent poultice for lipening and bringing for- ward all swellings, which it is desirable should suppurate. It is made by adding boiling water to so much of the meal as will ren- der it of a proper consistence. As a general rule, poultices should 70 be used twice or thrice a day, as they are liable to become hard, and irritate the parts to which they are applied. The linseed meal or powder, frequently sold, is that prepared from the seed after the oil has been expressed, instead of that from the seeds containing the oil. Fleabane, (Canada.) The Canada fleabane is very common throughout the northern and middle sections of the United States, and has become natural- ized in many parts of Europe. It abounds in neglected fields, and blooms in July and August. The plant, all parts of which is me- dicinal, should be collected while in flower. The leaves and flowers are said to possess its peculiar virtues in greatest perfec- tion. Its medicinal properties are said to he diuretic, tonic, and astringent; and has been found useful in dropsical complaints and diarrhea. It may be given in substance, infusion, tincture, or extract. The dose of the powder is from 30 grains to a drachm ; of an infusion, prepared in the proportion of an ounce of the plant to a pint of boiling water, from 2 to 4 fluid ounces. In each case the dose should be repeated every 2 or 3 hours.—U. S. Dispen- satory. Fleabane, (Philadelphia.) Diuretic, without being offensive to the stomach. It is a favourite remedy with some highly respectable practitioners in Philadelphia in gravel, and other nephritic diseases, and has been employed with advantage in dropsy. By the late Doctor Wistar, it was recommended in dropsy of the chest complicated with gout. When the obstinate character and long continuance of certain dropsical affections are considered, the advantage must appear obvious, of having numerous remedies calculated to mitigate 71 the symptoms without exhausting the strength of the patient j so that when one has lost its powers from repetition, we may appeal to another with some prospect of benefit. On this account it is said that Fleabane is worthy the notice of the profesion. It can- not be relied on for the cure of dropsy. It is most conveniently administered in infusion or decoction, of which a pint, containing the virtues of an ounce of the herb, may be given in 24 hours. The above grows in various parts of the United States and abounds in the fields about Philadelphia, where they are known and used under the curious, though inaccurate name of Scabious. The whole herb is used and should be collected while the plants are in flower. It has an aromatic odour, and a slightly bitterish taste, and imparts its properties to boiling water.—(U. S. Dispensatory.) Fennel Seed. Carminative and Aromatic. Fennel Seed is among our most grateful aromatics; and in this country is much employed as a carminative, and corrigent of other less pleasant medicines, par- ticularly senna and rhubarb. It is recommended for these purposes by the absence of any very highly esculant property. The infusion prepared by introducing 2 or 3 drachms of the seeds into a pint of boiling water is the form usually preferred. The dose of the bruised or powdered seeds is from a scruple to half a drachm. In infantile cases, the infusion is frequently employed as an enema to produce the expulsion of flatus.—(U. S. Dispensatory.) Fowler's Solution. OR SOLUTION OF ARSENIC. Tonic. Chiefly used in ague or intermittent fever. Dose from 3 to 15 drops; but requires great caution in the administra- tion. It is also used externally in lotions for cancerous affections. 72 Galls. Strongly astringent. Seldom used internally. Externally they are applied with advantage in the form of lotion and ointment, to piles. See ointment of galls. Galls are extensively used in the manufacture of ink. The following is an approved form for that purpose : take 8 ounces of blue or Aleppo galls in coarse powder, 4 ounces of logwood chips, 3 ounces of copperas, 1 ounce of blue vitriol, 1 ounce of sugar candy, and 3 ounces of small gum arabic. Boil the galls and logwood together in 12 pints of water for an hour or until half the liquor has been evaporated. Strain the decoction through a hair sieve, or linen cloth, and add the other ingredients ; stir till dissolved, and after allowing it to subside, for 24 hours, bottle and cork closely. The tincture of galls is a test for iron. Garlic. Stimulent, diuretic, expectorant and anthelmintic. In doses of from half a tea-spoonful to 2 tea-spoonsful of the expressed juice, mixed with sugar or without it. It is frequently used with advantage in spasmodic asthma, and hooping cough. Garlic may be taken in the form of pill, or the clove may be swallowed either whole or cut into pieces of a convenient size. The dose in such case is from half a drachm to a drachm. Asa medicine it is at present more used externally than inwardly. Bruised and ap- plied to the feet, it acts very beneficially as a revulsent in disor- ders of the head. Its juice, mixed with oil, or the garlic itself bruised and steeped in spirits, is frequently used as a linament in infantile convulsions, and other cases of spasmodic or nervous disorder among children. The same application has been used in cases of cutaneous eruption. A clove of garlic or a few drops 73 of the juice dropped into the ear, are said to prove highly effi- cacious in atonic deafness. Gentian Root. Tonic and stomachic. Chiefly used in infusion or tincture. Gentian has been known as a medicine from the highest antiquity and is said to have derived its name from Gentius a king of Illyria. The infusion is prepared as follows " take of gentian, bruised, half an ounce, orange peel, (dried peel of the Sevile orange,) bruised, each a drachm, diluted alcohol, four fiuid ounces; water (cold,) twelve fluid ounces; first pour on the alcohol, aud three hours afterwards the water; then macerate for 12 hours, and strain." One fluid ounce to be taken two or three times a day. Ginger, Jamaica. Carminative, Stomachic, Stimulant. Ginger is described by the most celebrated authors on Materia Medica as aromatic, anti- spasmodic and carminative, and recommended by them as being particularly serviceable in flatulent colic, debility, and laxity of the stomach and intestines, and in torpid and phlegmatic consti- tutions, to excite brisker vascular action. An infusion of the ginger, known by the name of ginger tea, is an excellent beverage for persons of dyspeptic and gouty habits. A few grains of the aroma or the finer parts of the Jamaica ginger, added to the ordi- nary beverage of such persons, will also be found particularly ser- viceable. Another useful preparation of ginger is the tincture, of which half a tea-spoonful may be taken under the same circum- stances. The infusion may be prepared by adding half an ounce of the powdered or bruised root to a pint of boiling water, and may be given in the dose of from one to two fluid ounces. The dose of the powder is from 10 grains to a scruple, or more, accor- ding to circumstances. Ginger, cither in substance or tincture, 10 74 may always be added to saline aperients, such as epsom salts, &c, with great advantage when they are liable to prove cold in the stomach. A tea-spoonful of the tincture, or essence of ginger, taken in a cupful of chamomile tea, is a good stomachic for flatu- lence. (Vide Chamomile Flowers.) Carpenter's Chalybeate Ginger Beer Powders Form an extremely pleasant and agreeable draught, and from their tonic and chalybeate properties, aided by the stomachic effects of the fine purified ginger in their composition, render them an ex- tremely valuable medicine, and adapted to many cases of weak and diseased state of the stomach and bowels. They have already been extensively used, and have given in all cases the highest de- gree of satisfaction, and produced the most salutary and beneficial effects. Ginseng. The plant is indigenous, growing in the hilly regions of the northern, middle, and western states, and preferring the shelter of thick shady woods. It is a native also of Chinese Tartary. The root is the part employed; this is collected in considerable quan- tities in Ohio and Western Virginia, and brought to Philadelphia, and other cities on the sea board, for the purpose of exportation to China where it is highly valued. While supplied exclusively from their own native sources which furnished the root only in small quan- tities, the Chinese entertained the most extravagant notion of its virtue, considering it as a remedy for all diseases, and as possessing almost miraculous powers in preserving health, invigorating the sys- tem and prolonging life. From its remote resemblance to the human figure, it is said that the Chinese name Ginseng originated. The extraordinary medical virtues, formerly ascribed to ginseng, had no other existence than in the imagination of the Chinese. It is little more than a demulcent, and in this country is not employed 75 as a medicine. Some persons, however, are in the habit of chew- ing it, having acquired a relish for its ta3te ; and it is chiefly to supply the wants of those that it is kept in the shops.—U. S. Dis- pensatory. Glauber's Salt. Purgative. Dose, 1 drachm to 1 ounce, plentifully diluted. This medicine is now seldom used, except in veterinary practice, as it generally contains impurities. Gold Thread. COPTIS TRIFOLIA. This little evergreen bears considerable resemblance to the strawberry in size and general aspect. It has a perennial creeping root, which, from its slenderness, and bright yellow colour, has given rise to the name, Gold Thread, by which the plant is com- monly known. The gold thread inhabits the northern regions of this continent, and of Asia, and is found in Greenland and Iceland. It delights in the dark shady swamps and cold morasses of the northern latitudes and Alpine regions, and abounds in Canada and the hilly districts of New England. Its blossoms appear in May. All parts of the plant possess more or less bitterness ; but this property is more intense in the root, which is the only portion di- rected by the Pharmacopoeia. Its medical properties and uses are simply a tonic, bearing a close resemblance to quassia in its mode of action, and applicable to all cases in which that medicine is prescribed. In New England it is much employed as a local ap- plication in apthous ulcerations of the mouth ; but it probably has no other virtues in this complaint, than such as are common to all simple bitters. It may be given internally in substance, infusion or tincture. The dose of the powder is from 10 to 30 grains; of 76 a tincture prepared by macerating an ounce of the root in a pint of diluted alcohol, one fluid drachm.—U. S. Dispensatory. Goulard's Cerate. It is used to dry up excoriations, to relieve the inflammation of burns, scalds and chilblains, and to remove cutaneous erup- tions. It is a most effectual application to blistered surfaces indis- posed to heal. Goulard's Extract. Cooling, astringent. It is only used externally, and then when greatly diluted, as under the head of the article Lead Water. (Vide Lead Water.) An excellent cooling poultice may be made by adding a tea-spoonful of Goulard's extract to a sufficient quan- tity of crumb of bread, previously macerated in cold water. Grains of Paradise. GRANI PARADISI. Considered by some authors as a species of cardamom. They are a warm aromatic, used by veterinary surgeons, also by brew- ers, to give flavour and pungency to porter. Gravel Root. Diuretic. This, according to Dr. Bigelow, has a bitter, aromatic and astringent taste; and is said to operate as a diuretic. Its vul- gar name of Gravel root, indicates the popular estimation of its virtues.—U. S. Dispensatory. Guaiacum Wood, (rasped.) Stimulant, diaphoretic. Principally used in the decoction of woods. 77 Gum Arabic. (white or picked.) Gum Arabic is demulcent. By the viscidity of its solution, it serves to cover and sheathe inflamed surfaces ; and by blending with, and diluting irritating matters, tends to blunt their acrimony. A small piece dissolved in the mouth relieves cough ; dissolved in boiling water, or barley water, in the proportion of an ounce to a pint, with the addition of a little lemon juice, it forms an agree- able cough mixture in slight cases of cold. Without the lemon- juice, the same composition is useful in affections of the bladder, kidneys and their passages. The inferior gum is extensively used in the arts, manufactures, &c. The mucilage of gum Arabic, made by boiling 4 ounces of the gum in half a pint of boiling water, and afterwards straining it through linen, besides being used in medicine, is the varnish used for water painting. It is also used for the same purposes as starch, where a greater degree of stiffness is required. Gum Arabic is highly nutricious; during the harvest the moors and negroes, who are employed in collecting it, live en- tirely upon it: six ounces a day are said to be sufficient to sus- tain life in a healthy adult. In many cases of disease, its solution may with propriety constitute the exclusive drink and food of the patient. Gum Ammoniac. Stimulant, expectorant, antispasmodic. Dose 5 to 25 grains, in pills or emulsion. The latter form is usually preferred, dose 1 to 2 table-spoonsful twice or thrice a day. It is in this form commonly used as an expectorant in asthma, and the hard cough which at- tends consumption. The gum is extensively used in veterinary 78 practice for chronic cough. The emulsion is made by rubbing 2 drachms of the ammoniac with half a pint of water, gradually ad- ded until they are thoroughly mixed. Gum Gamboge. Gamboge is a powerful, drastic, hydragogue cathartic, very apt to produce nausea and vomiting when given in the full dose. It is much employed in the treatment of dropsy, attended with tor- pid bowels, generally in combination with cream of tartar or jalap. It is also prescribed in obstinate constipation, and has been fre- quently found effectual in the expulsion of the tape worm. It is often combined with other and milder cathartics, the action of which it promotes and accelerates, while its own is moderated. The dose is from 2 to 6 grains. Gamboge is the yellow pigment used in water painting. Gum Guaiac. Antirheumatic, stimulant,and alterative.—1 he complaint in which it has been found most beneficial is rheumatism. It may be given in substance or tincture. The dose of the powder is from 10 to 30 grains, which may he exhibited in pill or bolus. The tincture is for the most part used. (Vide Tincture of Guaiac.) Gum Kino. Astringent.—In this country it is much used for the suppres- sion of morbid discharges. In diarrhea, (not allowed with febrile excitement or inflammation,) it is also'an excellent adjunct to opium and the absorbent medicines ; and is a favourite addition to the chalk mixture. (Vide Chalk, piepared.) It may be given in powder, infusion, or dissolved in diluted alcohol. The dose of 79 the powder is from 10 to 30 grains. The infusion, which is a very convenient form of administration, may be made by pouring 8 fluid ounces of boiling water on two drachms of the gum, and straining when cool. Aromatics may be added if necessary. Dose, 1 fluid ounce, or half a wine-glassful. Gum Mastich. It is much used in the arts as a transparent varnish; and is dis- solved for that purpose in pure alcohol, or the rectified oil of tur- pentine. It is used for filling the cavities of decayed teeth, and is the principal ingredient in most of the cements for that pur- pose. The women of Turkey chew great quantities of it, under the impression that it sweetens the breath, and preserves the gums and teeth. Gum Myrrh. POWDER. Emenagogue, tonic, astringent.—Dose, 10 to 30 grains, in pills or powders. It is used as a local application to spongy gums, the apthous sore mouths of children, and various kinds of unhealthy ulcers. The tincture is chiefly used as an external application. (Vide Tincture of Myrrh.) Myrrh enters into the composition of many dentifrices. Gum Tragacanth. Demulcent.—Dose and properties nearly the same as Gum Arabic. Hartshorn. Stag shorn. SHAVINGS. Used for jelly, refining coffee, &c. The jelly, made by boiling 80 an ounce of the shavings (in a digester,) in a quart of water, down to a pint, is a light nutriment for delicate and consumptive per- sons. It is also used by persons of laxed bowels. The artificial asses' milk, (much recommended in England for delicate and con- sumptive persons,) is made by boiling 2 ounces of hartshorn shav- ings, 2 ounces pearl barley, 2 ounces candied erynge root, and a quarter of an ounce of picked isinglass, in two quarts of water, reduced to one. Strain, and mix with an equal quantity of new milk, and take a tumbler full twice a day. The milk is best, added as required. Hellebore Powder. This medicine is seldom used alone; but enters into the com- position of several ointments for the cure of itch. It is, however, less certain than sulphur ointment, although less disagreeable. Hemlock. Narcotic, sedative, alterative.—Dose, 1 grain, gradually in- creased to 10 or 15. It is administered for cancerous affections, diseases of the glands, foul ulcers, and chronic rheumatism. The powder, prepared from the dried leaves, and the extract, are the preparations ordered by the colleges. The powder was for- merly highly extolled in whooping cough ; the dose varied from half a grain to a grain, according to the age of the child, and was repeated twice or thrice a day. Poultices, prepared from the fresh leaves bruised to a pulp, are advantageously applied to can- cerous sores, ulcers, and scrofulous glands. The hemlock cata- plasm is also used for similar purposes before suppuration has taken place ; but its liability to produce narcotic effects by the absorption of the active principles of the hemlock, should not be overlooked. 81 Henbane. Narcotic, sedative, alterative, and antispasmodic.—Henbane may be given in substance, extract, or tincture. The extract is more frequently prescribed, and for the same purposes as opium; and is on many occasions preferable, as it does not constipate the bowels. Dose, 1 or 2 grains, repeated and gradually increased till the desired effect is obtained. It is prescribed in hysterical affections, palsy, to procure sleep, allay pain, and diminish ner- vous irritability. The dose of the powdered leaves is from 5 to 10 grains. The dose of the tincture is 1 or 2 fluid drachms. The root is used by the credulous as an anodyne necklace, to ease the pain of cutting the teeth; and the fresh seeds are applied in the ca- vities of decayed teeth, to relieve tooth-ache. The fresh leaves are also used as a cataplasm in painful cancerous affections. Hiera Picra. Warm cathartic.—Dose, 10 to 20 grains, mixed up with honey or in the form of bolus. This is a medicine particularly adapted to females of indolent bowels, as it acts chiefly on the lower in- testines. It is found very serviceable in overcoming other irregu- larities to which they are liable. About an ounce of the powder is dissolved in a pint of Holland geneva, and a table-spoonful taken every morning. It is sometimes taken as a remedy against worms. Hive Syrup, Cox's. Emetic, diaphoretic, expectorant, cathartic.—It is given with ad« vantage in mild case3 of croup, in the latter stages of severe cases 11 82 where the object is to promote expectoration; and in other pectoral affections in which the same indication is presented. Dose foi chil- dren, from 10 drops to a tea-spoonful, according to the age ; and should be repeated in cases of croup every 15 or 20 minutes, till it operates. As an expectorant for adults the dose is 20 or 30 drops- Hoffman's Anodyne. Stimulant, antispasmodic.—Used under the same circumstances as ether. Dose, from \ a fluid drachm to 2 fluid drachms. Honey. Aperient, demulcent.—It is used for coughs and colds, in which case it is combined with vinegar, lemon juice, &c. As it acts on the bowels, it is often used to sweeten the food of infants, and is preferable to sugar for sweetening gruel, barley water, &c. Hops. Anodyne, sedative.—Extensively used in brewing, to give fla- vour, and render the beer capable of being kept for a longer pe- riod. The hop is supposed by many to be the principal cause of that stupefaction which attends drunkenness produced by beer. Some French writers have endeavoured to point out the peculiar effects of certain potations. To the practice of drinking ardent spirits, they attribute that phrensied state which leads to murder and violence; to wine, that of good feeling and hilarity ; and to beer, that of stupefaction, which renders the party unable to act or do mischief. If these effects be true, it would be well that all those addicted to inebriating liquors were beer drinkers. They would then at least avoid the excesses which are too frequently committed while under the influence of ardent spirits. The hop pillow is frequently used to produce sleep in cases of nervous de- 83 rangement. They should be moistened with spirits previously to being placed under the head of the patient, in order to prevent their rustling noise. The preparation most used in medicine, is the tincture of hops ; the extract is officinal but not so effective. (Vide Tincture of Hops.) Horehound. Tonic and laxative.—It is employed chiefly in catarrh, and other chronic affections of the lungs, attended with cough and co- pious expectoration. It is also, in domestic practice, much em- ployed in jaundice, menstrual obstructions, &c. The infusion is made by pouring a pint of boiling water on an ounce of the herb, of which a wine-glass may occasionally be taken. This medicine is also much used in the shape of lozenge and syrup. The dose of the powder is from 30 grains to a drachm. Horsemint. Stimulant, carminative.—In the state of infusion it is occa- sionally employed by families as a remedy for flatulent cholic and sick stomach ; and for other purposes to which the aromatic herbs are applied. (Vide Oil of Horsemint.) Horseradish. Stimulant, rubefacient.—" Its chief use is as a condiment to promote appetite and invigorate digestion ; but it is also occasion- ally employed as a medicine, particularly in dropsical complaints attended with an enfeebled condition of the digestive organs and of the system in general. It has moreover been recommended in palsy and chronic rheumatism, both as an internal and external remedy ; and in scorbutic affections is highly esteemed. Cullen found advantage in cases o( hoarseness from the use of a syrup 84 prepared from an infusion of horse-radish and sugar, and slowly swallowed in the quantity of one or two tea-spoonsful repeated as occasion demanded. The root may be given by the dose of half a drachm or more, either grated or cut into small pieces."—U. S. Dispensatory. The infusion is prepared in the following manner. " Take of horse-radish (fresh root) sliced, mustard seed bruised, each an ounce, boiling water a pint. Macerate for 2 hours in a covered vessel, and strain." Dose of this infusion from 1 to 2 fluid ounces 3 or 4 times a day. In this infusion the stimulant prop- erty of the horse-radish is much promoted by the stimulant proper- ties of its two active ingredients, and is occasionally used in para- lytic and dropsical affections, attended with general debility. Hydriodate of Potash. The ointment of hydriodate of potash is an excellent applica- tion for enlarged glands in the neck, and other parts which are of a torpid or scrofulous character. The ointment is prepared as follows : " Take of hydriodate of potash a scruple, prepared lard an ounce. Rub them together so as to form an ointment. Hydriodate of Soda. Used for the same purposes as Hydriodate of Potash. Hyssop. Expectorant, stimulant, and aromatic.—It is esteemed an excel- lent remedy for asthma, chronic cough, and all affections of the lungs. It is recommended as a good stomachic. " In this coun- try, however, it is very seldom used by regular practitioners."__ U. S. Dispensatory. 85 An infusion may be prepared after the form and according to the quantity directed for the infusion of horehound, and taken in the same doses. The horehound and hyssop are frequently, in domestic use, infused together ; and frequently a syrup is pre- pared by boiling down a quart of water, poured on two ounces of the horehound and hyssop, (an ounce of each,) to one half; and then strained, and one pound or more of refined sugar added ; a desert-spoonful of which is occasionally taken. Iceland Moss. Demulcent, tonic, nutrient.—In coughs, colds, hoarseness, dec, owing to its mucilaginous properties, it is found highly serviceable in removing the irritation which arises from a deficiency of mu- cous secretion in the throat, &c. For persons of consumptive tendency it answers two beneficial purposes, viz.: allaying the violence of the cough, and contributing nutriment to the system at large ; whilst the bitter principle with which that nutriment is combined, serves essentially in giving tone to the stomach. Some persons have a great objection to its bitter taste ; but it may be deprived of that taste by boiling it for a short time in two or three changes of water, which must be rejected ; it should then be washed in cold water, and allowed to simmer until it be dissolved. " The gum and starch contained in the moss render it sufficiently nutritive to serve as food for the inhabitants of Iceland and Lap- land, who employ it powdered and made into bread, or boiled with milk ; having first partially freed it from the bitter principle by repeated maceration in water."—U. S. Dispensatory. Most of the moss collected in Germany and Norway, is used in England by brewers and ship biscuit bakers; and it is found that the biscuit which contains the moss, is not so easily injured by worms in sea voyages. In Saxony, it was proved that seven pounds of the meal or ground Iceland moss, boiled with fourteen times its ?6 quantity of water, and afterwards mixed and baked with fifty-nine pounds and a half of flour, produced one hundred and eleven pounds and a half of excellent bread. It was proved that, without the addi- tion of the meal, only seventy-eight pounds and three-quarters of bread could have been produced from the flour alone. The de- coction for coughs is made by boiling an ounce of moss, well picked and washed, in a pint and a half of water, until only a pint re- mains; which may, when strained, be sweetened with honey. When intended for nutriment it should be boiled until it assumes the consistence of a jelly ; and this may be done either in water or milk, as the patient may fancy. This aiticle has been advan tageously combined with Carrageen, Slippery Elm, Horehound, &c. (Vide Carpenter's Compound Extract of Iceland Moss, &c.) Infusion, Infusion is the subjecting of a substance containing soluble principles to the action of a menstruum, which is usually water. Hot infusions are made by pouring'boiling water on the substance, and allowing it to remain in a covered vessel till cold. Cold in- fusions are made with cold water, and iequire several hours to al- low them full strength. As infusions do not keep well, especially in warm weather, they should be made extemporaneously and in small quantities.—U. S. Dispensatory. The infusions of buchu, cascarilla, catechu, chamomile, colum- bo, flaxseed, gentian and horse-radish, have been already treated of, and instructions for their preparation given under the respective titles of these articles in their alphabetical order; and the same course will be pursued with regard to the various medicinal infu- sions, attachable to the following drugs in the order of this cata- logue. Iodine. A chemical found in marine vegetables, and possessing proper- 87 ties similar (but of much greater strength) to the formerly celebrated burnt sponge ; so well known as a cure for bronchocele, goitre, scrofula, &c. Iodine is a remedy which should be used with great caution, as it is likely to produce serious derangement of the ner- vous system, it increases the pulse, and not unfrequently brings on violent palpitation of the heart, emaciation, indigestion, and even cholera morbus have been said to follow the use of it. In the February number of 1821, of the Bibliotheque Universelle, there is a memoir of Dr. Coindet, explaining numerous cases in which Iodine was known to have produced injurious results ; and it appears that the magistrates of the Pays de Vaud, subjected the use of it to certain salutary restrictions. Iodine has recently been recommended to be inhaled in its gaseous state for tuberculated consumption of the lungs, but with doubtful success. Iodine has been prescribed as an external means of curing certain painful affections of the nerves, such as tic-doloreaux, &c; it is for this purpose used in the form of vapour. If by this plan the iodine is absorbed, the same injurious effects are liable to follow the use of it as would result from the internal administration of it: it is, however, a pretty coloured vapour, and may therefore effect a cure by the novelty it affords to the nervous patient. Upon the whole, a vast deal is said for and against the iodine. Who can decide when doctors disagree 1 Its administration, however, in all cases should be left to the physician. Ipecacuanha. Emetic, expectorant, diaphoretic.—Dose as an emetic from 15 to 30 grains; as an expectorant and diaphoretic, from 1 to 3 grains. No medicine is more useful in a family than this; in cases where poison has been taken, or any thing that requires im- mediate removal from the stomach, to produce vomiting is the 88 most important consideration ; many a life has been lost for want of an emetic to administer. After administering an emetic the patient should be made to drink freely of tepid water, or chamo- mile tea ; this affords the stomach something to act upon, and at the same time by inducing the first symptoms of nausea, renders the stomach more susceptible of excitement. If an emetic be taken in the early stages of fever it will frequently cut short the disease. As an expectorant it may be either given alone or com- bined with a grain or two of Dr. James' powder, or when that can- not be procured with a grain of antimonial powder. The same quantity may be used to produce perspiration in colds ; when it should be taken at bed-time and succeeded by a bowl of hot gruel, or white wine whey ; the feet should likewise be immersed in water. Infants, during the process of dentition, are often suddenly attacked with wheezing at the chest, which is greatly increased by exposure to cold: after freeing the bowels by castor oil, or calomel and rhubarb, die., from half a grain to a grain in a little sugar may be given every six or eight hours. The same mode of practice in whooping-cough will also be attended with advantage, more especially in the inflammatory or first stage of the disease. In croup the same plan will prove decidedly beneficial, by relieving the patient; the warm bath should also be used, and bleeding may be required ; but this of course requires the decision of a practitioner in medicine. For the spasmodic stage of whooping-cough. (Vide Paregoric Elixir and Oil of Amber.) Iron, Precipitated Carbonate of. Tonic, alterative.—Dose, 4 grains to half a drachm, sometimes given to the extent of 1 drachm. In smaller doses it is adminis- tered for its tonic effects, in debility and laxity of the constitu- tion ; but in that painful disease, well known by the name of tic- 89 doloreaux, it is not unfrequently given to the extent of a drachm 3 or 4 times a day, and the strongest testimony in its favour has been advanced by most practitioner.^ who have prescribed it in that desperate disease since it was recommended by Mr. Hutchinson. The powder finely levigated is advantageously applied to cancer- ous sores. " No nicety need be observed in the dose ; its only obvious effects in very large doses being a slight nausea and a sense of weight at the stomach. Its use gives the stools a black colour."—U. S. Dispensatory. Iron, Rust of. Same properties and dose as the preceding. Isinglass, long staple. --------sheet. Isinglass is little used in medicine, having no peculiar medical properties. The jellies used at table nearly all derive their con- sistency from it. Isinglass dissolved in spirit by means of a gentle heat, is an excellent varnish for engravings, previous to applying the mastich varnish. Isinglass, also, when dissolved in strong acetic acid, forms a firm cement for uniting broken china or glass. Isinglass is used occasionally for making beef, mutton, or veal tea for invalids. The following is a form much in use for this pur- pose :—Cut a pound of lean gravy meat in small pieces, put it into a quart and half a pint of cold water, with half an ounce of isinglass; set the saucepan over-a very gentle fire, so as to be- come gradually warm, let it simmer for about an hour, and occasion- ally take off the scum, then strain it through a piece of muslin ; after being strained, it should be allowed to stand for a short time to allow any remaining sediment to fall down ; it is then fit for 12 90 use. It may be flavoured with pepper, allspice, or in any other way the patient or physician may decide upon. This is a species of nutriment that the stomach will bear when solids cannot be di- gested. Jalap. Cathartic, diuretic.—" Jalap is an active cathartic, operating briskly, and sometimes painfully, upon the bowels, and producing copious watery stools." " Jalap is applicable to most cases, in which an active cathartic is required, and from its hydragogue powers is especially adapted to the treatment of dropsy. It is generally given with other medicines, which assist or qualify its operation. In dropsical complaints it is usually combined with cream of tartar; and the same mixture is much employed in the treatment of the hip disease and scrofulous affections of other joints. With calomel it forms a cathartic compound, which has long been highly popular in the United States in bilious fever and other complaints attended with congestion of the liver. The dose of jalap in powder is from 15 to 30 grains; of calomel and jalap is 10 grains of each ; and that of cream of tartar and jalap two drachms of the former to 10 or 15 grains of the latter. The ex- tract has the medical properties of the root; but is not often ex- hibited alone, but chiefly used as an ingredient in purgative pills, for which the comparative smallness of its bulk adapts it. The dose is from 10 to 20 grains, or rather more than half that of jalap." —U. S. Dispensatory. Juniper Berries. Stimulant, diuretic—About two ounces of the berries, slightly bruised and macerated in a quart of old whiskey, forms a liquor much used by persons afflicted with gravel. It is combined with 91 hot water and sugar in the proportion of one wine-glassful of the liquor to a half pint of the water, and sweetened to taste. Gin and Holland's derive flavour from these berries. Kreosot, Carpenter's Solution of. For the cure of cancerous ulcers, old sores, tetters, ring-worms, and will immediately stop bleeding from fresh wounds, bleeding at the nose, roats or barley. Before using it should be deprived of its epidermis. Liquor of Potass. Antacid, lithontriptic.—Dose 10 to 30 drops. This is much 13 98 used by persons of gouty habits, for the purpose of correcting aci- dity in the stomach. It is also a remedy of great value in affec- tions of the kidneys and bladder, as it prevents the formation of uric acid, and consequently tends to lessen the disposition to uri- nary calculi and gravel. When it is had recourse to for neutral- izing acidity in the stomach, it should be combined with a light bitter, such as chamomile tea, or the infusion of Colombo, and taken twice or thrice a day. For affections of the kidneys and bladder it is best combined with barley water or the mucilage of gum arabic The liquor of potash is used to neutralize the acid of wine and beer. " In dyspeptic cases it may be associated with the simple bitters." Liver of Sulphur. Employed principally in the form of lotion for diseases of the skin. For a lotion it may be dissolved in water in the proportion of from 15 to 30 grains to the fluid ounce ; and for a bath the same quantity, or rather more, may be added to a gallon of water. Logwood. Astringent.—It is sometimes administered in the form of de- coction in diarrhea, dysentery, dec.; but it is chiefly used in dye- ing. Loosestrife. Demulcent and astringent; and may be advantageously given in diarrhea and chronic dysentery, after due preparation by eva- cuating treatment. The dose of the powdered herb is about a drachm three times a day. A decoction of the root, prepared by boiling an ounce in a pint of water, may be given in the dose of two fluid ounces. 99 Lime Water. (See Waters.) Linseed. (See Flaxseed.) Lupuline. The narcotic principle of the hop. Mace, Aromatic.—Used for culinary purposes. Magnesia, Calcined. Antacid and absorbent; aperient where it meets with acidity in the stomach or bowels. Dose, 15 grains to a drachm. When taken for acidity in the stomach, it may be mixed in a wine-glass- ful of peppermint or cinnamon water, in which case it generally acts upon the bowels. For heart-burn, it may be mixed either in water or milk. 2 grains of calcined magnesia, 4 grains of rhu- barb, and 1 or 2 of ginger, mixed in water, is a very useful medi- cine for persons of gouty habit. 20 grains of calcined magnesia and 5 grains of rhubarb mixed together and divided into 4 or 6 parts, will be found a useful medicine for infants labouring under affections of the bowels, costiveness, acidity, thrush, red gum, drc. One of these powders may be taken twice or thrice a day. The quality of calcined magnesia depends upon the description of carbonate it is prepared from, and the perfect expulsion of the carbonic acid. When only partially torrefied, it can of course be sold cheaper than when it is properly prepared. 100 Magnesia, (common or carbonate.) Dose, half a drachm to 2 drachms, taken under similar circum- stances as the above ; but it is not considered so useful where acidity prevails. Of late years it has been much used to counter- act the acidity in bread, when made with inferior flour. Manna. Manna is a gentle laxative, usually operating pleasantly ; but in some cases producing flatulence and pain. Though peculiarly adapted to children and pregnant women, it may be given with advantage in ordinary cases of piles from constipation, unatten- ded with dyspeptic symptoms. It is usually, however, prescribed with other purgatives, particularly senna, rhubarb, magnesia, and the neutral salts, the taste of which it conceals while it adds to the purgative effect.—U. S. Dispensatory. The dose for an adult is from 1 to 2 ounces; for children, from 1 to 4 drachms. It is usually given dissolved in water or some aromatic infusion, such as the essence of fennel, die A small portion of manna, triturated with castor oil, increases the effect of it, and renders it more pala- table. Marshmallow. Demulcent.—The decoction of the root is much used in Europe, for coughs, die The roots themselves are sometimes employed as a poultice. The leaves are applied to similar uses. Masterwort. Stimulant and Carminative.—Doctor Orm of Salem, Massachu- setts, used it successfully in cases of epilepsy, attended with fla- 101 tulence and gastric disorder. He directed 2 or 3 drachms of the powdered root to be taken daily for a long time ; and a strong in- fusion of the leaves to be drank at bed-time.—Thatcher's Dispen- satory, quoted from U. S. Dispensatory. Meadow Saffron. See Colchicum. Mezereon Root. Antisyphilitic. Used chiefly in the decoction of woods, sar- saparilla, die. The resinous extract of mezereon, combined with wax, suet, dec, forms a vegetable blistering ointment; it is used as a rubefacient. Milk. A few observations upon this article may not be considered ir- relevant. Milk is the natural food of the infant, and it has been found that those children are the strongest who have enjoyed the advantage of being kept at the breast of the mother for the longest time. Milk is highly nutritious, and constitutes, either pure or de- composed, the only drink of some nations. It, however, disagrees with some persons, and not unfrequently brings on a sense of full- ness andhead-ach, which may perhaps depend on yielding too great a proportion of nourishment being too rapidly converted into blood, and coming in contact with acid in the stomach. The secretion of milk is kept up by the regular practice of suckling, and as occurs in the cow, may continue for years unless pregnancy takes place. The quantity of milk secreted in 24 hours varies according to the description of food taken, and the constitution of the female. The quality of milk depends upon various circumstances; that 102 which is secreted immediately after delivery is serous, and acts as a purgative ; this is called colostrum ; it by degrees becomes darker; it is for this reason that new-born infants cannot digest the milk of a nurse who has suckled for any length of time. The food and medicine taken by the nurse affect the milk and alter its property. Garlic yields its odour to it. Excess in wine or beer, on the part of the nurse, renders the child unwell; the passions of of the mind, also have their effect: thus, anger in the nurse has been known to induce convulsions in the child, and grief has so far had its influence, that when the nurse has continued in this state for any length of time, the infant has been known to pine away. 7he following is a Table of Experiments upon the Milk of the Fe- male, with remarks transcribed from " Doctor Doantfs transla- tion of Doctor Maggrier's Midwifery illustrated." Ages of the females. Specific gravity of their milk. 22 to 24 years, - - - - 9\ to 10. 26 to 28 ".....8 to 9 30 to 32 ".....8 hardly. 34 to 36 " - - - - - 6 to 7 40 to 45 ".....4 to 5 REMARKS. " 1. The specific gravity of the milk of a female is proportioned to her age and not to her constitution. " 2. If the qualities of the milk are changed by its growing old, its specific gravity remains the same. " 3. The milk of a blonde is heavier than that of a dark com- plexioned person, " 4. Cow's milk is much lighter than that of the female, and its specific gravity also diminishes in a ratio with the age and not with the constitution of the cow. 103 " Milk is the special and may be called the exclusive nour- ishment of the child the first year after birth; but as in artifi- cial nursing, we are obliged to supply the milk of the mother by that of others, we have thought proper to form a scale of propor- tions of all kinds of milk which we can use, indicating them by the strength and richness of their products. " At the head is necessarily placed cow's milk, which is not only the richest in its products but also the most abundant; and which, in this last respect, presents all the sources imaginable. We cannot give it to the child as it comes from the animal; it is necessary to dilute it in proportion to the strength and age of the child. " When used for artificial nursing, care must be taken that it is always procured from the same cow. "Next comes goat's milk; it is less abundant in nutritions principle than cow's milk; it is nevertheless very advantageous, either as the primary nourishment of the child, or as medicine. In fact, it is used with success in pulmonary affections. " The following is the order in which the other kinds of milk must be placed. First, that of the female ; second, of the mare ; third, of the ass ; fourth of the sheep, " It follows from this, that for artificial nursing, the milk of cows and goats should be preferred to all others."—Doane'sMag- grier, pages 174-5. Cracked milk is made by adding a wine-glassful of buttermilk to a quart of new milk; it is exposed to a gentle heat, and fre- quently agitated. It is a favourite drink with some physicians for consumptive patients. Two milk whey is made by adding buttermilk to new milk, suf- ficient to change it to a curd. It is added when the new milk has just come to a boiling point. It should then be allowed to stand until the coagulation is completed, or until the whey is separated from the curd. 104 Wine whey is often taken for the relief of recent colds, and is made by turning the milk with wine. The best wines for the purpose are those of the subacid kind, such as hock, sauterne, bucellas, dec. Morphine, One of the constituents of opium. Morphine Acetate. One 6th of a grain is equivalent to a grain of opium. It may be given in pill or solution. (See Acetate of Opium.) Morphia, sulphate of. Same properties and dose as the Acetate of Morphine. Moxa, OR THE FOY CONG. A species of moss introduced into practice by Baron Larry, to produce local inflammation. It is applied over the part affected, and ignited; and is used with the same views as the veterinary operation of firing. Lint,.saturated with nitre, is found to answer all the purposes, and is now used by Baron Larry himself. Mustard. Mustard seeds swallowed whole, operate as a laxative ; and have recently enjoyed great popularity as a remedy in dyspepsia, and in other complaints attended with torpid bowels and deficient excitement. The white seeds are preferred, and are taken in the dose of a table-spoonful once or twice a day, mixed with molassip, 105 or previously softened and rendered mucilaginous by immersion in hot water. They probably act by mechanically stimulating the bowels. The bruised seeds or powder, in the quantity of a large tea-spoonful, operate as an emetic. Mustard in this state is ap- plicable to cases of great torpor of the stomach, especially that resulting from narcotic poisons. It rouses the gastric suscepti- bility and facilitates the action of other emetics. In smaller doses it is useful as a safe stimulant of the digestive organs, and as it is frequently determined to the kidneys, has been usefully em- ployed in dropsy. Whey, made by boiling half an ounce of the bruised seeds or power in a pint of milk and straining, is a con- venient form of administration. It may be given in the dose of a wine-glassful, repeated several times a day. But mustard is most valuable as a rubefacient: mixed in water in the form of a cata- plasm, and applied to the skin it very soon produces redness with a burning pain, which in less than an hour usually becomes in- supportable. When a speedy impression is not desired, espe- cially when the sinapism is applied to the extremities, the powder should be mixed with an equal quantity of rye meal or wheat flour. Care should be taken not to allow the application to re- main too long, as vesication with obstinate ulceration may result. This caution is particularly necessary in cases where the patient is insensible, and the degree of pain can afford no criterion of the suffering of the action.—U. S. Dispensatory. G. W. Carpenter, at the suggestion of several eminent practi- tioners, has made a series of successful experiments on the mustard, with a view of ascertaining the active constituent principle, and separating it in a form best adapted for application as a rubefa- cient, and succeeded in obtaining separately the active princi- ple of the mustard, which is combined with a volatile acrid oil. This peculiar principle he has denominated " Sinapine." (Sec Oil of Sinapine.) 14 106 Musk. It is chiefly used as a perfume. Being an article of great value it is very liable to adulteration both abroad and in this country ; and is seldom met with in a pure state. It is esteemed a strong anti- spasmodic and stimulant, and is used in hysterical affections, epi- lepsy, St. Vitus's dance, and other nervous and spasmodic dis- eases. It is sometimes given with benefit in the low stages of ty- phus fever, and to check the violent hiccup which frequently precedes death. Dose, either alone or combined with camphor or ammonia, 5 to 10 or even 15 grains, in bolus or pill. It is sel- dom met with in a pure state. Musk seeds. These seeds have the smell of snuff; they are aromatic and stomachic ; but are more used to give flavour to snuff than for any other purpose. Myrrh. (Vide Gum Myrrh.) Narcotine. One of the newly discovered constituents of Opium. Nightshade, deadly; OR BELLADONNA. The extract of this plant is given in minute doses as a narco- tic ; but it is chiefly used by surgeons and oculists preparatory to the operation for cataract and other affections of the eyes. It is said to prevent scarlatina. Nightshade, woody, OR BITTER SWEET. It was formerly recommended in various diseases ; but is now, 107 when used, chiefly confined to the treatment of cutaneous erup- tions. Nitre Is considered refrigerant and antiphlogistic ; and is much used in inflammatory diseases. It is known to be a powerful antisep- tic. It generally promotes the secretion of urine and sweat— lessens the heat of the body and the frequency of the pulse ; and has a tendency to keep the bowels in a soluble condition. It is very frequently prescribed with tartar emetic and calomel, form- ing a combination usually called the nitrous powder, which pro- motes most of the secretions, particularly those of the liver and skin ; and which, in many cases, is advantageously employed in lessening and modifying febrile excitement. The formula usually prepared, is eight or ten grains of nitre., the eighth of a grain of tartar emetic, and from the fourth to half a grain of calomel, ex- hibited every two or three hours.—U. S. Dispensatory. Eight grains of nitre, combined with 2 or 3 grains of antimo- nial powder, are sometimes taken at bed-time for the relief of colds, hoarseness, dzc. A small portion dissolved in the mouth is useful in sore throat, dec About 10 grains of nitre, half a drachm of gum arabic, and one drop of the oil of juniper, is ad- ministered 3 or 4 times a day for provoking a flow of urine. Nitre whey is likewise used as a beverage in febrile and inflammatory diseases. It is made as follows : add as much lemon juice to a pint of milk (boiling) as will turn it; then dissolve one drachm of nitre in it, and sweeten with sugar candy. Nitre is a medicine that should be used with caution, as it acts strongly on the blad- der and kidneys. Nutmegs. Aromatic.—Used for culinary purposes. 108 Nux Vomica. Principally administered to excite the nervous system, especially in palsy ; but should never be used except under the direction of a medical attendant. Oatmeal. The gruel made from this meal in the ordinary mode of pre- paring it, contains the heating and acrid properties of the grain ; but the following form, being that given by Dr. Cullen, in his treatise on aliments, will be found to, in a great measure, obviate those effects; " one ounce of oatmeal is sufficient to make two quarts of water gruel. The meal is to be put into 3 quarts of soft cold water and set over the fire; the meal is to be constantly stirred among the water till it boils; and then it is to be allowed to boil till a third of the water is boiled away ; the decoction is then to be poured through a linen cloth into a bowl a little larger than sufficient to contain it. in this bowl it is to be left to cool, and when cooled it will be found to separate into two parts, one of them a mealy cloud of sediment, and the other a very thin and clear liquor; the latter is to be carefully decanted or poured off for use. To render this more agreeable by the addition of sugar, acids, aromatics, or to impregnate it with medicinal substances, I leave to the judgment of the physician or nurse." Gruels di- gest easily, are soft and mucilaginous in their quality, and are used for drink and food, in fevers, inflammations, coughs, dzc. Caudle is described by Dr. Kitchener to be made by adding ale, wine, or brandy, with sugar, to gruel; and when the bowels are disordered, a little nutmeg or ginger grated. Poultices made by mixing oatmeal with beer grounds or yeast, are applied with ad- vantage to tumours and ulcers which have a gangrenous tendency. Oatmeal tea, which is made by pouring boiling water upon oat- meal, is a pleasant and demulcent drink in fevers, colds, die. 109 Flummery is also an article of diet for invalids, it is made as follows:—Put about 3 large handsful of the best oatmeal with about three pints of cold water in an earthern vessel, let them stand for 24 hours ; then pour off the clear liquor and add as much water again, which is also to stand for 24 hours, strain through a fine sieve, and mix the liquors, then boil any quantity required until it becomes as thick as custard; stir well whilst boiling; add sugar, wine, or milk, as circumstances may require, or as may be most agreeable to the palate. Oil of Almonds. Demulcent, emollient.—Dose, 2 drachms to 1 ounce. It enters into the composition of many ointments and cerates. Two parts of the oil of almonds, and one of spirits of hartshorn, form a use- ful embrocation for sore throats, dec One ounce of oil of al- monds, 30 drops of liquor of potash, and half a pint of distilled water, form a good emulsion for coughs. Oil of Amber, (rectified.) Stimulant, antispasmodic.—It has been employed with advan- tage in amenorrhea, and in various spasmodic and convulsive af- fections, as epilepsy, hysteria, hooping cough, and infantile con- vulsions from intestinal irritation, die. The dose is from 5 to 15 drops, diffused in some aromatic water by mean3 of sugar and gum Arabic. Externally applied the oil is rubefacient, and is con- siderably employed as a liniment in chronic rheumatism and palsy, and in certain spasmodic disorders, as hooping cough and infan- tile convulsions. In the latter affections it should be rubbed above the spine, and is highly recommended by Dr. Parrish of Philadel- phia, mixed with equal measure of laudanum, and diluted with 3 or 4 parts of olive oil and of brandy.—U. S. Dispensatory. 110 Oil of Anise Seed. Carminative, stimulant.—Dose 5 to 15 drops on a lump of sugar, Its comparative mildness adapts it to infantile cases. Oil of Caraway. Much used to impart flavour to medicines, and to correct their nauseating and griping effects. Dose from 1 to 10 drops. Oil of Cassia. Aromatic. Oil of Castor. (See Castor Oil.) Oil of Cinnamon. Much employed as an adjuvant to other medicines, the taste of which it corrects or conceals while it conciliates the stomach. Dose from 1 to 2 drops on sugar. It is also a powerfully local stimulant; it is also used as a perfume. Oil of Cloves. Chiefly used as an application for tooth-ache. Oil of Cajiput. Stimulant, antispasmodic.—Dose, 5 to 20 drops in camphor, jalap, or peppermint water. Three parts of rectified spirits of tur- pentine and 1 of the oil of cajiput is an excellent combination for chronic rheumatism, which should be taken in the same doses Ill as the oil itself. If the oil of cajiput be combined with opodeldoc, it may be used with advantage externally for local rheumatic pains. (See Opodeldoc.) The cajiput oil has been administered with great success in cholera morbus in doses of 20 drops every few hours. Oil of Euphorbium. Drastic purgative.—This is one of the remedies recently ad- ded to the catalogue of medicines. It belongs to the class Poi- sons, and to the order kill or cure. Our forefathers used the seeds of the euphorbia lathyris, and conceived them, even when com- bined with farina, die too hazardous to remain in the materia me- dica; but we have become so undaunted in the present age of medicine, that even the quintessence of poison does not alarm us. Arsenic, prussic acid, even caustic itself, are now adminis- tered with as little hesitation as milk and water. We prefer such things only as admit of one drop for the dose; those that allow of ounces are considered too impotent for science to prescribe. Any body can order the old fashioned castor oil, rhubarb and jalap; but it is only such persons as have conducted their friends to the verge of eternity, and have brought them safely back again, that can have acquired the nice discrimination of exhibiting doses of a drop, a minim, or an atom ; or in short have learned how far and no further we can go with safety. Oil of Juniper. Stimulant, carminative, diuretic.—Dose, 3 to 15 diops on a lump of sugar. Oil of juniper gives the flavour to British gin and Holland Geneva, and it is questionable whether a glass of gin and water is not the best way of taking the juniper; at least it is so preferred by many. 112 Oil of Lavender. A perfume.—Sometimes taken in cases of nervous languor and head-ache. Dose, 1 to 5 drops. Oil of Nutmegs. Aromatic Oil of Olives, OR SALAD OIL. Gently aperient.—Dose from half an ounce to an ounce. It is administered to counteract the effect of acid poisons. A mix- ture of olive oil and hartshorn is a good liniment for sore throat, enlarged glands, dec. Olive oil is said to have been used successfully in preventing the contagion of plague from taking effect. The entire surface of the person exposed to the contagion is for this purpose anointed with it. Two table-spoonsful of olive oil, the same quantity of Epsom salts and of treacle, dissolved in a pint and a half of water or thin gruel, form an excellent purga- tive enema. Oil of Origanum. A favourite article in veterinary practice, for embrocations, blisters, die, it is sometimes used to allay tooth-ache, by intro- ducing the oil on cotton or lint in the orifice of the carious tooth. Oil, Palm. Used in the manufacture of palm soap, and when fresh is some- times eaten as butter ; it is also applied as an emollient ointment. Oil of Pennyroyal. Stimulant, antispasmodic.—Dose, 1 to 6 drops on sugar. 113 Oil of Peppermint. Stimulant, carminative.—Dose 1 to 4 drops on sugar. Oil of Rhodium. It is said to have the power of attracting rats; oil of carraway has the same properties and is much cheaper. Oil of Rosemary. Stimulant, also a perfume. Oil of Spearmint. Stimulant, carminative.—Dose, 1 to 4 drops on sugar. Oil of Savine. Emenagogue, stimulant, rubefacient.—Dose, 2 to 5 drops. (See Savine.) Oil of Sinapine. Sinapine bears the same relation to mustard that piperine does to pepper, and like it is united with an acrid oil, and is otherwise analogous to piperine in its chemical properties in not forming salts with acids, die This differs essentially from the volatile oil obtained by distillation, being in every respect superior, and will entirely answer all the purposes of the mustard plaster as a rubefacient. It is simply to be applied to the skin, and in a few hours all the effects of the mustard plaster will be experienced, and vesication may be produced by a second application of the oil. This oil is so concentrated a preparation, that a small vial will be sufficient for several applications. As its action will always be uniform, and it will not be liable to deteriorate in any length of time it will be found as a rubefacient to be a valuable substitute for the crude mustard. Prepared and sold, only, at Carpenter's Chemical Warehouse, Philadelphia. 15 114 Oil of Cantharidin. This is a new and highly valuable article, and from the many advantages which it possesses, will no doubt entirely supersede the common mode of blistering : a few drops rubbed two or three times on the part will effectually draw a full and complete blister, with little or no pain, and without the necessity of applying any thing on it to assist the operation. This is certainly preferable to applying a plaster, which often gets removed from one place to another, and thus frequently vesicates a greater surface than was intended or required : and sometimes, from the frequent transi- tion, only partially vesicates, and causes considerable pain with- out having produced the effect intended, or having been any benefit whatever to the patient. One drop is sufficient to make a blister of the size of a quarter of a dollar. On such places where the skin is thicker, or mere solid than those which are less exposed and covered with clothing, it requires that the oil be applied two or three times in the course of one or two hours, or that the part to be blistered be covered rather more with the oil: this, however, will be seldom necessary, as blisters are most frequently applied on parts which does not require this precaution. A piece of paper which has been made to imbibe this oil forms an excellent blister, which may be accommodated accurately to the shape of any part, however irregular. The vesication thus produced is so exactly circumscribed, that the blister produced corresponds with the sharpest angles which may be given to the paper employed. It begins to draw in 4, 5, or 6 hours according to the place where it is applied. In some cases it may be advisable to cover the part with a little soft paper or linen, where it is likely to get rubbed ; but in most cases no protection whatever is necessary. After the blister ia 115 cut and the lymphatic water is discharged, press the epidermis close to the skin, and in most cases it heals in 20 to 48 hours.— When a rubefacient is wanted, one drop dissolved in 10 or 15 drops of Sweet Oil, or mixed with lard, will answer that purpose; and from its convenience and ready application will be better adapted than any pieparation I am acquainted with. One ounce of this oil contains the vesicating properties of nearly one pound of cantharides. Its use is so mild, that, generally speaking, it produces a blister without the least disagreeable sen- sation, except on those places where muscles, nerves, or tendons are in a state of compression. We trust an article possessing so many advantages will receive the sanction of the faculty. This article is manufactured and sold, only, at Carpenter's Chemical Warehouse, No. 301 Market Street, Philadelphia. Oil of Rue. Stimulant, antispasmodic.—It has been given in hysteria, con- vulsions, and amenorrhea. Note.—The essences of cinnamon, fennel, peppermint, and pennyroyal, being more agreeable and convenient than the oils, are recommended in their stead. Ointment, Citrine. Stimulant and detergent.—An application extensively useful for indolent and scaly eruptions of the skin. The weaker citrine ointment is often applied with advatage to affections of the eye- lids of long standing, and to scrofulous ulcers. Ointment, Elder Flower. Cooling. Ointment, Mercurial, strong. Alterative, discutient,antisyphilitic.—Where it is necessary to charge the system with mercury without affecting the bowels, from 116 half a drachm to a drachm of the ointment may be rubbed in night and morning; but this requires the direction of a medical man. In chronic affections of the liver it is sometimes necessary to rub mercurial ointment near the seat of the disease. This also is a case for the practitioner. Ointment, Mercurial, mild. Employed only as an application to ulcers, and to certain cuta- neous eruptions. This ointment is also much employed for cu- taneous diseases of cattle. It is liable to much adulteration being an article that more generally falls into the hands of persons who are unacquainted with the quality of it, and who regard cheapness as the chief object; but this is not the only article in medicine that is made to meet the views of the public, who ought, in all cases where life and health are concerned, to have implicit reliance on the character of the house from which they are supplied. Adulterated medicines are imported to meet the wishes of some, and adulteration is by others made a trade of; and so complete has the adulteration of drugs become a business, that even the apothecaries and druggists, who are every day in the habit of seeing the various articles in pharmacy, can only be cer- tain of the purity of many compounds by preparing them under their own immediate inspection. The price therefore should be regulated by the quality, and not the quality by the price to meet the wishes of a few persons who are satisfied so long as they ob- tain an article bearing the name of what they require. George W. Carpenter begs to notify the public that they are guaranteed against such imposition by directing their orders to his establishment, as the various compounds and preparations that are liable to such adulteration are prepared under his own imme- diate inspection, at his Chemical Laboratory, No. 301 Market street, Philadelphia. 117 Ointment, Red Precipitate. Used for removing fungus or proud flesh, and as a stimulant to chronic ulcers. Ointment, Spermaceti, This ointment is employed as a mild dressing for blisters, and excoriated surfaces. , Ointment of Galls. This ointment is an excellent application to piles and prolap- sus ani, or the falling down of the gut, to obviate the pain which it is liable to produce. It is sometimes combined with opium in the proportion of a drachm of the powder to an ounce of oint- ment, but thus modified it requires to be used with caution.—U. S. Dispensatory. Ointment of Iodine. This ointment when rubbed upon the skin imparts to it an orange colour, which, however, slowly disappears with the evapo- ration of the iodine. It is useful as a local application in goitre and scrofulous swellings>f the glands, operating probably through the medium of absorption of the glands. When continued for some time, it occasionally produces a pustular eruption upon the portion of the skin to which it is applied. Ointment of Tarm This ointment is used for affections of the skin, such as scald head, scorbutic diseases, die " It should be applied night and morning; and in bad cases the patient should wear a cap, thickly spread with the ointment on its internal surface." It is some- times combined with an equal quantity of citrine ointment for these purposes. iin Ointment, Sulphur. " This ointment is a specific for the itch. It should be applied every night until the complaint is cured ; and it is recommended that only one fourth of the body should be covered at a time. Four applications are usually sufficient to effect a cure. It is thought by some that powdered roll sulphur is more efficacious than the sublimed. The disagreeable odour of the ointment may be in some measure concealed by a little oil of lemons."—U. S. Dispensatory. Ointment, called " Tulty Ointment." Useful in excoriations. Ointment of Oxide of Zinc. This ointment is useful in various cutaneous eruptions; soie nipples, and other instances of excoriation or ulceration. Ointment, J^ hite precipitate. This ointment is chiefly employed in cutaneous diseases, such as scald head, dec Opium. Anodyne, narcotic, sedative, and stimulant.—Dose, ^ a grain to 2 grains. Although opium in the common acceptation of the word is a poison, and is too frequently taken to destroy life, it nevertheless is one of the most valuable things in the materia me- dica. The first operation of small doses of opium is generally stimulant; but this is soon succeeded by narcotic and sedative effects, in larger doses. Stupefaction and depression of the vital energies are almost immediate. When taken in a poisonous dose, delirium, convulsions, cold sweat and death, rapidly follow. Opi- um is resorted to for effects apparently widely different. It is 119 used by the Turk to produce the feeling of intoxication. It in- spires courage, raises the animal spirits, allays grief by drowning recollection, awakens imagination, eases pain, and composes the mind ; and all by its intoxicating properties. It is the drachm of the debaucher, the cordial of the nervous lady, and the concealed instrument for perpetrating the most atrocious acts in the hands of the villain. Opium, to the physician, is a most valuable reme- dy ; it upholds the vital powers, eases pain, diminishes irritation, overcomes cramps or spasm, and lessens the sensibility to exter- nal impressions. It should never be used in inflammatory dis- eases ; and as great caution is necessary in ascertaining the proper time when it is admissible, and the symptoms to which it is appli- cable, the use of it should be left to the decision of the medical attendant. The practice of opium eating cannot be too strongly condemned. It may give solace for a time, but, to keep up the effects, like the baneful habit of drinking spirituous liquors, the quantity must be from time to time increased, until at length the constitution becomes so undermined that life becomes a burden. A small piece of opium is sometimes put into the cavity of a tooth to allay tooth-ache. (See Laudanum.) Opodeldoc. CAMPHORATED SOAP LINIMENT. Stimulant and anodyne.—Externally applied for bruises, sprains, chilblains, and rheumatic pains. When used for chronic swellings affecting the joints, it promotes absorption and facilitates their mo- tion. Orange peel. Stomachic.—An infusion of orange peel forms an excellent ve^ hide for taking epsom salts in, and alone is a pleasant bitter in slight cases of indigestion. The infusion is made as follows : " Take of dried orange peel 2 drachms, fresh lemon peel a drachm, 120 cloves bruised, half a drachm, boiling water half a pint. Mace- rate for a quarter of an hour in a covered vessel, and strain.'' Dose, 2 or 3 fluid ounces. Orange peas, turned. Used to keep up the irritation necessary for promoting the dis- charge from issue ; they are either inserted unmedicated in the opening for this purpose, and covered with an issue plaster, or when a greater degree of irritation is necessary they are coated with savin ointment or a solution of blue vitriol. Orris root. Used to sweeten the breath, for which a small piece is kept in the mouth a short time. Orris powder. This is one of the ingredients in most tooth-powders. Otto of Roses. An admired perfume. The produce of Persia, Turkey, and India. Oxygen gas, OR VITAL AIR. Doctor Thornton of London speaks highly of this gas in some affections of the lungs and chest, more especially in those attend- ed with loss of voice. The proportions inhaled by his patients were 1 part of the gas and 3 of atmospheric air. Oxygen gas seems to have a powerful effect upon the voice, It is related in the monthly London Gazette of Practical Medicine, that the late celebrated actress Mrs. Siddons, used to experience the good ef- fects of oxygen gas. She was in the habit of inhaling six quarts di- luted with twelve of atmospheric air; and that after this practice 121 her lower tones were distinctly heard in every part of the house. It is also remarked in the same Journal, that oxygen gas raises the voice one or two notes higher, as Mr. Melrose has experi- enced after inhaling it previous to his performance ; and that Mr. Tinney could go as far as G natural below the line on the bass cleff, which he could not accomplish at any other time. The cases of leprosy cured by the oxygen gas are also curious. One patient inhaled six quarts diluted with common air four times a day; and in six weeks the scaly eruption entirely disappeared. Oxymel. Cooling, externally detergent—It is used or mixed with water as a gaigle in cases of recent sore throat. Oxymel of Colchicum, OR MEADOW SAFFRON. Expectorant, diuretic.—Dose, 1 drachm repeated twice a day, and gradually increased till it produces the desired effect. It is seldom prescribed in this country ; the wine of meadow saffron being equally efficacious. (See Wine of Colchicum.) Oxymel of Squills. Expectorant, detergent, and diuretic.—This preparation has the virtues of squill, but is not superior to the syrup. (See same.) Dose from 1 to 2 fluid drachms. Paregoric eHxir. Anodyne, antispasmodic.—This is a very pleasant anodyne and antispasmodic. In coughs, more particularly affecting old people, and arising from irritation or spasm, this preparation affords deci- ded relief. It is also serviceable in asthmatic affections, and may be taken with advantage in the troublesome cough to which con- sumptive persons are sometimes subject; it should be avoided in 16 122 recent colds attended with fever. Two tea-spoonsful of paregoric elixir, one table-spoonful of syrup or oxymel of squills, the same of water and of mucilage of gum arabic, form a good mix- ture for whooping-cough. A tea-spoonful may be taken 3 or 4 times a day, or when the cough is most troublesome. Partridge berry, OR GAULTHERIA. This berry has the usual stimulant operation of the aromatics, united with astringency ; and may therefore be used with advan- tage in some forms of chronic diarrhea. Like other substances of the same class it has been employed as an emenagogue, and with the view of increasing the secretion of milk ; but its chief use is to impart an agreeable flavour to mixtures and other prepa- rations. It may be conveniently administered in the form of in- fusion, which in some parts of the country is not unfrequently used at the table as a substitute for common tea. The oil, how- ever, is more used in regular practice than the leaves.—U. S. Dispensatory. Peach leaves. Anthelmintic, laxative.—" Peach leaves are said to be laxative ; and they probably exert, to a moderate extent, a sedative influ- ence over the nervous system. They have been used as an an- thelmintic with great reported success. More recently their infu- sion has been recommended in morbid irritability of the bladder. Half an ounce of the dried leaves may be infused in a pint of boil- ing water, and half a fluid ounce given for a dose three times a day. The flowers are also laxative ; and a syrup prepared from them is considerably used in infantile cases upon the continent of Europe. Woodville states that a drachm of the dried flowers, or half an ounce in their recent state, given in infusion, is the dose as a vermifuge. 123 " The kernels have more of the peculiar powers of hydrocyanic acid, and therefore require to be used with some caution. Blanched and rubbed up with hot water they form an emulsion well adapted to coughs depending on or associated with nervous irritation. " The dried fruit stewed with sugar is an excellent laxative ar- ticle of diet, suitable to cases of convalescence attended with tor- pid bowels."—U. S. Dispensatory. Peppermint Is a very grateful aromatic stimulant, much used for all the pur- poses to which medicines of this class are applied. To allay nau- sea, to relieve spasmodic pains of the stomach and bowels, to ex- pel flatus, to cover the taste or qualify the nauseating or griping ef- fects of other medicines, are among the most common of these pur- poses. The fresh herb, bruised and applied over the epigastrium, often allays sick stomach, and is especially useful in the cholera of children. The medicine may be given in infusion; but the volatile oil alone, or in some state of preparation, is almost al- ways preferred, (Vide Oil and Essence of Peppermint.) Pellitory root. Sometimes used as an application for tooth-ache, but with doubtful success. It may, however, give temporary relief. Pennyroyal Is a stimulant aromatic, and may be given in flatulent colic and sick stomach, or to qualify the action of other medicines. Like most of the aromatic herbs, it possesses the property, when administered in waim infusion, of promoting perspiration and of exciting the menstrual flux when the system is predisposed to the effort. Hence it is much used as an emenagogue in popular prac- 124 tice, and frequently with success. A large draught of the warm tea is given at bed-time in recent cases of suppression of the menses, the feet having been previously bathed in warm water. Pepper, black, white, and long. Black pepper is spoken of in the highest terms by Doctor Louis Frank, principal physician to her Majesty Maria Louisa, Dutchess of Parma, as a remedy for ague ; he prescribes from 5 to 10 whole grains to be taken twice or thrice a day, and asserts that it almost invariably cured the disease. " Its chief medicinal application is to excite the languid stomach and to correct flatulence." The dose of pepper is from 5 to 20 grains. It may be given in the state of the berry or in powder, but is more energetic in the latter. White pepper is the ripe berry deprived of its skin by maceration in water and subsequent friction, and afterwards dried in the sun. It has less the peculiar virtues of the spice than black pepper. Long pepper is considered inferior to the black pepper, and is sel- dom used. Phosphorus. Principally used for making the phosphorus fire box. Great cau- tion should be used in this article, as very serious accidents have occurred from its being wantonly employed. Pills of Aloes, compound. This combination is well adapted as a laxative to the costiveness of sedentary and dyspeptic persons, the dose is from five to twenty grains according to the degree of effect required. Pills of Aloes and Assafoetida. These pills are peculiarly adapted, by the stimulant and carmina- tive properties of the assafoetida, to cases of costiveness attended with flatulence and debility of the digestive organs. From 2 to 5 may be given for a dose. 125 Pills of Aloes and Myrrh, (CALLED RUFUR's PILLS.) These pills are employed as a warm stimulant cathartic in debili- tated states of the system, attended with constipation and reten- tion or suppression of the menses. From 3 to 6 pills may be given for a dose. Pills of Assafoetida. (Vide Assafoetida.) Pills, compound Cathartic, or Antibilious. These pills may be employed in most cases where a brisk ca- thartic is required; but are particularly applicable to the early stages of bilious fevers, to hepatitis, jaundice, die, dee Pills of Copaiba. (See Copaiva.) Pills of Iron, compound. This composition is a good emenagogue and antihectic tonic- From two to six pills may be given as a dose three times a day. Pills of Assafoetida, compound. This compound is given as an antispasmodic and emenagogue in chlorosis and hysteria. Dose from 10 to 20 grains. Pills of Mercury. (Vide Blue Pill.) Pills of Calomel. (Vide Calomel.) 126 Pills of Calomel, compound. CALLED PLUMMER's FILLS. This combination is well adapted to the treatment of chronic rheumatism, and of scaly and other eruptive diseases of the skin, especially when accompanied with a syphilitic taint. From 3 to 6 grains, or more, may be given morning and evening. Pills of Opium. (Vide Opium.) Pills of Quinine. Twelve of these pills are equivalent to one ounce of good Pe- ruvian bark. For properties, (see Quinine, Sulphate of.) Pills of Rhubarb, compound. These are a warm tonic laxative, useful in costiveness with de- bility of stomach. From 2 to 4 pills may be taken twice a day. Pills of Sulphate of Iron, compound. This is a good tonic pill, applicable to most complaints, in which chalybeates are administered. About two grains of the sulphate are contained in a pill of 5 grains. Note.—The formula of the foregoing preparations, under the head of pills, will be found in the United States Dispensatory, by Drs. Wood and Bache, edition of 1830. Pimento, OR ALLSPICE. Aromatic Pink Root, OR SPIGELIA. This root is generally considered amongst the most powerful 127 anthelmintics. In the ordinary dose it usually produces little sen- sible effect on the system; more largely given it acts as a cathar- tic, though unequal and uncertain in its operation, in overdoses it excites the circulation, and determines to the brain, giving rise to vertigo, dimness of vision, dilated pupils, spasms of the facial muscles, and sometimes even to general convulsions ; spasmodic movements of the eye-lids have been observed among the most common attendants of the narcotic action. The narcotic effects are, however, entirely obviated by combining it with cathartics. The vermifuge properties of the spigelia were first learned from the Cherokee Indians. They were made known to the medical profession by Drs. Lunig, Garden, and Chalmers, of South Caro- lina. The remedy stands at present in this country at the head of the anthelmintics. It may be given in substance or infusion ; the dose of the powdered root for a child three or four years old, is from 10 to 20 grains; for an adult, from 1 to 2 drachms, to be repeated morning and evening, for several days successively, and then followed by a brisk cathartic The infusion, however, is the most common form of administration : it is prepared by macerating a pint of boiling water on half an ounce of the root for two hours, in a covered vessel, and then straining. The preparation, however, most esteemed is the Compound Fluid Extract of Pink Root, pre- pared at my Chemical Laboratory, 301 Market street, and has been found the most effectual worm-destroying medicine yet dis- covered. Plaster, Diachylum. Discutient. Do., Do., Spread. For holding together the edges of recent wounds, bandages, die All that is required for cut wounds or lacerations where no se- rious bleeding occurs (as when arteries are injured), is to biing 128 the lips or edges of the wounds into their proper situation, and cleanse them with tepid water by means of a sponge. Slips of plaster in succession should then be placed across the wound un- til the whole is covered, which will exclude the air and extraneous substances, and generally cause the wound to heal by the first in- tention. The plaster may be removed in two or three days, and fresh applied, which may remain until the wound is healed; every housekeeper should have a sheet of this plaster at hand in case of accidents. Plaster of Soap. Emollient. Plaster, Blistering. A blister applied to any part affected by inflammation will ge- nerally be succeeded by relief. In affections of the lungs, liver, or any local pain, no injury can be produced, but much good may result from its application. It may, however, be well to observe here, that in all acute inflammations of the lungs, dec, a blister has generally a better effect when preceded by bleeding. A blis- ter should, generally speaking, remain on a part from twelve to twenty-four hours; when removed, the lower part of the skin, containing the fluid, should be clipped with a pair of scissors, so as to allow the fluid to pass out. The whole surface should then be dressed with spermaceti ointment, spread on soft linen or lint; if it be required to keep the blister open, with savin ointment, the ointment of Spanish flies, or basilicon ointment. During the operation of a blister it not unfrequently happens that violent stranguary or an affection of the bladder will take place ; in this case the patient should be made to drink freely of barley water, in which a small quantity of gum Arabic may be dissolved, and the lower part of the abdomen fomented. Blisters will occasion- ally be found to act stronger or milder on different constitutions ; 129 in the former case they should be covered with silver leaf, which mitigates their action; whilst in the latter, a small quantity of the powder of cantharides sprinkled over the plaster will increase their operation. If powder of camphor be spread over a blister, it is said by some persons to have the effect of obviating stran- guary. The oil of cantharidin prepared by George W. Carpenter has the long wished for effect of obviating stranguary. (Vide Oil of Cantharidin.) Plaster, Burgundy pitch. Used for the same purposes as warm plaster, but being less stimulant is not so efficacious. Plaster, Roborans, OR STRENGTHENING. Chiefly applied to the loins for weakness, debility, dec Plaster roborans, warm. Applied to the chest, when spread on leather, as a stimulant application for affections of the lungs and their membranes. The chief use is to keep up an irritation to the surface. Pomegranate peel. Highly astringent.—The decoction of pomegranate, made by boiling 2 ounces of the peel or shell in a quart of water or milk for 1 hour; and after it is strained adding 1 ounce of the tinc- ture of rhatany to it, has been used with most decided advantage in dysentery and hemorrhage of the bowels. A wine-glassful is the dose which should be taken every three hours, previously taking a dose of Dover's powder and blue pill. If great pain and tenesmus attend the disease, 1 drachm of laudanum may be added J7 130 to the entire mixture, which will increase its constipating effects, and afford ease to the patient. Poppy heads. Four ounces, boiled in 4 pints of water for 13 minutes, is the anodyne fomentation which is used to allay the pain of ulcers and wounds of an irritable character. It is also an excellent ap- plication for inflammation of the eye, especially when great pain is attendant. Pleurisy root- OR BUTTERFLY WEED. " Diaphoretic and expectorant, without being much stimulant. In large doses it is often also cathartic. In the southern states it has been employed by regular practitioners in catarrh, pneumo- nia, pleurisy, consumption, and other pectoral affections ; and ap- pears to be decidedly useful if employed in the early stages, or after sufficient depletion when the complaint is already formed." —U. S. Dispensatory. It has also been advantageously administered in acute rheuma- tism, and for flatulence and indigestion. Dr. Eberle found it useful in dysentery. (Eberle's Practice, i, 216.) "From 20 grains to a drachm of the root in powder may be given several times a day ; but as a diaphoretic it is best administered in de- coction or infusion, made in the proportion of an ounce to a quart of water, and given in the dose of a tea-cupful every two or three hours till it operates." Precipitate, red. (Vide Ointment.) Precipitate, white. Do. 131 Quassia shavings. Quassia is taken in the form of infusion as a tonic; but the taste being so intensely bitter, it is seldom used in medicine. The brewers in England, and probably in this country, consume a large quantity of it in their manufacture to impart bitterness to their liquors. A weak infusion of quassia is a good vehicle for taking epsom salt, as it conceals the taste and acts as a tonic. A strong infusion of quassia, combined with molasses or sugar and placed in a saucer, attracts and destroys flies. Quicksilver. This is the basis of all mercurial preparations. In its natural state it is rarely used medicinally. Quicksilver is extensively used in the arts, and in the manufacture of vermilion, coating mirrors, &c Quinine, Sulphate of, Possesses all the properties of peruvian bark, and being free from fibrous and extractive matter, is capable of being adminis- tered in cases in which bark would not be admissible. Its virtues are tonic and febrifuge ; which render it, of course, an excellent medicine in intermittent and low typhus fever. It is also of great value in affections of the stomach, arising from debility of that organ. Twelve grains of the sulphate are equivalent to one ounce of good peruvian bark. The dose varies exceedingly, ac- cording to the circumstances of the patient and the object to be accomplished. The usual doses are £ a grain to 6, as a febrifuge ; as a stomachic, | a grain to a grain and a half, repeated two or three times a day, either in water, port, or madeira wine. The form of pill is the mode usually preferred. The tincture, which 132 is a combination of the Seville orange peel with the quinine, is also recommended as a good and agreeable tonic medicine. Rhatany root, " Is gently tonic, and powerfully astringent; and may be ad- vantageously given in chronic diarrhea, passive hemorrhages, some forms of leucorrhea, and in all those cases in which kino and catechu are beneficial. The dose of the powder is from 20 to 30 grains; but in this form the root is very little used. The decoction is more convenient, and is usually preferred. It may be prepared by boiling an ounce of the bruised root in a pint of water, and taken in the dose of 1 or 2 fluid ounces. A tincture may be prepared by macerating 3 ounces of the bruised or pow- dered root in a pint of diluted alcohol for two weeks. Half an ounce of cinnamon, or an ounce of orange peel may be added to improve the flavour and render the tincture more plea- sant to the stomach. The dose is one or two fluid ounces.— U. S. Dispensatory, Rhubarb, Turkey. Purgative, stomachic, and astringent.—Dose, 10 to 30 grains. It will appear to those unacquainted with this medicine, rather anomalous that any article can be both purgative and astringent; but these are the peculiar properties of rhubarb. In cases where the bowels are affected with relaxation, arising from debi- lity, a dose of rhubarb will oftentimes be found the best means of checking its progress, and this is affected by its giving tone and acting as an astringent on the surfaces over whicn it passes. In looseness of the bowels to which infants are subject it. is the best possible remedy; and where acidity is concerned, if combined with calcined magnesia, it will generally afford lelief. (Vide Cal- cined Magnesia.) As a stomachic, where the taste is not objec- 133 tionable, about 5 grains of the root gradually dissolved in the mouth, is much used, and decidedly with advantage, particularly when had recourse to early in the morning or an hour or two be- fore dinner. The same may be taken in powder or pills. From 5 to 10 grains, with one drop of the oil of peppermint may be taken to relieve flatulence and distension in the stomach. The powder, well known in Scotland under the name of " Dr. Grego- ry's powder," is composed of Turkey rhubarb, calcined magnesia, and the aroma of Jamaica ginger; and is found very useful to per- sons of gouty and dyspeptic habits. Rhubarb, India. This is similar in its properties to the Turkey ; but weaker, and more liable to gripe. Rochelle salt. Mildly aperient. Dose half an ounce to an ounce and a half. It is used as a cooling purgative, and for the same purposes as epsom salt. The powder of this salt enters into many of the ef- fervescing aperient medicines : it is combined with the infusion of senna or rhubarb, and is esteemed an excellent medicine in bi- lious affections, or when the constitution isthreatened with plethora: in which latter case a small dose should be taken every morning fasting. It is frequently adulterated with the powder of other nu- tral salts of inferior value. Rose leaves. Astrigent.—Used for making the infusion, confection, and water. Resin, yellow, Enters into many plasters and ointments ; it is also sometimes combined with Castile soap, nitre, and oil of juniper, and thus ad- ministered for the cure of urethral diseases, and to provoke the flow of urine. 134 Saffron. Cordial, Diaphoretic.—Little used in medicine, except to give colour. By old women and nurses saffron tea is frequently used in exanthematous diseases, to promote the eruption ; a practice intro- duced by the humoral pathologists, but afterwards abandoned by the profession, and not"greatly injurious only from the inactivity of the medicine. From 10 to 30 grains may be given for a dose.—U. S. Dispensatory. Sage, Leaves of. In the state of infusion sage is given in debilitated states of the stomach attended with flatulence, and is said to be useful in check- ing the exhausting sweats of hectic fever. But its most usual application is as a gargle in inflammation of the throat and relaxa- tion of the uvula; for this purpose it is usually employed in infu- sion with honey and alum or vinegar. From 20 to 30 grains of the powdered leaves may be given for a dose. The infusion is prepared by macerating an ounce of the leaves in a pint of boiling water, of which two fluid ounces maybe administered at once. Where intended to be used merely ;;s a pleasant drink in febrile complaints, or to allay nausea, the maceration should continue but a very short time, so that al? the bitterness of the leaves may not he extracted. Sago Is used as an article of diet for invalids. It should be first soaked in cold water for an hour, to remove the earthy taste ; after pouring off the first water fresh should then be added, and the whole allowed to simmer until it becomes tiansparent. It may be flavoured with spice, wine, die,, and sweatened with sugar. That known by the name of peail sago is preferable to the brown. 135 Salep Is highly nutritive, and may be employed for the same purposes with tapioca, sago, die It is much used in London as an article of diet, particularly by the labouring classes, and is considered by men of eminence in the profession as affording the largest quantity of vegetable nourishment in the smallest bulk. It is re- storative, mucilaginous and demulcent; hence in sea scurvy it has been recommended with particular advantage. In diarrhea and dysentery it is serviceable by sheathing the internal coats of the intestines. It is used in the same way as arrow root, and may be flavored with lemon, wine, and sugar, or combined with milk. Care should be taken in calling for the article to pronounce it cor- rectly, otherwise the article " Jalep" may be substituted; the con- sequence of which may be easily guessed at. Sal Ammoniac. (Vide Ammonia muriate of.) Sal Aeratus. Same properties and dose as the carbortae of potash. Sal Enixum. Purgature, refrigerant.—Dose, 15 grains to 2 drachms. Incases requiring a mild purgative of a cooling nature, this salt may be advantageously taken. In internal hemorrhage it is also a good medicine. About 15 grains dissolved in a wine-glassfull of water may be administered three times a day for spitting of blood; the same dose may also be given for the purpose of checking night sweats. If a drachm of the salt be dissolved in about a quarter of a pint of water and half a drachm of the super carbonate of soda, in a wine glass, and the two solutions be then mixed, a very agree- able and cooling draught will be formed, which should be taken whilst it is effervescing. 136 Sal Prunelle. (For properties, Vide Nitre.) Sal Soda. Soda is used for making the saline'mixture; for which purpose an ounce should be dissolved in a pint of water, to which an ounce of the syrup of orange peel may be'added. Two table-spoons- ful of the above mixture should be added to one of lemon-juice, and taken in a state of effervescence. Salt, Common. The use of common salt in domestic economy as a condiment and antiseptic is well known. Salt is sometimes prescribed with advantage for the expulsion of worms; it is also administered combined with gruel, in the form of enema, and if dissolved in water to the extent of an ounce to a pint, is a good application for slight bruises. Salt is said to assist digestion, and prevents the too rapid decomposition of food takenMnto the stomach, thereby correcting the' fetid eructations and accumulations of flatus to which some persons are liable ; this, however, refers to the prac- tice of eating salt with the food, and not to salted provisions, which are rendered hard, and are deprived of a great proportion of nourishment by being strongly pickled. The practice of of eating salted provisions is liable to create scurvy; it is for this reason that sailors are frequently subject to that disease. Bay salt dissolved in water is a good substitute for sea water, and bathing in it will be found as beneficial, in most cases, as the sea itself, except when the additional advantage of sea air is required. 137 Salt of Tartar, OR SALT OF WORMWOOD. This salt is occasionally used as an antacid in dyspepsia, as a diuretic in dropsy, and as an anthilitic in gravel, accompanied with red deposition in the urine; but the purpose for which it is most commonly applied is the formation of the neutral mixture and effervescing draught. It is also used with much advantage in some cases of jaundice.—U. S. Dispensatory. As it neutra- lizes acid it is employed for removing the acidity of wine or beer. The dose is from 10 to 30 grains, given in some aromatic water sweetened with sugar. Carpenter's Citrated Kali, a most va- luable preparation for making the saline draught or neutral mix- ture, is prepared by G. W. Carpenter, 301 Market street, Phila- delphia. Sarsaparilla. Alterative, diaphoretic, demulcent, and antiscorbutic.—From this root the extract and decoction are made. (Vide Extract.) There are various descriptions and qualities of this article, and perhaps the great difference of opinion entertained by various persons in the pro- fession as to the properties of sarsaparilla, may have arisen from the circumstance of each having used a different kind. The greater quantities used is said to be imported from Vera Cruz and Hon- duras ; but that most esteemed is from Lisbon, very little of which makes its way to this country. The Caraccas Sarsaparilla of Guibourt is occasionally imported from La Guayra. The decoc- tion of sarsaparilla is made by boiling 6 ounces of the root sliced and bruised in six pints of water down to four. Sarsaparilla Powder. Dose, 1 to 2 drachms in milk, barley water,or'gruel. 18 138 Sassafras Shavings Is one of the ingredients for making the decoction of woods. Sassafras tea is much used in England as a beverage for breakfast. It is made by boiling or infusing a few of the shavings in water for a quarter of an hour, milk is then added to it, and it is sweet- ened with sugar. It is considered a good diet for persons of gouty habit, or those who are troubled with indigestion. It is used also by such as are affected by the scurvy. The sassafras cocoa, which is made from the nuts, is taken with similar views. The bark of the root and the pith of the twigs, or extreme branches are gene- rally used. Scammony, Aleppo. " Scammony is an energetic cathartic, apt to occasion griping, and sometimes operating with harshness." It is principally used in obstinate constipation of the bowels, and is more generally combined with other purgatives, as aloes, rhubarb, calomel, and colocynth. The best preparation of which it forms an ingredient is the compound extract of colocynth. Seltzer Water. This water, when genuine, is procured from the natural sprint of Neider Seltzer in Germany; it is perfectly transparent, has a slight saline taste, and holds in combination a large proportion of fixed air. It is an extremely refreshing beverage, and is esteemed particularly serviceable in relieving many of the symptoms atten- dant upon consumption, such as hectic fever, thirst, dec. It is also used advantageously in diseases of the kidneys and bladder; it allays irritability of the stomach, checks vomiting, acidity, and heartburn, and is sometimes prescribed in eruptive diseases. Lord 139 Byron says that hock and seltzer is classic drink. Those who are not poets, or too fastidious, must admit that sherry and seltzer water is not to be condemned ; a tumbler of seltzer with a glass of Eau de Vie mixed with it is a nectar fit for the gods, and to the stomach that is labouring under the effects of " last night's conviviality,5' the last named mixture will be considered no doubt well charac- terized. Seidlitz Powder. These consist of a mixture of two drachms of Rochelle salts and 2 scruples of the Bicarbonate of Soda, put up in a white paper, and 35 grains of Tartaric acid contained in a blue. The contents of the white paper are dissolved in about half a pint of water, to which those of the blue are added, and the whole are taken in a state of effervescence. Seneca root. Expectorant, also diuretic and cathartic.—A large wine-glass- ful of the decoction (which is made by boiling an ounce of the root in a quart of water) is given twice or thrice a day for the re- lief of asthma, chronic coughs, dropsy, and gout. An equal weight of liquorice root may be advantageously added to the decoction. Senna Leaves, Alexandria. Cathartic.—Senna is generally used for making the infusion or tea. On half an ounce of senna, and about a scruple of ginger, pour a breakfast cupful, or rather less than half a pint of boiling water; cover the vessel, let it stand for an hour, then strain; a large wine-glassful is the dose for an adult. The infusion of senna, combined with Epsom salts and the tincture of jalap, form the celebrated black draught. Two table-spoonsful of the infu- 140 sion, sweetened with sugar and coloured with milk, is a medi- cine which can easily be imposed on children for strong tea, and is given as a purgative when they will not take any other medi- cine. A few drops of the spirit of Sal Volatile added to the in- fusion of senna is found to prevent the griping effects which not unusually attend the operation of this medicine. Two or three grains of calomel may be given over night, if required. Senna, American. American senna is an efficient and safe cathartic, closely re- sembling the imported senna in its action, and capable of being substituted for it in all cases in which the latter is employed. It is however less active; and to produce an equal effect must be administered in a dose about one-third larger. Like senna, it is most conveniently given in the form of infusion, and should be similarly combined in order to obviate its tendency to produce griping. Senna, Indian. The leaves of this senna, if very fine, are more perfect than the Alexandrian; but it is very subject to mildew and to be worm eaten. Two ounces of the senna will not yield the same strength of infusion, or tincture, as one ounce of Alexandrian, besideswhich it is more griping in its effects. Senna Powder. Dose, 20 to 40 grains. Shell lac. Used extensively in the arts for making varnish, hats, dec. A saturated tincture of shell lac, is in England generally ordered by dentists to be used for the purpose of fastening the teeth when the gums have become detached, and also as a coating for broken teeth. For these purposes it is used three or four times a day. 141 Slippery Elm Bark. " Slippery elm bark is an excellent demulcent, applicable to all cases in which this class of medicines is employed. It is es- pecially recommended in dysentery, diarrhea, and diseases of the urinary passages. Its mucilage is highly nutricious, and we are told that it has proved sufficient for the support of life in the ab- sence of other food. The instance of a soldier is mentioned who lived ten days in the woods on this bark and sassafras; and the Indians are said to resort to it for nutriment in extreme emergen- cies. " It is usually employed as a drink in the form of infusion ; or the powder may be used stirred in hot water, with which it forms a mucilage, more or less thick according to the proportion added. The bark also serves as an emollient application, in cases of ex- ternal inflammation. For this purpose the powder may be formed into a poultice with hot water, or the bark itself may be applied, previously softened by boiling. The infusion is prepared by ma- cerating an ounce of the bark in a pint of boiling water for 12 hours, and then strained."—U. S. Dispensatory. Papers, containing 1 ounce each of the powdered bark, carefully put up, also in pound and \ pound parcels, are to be had at 30] Market street. Silk Weed, OR MILK WEED. Same properties and doses as pleurisy root. (Vide same.) Snake Root, Black. Used chiefly in domestic practice as a remedy in rheumatism, dropsy, hysteria, and various affections of the lungs, particularly those resembling consumption. The form of decoction is usually prepared. An ounce of the bruised root may be boiled for a short 142 time in a pint of water, and one or two fluid ounces given for a dose several times a day.—U. S. Dispensatory. Snake Root, Seneca. (Vide Seneca root.) Snake Root, Virginia. (Vide Virginia Snake Root.) Snake Weed, OR BISTORT. Very astringent.—It is used in decoction for relaxation of the bowels. It is also administered in substance. The dose is from 15 grains to a drachm twice or thrice a day. Sorrel leaves Are pleasantly sour and]without odour; but their taste is almost entirely destroyed by drying. They are refrigerant and diuretic, and may be used with great advantage as an article of diet in scorbutic complaints. They are prepared in the form of salad and boiled like spinach. The juice of the fresh leaves boiled with water forms a pleasant acidulous drink, sometimes given in fevers. Snuffs, medicated. Used for relieving headachs and affections of the eyes. There are various kinds ; but those most in use are the cephalic and Asarabacca; they are resorted to for the purpose of increasing the discharge from the nostrils; whenever they fail to produce this effect, or cause violent sneezing, they are injurious, especially when the head is engaged. Soap cerate When spread upon lint or linen is applied externally for the 143 purpose of resolving swellings. It is much used as an application to the breasts after weaning, for the purpose, as it is termed, of drying up the milk. Soap, white, yellow, and soft. The Castile soap is more generally used for internal purposes. (Which see.) A strong solution of white soap is one of the best antidotes for some poisons, especially the mineral acids and metallic salts: a cupful should be given, and if succeeded by vo- miting it should be repeated. About half an ounce of white soap dissolved in a quart of warm water forms a good enema for remov- ing hardened feces. The yellow soap, which is more stimulating, is sometimes used with advantage as a suppository to excite the lower bowels when it is not desirable to teaze the bowels with medicine ; for this purpose a small piece in the form of a cone is introduced into the lower gut, and allowed to remain there. This practice is found extremely useful in relieving the constipa- tion of very young children. Soft soap being more caustic than either of the above, is frequently used with decided benefit in scald head, and diseases of the scalp. Soap enters into several embrocations, such as the opodeldoc, dec. Soda Water Is so generally known that it is almost unnecessary to make any comment upon it. It is antacid, diuretic, and lithontriptic. It is recommended for indigestion, and affections of the kidneys and bladder; and is a cooling beverage adapted to febrile and inflam- matory diseases. Soda, bicarbonate or supercarbonate of. This preparation is much used for the purpose of correcting acidity in the stomach, for which it is an excellent medicine ; the 144 dose for this effect is from 10 grains to a scruple, either in water or some bitter infusion. This is the best preparation of soda for making saline draughts, and the following will be found a good form : Dissolve an ounce of the salt in a pint of water, (cold, boiled or distilled,) to which add about an ounce of the syrup of orange peel. Two table-spoonsful of this mixture should then be added to»one of lemon juice, and the draught taken whilst effer- vescing, and repeated as often as required. Soda, acetate of. Mildly aperient, and diuretic.—Dose, a scruple to 3 drachms. Sodium. A metal found in Soda. Soda, phosphate of. Aperient.—Dose from 1 to 2 ounces. This salt was intro- duced into regular practice about the year 1800, on the recom- mendation of Doctor Pearson of London. It is a mild purgative, and from its pure saline taste is well adapted to the cases of children and of persons of delicate stomach. The salt is best ad- ministered in gruel or weak broth, to which it communicates a taste as if seasoned with common salt. Soluble Tartar. Gently laxative.—Dose, 1 drachm to 1 ounce. Used in com- bination with other purgatives to obviate their griping effect and lo quicken their action. With the infusions of senna and rhu- •barb it is esteemed an excellent medicine for children. Spearmint. The properties and doses of spearmint are the same as those of peppermint. (See Peppermint.) 145 Spermaceti. Demulcent, emollient.—Dose, 20 to 60 grains. Equal parts of sugar candy and spermaceti formed into a paste or powder, is a combination frequently used to allay coughs. Spermaceti also enters into the composition of cerates and ointments. Spigelia. For properties, dec, see Pink Root. Spirit of Hartshorn. Antispasmodic, antacid, stimulant, externally rubefacient.— Dose, 30 to 60 drops in water. In hysterical affections, spasms, or fainting fits, if a dose of thi3 be taken it will generally give re- lief; it is also serviceable in heartburn, and flatulence, by neu. tralizing the acid in the stomach. It may be taken in any of the medicated waters, or even in plain water, should those not be at hand. Doctor Pertier, a German physician, states that he has found the spirit of hartshorn, (in the dose of a tea-spoonful in a glass of water) to counteract the inebriating effects of fermented liquors and spirits. Combined with oil, it forms an excellent lini- ment for sore throats and glandular swellings of the neck. (Vide Oil of Almonds.) Spirit of Ammonia, aromatized, OR SPIRIT OF SAL VOLATILE. Properties and dose the same as spirit of hartshorn, and is ap- plicable under the same circumstances ; but owing to its contain- ing aromatics, it is more agreeable, and perhaps better, than harts- horn, as a carminative. Spirits, sweet nitre. Diuretic, antispasmodic, diaphoretic, and cooling.—Dose, 20 19 146 drops to a tea-spoonful. In affections of the kidneys and bladder, particularly where the secretion of the former is diminished, if a tea-spoonful be given either in water or gruel 3 or 4 times a day, a proper action will be excited. In dropsical cases the same dose may also be given with advantage, and repeated as often. A tea-spoonful mixed in a breakfast-cupful of hot whey, and taken at bed-time-, is serviceable in colds by producing an action to the skin. Twenty or 30 drops in a wine-glass or even a tumbler of water is an agreeable draught in fever or to allay thirst. Spirit of Lavender, compound. Cordial, exhilarant.—"This is a delightful combination of spices," and is much used for lowness of spirits, nausea, melan- choly, fainting fits, and all diseases indicating exhaustion, and a deficiency of nervous energy. Dose, 30 drops to a tea-spoon- ful, dropped on sugar. Spirit, Mindererus. Diaphoretic, externally cooling or refrigerant.—Dose, half an ounce to a table-spoonful in gruel, toast water, plain water, dec. A table-spoonful with 30 drops of spirits nitre, or the same quan- tity of antimonial wine in a tea-cupful of water, is a good sudori- fic in colds, fevers, dec. Externally applied to inflamed parts, it is an excellent lotion, when combined with an equal part of water and a small quantity of spirit. Spirit of Turpentine, rectified, Diuretic, stimulant, antirheumatic.—Dose, 10 drops to half an ounce. A. drachm of this medicine combined with an ounce of castor oil, has been found an excellent means of affording relief in spasmodic affections of the bowels, colds, dec Twenty or 30 drops taken twice or thrice a day in a wine-glassful of water, is 147 frequently prescribed in rheumatism. If three parts of spirit of turpentine, and one of the oil of cajiput, be mixed together, and 20 drops of the mixture be taken twice or thrice a day in water, it will prove, in general, a most effectual remedy in rheumatic af- fections of long standing. For removing tape worms of the bow- els, it is perhaps the best remedy ; but it is then taken to the ex- tent of one or two table-spoonsful in water. As an embrocation for rheumatism and chilblains, it is an excellent stimulant. A table-spoonful with about a pint of gruel and a small quantity of sweet oil, will be found an excellent stimulant and antispasmodic enema in the sinking stage of fever, when the vital powers re- quire to be excited, and in convulsions to overcome spasm. The same may be used in violent attacks of cholera morbus, to check the pain, spasm and vomiting which attends this disease. Spirit Turpentine, Common. Used only in veterinary practice and the arts. Spirit of Wine. (Vide Alcohol.) Spirit of Wine, proof. OR DILUTED ALCOHOL. Used in Pharmacy as the menstruum for most tinctures. Flan- nel, moistened in hot spirit and water, is applied to the abdomen for relief of cramp in the stomach, and violent pains in the bow- els ; and to increase the effect, laudanum is sometimes added to it. Spirit and water is also used as an evaporating lotion for the relief of local inflammation. Every country has a spiritous liquor peculiar to itself. In England, Gin is the spirit in general use ; it is flavoured with turpentine. In Holland, the spirit called Geneva Brandewyn, is flavoured with juniper berries. Both these are corn spirits, and are strongly diuretic Biandy or Eau de Vie, is the 146 spirit of France, it is produced from wine, and the flavour pecu- liar to it is derived from an essential oil, called the oil of wine : it is considered more cordial than other spiritous liquors, and is frequently prescribed as a stomachic. Pure brandy is colourless; but that most used in England is browned by burned sugar; Ar- rack is produced from rice, and is the favourite spirit in India. Kirch Wassar, or Cherry Water, is the local spirit of Germany and Switzerland; it is distilled from cherries, and holds in combi nation the Prussic acid derived from kernals. Rum is produced in the West Indies from the uncrystallizable liquor which remains after the manufacture of sugar; it has a very disagreeable and empyreumatic flavour, when new ; and requires age before it can be used. Whiskey is the favourite spirit of Ireland and Scotland; it is distilled from malt in Ireland ; but in Scotland, from oats, or oats and malt combined. Whiskey is also a favourite spirit in this country. The whiskey generally preferred is that which has no particular flavour. All the above spirits are highly stimulant, and when taken me- dicinally, either to relieve spasm in the stomach, to act as a car- minative, to increase the action of the heart and arteries, and to restore the energy of the nervous system, as is sometimes indi- cated in low fevers and other diseases, they may be resorted to with good and beneficial results : but the practice of drinking them daily, produce the most deplorable consequences. Besides the moral degradation which they cause, their habitual use gives rise to various formidable diseases. One of the primary effects is loss of appetite, and inability on the part of the stomach to di- gest the food which is received into it; the frame is so debilitated as a consequence of past excitement, and want of its natural sup- port, that it is again felt necessary to seek temporary relief from a repetition of the stimulus ; this being frequently repeated lays the foundation of biliary derangement, and ultimately destroys the structure of the liver. Debility, emaciation, and dropsy succeed, 149 and the constitution, once healthy and robust, and which might have endured for a long life, vigorous, by temperance, is broken down, and is only relieved by a lingering death. Many other ef- fects might be enumerated, such as that state or disease, known by the name of delirium tremens, in which the nervous system is so completely upset, that the martyr to it can only exist under a state of intoxication. The countenance becomes cadaverous, the mind loses its powers, and every muscle, (if mere fibre can be called muscle) is perpetually in a tremulous state, and the being becomes rather a subject of disgust than sympathy. Sponge. Burnt sponge, formerly much used in medicine, for the remo- val of wens, goitre, die; but the iodine (of which sponge contains a small portion) has now taken its place. (Vide Iodine.) Fine sponge is used for applying collyriums and for the encouragement of bleeding after leeches have been removed, dec Squill OR SEA ONION. Diuretic, expectorant, and emetic.—Dose of the fresh root, 5 to 15 grains ; of the powder, 1 to 3 grains three or 4 times a day. It is administered in asthma, dropsy, and water on the chest; but the preparations of medicine most used are the vinegar, the oxymel and syrup of squills. (Which see.) The fresh root is occasionally applied externally as a rubefacient. The common onion possesses similar properties, and therefore, is recommended as an article of diet for dropsical patients. Many cases of dropsy have been relieved by eating the onion ; they act strongly on the kidneys, and increase the flow of urine. Roasted or boiled onions are sometimes applied as poultices to foul ulcers. 150 Starch. Demulcent.—It enters into the composition of lozenges, and the mucilage prepared from it is sometimes prescribed for the re- lief of cough, either simply or combined with honey. The muci- lage is prepared as follows: take of starch 3 drachms, water 1 pint; rub the starch, gradually adding the water to it, then boil until it is converted into a mucilage. The mucilage of starch is also prescribed in dysentery and relaxation of the bowels. When taken as a beverage, its effect is to lubricate the internal coat of the in- testines and diminish the tenesmus, and irritation arising from ab- rasion, or injury of the mucous membrane. It is also administered as an enema for the same purpose, and is sometimes combined with opium. Starch, milk, and fresh suet, perfectly blended by boiling them together, was prescribed by Sir John Pringle as a soup for patients labouring under dysentery, when it was suspec- ted that the lining of the bowels was injured. Staves acre. Seldom used internally, it is prescribed in the form of ointment for the cure of itch; but is chiefly used to destroy vermin, for which reason it is vulgarly called " louse wort." In some coun- tries the seeds are used to intoxicate fish, in order that they may- be caught, and it is asserted that the fish thus taken have no poi- sonous properties. The chemical called Delphine is derived from this plant. Stramonium Is smoked in the same way as tobacco by asthmatic persons, for the purpose of loosening the phlegm, and removing the spasmo- dic affections they often experience ; but much caution is neces- sary in its use. It has been found equally as efficacious as bella- donna in dilating the pupil of the eye previous to the operation for cataract. 151 Sugar Is antiseptic and preserves animal substances from putrefaction ; for which reason it is sometimes applied to foul and putrid ulcers 5 it is for this purpose combined with crumbs of bread or charcoal as a poultice to the part affected. Sugar is also escharotic, and is used to proud flesh or fungous excrescences and indolent sores, such as chilblains, dec. It is also blown in the eye to remove specks upon the cornea. Brown sugar is considered more laxative than the refined, and is for this reason used by some persons whose bowels are liable to constipation. Treacle is the residuum of sugar, which cannot be crystallized ; it is esteemed aperient, and enters into many electuaries of this description ; it is very liable to fermentation. Sugar enters into all syrups, and is intended to render the medicine with which it is combined more palateable. Sugar of Lead. Astringent and Sedative, externally coolimg.—Dose from half a grain to a grain. It is a medicine which requires much caution in the administration, as it is liable to affect the bowels and induce paralysis it is sometimes however extremely useful in checking hemorrhage, especially from the lungs, and is given in the above dose, combined with about half a grain of opium twice or thrice a day. Doctor Fouquier of Paris speaks of if as a valuable medi- cine for repressing the profuse sweats which so greatly contribute to exhaust the consumptive patient. It has of late years been re- commended and used to counteract the effects of mercury, and it is said to check salivation. From 4 to 8 grains dissolved in half a pint of distilled water forms a cooling collyrium for inflamed eyes; About 2 scruples, or even a drachm, dissolved in a pint of water, is an excellent lotion for burns, scalds and inflammation, when the skin is not injured,—a precaution necessary to be attended to in all applications of lead. White lead or flake white, is some- 152 times used by nurses to dry up the excoriations, which infants (from too often careless nurses,) are liable to; it is a dangerous prac- tice, as it is sometimes absorbed, and instances are known in which it produced all the symtoms of cholic of the worst description. Sulphur flowers. Laxative and Diaphoretic.—Dose, half a drachm to 2 drachms. An electuary composed of an ounce of sulphur, half an ounce of cream of tartar and two ounces of honey or lenitive electuary, is an excellent cooling aperient medicine, for persons affected with piles; a tea spoonful of it may be taken once or twice a day, as occasion may require. For the external use of sulphur in cuta- neous diseases. (Vide sulphur ointment and sulphur bath.) Sul- phur acts upon the skin and increases insensible perspiration. It is taken internally for the cure of itch ; but persons thus using it should lay aside all metallic substances, as money, knives, watches, dec As they are liable to varnish by the vapour which passes from the skin.—See sulphur ointment. Sulphur Milk, or precipitated. This is sulphur in its purest form; and for internal use is gen- erally considered preferable to the flower; it has less taste and smell, and is not so gritty. Sulphur Roll, OR CANE BRIMSTONE. Sweet Scented Flag. OR CALAMUS AROMATICUS. Aromatic and Stomachic.—Dose in substance from a scruple to a drachm. An infusion made in the proportion of an ounce of the root to a pint of boiling water, is sometimes given in the dose of a wine glassful or more. It may be taken with advantage in pain or uneasiness of the stomach or bowels arising from flatulence, 153 and it also forms a useful adjuvant to tonic or purgative medicines in cases of torpor or debility of the alimentary canal. Syrup of Buckthorn. Cathartic.—Dose, 2 drachms to an ounce. It has fallen into disuse owing to its unpleasant taste and-griping effects. Syrup of Dandelion. This is a pleasant form for taking the Dandelion, but contains no useful quantity of the extractive, and is liable to fermentation. Syrup of Iceland Moss. Used for coughs. Dose, a table-spoonful whenever the cough is troublesome. It is not so demulcent a preparation as the jelly. (Vide Iceland Moss.) Syrup of Rhubarb, aromatized, OR SPICED SYRUP OF RHUBARB. " This is a warm stomachic laxative, well calculated for the bowel complaints of infants, which are so frequent in our eities in the summer season. The dose for an infant with diarrhea, is a fluid drachm repeated every two hours till the passages indicate by their colour that the medicine has operated.—U. S. Dispen- satory. Syrup of Saffron. Little used except as a means of distinguishing one medicine from another. Syrup of Sarsaparilla. (Vide Extract.) Dose, 1 to 4 drachms. 20 154 Syrup of Senna. This preparation being a compound of manna and senna, is an excellent laxative when it is required merely to act on the bow- els slightly. Dose, 1 to 2 tea-spoonsful. Syrup of Squills. Expectorant, diuretic.—Dose, 1 to 2 tea-spoonsful, 2 or 3 times a day, for relieving cough. Syrup of Balsam of Tolu. Dose, 1 to 2 tea-spoonsful. Used for coughs, dec Syrup of Violets, A very pretty medicine when genuine, and possessing the same properties as syrup of saffron. When violets are scarce, it is very often made with Prussian blue and orris root, to give the flavour to it. Tamarinds. Cooling, aperient.—Dose, half an ounce to an ounce and a half. Tamarind tea is made by pouring boiling water on the fruit, which makes an excellent drink in fevers. If the infusion be made very strong it may be used as a gargle in slight sore throats, or a few tamarinds may be dissolved in the mouth for the same purpose. Tansy. This herb is chiefly used as an anthelmintic. The seeds are said to be most effectual. The dose of the powder is from 30 grains to a drachm 3 or 4 times a day ; but by way of infusion it is more frequently administered. 155 Tapioca. Is an article of diet for invalids. To make the jelly, the tapio- ca should first be washed 2 or 3 times a day in cold water; it should then be left to soak in fresh water for 4 or 5 hours, and afterwards to simmer gently over the fire until the jelly becomes perfectly clear. It may be flavoured or sweetened as sago. Tar. For its effects, when applied externally, vide Ointment of Tar. The vapour of tar diffused through the chamber of the phthisical and asthmatic patient, was strongly recommended by Sir A. Crich- ton to facilitate the breathing, and to counteract the morbid se- cretion from the lungs. The simplest method of using it, is to stir a hot poker in common tar or pitch ; but the chance of fire must be guarded against. Tar water, which has been used with some advantage in eruptive diseases, consumption, and in affec- tions of the kidneys, is made by pouring boiling water upon com- mon tar. Tartar emetic. TARTARIZED ANTIMONY. Emetic.—Dose, 2 to 4 grains. As an alterative, expectorant, or a diaphoretic, from one eighth to half a grain ; externally ru- befacient. As an emetic upon ordinary occasions, ipecac is pre- ferable. (Vide that article.) But where it is desirable that no time should be lost in producing vomiting, (as for poisons,) a grain or two may be added to 25 or 30 grains of ipecacuanha. If a grain be rubbed up with a small quantity of sugar, and divi- ded into 6 or 8 parts, they form excellent powders in fever, in which case one may be taken every 3, 4, or 6 hours, observing 156 always to drink plentifully of cold water afterwards. One of the same powders may be taken 2 or 3 times a day, as an expectorant. For children, other medicines are more desirable. An emetic similar to the above, if given early, will oftentimes throw off a tendency to fever. Tartar emetic is used locally in the form of ointment, for the purpose of producing an eruption on the skin to relieve internal affections of the part. Thoroughwort. Tonic, diaphoretic, emetic, and aperient.—Thoroughwort is said to have proved successful in the cure of intermittent fever. Given in warm infusion, so as to produce vomiting or copious perspira- tion, in the commencement of catarrh, it will frequently arrest that complaint. It has also been employed in most cases in which the simple bitters were employed. " With a view to its tonic effect, it is best administered in substance or in cold infu- sion. The dose of the powder is 20 or 30 grains ; that of the infu- sion, a fluid ounce, frequently repeated when the diaphoretic ope- ration is required in addition to the tonic, the infusion should be administered warm, and the patient should remain covered in bed. As an emetic and cathartic, a strong decoction, prepared by boiling an ounce in three half pints of water to a pint, may be given in the dose of one or two gills or more. The infusion is prepared by pouring one pint of boiling water on an ounce of the dried herb, macerating for two hours in a covered vessel and straining. Teas, Black and Green. Both species are astringent, stimulant, and nervine.—On the continent they are used medicinally, where, from it not being the practice to drink tea as a common beverage, they are often advantageously administered for the relief of many nervous af- fections. Green tea is the most powerful in its effects, and acts 157 strongly on the nervous system, causing sleeplessness, head-ach, and even subsultus tendinum, or violent twitching of the muscles; but this, when it is taken to excess, or by persons of extreme ir- ritability of constitution. The infusion of tea, taken in modera- tion, tends to exhilarate, and will frequently relieve head-ach arising from fatigue, study, or anxiety ; it is the most refreshing beverage that can be taken during a journey, as it raises the ani- mal spirits, keeps up the insensible perspiration, and does not leave behind it any of those febrile symptoms which follow wine, beer, and similar drinks. Green tea is the only beverage for the nurse who has the care of a patient during the night. A strong infu- sion of green tea, of an ounce to a pint of water, is an excellent injection for the relief of fluor albus, and the same will be found a good collyrium for some affections of the eyes, and the inflam- mation and ulceration of the eye-lids, which many are liable to, as the effect of small pox, measles, dec. Green tea is recom- mended to counteract the effects of narcotic poisons ; but the stomach must previously be evacuated by the syringe or emetics. As coffee is used under the same circumstances as tea, and as its effects are somewhat similar, a few observations may as well be introduced under this head. It also acts powerfully upon the nervous system, and causes sleeplessness; it counteracts the ef- fects of narcotic poisons, and is for this purpose given plentifully in cases of poisoning by laudanum. It is taken by the Turks to remove the soporific effects of the opium which they are in the practice of chewing; and it is sometimes used as a vehiele for the administration of laudanum, when it is desirable to allay pain without inducing a disposition to sleep. A cup of strong coffee taken immediately after dinner, is supposed to quicken digestion and prevent that drowsiness which many persons are liable to after this meal. It is for this purpose that the French universally take it. Coffee, like tea, should be infused, (not boiled) by which all its aroma and other properties are retained ; and coffee, to bo 158 good, should be like Mr. Daniel Edwards', the first man who sold coffee in London, " black and boiling hot." Tincture of Assafoetida. Operation and use the same as assafoetida. Dose, 20 drops to a tea-spoonful in water or milk. Tincture of Balsam of Tolu. Expectorant, balsamic.—Dose, 30 drops to a tea-spoonful in mucilage of gum Arabic, honey, or boiling water, for relieving obstinate coughs, when inflammation is not present. Tincture of Bark, Simple. Tonic, stomachic.—Dose, a tea-spoonful to a table-spoonful in water or wine, for indigestion or loss of appetite. It is also used as an astringent for the gums, by adding a tea-spoonful to a wine- glassful of water. Tincture of Bark, Compound. or huxam's tincture. It has the same properties and dose as the simple tincture ; but being more agreeable, is generally used in preference, but of late years the sulphate of quinine has superseded both preparations. (Vide Quinine.) Tincture of Benzoin, Compound. or Turlington's balsam, Is used as a styptic for recent cuts or wounds, but it is decidedly a bad practice; adhesive plaster and slight pressure is the best mode of treatment. (Vide Plaster, Adhesive.) Tincture of Buchu Leaves. Lithontriptic, tonic, astringent.—Dose, a tea-spoonful to a table- spoonful. In affections of the bladder and kidneys, irritation in 159 the urinary passages, gleet, fluor albus, djc, a tea-spoonful of this preparation, with thirty drops of spirits of nitre, may be taken with advantage in a wine-glassful of water, three or four times a day. The tincture of buchu has also been used with decided benefit in gout and rheumatic affections of a chronic character to the extent of one or two tea-spoonsful twice or thrice a day in water or camphor jalap. In indigestion it has also been employ- ed with similar good effects. The Compound Extract of Buchu is however a much preferable article. Tincture Cardamom, Compound. Cordial.—Dose 1 to 3 tea-spoonsful in any of the aromatic waters. It is principally used for pains in the bowels, arising from flatulence, spasm, dec; and is sometimes combined with bitter infusions to give them a carminative effect. Tincture Cardamom, Simple. Dose and properties the same as above. Tincture of Castor. Antispasmodic, stimulant.—Dose, 30 drops to a tea-spoonful, in any of the aromatic waters. It is advantageously prescribed in hysterical affections, fits, spasmodic cases, dze Twenty drops with a scruple of calcined magnesia, a tea-spoonful of syrup of poppies, and an ounce of fennel water, is an excellent carminative for infants. Of this, a tea-spoonful is the dose, which may be taken three or four times a day, for the relief of griping pains, wind in the stomach, dec. Tincture of Catechu. Astringent.—Used for the same purposes as the tincture of kino, and similar doses. 160 Tincture of Cinnamon. This is a very warm aromatic tincture, useful in flatulence, spasm of the stomach, and gastric debility. The dose is one or two fluid drachms, or a tea-spoonful. Tincture of Columbo. Same properties as the tincture of bark. It is especially ap- plicable to the cases of drunkards. Dose, from one to four fluid drachms. Tincture of Cubebs. Stimulant, carminative.—Dose, from one to two fluid drachms. It has been highly extolled in diseases of the bladder, and the uri- nary passages. It is taken either in water or barley water, and may be repeated twice or thrice a day. The affections for which it is more generally used, are fluor albus, gleet, and other dis- charges from the parts whence these emanate. It is sometimes combined with the balsam of copaiva, (which see,) and sometimes with nitre, or soda; but the combination prepared by Geo. W. Car- penter, composed of sarsaparilla, cubebs, and copaiva, is certainly a most excellent mode of administering cubebs for the above dis- eases. Juncture of Foxglove, OR DIGITALIS. Diuretic, sedative.—Dose, 5 drops gradually increased to 30. As it diminishes the frequency of the pulse, and controls the cir- culation of the blood, it is advantageously usedf in hemorrhages ; but as the quantity of blood generally requires to be diminished previously to the use of it, it is a remedy only fit to be employed 161 by the direction of the practitioner. In consequence of its diu- retic properties, it is a valuable medicine in dropsy; but in this case, also, it cannot be safely administered by those who are ig- norant of its properties. Tincture of Gentian, Compound. Tonic, stomachic.—Dose, one drachm to half an ounce, in water or chamomile tea. It is chiefly had recourse to in debility of the stomach, loss of appetite, die The best time for taking bitters, is about 11 in the morning and 4 in the afternoon ; or as a gene- ral rule, an hour or two before or after a meal. Tincture of Guiacum, volatile. Stimulant, sudorific, antispasmodic, antirheumatic.—Dose, 1 to 2 drachms, twice or thrice a day in barley water, milk, mucilage, dec This medicine has been long approved in chronic rheuma- tism, and gouty affections; it has also been successfully used in paralysis. Tincture of Hops. Tonic and narcotic.—It has been proposed as a substitute for laudanum, when the latter disagrees with the patient; but little reliance can be placed upon it. The condition of disease to which it appears to be best adapted, is the wakefulness attended with tremors, and general nervous derangement to which habitual drunk- ards are liable. The dose is from one to three fluid drachms. Tincture of Jalap. Cathartic.—Dose, 1 to 4 drachms in peppermint water. It is more generally taken in conjunction with the infusion of senna and epsom salts. Tincture of Kino. Astringent.—Useful in dysentery and looseness of the bowels. 21 162 Dose, from a tea-spoonful to a table-spoonful, usually combined with the chalk mixture, (which see.) The powder of kino is given in doses of 1 or 2 drachms for the same affections when more than ordinary looseness prevails, and is frequently taken in port wine under these circumstances. Tincture of Myrrh. Tonic, astringent.—Seldom given internally.. "As a local ap- plication it is employed to stimulate indolent and foul ulcers, and promote the exfoliation of bones; and, diluted with water, is ap- plied to spongy gums, apthous sore mouth, and ulcerations of the throat. The dose, as a stimulant, expectorant, and emenagogue i3 from half a fluid drachm to a fluid drachm."—U. S. Dispensa- tory. Tincture of Opium. (Vide Laudanum.) Tincture of Rhubarb. Aperient, tonic, stomachic.—Dose, 2 drachms to an ounce in peppermint or cinnamon water. It is chiefly used for affections of the stomach and bowels to remove griping pains, and relieve flatulence and spasm. It is also taken by some persons as a tonic an hour before dinner, in the same manner as the root is taken to assist the digestion. Tincture of Rhubarb and Senna. called warner's gout cordial. It is a feeble purgative, usually very grateful to the stomach, and well adapted to costiveness with gastric uneasiness in persons of a gouty habit, and accustomed to the free use of wine and other stimulating drink. The dose is from half a fluid ounce to two fluid ounces. 163 Tincture of Senna, Simple. Cathartic.—Dose, 2 drachms to one ounce. It is used in the same way and for the same purpose as the following. Tincture of Senna, compound, or daffy's elixir. Cathartic, carminative.—Dose, a desert to two table spoonsfull in peppermint or cinnamon water. It is more generally used as an adjunct to castor oil, to render its operation more effectual, and to relieve griping sensations. Tincture of Virginia Snake Root. This tincture possesses the tonic and cordial properties of the root, and may be advantageously added to the infusion of Peruvian bark in low states of the system. The dose is one or two fluid drachms. Tincture of Muriate of Iron. Tonic, Antispasmodic, and Diuretic.—Dose, 10 to 30 drops in water. This medicine, if taken two or three times a day for a week or two, is often serviceable in debility of the constitution, languid circulation, and indigestion. It is sometimes combined for these purposes with the infusion of quassia, or columbo, or the aromatic waters. Should headach be produced by its use it should be discontinued and a purgative taken. In retention of urine, arising from spasm of the parts, 10 or 15 drops repeated every half hour, gives relief. It is also prescribed with decided advantage in case of hemorrhage from the kidneys, bladder, and the parts con- tiguous, after sufficient depletion. It is particularly recommended as a tonic in scrofula, in which it is often given, combined with the solution of muriate of lime or muriate of baryta. And it has been successfully used in tic doloreux. 164 Juncture of Acetate of Iron. Tonic, used chiefly in general debility of the constitution, and is particularly serviceable in relieving the irregularity to which fe- males of delicate habits are liable. Dose 10 to 40 drops twice or thrice a day, in pennyrowal water. It is sometimes combined with vegetable tonics, such as the infusion of quassia, orange peel, dec, and thus administered to restore the stomach, which has been weakened by long illness, to its proper condition. Tincture of Valerian. The tinctnrfi possesses the properties of the valerian (which see) —hut cannot be given in ordinary cases, so as to produce the full effect of the root, being too stimulating. Tincture of Valerian Ammoniated. This tincture is employed as an antispasmodic in hysteria and other nervous affections. The dose is one or two fluid drachms, and should be given in sweetened water, milk, or some mucila- ginous fluid. Tobacco, Indian. This plant has been strongly recommended for affections of the chest, especially those of a spasmodic nature, it is therefore more particularly serviceable in asthma. The tincture is most frequently administered for the above purposes, which is given in doses of 30 or 40 drops every 3 or 4 hours till its effects are experienced. Tobacco, Virginian. From the leaves of this plant the various kinds of tobacco and snuff, so generally in use, are prepared. The medicinal properties of tobacco are powerfully sedative. The tincture of tobacco haa been, successfully used in dropsy, and also, in violent attacks of lock jaw and tic doloreux ; and several cases are reported in 165 which it was successful in relieving difficulty of passing the uri. nary secretion, which arose from gravel, calculi, dec. The infu- sion of tobacco has also been administered with success in ex- treme cases of strangulated hernia, obstinate colic, and retention1 of urine from spasm of the urethra, but the practice is attended with hazard, and is better avoided until all other means shall have failed. Serious consequences, fainting fits, convulsions, and death have followed the use of tobacco; the smoke of tobacco has been used, with success, in cases of spasm about the upper part of the windpipe, and also in spasmodic croup and asthma. Dr. Chap- man recommends the vapour to be produced by smoking a cigar, and advises that the patient should frequently draw in the breath freely, so that the internal surface of the air vessels may be ex- posed to the action of the vapour. " The relaxation produced by smoking in a person unaccustomed to it, has been very happily resorted to by Dr. Physick, in a case of obstinate and long con- tinued dislocation of the jaws." Smoking is considered in Holland to prevent contagion, and to be serviceable in a humid climate in counteracting ague. The occasional use of a cigar has been found serviceable to relieve sore throat; and with persons who are liable to attacks of that annoying complaint to prevent it, es- pecially when they are exposed to night air. The infusion of tobacco is applied to some eruptive diseases ; but the practice is hazardous, and if we may draw conclusion from the effect of it upon sheep, who are sometimes washed with a similar preparation, it produces great emaciation, and not unfrequently destroys life. " The infusion of tobacco for enemata is prepared by macerating a drachm of tobacco in a pint of boiling water for an hour in a covered vessel and straining; only one half of the pint should be employed at once, and if this should not, in half an hour, produce relaxation, the remainder may be injected." The ointment or liniment of tobacco is useful in irritable ulcers 166 and various cutaneous eruptions, but great care must be taken* especially in infants, not to employ it in such quantities as to en- danger the production of the constitutional effects of tobacco. The ointment is prepared as follows: " Take of fresh tobacco, cut in pieces, an ounce, lard a pound; boil the tobacco in the lard over a gentle fire, until it becomes friable ; then strain through linen." The following remarks upon the habitual habit of smoking and chewing tobacco were addressed by a professor of medicine to his pupils. " When tobacco is taken into the mouth for the first time, it creates nausea and extreme disgust. If swallowed, it excites vio- lent convulsions of the stomach and of the bowels, to eject the poison either upward or downward. If it be not very speedily and entirely ejected, it produces great anxiety, vertigo, faintness, and prostration of all the senses, and in some instances death has fol- lowed. The essential oil of this plant is one of the strongest vege- table poisons : in so much that no known animal can resist its mortal effects. •' The first effect of tobacco on those who have surmounted the natural abhorrence of it, and who have not only learned to endure it, but even to enjoy it, and who have already commenced the custom of chewing or smoking, is either a waste or vitiation of the saliva. " The saliva or spittle is secreted by a complete glandular ap- paratus from the most refined arterial blood, and constantly distils into the mouth in health, and from the mouth into the stomach, at the rate of twelve ounces a day. It very much resembles the gas- tric juice in the stomach ; and its importance in digestion may be imagined after listening to the words of the great Boerhaave. Whenever the saliva is lavishly spit away we remove one of the strongest causes of hunger and digestion. The chyle prepared without this fluid is depraved, and the blood is vitiated from want of it. I once tried,' says this great philosopher and consummate 167 physician, ' an experiment on myself, by spitting out all my saliva; the consequence was, that I lost my appetite.' Hence we see the pernicious effects of smoking and chewing tobacco. " To lean and hypochondriacal persons the smoking of tobacco is very pernicious; it destroys their appetite and weakens their digestion." The celebrated Cullen says, that a constant chewing of tobacco destroys the appetite by depriving the constitution of too much saliva. " Some do not eject the saliva; but prefer swallowing the un- wholesome mixture, which seldom fails to induce faintness, palpi- tations of the heart, trembling of the limbs, and sooner or later, some serious chronical inconvenience. "Asa sedentary man advances in life, he perspires less, while his lungs labour more. There is an accumulation of viscid phlegm among the inert and almost insensible solids of the lung3 in elderly people, which, in cold weather, produces a kind of chronic catarrh, or humoral asthma, for which smoking is benefi- cial. Here tobacco is a safe and efficacious pectoral. There is, however, a doleful difference between a man of 65 taking three or four pipes of tobacco in twenty-four hours, and a boy of seven- teen, who smokes ten or a dozen cigars in that time. In one, the cold and inert fibre is warmed and animated, to throw off an of- fensive load ; in the other, it is adding fuel to fire, and irritating glands already sufficiently stimulated by his youthful nature." " The fashion of smoking tobacco was introduced into England by Sir Walter Raleigh, in the reign of James the 1st. The cus- tom was followed by almost all the nobility, and high officers of the realm, to the great dissatisfaction of the fastidious monarch. So universally prevalent was this fashion that His Majesty could not readily find any one to write or preach against it. He there- fore wrote a tract himself, which he entitled ' A Counterblast to Tobacco? a copy of which may be seen in the New-England University. After exposing in strong language the unhealthiness 168 and offensiveness of this practice, he closes with this royal coun- terblast:—'It is a custom loathesome to the eye, hateful to the nose, harmful to the brain, dangerous to the lungs; and in the black stinking fume thereof, nearest resembling the horrible Sty- gian smoke of the pit that is bottomless I'" Snuff is sometimes used with benefit in affections of the head and eyes; but it is doubtless taken frequently by many who have no real necessity for using it. Tonquin Beans. A perfume. Tooth-ach Tree, or angelica tree, or prickly ash. This is an indigenous arborescent shrub, variously called as above. It is found chiefly in the southern and western states, though cultivated in the gardens of the north as an ornamental plant. It flourishes in low fertile woods, and flowers in August and September. The bark, root, and leaves are medicinal; but the first only is directed by the Pharmacopoeia. Its virtues are those of a stimulant diaphoretic. According to Elliott, an infu- sion of the recent bark of the root is emetic and cathartic. The remedy is used in chronic rheumatism and cutaneous eruptions. Parsle states that a various or spirituous infusion of the berries is remarkable for relieving rheumatic pains ; and a similar tincture is said to be employed in Virginia with advantage in violent cholic The pungency of this tincture has also been found use- ful in relieving tooth-ach. The bark is most conveniently ad- ministered in decoction.—U. S. Dispensatory. Trailing Arbutus, OB bear bebry. The powder of this plant is administered in calculous affections, 169 gravel, and diseases of the kidney, to the extent of from a scruple to a drachm. The decoction of the leaves is also used as a tonic in diseases of the bladder and urinary passages; it is most ser- viceable in cases of irritability of the bladder, or incontinence of urine. Turmeric powder Enters into most forms for making curry-powder; but is chiefly used for its colour. Turner's cerate. A cooling and healing ointment applied to recent ulcers, broken chilblains, burns, and scalds. Turpentine, ----- Chian, ----- Venice, ----- common, ----- Canada balsam. The turpentines resemble each other in odour and taste, though distinguished by shades of difference. The effects of the turpen- tines upon the system are dependent entirely on their essential oil. They are stimulant, diuretic, anthelmintic, and in large doses laxative; externally applied, they act as rubefacients. At present they are less used than formerly, having been superseded by their volatile oil. They are, however, occasionally prescribed in leucorrhea, gleet, and other chronic diseases of the urinary passages ; in piles and chronic inflammations or ulcerations of the bowels; in chronic catarrhal affections, and in various forms of rheumatism, especially sciatica and lumbago. The white turpen- tine is usually employed in this country. They may be given in 22 170 the shape of pill made with powdered liquorice root, or in emul- sion with gum arabic or yolk of egg, loaf sugar and water, or in electuary formed with sugar or honey. Their dose is from a scru- ple to a drachm. In the quantity of half an ounce or an ounce, triturated with the yolk of an egg, and mixed with half a pint of mucilaginous liquid, they form an excellent injection in cases of ascarides, and of constipation attended with flatulence.—U. S. Dispensatory. Tutty powder. Absorbent and astringent.—Used in ointments for inflammatory affections of the eye-lids, and to excoriations. It is also applied in powder for the latter purposes; but the Calamine powder is a better application, especially for the chafings and injuries of the skin to which infants are subject from having allowed to remain long without a due change of linen. One part of calamine pow- der, and one of arrow root, mixed well together, is also used for the same purpose. Valerian root. Valerian tea, which is made by pouring a pint of boiling water upon half an ounce of the root, is much used in hysterical affec- tions. The dose is a large wine-glassful twice or thrice a day, to which may be added about 30 drops of the ammoniated tincture of valerian. Vermillion. A pigment used in the arts. Vinegar, common. Antiseptic, diaphoretic, externally refrigerant.—Half an ounce of vinegar, added to a pint of water and sweetened with honey, 171 forms a refreshing and agreeable drink in fever, and tends to in- duce perspiration. The same is advantageously used as an anti- dote to narcotic poisons, after the stomach has been evacuated by the syringe, or by emetics. Vinegar is a good immediate appli- cation for bruises; and for this purpose may be used undiluted. Vinegar is frequently sprinkled about the chambers of the sick to remove offensive smells ; it at the same time refreshes the patient. It is also applied to the nostrils and temples during fainting fits, and for the relief of head-ache. Sponging the body with vinegar once or twice a day, has been strongly recommended in hectic fever, to check the profuse night perspiration which attends that wasting disease. The acetic fumigation used in infectious cham- bers, is made by stirring a hot poker in strong vinegar; little re- liance, however, can be placed upon it in preventing contagion ; but it is both agreeable to the patient and attendant. One pint of vinegar and two of water, is sometimes administered as an enema for internal hemorrhage, fever, dec A wine-glassful of vinegar, the same of port wine, added to a pint of water, is a gar- gle frequently used for recent sore throats. As a condiment, vinegar is most grateful; even the smell of it has been known to create appetite ;—but it should be cautiously used, and always combined with a due proportion of oil, or some other lubricant, as it is supposed to interfere with the process of digestions when the asperity of it is not modified. It is a practice with some fe- males, who wish to avoid growing embonpoint, to drink vinegar,— it has the effect, but the effect is a state of disease,—enlarge- ment of the glands, tubercles in the lungs, atrophy, and consump- tion are the consequence of such an endeavour. This is growing thin with a self vengeance. The vapour of vinegar is frequently in- haled for the relief of inflammation of the throat, tonsils, dec. (Vide Acid, pyroligneous.) Vinegar, distilled. Similar in properties to the foregoing. The use of it is chiefly 172 confined to the laboratory ; the various medicated vinegars are prepared from it. Warner's gout cordial. See Tincture of Rhubarb and Senna. Water dock root. The medical properties of this root are astringent and mildly tonic It is said to have an alterative property, which renders it useful in scorbutic diseases and cutaneous eruptions, particularly the itch, in the cure of which it enjoyed at one time considerable reputation. It is said to have proved useful also in syphilis. Dock root is given in powder or decoction. Two ounces of the fresh root bruised, or one ounce of the dried, may be boiled in a pint of water, of which two fluid ounces may be given at a dose, and re- peated as the stomach will bear it. The root has often been ap- plied externally in the shape of ointment, cataplasm, and decoc- tion, to the various cutaneous eruptions and ulcerations for which its internal use is recommended. The powdered root is recom- mended as a dentifrice, especially when the gums are spongy. Water of Ammonia. Antacid, stimulant, and rubefacient.—Dose, 10 to 20 drops, well diluted with water. It is used internally for the same pur- pose as the spirits of hartshorn, as it counteracts acidity. It is ad- ministered with advantage for the relief of heaitburn ; it is also prescribed for fainting fits, hysterical affections, dec. Dr. Gerard, of Lyons, states that if it be given in doses of 7 or 8 drops it in- stantly removes the state of drunkenness. It is more generally ordered for external purposes. Mixed with almond or olive, it forms a saponaceous liniment, which is much used for inflammatory sore throat, paralytic affections, dec It is applied as a local stim- ulant to the nostrils in syncope ; and when an instantaneous blis- 173 ter is required, if a small quantity of the solution be put in lint, and applied to any part of the body, vesication will generally follow. Water, Aniseed. Carminative.—Dose, 1 to 4 ounces. Water, Cinnamon. Stomachic.—Dose, 1 to 4 ounces. Water, Dill. Carminative.—Dose 1 to 4 ounces. Water, Distilled. As water, in its natural state, invariably holds in solution more or less of saline or earthy matter, which constitute the various degrees of hardness, as it is termed, it has been found necessary to distil it, and thereby free it from those matters, for the purposes of pharmacy. In forming lotions, which contain any of the che- mical salts, such as sulphate of zinc, sugar of lead, lunar caustic, dee, it is highly essential that the water in which they are to be dissolved should be distilled, or decomposition must take place. A familiar instance may be seen in washing the hands with soap in hard water; in which case the soap is rendered insoluble, and floats on the surface, instead of combining with the water ; this arises from the quantity of earthy ingredients it contains. In making tea, beer, dec, the strength of the infusion will greatly depend on the hardness or softness of the water. Where distilled water cannot be procured for medical purposes, cold boiled water may be used as a substitute. Water, Lime, Antacid, tonic, astringent.—Dose, a wine-glassful. Exter- nally it is used as a detergent. One part of linseed oil, and two of 174 lime water, mixed well together, form an excellent cooling appli- cation for burns or scalds when the skin is broken. Lime water is taken to counteract the effect of acids and acid poisons; and in cases of indigestion, accompanied with acidity and heartburn, a wine-glassful of the following infusion, taken once or twice a day, has often proved very beneficial:—Take of rhubarb, sliced, one drachm, lime water, half a pint; let them stand together in a close- ly covered vessel for 24 hours, observing to shake them from time to time, and,g{rain for use. Sarsaparilla is also frequently taken in lime water to correct acidity. Water, Minh=or Spearmint. Carminative.—Dose, 1 to 4 ounces. Water, Peppermint. Carminative.—Dose, 1 to 4 ounces. Water, Pennyroyal. Stimulant.—Dose, 1 to 4 ounces. Water, Rose, Cooling.—Chiefly used in lotions for the eyes, and as a perfume. Note.—The essences of aniseed, dUlseed,- cinnamon, ienhel, peppermint, and pennyroyal, for making the water instantaneously, may be had of Geo. W. Carpenter, and as a general rule 15 or 20 drops of the essences will be found sufficient for making two ounces, or a large wine-glassful of any of the waters. Wax, White. Is used internally in dysentery, when abrasion or injury of the lining membrane of the intestines is suspected. But the prepa- tion made with suet, under the head of Starch, is preferable. Wax, Yellow. Useld in plasters, ointments, dec. 175 Wheat Flour Consists, chemically, of two ingredients, viz, starch and gluten ; to the former we have alluded under the article starch. Gluten is that part of flour which gives to it the necessary tenacity to be formed into a mass with water, yeast, dec, and renders it subject to the fermentation requisite for making bread. The quality of flour depends upon the quantity of gluten it contains ; bad flour is deficient in gluten. Bread varies according to the different pro- cesses adopted in the manufacture of it. English bread is solid and tenacious ; french bread light and full of cells. This differ- ence arising chiefly from the modes of fermenting them. Brown bread is made of flour which has not been freed from the bran, and is esteemed more laxative than homebaked bread; but the bread prepared from wheaten flour is still more aperient, and is preferred in many parts of England as well for this property as being sweeter and keeping longer without becoming dry or hard. It would be waste of time to comment on bread as an article of diet, the use of it in this way being universally known ; there are however various ways in which bread and flour are employed as diet for invalids, and medicinally, to which I shall confine myself. For making Toast Water.—Cut a crust of bread off a stale loaf, about twice the thickness that bread is usually cut for making toast; let it be carefully toasted until completely browned all over, (but care must be taken that it is not blackened or burnt,) put it into a pitcher, and pour as much boiling water on it as may be required ; cover it, and let it stand till cold; it is then fit for use ; it may be flavoured with skins of lemon, orange, or apple. This is a refreshing drink during the summer, or for invalids under fever or inflammatory affections. Panada is made by boiling crumbs of bread in water for a few minutes; it is thus reduced to a pulp in a basin, and as much 176 water or milk added to it as will render it of a proper consistence; it may be sweetened to the taste; and sometimes a small piece of fresh butter is added to it. This may be used as a variety by the invalid, when it is necessary to make the changes in diet. Biscuit powder is much used in London for the food of infants; it is made into a kind of panada similar to the foregoing article, but is more gelatinous in its appearance. Rusks, and what are called tops and bottoms, which are twice baked bread, are also very gen- erally ordered in London for invalids, it being considered that they are digested better than ordinary bread. Bread and water and bread and milk are frequently used as poultices for the pur- poses of softening the skin, reducing inflammation, assisting sup- puration, and cleansing wounds; and with good effect. Flour is sometimes used to check hemorrhage from bleeding surfaces, in which case it is sprinkled over the part affected, and allowed to remain on, until all chance of recurrence is past. Wheaten flour has also been used to the vesicated and denuded surfaces of burns and scalds; it affords instant relief by excluding the atmosphere. ltds best applied by the common dredging box, and should be re- peated as often as the discharge may have moistened the preced- ing layer of flour. In the cases in which it has been tried, no after dressing was used, but it was allowed to remain on until the cure was effected. M. Taddei recommends wheaten flour, or gluten, to be given in cases of poisoning from corrosive sublimate, which salt they reduce to the state of calomel; he ascertained that considerable quantities of a mixture of flour or gluten with cor- rosive sublimate, may be taken by animals without any injury. In order to render a grain of the salt innocuous, 25 grains of fresh gluten, or 13 of dry gluten, or from 500 to 600 grains of flour are necessary. Corrosive sublimate is used to render paste capable of being kept for a long time; but the essential oils of lavender, rosemary, die answer the purpose better. 177 White Vitriol. Emetic.—Dose, 10 to 30 grains. Externally astringent. This article is used as an emetic in cases of poison, it being found to act more speedily on the stomach than any other medicine. To assist the operation, the patient should be made to drink plenti- fully of warm liquids. About 2 or 3 grains dissolved in two ounces of water, form an excellent cooling lotion for inflammation of the eyes, arising from slight colds. An injection made with 1 or 2 grains to an ounce of cold boiled water, is used for the re- lief of acrid discharges from the urinary passages, dec. Wild Cherry Bark. " This bark is amongst the most valuable of our indigenous remedies; uniting with a tonic power, the property of calming irritation and diminishing nervous excitability, it is admirably adapted to the treatment of diseases in which a debilitated condi- tion of the stomach, or of the system at large, is united with general or local irritation ; when largely taken it is said to dimin- ish the action of the heart, an effect which has been ascribed to the hydrocyanic acid supposed to be contained in it. Doctor Eberle states that copious draughts of the cold infusion taken several times a day, and continued for nearly two weeks, had the effect of reducing his pulse from seventy-five to fifty strokes in the minute. The remedy is highly useful in the hectic fever of scro- fula and consumption, in the treatment of which it has long been a favourite with many American practitioners. In the general debi- lity which often succeeds inflammatory diseases, it has also been found advantageous, and is well adapted to many cases of dyspep- sia. It has been used successfully in intermittent fever; but in this complaint is much inferior to bark. It may be used in powder or infusion. The dose of the pow- 23 178 der is from 30 grains to a drachm. The infusion is prepared by macerating half an ounce of the bark, bruised in a pint of cold water for twelve hours and straining. Dose 2 or 3 fluid ounces three or four times a day, or more frequently where a strong im- pression is required.— U. S. Dispensatory. Wild Cucumber. The preparation called Elaterium is procured from the fruit of this plant. It is a drastic purgative and hydragogue, causing co- pious liquid motions, when given in doses from half a grain to 2 grains. It is more especially prescribed in dropsical affections; but it should be given with caution and not frequently repeated, as it is liable to produce violent diarrhoea, followed by excessive debility. Willow. The bark of the Willow is tonic and astringent, and has been employed as a substitute for Peruvian Bark in intermittent fever. Like many other articles in the Materia Medica, it has risen and fallen at various times in the estimation of the profession. Some have asserted that it is equal to the Peruvian bark in its medicinal properties; others again have tried it, and declared it almost im- potent. These discrepancies of opinion may have depended upon one using it at a proper degree of maturity and in a comparatively fresh state ; whilst another may have tried it under more unfa- vourable circumstances, or perhaps not at all. " There seems, how- ever, to be no room to doubt, from the testimony of numerous practitioners in France, Italy and Germany, that this principal has the property of arresting intermittents; though the ascription to it of equal efficacy with the sulphate of quinine was certainly premature.'' It may be employed in substance or decoction ; but the usual mode of using is the form of decoction of an ounce to a pint of water, of which a wine glass may be taken for the dose. 179 A new alkali has lately been derived from this bark, called sali- cine, and according to the report given of it by Dr. Elliotson, it possesses the same properties as Quinine. It has been tried by him in remittent and intermittent fever, in the same doses as the sulphate of Quinine, and with the same beneficial results. "The decoction of willow has been found beneficial as an external ap- plication to foul and indolent ulcers." Wine. Previously to entering upon the subject of medicated wines, it will not be uninteresting to the reader, nor irrelevant to the pur- pose of this compilation, to give a brief outline of the medical opinion entertained of certain wines in common use, and the ap- plicability of them to the constitution under disease. Wine is used as an exhilarant and tonic, for the purpose of stimulating the stomach, invigorating the circulation, and supporting the system. All wines contain alcohol; and it is to the quantity of this spirit contained in them, that the difference in strength of different wines is attributable. Wines also hold in combination an acid, which in wines manufactured from the grape, is the tartaric acid; but most of the home-made wines contain the malic acid, such as is found in cider. According to the best experiments, port, sherry, and madeira wines yield from a fifth to a fourth part of their measure of pure alcohol; thus the man who drinks his bottle of either of these wines every day, drinks half a pint of pure alcohol; the effect, however, of the spirit as it exists in wine, is very different from spirit when mixed with water: in the latter case it is merely diffused, and acts more directly on the brain and nervous system; whilst in the former it is a natural combination, and guarded by the extractive matter and an acid, which, as is the fact with other narcotics, may act to a certain degree as an ante- dote to it. The wines preferred for invalids, are Port, Sherry, 180 Madeira, CJaret, Burgundy, Hermitage, and those from the Rhine, such as Hock, Mosella, die Port is more generally advised as a tonic and astringent, and is applicable to debility of the constitution generally; and to assist the effects of it, bark, the sulphate of quinine, or the solution of quinine are frequently combined with it. It is also given in the sinking stages of typhus fever, and when mortification is suspected. Madeira and sherry are recom- mended as cordials and exhilarants in those affections where the stomach and digestive organs are more immediately concerned. Claret, Burgundy, Hock, Moselle, dec, from containing less spirit, and being more acidulous, are better applicable than either of the above, to convalescents after hemorrhagic diseases, inflammatory and acute febrile affections. Wine, Aleetic. Purgative, Stomachic.—Dose from one to two table-spoonsful. Wine, Antimonial. Emetic.—" The advantages of antimonial wine are that it affords the means of administering minute doses of tartar emetic, and is more permanent than an aqueous solution of that salt, which is liable to spontaneous decomposition. It is usually administered in small doses as a diaphoretic or expectorant, or as an emetic in infantile^cases. Where a considerable quantity of tartar emetic is requisite, it should always be given in extemporaneous aqueous solution. The dose of the wine, as an expectorant or diaphoretic, is from 10 to 30 drops, given frequently ; as an emetic for infants from 30 drops to a fluid drachm, repeated every 15 minutes till it operates."—U. S. Dispensatory. Wine, Colchicum. From the Root.—Anti-rheumatic and used for the relief of gout. Dose for urgent attacks, 20 drops to a drachm in some aromatic 181 water, three or four times a day, or more frequently in severe cases, until its effects are experienced. It is frequently prescribed in combination with calcined magnesia, when acidity in the stomach is suspected ; and in neuralgic cases it has been found advanta- geous to combine it with the solution of sulphate of morphia, especially when the object in view was to give it a direction rather to the skin than to the bowels." Wine, Colchicum. From the Seeds.—Same properties and dose as the foregoing, and administered under similar circumstances. Wine of Ipecacuanha. Emetic.—Dose half an ounce to an ounce. Diuretic and febri- fuge, dose 10 to 30 drops. This is an excellent emetic for infants and young children, as its operation is milder than ipecac in sub- stance, or than the antimonial wine; a small tea-spoonful may be given every 10 or 15 minutes until vomiting is produced. Wine of Opium. called Sydenham's laudanum. Anodine narcotic.—Dose 10 to 30 drops. Wine of Rhubarb. Dose, half an ounce to an ounce and a half. It is used as a laxative and corroborative; but possesses no advantage over the tincture. Wine, Steel. Dose, one to two drachms in any of the aromatic waters, and applicable in similar cases for which the acetated tincture of steel is recommended. 1N-2 Yeast Is esteemed antiseptic and tonic, and is prescribed in doses of a table-spoonful three or four times a day in putrid or malignant fevers. Fermented sweet wort, which is the wort of beer before it is hopped, is also given for the same purposes, and the patient may be allowed to drink it frequently in the course of the day. The yeast poultice is applied to gangrenous wounds, and may be prepared as follows: take one pound of flour, half a pint of yeast, and a table-spoonful of treacle, mix them well together, and ex- pose the mass to a gentle heat, until it rise or swell up; it will then be fit for applying. Zinc. White Vitriol—(which see,) is a salt of zinc. The oxide or flowers of zinc are tonic and antispasmodic, and are prescribed in doses of from 2 to 8 grains several times a day for the cure of epilepsy, hooping cough, St. Vitus's dance, hysterical affections, dee, they are also applied to excoriated surfaces. The zinc oint- ment, prepared from the flowers, is cooling and astringent, and is frequently ordered for sore eyes, and eruptions upon the skin ; it is also agood application for the aberations and excoriations which infants are liable to upon the thighs and behind the ears. The metal of zinc defends steel from rust; small pieces of it are for this purpose kept in cases of surgical instruments, which prevent them from being injured or affected by the atmosphere even in the most humid state. FOR Fumigating Infected Chambers. Chlorine Fumigation. Vide article under head of chloride of lime.* Nitric Fumigation. Pour one ounce of sulphuric acid, or oil of vitriol, into a pipkin or saucer; let it be placed in another vessel containing heated sand ; a small quantity of nitre or salt petre should then, from time to time, be put into the acid; and the gas required will be imme- diately disengaged, one or two of these fumigators may be placed in the room, and one or two on the outside of the apartment. Muriatic Fumigation. On one pound of common salt, put into a deep dish, pour from time to time a small quantity of oil of vitriol, which will produce the gas required. This kind of fumigation is much used for puri- fying infected apartments, and linen which has been wore by per- sons under contagious diseases. Acetic Fumigation. (Vide Vinegar.) * The following judicious remarks are quoted from a paper written by Dr. Ure, on disin- fection, and published in the fourth number of the Journal ol'the Royal Institution of Great Britain. "If chlorine be made to exhale from capsules, placed on the floor of a still apartment, 184 Bituminous Fumigation. Vide article under the head of " Tar." THE BEST MEANS OF OBVIATING THE EFFECTS OF POISONS. The following are plain and concise directions for removing or counteracting the effects of mineral, animal, or vegetable poisons. As the first object, when a poison has been taken, is to endea- vour to remove it from the stomach as soon as possible, no time should be lost in using the stomach pump. In case a pump cannot be procured, the stomach should, without delay, be excited by emetics to throw off its contents, which will containing beds and other furniture, the gas will be arrested in its diffusive ascent, and will never reach, in adequate force, the upper walls or ceiling to which the hot effluvia of conta- gious pyrexia (as typhus, scarlatina, small pox, &c.,) naturally rise. Should the walls of the apartment have been recently washed with milk of lime, the gas will be condensed on them; but if washed with whiteing, no absorbtion will ensue ; for chlorine does not displace carbonic acid from lime ; nor does it combine with the calcareous carbonate, " We are thus clearly led to the conclusion, that chlorine gas, when used as a disinfecter, should be considerably diluted with air before it is distributed into apartments, in such a de- gree and manner as neither to injure furniture nor merchandize, nor materially to annoy respiration. We must throw out of view those constitutions, indeed, which are so delicate or fastidious as to be intolerant of even the smell of chlorine. The said aerial mixture should be introduced into the middle br upper regions in preference to the lower ; and its diffusion should be promoted by propulsion : moist litmus paper, suspended in various parts of the chamber, will serve to show when the chlorine has done its duty. " An apartment may be conveniently disinfected by placing on a shelf or support near the ceiling a small basin or pipkin containing the chloride of lime, having set over it a glass or earthen ware funnel, with muriatic acid, diluted with about its weight of water ; the beak of the funnel being partially closed with a cork, so that the acid may drop slowly down on the chloride. Eight ounces of good chloride thus treated, with ten ounces of muriatic acid, will suffice to fumigate and sweeten the air of a common sized chamber." 185 be produced by the means explained under the heads " Ipecacu- anha, Tartar Emetic, Mustard, ivhite and blue Vitriol," assisted by warm water, and by passing the finger or a feather down the throat, until the irritation shall excite vomiting. laudanum, Opium, Morphine, »fcc.-After the stomach has been evacuated by either of the means referred to above, the pa- tient should be made to drink a cup full of strong coffee, (which may be made by infusing half a pound of coffee in a quart of boil- ing water for ten minutes,) and which should be frequently re- peated, until the patient be out of danger; he should not be allow- ed to sleep, but, as much as possible, be kept in motion; the legs and arms should be rubbed with a flesh brush or a piece of course flannel. Cold water should be applied to the head, while the body is immersed in a warm bath; or where a warm bath cannot be had, putting the feet in warm water will prove useful. For all other vegetable poisons, the best general directions that can be offered is, to take an emetic, and as soon as possible to relieve the stomach of its contents; and when the symptoms of alarm are at an end, to give some mild purgative, such as castor oil, dec. Oxalic and other Acids.—Calcined magnesia is found to be the best antidote to acids, and should be given without delay. Two ounces of calcined magnesia, to which a drachm or two of ipecacuanha may be added, if at hand, should be mixed with a quart of water, of which a cupful should be given every two or three minutes. To prevent the acid from acting on the stomach, mucilage of starch, or gum arabic, should be administered from time to time. When magnesia cannot be procured, a cupful of strong solution of white soap may be given every five minutes, or a mixture of chalk and water, which is consiJered by some physicians as pre- ferable to magnesia. Lime Water may also be given as a substitute for the mag- nesia. Lime water may be made on an emergency by boiling a 24 186 quarter of an ounce of quick lime in two quarts of water for five or six minutes,- it should then be strained. AB*§£MBC.—Orfila recommends that the patient should be made to drink plentifully of sugar and water, warm or cold water, lime water and sugar, chalk and water, or the decoction of linseed and marsh mallows; so that by filling the stomach, vomiting will be the consequence. It may, however, be well to combine a dose of Ipecacuanha with the first draught, and to irritate the throat by means of the finger or a feather. As the decoction of marsh- mallows, &c is not to be had instantly, the starch mucilage will be an excellant substitute. Corrosive SlihSliiaatc.—The whites of 10 or 12 eggs should be beaten up with a small quantity of water, and given as soon as possible. This has been found to combine so completely with the poison as to render it perfectly inert., Wheaten flour is also advised for the same purpose. Milk or flaxseed tea drank in large quantities will be useful. White Iiead*—Epsom or glauber salt dissolved in water, or where they are not to be had immediately, very hard water is found to be the best means of obviating the effects of this poison. The patient should be made to drink a wine-glassfull every five minutes, until either the stomach or bowels are acted upon. The sugar of lead is sometimes fraudulently mixed with white wines, which have acquired an acid taste, in order to give them a sweet- ness of flavour, which, from fermentation they have lost. That left in wine bottles are more or less dissolved by the acid of the wine, and produce all the symptoms of the sugar of lead : in either case the same treatment will be required as for white lead. Salt Petre or Nitre.—May be treated in the same way as arsenic Water would be improper for this poison. Copper is seldom taken internally for the destruction of life; but it is sometimes conveyed into the stomach accidentally, through inattention to cleanliness in copper culinary utensils, 187 which are acted upon by grease, acids, &e When it is suspected, whites of eggs, as ordered for corrosive sublimate, but mixed with sugar, should be given. Vomiting should be excited and the bowels freed by a purgative. Poisonous Mushrooms.—The symptoms which follow eat- ing poisonous mushrooms, are nausea, heat and pain in the stomach and bowels, which are followed by purging and vomiting; exces- sive thirst, convulsions, and syncope then succeeds, the pulse be- comes small and frequent, and delirium, and even stupor follow, which not unfrequently terminates in death. The treatment is the same described under the head of laudanum—namely, causing vomiting and freeing the bowels. RECOMMENDED uy the BRITISH ROYAL HUMANE SOCIETY, MJV C.&SE& OF SUSPEJYBEn aJVXJtlATIOJY. CAUTIONS. 1. Lose no time.—2. Avoid all rough usage.—3. Never hold the body up by the feet.—4. Nor roll the body on casks.—5. Nor rub the body with salt or spirits.—6. Nor inject tobacco smoke, or infusion of tobacco. Restorative means, if apparently drowned. I. Convey the body carefully, with the head and shoulders sup- ported in a raised position, to the nearest house. II. Strip the body, and rub it dry; then wrap it in hot blankets, and place it in a warm bed in a warm chamber. III. Wipe and cleanse the mouth and nostrils. IV. In order to restore the natural warmth of the body. 1st. Move a heated covered warming pan over the back and spine. 2d. Put bladders or bottles of hot water, or heated bricks, to the pit of the stomach, the arm pits, between the thighs, and to the soles of the feet. 3d. Foment the body with hot flannels ; but, if possible, 4th. Immerse the body in a warm bath as hot as the hand can bear without pain, as this is preferable to the other means for re- storing warmth. 189 5th. Rub the body briskly with the hand; do not however sus- pend the use of the other means at the same time. V. In order to restore breathing, introduce the pipe of a common bellows, into one nostril; carefully closing the other and the mouth, at the same time drawing downwards, and pushing gently backwards the upper part of the wind pipe, to allow a more'free admission of air: blow the bellows gently, in order to inflate the lungs, till the breast be a little raised: the mouth and nostrils should then be set free, and a moderate pressure made with the hand upon the chest. Repeat this process till life appears. VI. Electricity to be employed early by a medical assistant. VII. Inject into the stomach, by means of an elastic tube and syringe, half a pint of brandy, and water, or wine and water. VIII. Apply sal volatile or hartshorn to the nostrils. If apparently dead from intense cold, Rub the body with snow ; ice, or cold water.—Restore warmth by slow degrees; and after some time, if necessary, employ the means recommended for the drowned. In these accidents it is highly dangerous to apply heat too early. If apparently dead from hanging. In addition to the means recommended for the drowned, bleed- ing should early be employed by a medical assistant. If apparently dead from noxious vapours, tfc. 1. Remove the body into a cool fresh air. 2. Dash cold water on the neck, face, and breast, frequently. 3. If the body be cold, apply warmth, as recommended for the drowned. Use the means recommended for inflating the lun^sin direction V. Let electricity (particularly in accidents from light- ning,) be early employed by a medical assistant. If apparently dead from Intoxication, Lay the body on a bed with the head raised ; remove the neck- 190 cloth, and loosen the clothes. Obtain instantly medical assistance, as the treatment must be regulated by the stale of the patient; but in the mean time apply cloths, soaked in cold water to the head, and bottles of hot water or hot bricks to the calves of the legs, and to the feet. If apparently dead from Apoplexy. The patient should be placed in a cool air, and the clothes loosened, particularly about the neck and breast. Bleeding must be early employed by a medical assistant; the quantity regu- lated by the state of the pulse. Cloths soaked in cold water, spirits, or vinegar and water, should be kept applied to the head, which should be instantly shaved. All stimulants should be avoided. In cases of coup de soleil, or strokes of the sun, the same means to be used as in apoplexy. GENERAL OBSERVATIONS. On restoration to life a tea-spoonful of warm water should be given ; and then, if the power of swallowing be returned, small quantities of warm wine, or weak brandy and water, warm. The patient should be kept in bed, and a disposition to sleep encou- raged, except in cases of apoplexy, intoxication, and coup de soleil. Great care is requisite to maintain the restored vital actions, and at the same time to prevent undue excitement. The treatment recommended by the society is to be persevered in for three or four hours. It is an erroneous opinion, that per- sons are irrecoverable because life does not soon appear. ----:o:---- To give a description of the medicinal properties of the mine- ral waters of Great Britain, may, by some persons, be considered of inutility, and foreign to the object of this work ; but the many families who from this country continually visit Great Bri- tain, a great number, no doubt, are ordered by their physicians to cross the great western Atlantic, will not, (should this work come to their hands,) find any fault with such foreign information, especially if their intentions are to visit the most celebrated springs of Old England. The medicinal properties of the most celebrated mineral waters of Saratoga and Ballston are also de- scribed, as taken from the interesting treatise of Dr. John H. Steel, published in 1831, on the medicinal properties of those springs; also a brief description of the most prominent springs in the United States, and in giving a description of the medicinal pro- perties of all those waters, the same course will be pursued as has been adopted under the respective articles in the materia medica.. Viz: to describe the qualities—the diseases to which they are ap- plicable, and the quantities in which they are usually taken, to- gether with the necessary precautions in using them. MatH. The Bath waters are celebrated more for their peculiar warmth, than for any active medicinal properties they contain ; and are* therefore, more valued when applied externally, than to be relied upon for their internal effects. The water, when drank from the spring, accelerates the pulse, increases the heat of the body, and 192 promotes various secretions. One of the effects of the Bath water, for which it is most remarkable, is its action on the kid- neys and bladder. Its operation on the bowels differs according to the constitution of the patient; but a continuance in the use of it almost invariably produces costiveness, which is supposed to be occasioned by the quantity of lime it holds in solution. To the glowing heat it produces when taken internally, and applied externally, its sudorific effects may be attributed, which afford such relief in the many complaints for which it is used: amongst which, Dr. Saunders, in his treatise, has arranged chlorosis, or the irregularities to which young females are liable, the diseases resulting from a long residence in hot climates, bilious affections, jaundice, rheumatic complaints, gout, palsy, and nervous diseases. The quantity taken daily is from a pint and a half to two pints ; and the bath is used twice or thrice a week, according to the strength of the patient. The season for Bath is from November to May. Bristol or Clifton Hot Welts. The waters of the Bristol Hot Wells, according to the best ex- periments made upon them, have been found to contain less saline matter than any of the ordinary springs: the temperature of 74 degrees, its purity, and the large quantity of carbonic acid it con- tains, seem, in fact, to be its chief peculiarities. This water is esteemed diuretic, lightly sudorific, and improves the appetite and health. It effects the bowels very slightly, and, like the Bath water, if used for any length of time, produces costiveness. It is more particularly celebrated as a cure for consumption ; and even when it fails, it at least relieves the patient of many unpleasant symptoms, and renders the last moments less distressing, by miti- gating the burning heat of the hands and feet, the partial night perspirations, and the various other hectic symptoms. The other 193 diseases for which these waters are celebrated, are affections of the kidneys and bladder, chlorosis, diabetes, &c. They are ta- ken in the same manner as the bath waters. The season for the hot wells is from the middle of May till October. Cheltenham^ Is celebrated for its mineral water, of a chalybeate and aperient nature ; at the commencement of a course of the waters, the usual effects of them are drowsiness and slight headach ; but which va- nish imperceptibly, and often previously to the evacuation of the bowels. The Cheltenham waters may be considered tonic ; their action is principally on the digestive organs : they have, therefore, gained the greatest celebrity for the cure of bilious affections, in- digestion, jaundice, affections of the liver, habitual costiveness, hypochondriacal affections, and the whole train of complaints resul- ting from a long continuance in tropical climates, and the dissi- pations of a winter's residence in the metropolis. The usual dose of the water is from one to two pints, taken in the morning, fasting ; and as its effects are facilitated by exercise, the proprietors of the different Spas have provided most beautiful rides, walks, and pro- menade rooms, enlivened by bands of music, as an inducement for early rising, which with the temperance enjoined by the phy- sicians, and general custom of the place, tend to produce a speedy convalescence and recovery. The season is from May to Novem- ber, and many families divide their residence between this place and Bath, at each place in their season. Leamington. The waters of Leamington possess similar properties to those of Cheltenham, and are, of course, applicable in the same diseases. It is a place gaining considerably in repute, but its advancement may rather be attributed to the very extended state of Cheltenham, than to any advantages it possesses over that place. 25 194 Jfialuem. Maluem is most delightfully situated, and the waters have been long celebrated for the cure of many diseases; although the use of them has been followed with restoration to health, after other means have failed, those professional men who have analyzed them, are at a loss to determine from what property contained in the water, the benefit has proceeded. They have found that the water is more pure than most others: that it contains a very mi- nute portion of mineral salts and earth; and it is questionable, whether the great salubrity of the air, the delightful scenery of the vicinity, the regularity of living, contrasted with that which the invalids have just abandoned, may not be entitled to three parts of the credit attributed to the water. The diseases for which it is most frequented, are nervous diseases, consumption, scrofula, cutaneous eruptions, diseases of the kidneys, dec The Maluem-water is said by a medical writer to be a perfectly safe application, and it may be used with the utmost freedom, both ' externally and internally. Buxton. This spring is similar to that of Bristol Hot Wells, as regards temperature, which is 82 ; but its chief peculiarity appears to consist in the large quantity of elastic vapour which it contains, and which has been found to be exotic gas ; it also holds in solu- tion aperient, salts. The diseases to which it is applicable, are gout, chronic rheumatism, paralytic affections, contracted joints, diabetes, scorbutic complaints, glandular swellings, dse When the waters are used for bathing, Doctor Denman recommended them for that purpose between breakfast and dinner. The course consists of two tumblers before breakfast and two between break- fast and dinner, to be continued for a period. 195 JflatlocU Is one of the few thermal springs of Britain; and its effects seem referrible to its temperature, excepting which it differs little from common spring water. Its temperature is from 66 to 68 degrees, and it is therefore more generally used as a tepid bath for nervous and irritable habits, and patients labouring under a debilitated constitution ; for which reason it is generally employ- ed as a grade after the Bath and Buxton waters, preparatory to sea bathing. Marrowgate. The springs of Harrowgate are chalybeate and sulphureous. The former was, until the last fifty years, the only one taken in- ternally, whilst the latter was used as a bath. It has, however, been found, of late years, that the internal use of the latter has been attended with great advantage in many cases. Its taste is bitter, strongly saline, and nauseous, and the smell of it resem- bles that of rotten eggs. When first taken, it often produces head-ach and giddiness, which are succeeded by a speedy and gentle action upon the bowels. The diseases for which the water is more generally taken, are those of the skin ; as scurvy, scrofula, eruptions, ulcers, &c. It is also used with advantage in diseases of the alimentary canal, bilious affections, jaundice, gout, rheu- matism, worms, palsy, &c. It is sometimes exhibited in the form of enema, for the removal of ascarides. The dose of the Harrow- gate-water is half a pint, three or four times a day, or so much as will produce a slight effect upon the bowels. To remove the un- pleasant taste from the mouth, a piece of dry bread or biscuit is taken after each draught. In using the bath or waters, care should be taken not to have any ornaments about the person, as they are liable to be tarnished by the exhalation of sulphur from 196 the body; and ladies who are in the habit of using cosmetics, should be careful to lay them aside whilst they remain at Har- rowgate, or they may be placed in the same unpleasant situation as a young lady was some few years ago, who, from not being aware of the chemical action of the sulphur upon her cosmetic, went into the bath more than naturally white, and to her great surprise, on looking into the glass when she came out, found herself the colour of an Ethiop. The season is from May to October. Tunbridge W*ells. The waters of this place, owing to then contiguity to the metro- polis, have gained a celebrity, perhaps more than they really me- rit. As to the water itself, it differs little from common water, except that it contains a chalybeate, and more than the usual quantity of carbonic acid gas, or fixed air ; and it is questionable whether an equal benefit might not be found from the same quan- tity of soda water and a few drops of any of the solutions of iron. It is used in disorders of debility, irregular digestion, chlorosis, and the many diseases to which females are liable. The dose of Tunbridge Wells water varies from half a pint to a pint twice or thrice a day. The following- is a brief description of some of the principal Springs in the United States. White Sulphur Springs. These springs are situate in the county of Greenbriar, Virgi- nia, in a hilly and mountainous region of country, 37 miles in a south-westerly direction from the hot springs. There are two Gums, as they are called, or small wooden reservoirs, into which the water rises, and whence it flows, after a short distance, into Howard's creek, a branch of the Kenhawa river. The waters resemble, in chemical analysis, the springs of Harrowgate, before described, and are therefore applicable to the same diseases ; but for want of suitable conveniences for bathing, which exists not at Harrowgate, is a great drawback to the benefits desirable from visiting those springs. There is, however, one great resource in this difficulty, and it is one which is peculiar to this district of country. At a distance easily passed over in a day's ride, the in. valid finds thermal waters—the hot springs, in the warm bath of which he can enjoy the luxury and benefit from bathing. The quantity to be drank of the white sulphur water must de- pend on personal experience. Some recommend the individual to drink four half pint tumblers in the morning and one at night; (supper to be abstained from) Much, however, will depend on the immediate effects which are desired to be obtained. Salt Sulphur Springs. Red Sulphur Springs. 198 Warm and Hot Springs. Sweet Springs. " The salt sulphur spring is in Monroe county, and the red sul- phur in Giles county; in the same mountainous region in which we meet with the white sulphur, and sweet springs, and the warm and the hot springs. The salt sulphur, and the red sulphur springs appear to attract most attention. " Patients with enlarged livers, distended abdomen, yellow skin, drc, are often restored to health in a few weeks at this place. Dyspeptics, (if derangement of the liver is the cause,) are almost universally relieved. The most delicate stomachs are under their use enabled to digest pastry, fruit, dec" Affections of the kidneys, die, are also relieved. " The red sulphur is peculiarly adapted to affections of the chest, or to speak more definitely, to pulmonary consumption in all its stages." The benefit from the waters is most apparent in those who drink largely ; but the permanent advantage remains entirely with those who drink less and use it longer ; but the water should not be used for more that twelve or fourteen days successively: omit- ted for a week, and then resumed. Dr. Bell quotes another medical friend residing in that section of the country in which the springs are situated. " From my own observation," says this gentleman, " I am in- duced to believe that the white sulphur springs are best adapted to such diseases as we familiarly denominate bilious and liver complaints ; the salt sulphur, to dyspepsia and all diseases of the stomach, whether connected with the state of the liver or not. " The red sulphur is certainly a very peculiar water, and is said to be especially adapted to pulmonary affections." 199 Report speaks highly of the warm and hot springs in a variety of diseases. Sweet Springs Are in Monroe County, 29 miles from Fincastle, 46 from the red sulphur springs, 22 from the salt sulphur, 20 from the white sulphur, and 43 from Bath Court House. The sweet springs rise on the north side of a large mountain called by the same name. The house and cabins afford accommodations (as Dr. Bell states he has been informed,) for about 300 persons. The same author expres- ses a wish that in place of these wooden or log cabins raised on logs and under which pigs often repose unheeded, small houses of brick, well plastered, were erected. The temperature of the sweet springs is 73 far. the same as that of Bristol hot wells. There is a considerable resemblance between the two in other respects, as well as the abundant evolution of carbonic acid as in the earthly and saline matters held in solution. The sweet spring water is serviceable in the varieties of dys- pepsia accompanied by gastrodynia, or spasm, with pains occur- ring at irregular intervals and heart burn, where the extremities are cold and the skin torpid. In secondary debility of the diges- tive canal, from the exhausting heats of summer, or in chronic diarrhea, and dysentery without fever, or not sustained by hepatic inflammation, much good will be produced by the internal use of these waters, also in gout, rheumatism, nervous debility, dec. (See article under the head of Bristol, or Clifton Hot Wells,) the sweet springs are used for the diseases mentioned in that ar- ticle. The waters are used early in the morning, some little time before dinner, and in the evening at tea time. Dr. Bell, says, that this latter epoch is an improper one, except the invalid suffer at the time from spasm of the stomach, or experience a morbid and gnawing sensation of hunger. 200 The same author also remarks that few mineral waters have ac- quired such fashionable and well merited celebrity as the sweet springs. I am inclined to think that they must possess the narcotic principle in a highly concentrated state when the pigs repose so unheededly among so many fashionables. These springs should be analysed with that view. Bedford Springs. The Bedford are the most noted springs in Pennsylvania. They are within two miles of a town whence they derive their name, and which contains upwards of a thousand inhabitants. It is the seat of justice for Bedford county, and is situated on the great Western Turnpike, which passes through Pennsylvania from Philadelphia to Pittsburgh;—being 195 miles from the for- mer, and 93£ from the latter city. It is 130 miles from Baltimore, and the same distance from the federal city. The valley (Sho- ver's) in which the springs are situated, lies between Constitution hill on the east and Federal hill on the west: it is watered by Shover's creek, which passes through it, and discharges itself into the Raystown branch of the Juniata river, about a mile east of the town of Bedford. The principal springs are Anderson's or the Main Spring, Fletch- er's or the Upper Spring; the Limestone Spring; the Sweet Spring; the Sulphur Spring, and the Chalyheate Spring. The improvements at the springs are extensive and beautiful, and are annually increasing " by the appropriation of all the yearly taxes and contributions received from visiters using the waters." The accommodations afforded visiters are not, by description, surpassed by any of the European watering places. Serpentine and beautiful walks, shrubberies, &e Spacious and beautiful suits of apartments. Good board and good attendance, together with the efficacy of the waters render this a very desirable resi- dence, not only to recover but to enjoy health. 201 The waters are of the class Chalybeate, and in the absence of febrile irritation, and undue local excitement and pain, (circum- stances which clearly forbid the use of these waters,) may be used as directed in the publication of the Board of Managers of the Bedford springs, circulated at that place for the information of the visiters. They are found to be salutary in hepatic affections, in diseases of the stomach and intestines, in dyspeptic and hypocon- driacal derangements, in hemorrhoids; and in all the varieties of intestinal worms the waters have effected numberless cures: also, in asthma, affections of the chest, gravel, gout, rheumatism, dropsy, and the various uterine diseases, as obstructions of the menstrual flux, its excess, fluor albus, painful menstruation, die, many cures have been effected, whilst its use has been generally beneficial. Bath. Within a moderate day's ride of Bedford is the little town of Bath, in Berkely county, Virginia; the mineral water of which has acquired considerable celebrity in that part of the country. It is a carbonated water of the temperature of 76 F. and has been found serviceable in dyspeptic and chronic diseases of the bowels, also in chronic rheumatism, used as a drink and for bathing. It is common for invalids to divide their time between Bath and Bedford. Ballston and Saratoga. The reputation of these waters is known to every citizen in the union. The first, or Ballston spa, are those coming more imme- diately under the head of chalybeate. The springs there are nu- merous, and present differences in the nature and proportion of their saline ingredients. The water of the Sans souci springs is sparkling and acidulous, and its taste highly chalybeate and some- 26 202 what saline. Low's Spring differs but little in sensible properties or composition from the Sans souci. Park spring affords a much less quantity of all the saline substances excepting the iron, with which this water is undoubtedly saturated. " In all cases where simple chalybeates alone are recommended this water should undoubted- ly have the preference." The water of the New Washington Spring is also of the same class. Dr. Steel mentions that " all these waters, if drunk in large quantities or taken by persons whose stomachs are rather irritable, operate as an aperient, and, at the same time, have a powerful effect as a diuretic, and are of eminent service in all those chronic affections where chalybeate medicines are indicated." " There are springs at Saratoga differing but little from the Ballston spa, viz : the Flat rock, Columbian, High rock, and Ellis' springs; they have, however, this additional advantage in their excess of carbonic acid, by which they are much less apt to offend the stomach. Of the saline mineral springs of the United States those of Sara- toga are by far the most celebrated—and the most celebrated of the numerous springs of Saratoga is the Congress spring, the me- dicinal qualities of which have acquired for it a reputation abroad to which no other fountain in the United States has yet attained. The water of the Columbian spring resembles that of the Con- gress in its saline ingredients, and from the large proportion of iron which enters into its composition, it occupies a distinguished rank among the tonic waters which the place affords. Near the Columbian is the Washington spring, which closely re- sembles the former except in being rather less chalybeate. A lart.' e and commodious bath house has been erected close to the spring, called " the Washington bath," which is supplied with mineral wa- ter from this spring. The waters of the Hamilton Spring ranks first among the springs as a diuretic, and has been long celebrated for its good effects in gravelly and calculous affections. 203 The Flat Bock Spring Resembles that of Columbia. The High Boclc Spring, Once in great vogue, has given way to the Congress Spring; and the President Spring is thought to have a common origin with the High Rock. The Bed Spring & Ten Springs Are not much in use. JEllis' Spring Is an excellent chalybeate, but little resorted to from its re- mote situation. The morbid states of the animal economy, in which recourse may be had to the Saratoga and Ballston waters, are clearly and dis- tinctly described by Dr. Steel; amongst which are bilious affec- tions, dyspepsia or indigestion, gravel, chronic rheumatism, cu- taneous eruptions, scrofula, ill-conditioned ulcers, paralysis, chlo- rosis, and a variety of other complaints peculiar to the female sex ; the waters maintain a high and deserved reputation. Of the accommodations afforded at these public places, the only want is that of a suitable hospital for the reception of suita- ble treatment of the sick poor who annually visit these places to drink the waters ; but who have no means of paying for lodging, nursing, and regular medical attendance. Dr. Steel's hints on that subject are praiseworthy ; and I trust they will soon be attended to. There are several other springs, no doubt, in the United States, as well worth treating upon as those just named, and the medici- nal properties of which are, no doubt, well known to those who reside in the immediate neighbourhood ;—but as fashion rules the 204 world in every thing, why not in physic ? For my own part, I be- lieve that the cures attributed to the waters, should, in nine cases out of ten, be put to the account of the beautiful rides, walks, and promenades, pure air, the agreeable society met with, early rising, the physician's temperate injunctions, dec, dec ; all of which could be equally obtained in other sections, where supurb scenery also abounds, without being forced to travel to those sec- tions of the country where the springs immediately are, and by taking a few boxes of Carpenter's Saratoga powders,* or a few bottles of Congress water, or any of the waters of those celebrated springs (which are imitated according to the exact chemical analysis taken of those waters,) the result would prove equally as effectual. I confess that I am not equally as sceptical as Hufeland, who commends the Toeplitz waters as possessing the properties of making the lame walk, the deaf hear, and the dumb to speak ; nor yet can I believe that the waters of Bourbon Lancy of themselves were capable of curing Catherine de Medecis, wife of Henry 2d, of her sterility, although she did use those waters according to her physician's advice. She had, however, after her visit to these springs, three children; Henry, Charles, and Fran- cis, all three kings of France in succession ; and her physician was presented by her, on the birth of each child, ten thousand crowns. •Dr. Bell thinks the Saratoga powders bear no resemblance in effects or properties to the Congress waters. He, however labours under a very great error, inasmuch as they are similar both in properties and effects ; and in this I am sustained by some of the best medi- cal authorities, and the concurring testimony of some of the most respectable citizens in the United States. Dr. B. is, however, in so obvious a minority that it is unnecessary to dwell further upon it, except simply to state that all the essential constituents, according to the analysis, are used in the composition of these powders, and that they are preferred (for sub- stantial good reasons) to the Seidlitz powders by those who have used both. We should like to know whether Dr. Bell's opinion is the result of experimental ivestigation. The prac- tice which some persons have, of publicly denouncing articles which do not please then- fancy, without experiment or a knowledge of their properties, from hasty conclusions fre- quently the result of prejudice, should be deprecated by every advocate of truth and science. 205 The Saratoga and Congress springs, also the Ballston, Chelten- ham, and Bedford waters, are always in readiness at 301 Market street, where can be had any quantity of the waters, made after any of the springs in the United States or any part of Europe. m>&>^m$i®& Bathing having been found a powerful auxiliary to other reme- dies in the cure of a variety of complaints, it may not be deemed uninteresting to make a few observations respecting its use. The Cold Bath, Wherejudiciously applied, gives strength to the nervous system, in- creases muscular elasticity, accelerates the circulation of the blood, and promotes the different secretions. When improperly used it has produced the most baneful effects, by confirming in the habit those complaints which it was intended to remove, and rendering them incurable. Cold bathing should, therefore, never be had re- course to without medical advice ; and, where it is deemed proper a dose of medicine should be taken and a tepid bath at 96 first used as a preparation. The bather should always go into the cold bath when warm, and seldom, if ever, exceed one plunge ; this produces a quick return of warmth, a glowing healthful ap- pearance on the countenance, and an additional flow of spirits. Where this is not directed, the cold bath should not be repeated. In epilepsy, hysteria, St. Vitus' dance, and other convulsive dis- orders, cold bathing may be used with advantage. The Cold Shower Bath Is, however, less alarming to nervous persons, and less liable to produce cramps than the cold immersion ; it may therefore be considered as the best and safest mode of cold bathing. In chro- nic headach and other complaints, classed under the head of ner- vous affections, the shower bath will be found more efficacious if the feet are kept in warm water while the head is exposed to the shower. In all disorders affecting the head with pain, sense of fullness 207 and giddiness ; in hydrocephalus and deafness; in all diseases of the breast; in asthma, catarrh, water on the chest, and every species of consumption ; in indigestion, chronic pains in the sto- mach or bowels; in all internal inflammations of the liver, spleen, kidneys, or intestines; in gout, rheumatism, diseases of the joints, scrofula, glandular swellings ; in every species of dropsy ; and in all eruptive and cutaneous diseases; in early infancy ; in every pe- riod of pregnancy; and in advanced life, the cold bath is liable to prove injurious, and should therefore be adopted with great caution. The Warm Bath At 98 will be found a powerful agent in the cure of most of the foregoing disorders; and in all cases where the action of the absor- bents is required to be increased. In dropsical swellings of the limbs ; in stiffness and contraction of the joints; in all those dis- orders called nervous ; in every case requiring a course of mercury; in early infancy; in the latter periods of pregnancy; and in the decline of life, the warm bath may be used with advantage and safety. The Russian mode of bathing, which is to pour cold wa- ter on the head while the body is immersed in a warm bath, has been recommended successfully for many years, to remove that over distension of blood vessels and preternatural fullness in the brain, indicating a tendency to apoplexy. The Vapour or Steam Bath. The cases to which the vapour bath seems best adapted are chiefly gout, rheumatism, palsy, diseases of the hip, knee, and el- bow joints, glandular swellings in the neck, female obstructions, and inflammation of the stomach and bowels. In cases attended with fullness of habit, or where there is a great determination to the head, it is necessary to bleed, and take a dose or two of me- dicine, before attempting the use of this or the following bath. The Sulphur Vapour Bath. In some of the most complicated and embarrassing diseases of 208 the skin, as scurvy on the face, leprosy, mercurial and venereal eruptions, itch, dzo., this remedy has been found the most effectual yet discovered ; but like all other principal remedies it should not be used except under the direction of a medical man of ex- perience, as great mischief may arise from its abuse or mal-appli- cation. The French and German physicians are adopting this remedy with success in all cases of diseases of the skin, and in all obstinate and chronic affections which resist the usual adminis- tration of medicine. The Douche, or Pumping Bath. This remedy has been found to produce powerful effects in lum- bago, sciatica, and diseases of the hip joints. The Nitro-Muriatic Bath Is usually made by adding so much of the nitro-muriatic acid to any quantity of water as will make it as sour as weak or ordinary vinegar ; it is employed in chronic affections of the liver, when it is applied to the side affected; it is frequently used as a foot bath to restore the circulation to the extremities, and in cases where there is an unequal supply of blood to some internal organ, as in chronic affections of the liver, stomach, &e The Pediluvium, or Foot Bath. In recent catarrh, when it is desirable to produce perspiration, this bath will always be found an excellent auxiliary to the means laid down for that purpose. It should be used as warm as it can be borne for fifteen or twenty minutes, and the patient should get into bed immediately afterwards. The following are the temperatures of baths, as ordered by the Profession, under different circumstances. Tepid bath, 86 to 97 degrees. Hot, " 97 to 100 do. Vapour " 100 to 130 do. GLOSSARY OF TERMS Used in the Work to express the Properties of Medicines. / ----:o:---- Absorbents.—Such medicines as have no acrimony in themselves, and yet annul acidities in the stomach and bowels. Alteratives.—Remedies which restore health to the constitution without producing any perceptible effect. Analeptics.—Restoratives to health. Anodyne.—That which eases pain, and procures sleep. Antacids.—Such medicines as overcome acidity. Anthelmintics.—Medicines which have the power of destroying and expelling worms. Antibilious.—Applied to medicines which are useful in bilious affections. Antirheumatics.—Remedies useful in rheumatic complaints. Antiseptics.—Medicines which oppose putrefaction. Antiscorbutics.—Remedies against scurvy. Antispasmodics.—Medicines which remove cramps, spasms, dec Antisiphilitics.—Medicines used in syphilis, or the venereal dis- ease, dec. Aperients.—Medicines which gently open the bowels. Aromatics.—Medicines of an agreeable, pungent and cordial nature. Attenuants.—Medicines which are supposed to thin the blood. Astringents.—Such remedies as contract the fibre of the body, diminish discharges, dec. Balsamics.—Medicines of a healing and soothing nature. 27 210 Carminatives.—Remedies which relieve flatulence, and allay pain in the stomach and bowels. Cathartics.—Strong purgative medicines. Cordials.—Medicines of cordial and exhilarating properties. Corroborants.—Medicines and food which give strength. Demulcents.—Medicines of a softening character, which correct acrimony and diminish irritation. Deobstruents.—Remedies which overcome obstructions in any of the passages. Detergents.—Such applications as cleanse the surfaces over which they are passed. Diaphoretics.—Medicines which produce gentle perspiration. Digestives.—Such applications as are used to wounds to produce suppuration, or the formation of matter. Discutients.—Remedies which have the power of repelling swel- lings. Diuretics.—Medicines which act on the kidneys and bladder, and increase the flow of urine. Drastics.—Purgatives of a strong and violent character. Emetics.—Medicines which have the power of exciting the sto- mach to throw off its contents. Emollients.—Medicines used externally, which have the power of softening or releasing the animal fibre. Emenagogues.—Such medicines as restore the female periodical discharge. Exhilarants.—Medicines which raise the spirits. Expectorants.—Medicines which increase the discharge from the lungs, throat., and chest. Escharolics.—Corrosive applications, which remove fungus, warts, proud flesh, dec. Febrifuge.—Medicines useful in fevers. Hydragogues.—Medicines which have the effect of removing the fluid collected in dropsy, by increasing the natural evacua- tions. 211 Laxatives.—*Medicines which render the bowels rather more re- laxed than natural. Lithotitriplies.—Medicines applicable to gravel, stone, dec. Narcotics.— Medicines which have the power of procuring sleep, and inducing a state of stupefaction. Nutrients.—Such remedies and food as support and nourish the body. Purgatives.—Medicines which evacuate the bowels. Refrigerants.—Remedies of a cooling nature. Restoratives.—Medicines which have the power of recruiting life. Rubefacients.— Applications which redden the skin, and thereby cause a determination of blood to the part. Sedatives.—Medicines of an assuaging and composing nature. Stimulants.—Internal and external applications, which excite the energy of the body, or the part to which they are applied. Stomachics.—Medicines which restore the tone of the stomach, and render its action healthy. Sudorifics.—Medicines which cause a profuse increase of perspi- ration. Tonics.—Medicines which give general strength to the constitu- tion, and which restore the natural energy. ^^S^Sl^f 2D»2£^ TO THE FAMILY MEDICINE CHEST DISPENSATORY. Being a concise and familiar description of Diseases, with direc- tions for the treatment of such as are unattended with serious consequences ; showing also, the best immediate measures to be adopted in those disorders and accidents which are destructive to life, when the physician or surgeon is not at hand, or until his assistance can be procured. The objects of the following Appendix are, 1st, to teach unpro- fessional persons to distinguish such diseases as are dangerous in their nature and rapid in their progress, in order that proper as- sistance may be had without unnecessary delay. 2d, to instruct them how to act reasonably in such cases as either do not require the physician's attendance, or in which his presence cannot imme- diately he had. To attempt more would be rather mischievous than serviceable ; inasmuch as it might lead the inexperienced to tamper with the lives of their fellow-creatures. If the disease be really serious, no book can give such directions as will put the unlearned person, in its treatment, on a par with those who have been taught by long study and observation the dangers that are to be apprehended, and the best means of guarding against them. A SHORT DESCRIPTION OP THE AND STRUCTURE OF THE HUMAN BODY. The human body is composed of solids and fluids. The solid 213 parts are the chief subject of anatomy, properly so called. The history of the fluid parts occurs only occasionally, because it pro- perly belongs to what is called Physiology, or the Animal Econo- my. The constituent parts of the animal body are fibres, mem- branes, arteries, veins, lympheducts, nerves, glands, excretory vessels, muscles, tendons, ligaments, cartilages, and bones. To these may be added the hair and nails. The human body is commonly divided into the head, trunk, and extremities. The trunk is again subdivided into the neck, thorax, abdomen ; and the extremities into superior, called the arms, and inferior, called the legs, each of which portions are, by anato- mists, again subdivided. The head, viewed from the outside, is divided into the hairy scalp, and face. The inner parts of the head are surrounded by the bones of the cranium. The face comprehends all that portion of the surface of the head which is between the hairy scalp, and the neck; viz: the forehead, eye-brows, palpebrae, eyes, nose, mouth, chin, cheeks, and ears. The Cranium comprehends all that portion of the head which reaches from the upper part of the orbit to the upper and back part of the neck ; at the sides it extends as low as the passages into the ears. It is lined internally by the dura mater, and divi- ded by a process of that membrane into a large upper cavity and a small under one. The upper cavity contains the cerebrum, the under one contains the cerebellum, and the medulla oblongata. The Neck in general is divided into the anterior part, or throat, and posterior part, or nape. The throat begins by an emi- nence, and terminates by afossula. The nape begins by a fossula which, as it descends, is gradually lost. By the Thorax we commonly understand all that part of the body which answers to the extent to the sternum, ribs, and verter- brae of the back, both outwardly and inwardly. The thorax is divided into the anterior part, commonly called the breast; the posterior part, called the back ; and the lateral parts called the right and left sides. The external parts of the thorax besides the skin and membrana adiposa, are principally the mammae, and the muscles which cover the ribs, and fill the space be- tween them. In the mammae we see the papilla or nipples, and a 214 small coloured circle which surrounds them. The internal parts of the thorax are contained in the cavity of the breast. The cavity is lined by a membrane named pleura, and divided into two lateral cavities by a membranous septum, named medi- astinum, which is a production or duplication of the pleura. These parts are the heart, pericardium, trunk of the aorta, beginning at the carotid and subclavian arteries, the superior proportion of the descending aorta, the intercostal arteries, the vena cava superior, vena azygos, termination of the sttbclavian veins, a portion of the asperia arteria, and the asophagus ; the ductus lacteus or thora- cicus, the lungs, pulmonary artery, pulmonary veins, &c. The cavity of the thorax is terminated downward by the diaphragm which parts it from the abdomen. The abdomen begins immediately under the thorax and terminates at the bottom of the pelvis of the ossa innominata. Its circum- ference or outer surface is divided into regions, of which there are three anterior, viz : the epigastric or superior region, the umbili- cal or middle region, and the hypogastric or lower region. There is but one posterior region, named regio lumbaris. It contains likewise the mesentery, mesecolon, omentum, liver, gall bladder, spleen, pancreas, glands of the mesentery, vasa lactea, receptacu- lum chyli, kidneys, renal glands, ureters, bladder, and the interior parts of generation in both sexes. The whole arm is divided, as in the skeleton, into the shoulder, the arm properly so called, the foie-arm, and the hand ; to these we must add the axilla or arm-pit, the elbow, the fold of the arm and the hollow of the hand. The lower extremities of the whole body are divided into the thigh, leg, and foot. Blood vessels and nerves, in divisions wonderfully minute, combine to form the different structures or tissues of the body; there is scarcely an appreciable space that does not possess them; thus the point of a needle cannot be pushed into any part of the skin without drawing blood and causing pain. The different tissues unite to form organs, to which particular functions are allotted. The brain, spinal marrow, and nerves are the organs of mind and sensation ; the nerves being the agents in the conveyance of 215 the impressions of external objects to the mind, and of the deter- minations of the will to the moving powers. The blood is conveyed to every part of our frame; by it each part grows and is maintained. The organs for circulating the blood are the heart and blood vessels. The heart may be con- sidered to perform the offices of a forcing pump; it first receives the blood from the veins, and then by contraction propels it through the arteries. The blood vessels consist of arteries and veins. The arteries are pretty thick, firm tubes, serving as con- duits of the blood from the heart to the extreme parts; in them resides the pulse, the throb of which is caused by the influx of blood from the heart. In healthy adults, the pulse beats from 60 to 80 in a minute. In disease it is sometimes reduced in fre- quency, but often increased to 120 or more. In infants, when in health, it is as high as 930. The veins collect the blood from the arteries, and reconvey it to the heart. Veins have their transparent coats, through which the dark coloured blood is seen. Absorbent or lymphatic vessels convey a white or transparent fluid, the chyle and lymph, that is poured into the mass of blood. The lungs are appendages to the circulating system; the blood which has circulated through the body is unfit for the purposes of life or health, until it has been exposed in the lungs to the influ- ence of the common air. To supply materials for growth, and the constant wear of the body, we have organs of digestion. Food is taken into the sto- mach, where it undergoes various changes ; it passes into the bowels, where the chyle is taken up and carried into the system to replenish the mass of blood, while the refuse is thrown out. Besides these, the leading systems in the body, there are other parts to which it may be necessary briefly to allude,—glands or organs that separate particular matters from the blood. Thus the saliva is separated by glands above the throat and cheeks, the liver secretes bile—the kidneys urine, dec. dee Other glands called lymphatic are met in different situations* as in the neck, armpits, groins, dec, which do not secrete any particular matter. Muscles are the acting moving powers, and are generally attach- ed to bones by means of smooth, shining, strong cords, called ten- 216 dons. By the contraction of muscles the bones are moved, and through them the parts or limbs. The red flesh of animals is the muscle. Bones are living parts of the frame and have vast numbers of blood vessels passing into their texture. The ends of bones mov- ing on each other and covered by a smooth, elastic substance, car- tilage or gristle. Cartilage prevents the bad effects of friction, and diminishes shocks from jumping, dec. A glairy fluid, not inaptly called joint oil, still further facilitates motion. The foregoing observations, from the nature of the work, are necessarily very concise; it seemed necessary however to premise them, that what follows them might be more easily understood. Fever. It is the usual custom in treatises on the practice of medicine, to commence with the disease called " Fever," and although this work can have no pretensions to what in medical science is called a " treatise," still as fever is a very common disease and liable to combine with many other ailments, I deem it proper to so far follow the path of medical science as to commence with it. Fever, as an independent affection, commonly sets in by cold- ness, chill or shivering, paleness; generally succeeded by increased heat of the skin and flushing of the face. There is loss of strength, languor, yawning, stretching, headach, wandering pains of the back or joints, or soreness over part, or the entire body ; an unpleasant sensation in the stomach. The face may be pale, flushed, or of a leaden, dirty, or yellow hue, the eyes dull, heavy, little sensible, or red,and impatient of light. The pulse is commonly very quick, small and weak, or full and strong, sometimes irregular : breath- ing hurried and hot, or slow and interrupted by sighs. Lips parched ; mouth dry ; tongue white, foul, dry, and red, or trembles when put out. Thirst, loss of appetite, nausea or vomiting, bow- els usually constipated, urine scanty and high coloured, muddy on standing, or abundant and watery; sleeplessness, disturbed rest, frightful dreams, raving, especially towards night, giddiness, deli- rium. All the symptoms enumerated are not to be expected in the same case, there is not any of them that may not be absent, 217 but a number of them occurring at the same time, indicate the presence of fever. According to the prominence of some symptoms fevers have been named. Thus if the pulse be strong, quick, full and boun- ding, or hard and unyielding under the finger, while the sense of weakness is not great, it has been called inflammatory. If there be discharges of bile from stomach and bowels, with yellow skin— bilious. If weakness and much disturbance of the head and ner- vous system—typhus. If the skin with the latter signs, be spotted with red or purple—spotted fever. If there be marks of putridity, that is, if there be a very bad smell, from the body and discharges —putrid. In the commencement of fever, it is difficult to predict its char- acter or event; those apparently mild may in their progress be- come very formidable; although this is not the general course. All fevers are closely allied, being convertible from one type to another. Of continued fevers, for convenience sake ; I shall describe the inflammatory, the simple, and the typhus. In the first, which is unfrequent, unless as an attendant on rheu- matism or inflammation, the pulse is frequent, full, strong, hard; the heat is considerable, the thirst intense, urine high coloured and scanty ; severe pain of the loins, back and joints; headach, flushed face, throbbing temples ; eyes red ; delirium, blood when drawn, and allowed to cool, will often have a white crust on its surface. In the simple, pulse mostly quick and full, appearance not much changed, symptoms in general moderate, indicating disturbed or hurried circulation ; often determinations of blood to certain parts. If to the head, marked by headach, flushed face, dislike of light, heat of head, throbbing temples, even raving. If to the chest; by cough, impeded breathing, pain on taking full inspiration. If to the digestive organs; by pain or uneasiness, increased if pressure be made over the pained parts, constipation or sometimes the re- verse. In the typhus the pulse is usually small, quick and weak; great languor, lassitude, and want of strength; headach, confusion of in- tellect: foul tongue and teeth, hot offensive breath, sleeplessness, delirium, skin with a pungent heat, sometimes not very warm, 28 218 sometimes covered with red or brown spots like flea bites, or suf- fused with yellow: strong tendency to putridity, tremors or spasms, picking at the bed clothes, stupor; discharges sometimes retained or passed unconsciously. The duration of fever is very doubtful, sometimes only of one, two, or three days ; otheis of several weeks. Treatment, if possible, should be left to the Physician, as it varies exceedingly, according to the age, type, temperament, dec, die In the commencement of the disease emetics are often of service ; their employment is particularly indicated by the nausea that prevails, or our knowing that improper or much food has been previously taken. " As the bowels are always invariably more or less constipated in the varieties of fever under consideration, and liable, therefore, to irritation from this source, they ought always to be early evac- uated by suitable purgatives;" they diminish the tendency to con- gestion of blood in the head, chest, dec. " The saline purgatives are generally preferable, on account of the usual mildness of their operation and their tendency to allay febrile excitement, by their general refrigerant influence, independently of their evacuant ef- fects." They may be administered with peculiar advantage ac- cording to the following formula : Epsom Salt or Glauber's Salt 2 ounces Tartar Emetic 1 grain Fountain Water 10 fluid ounces. Dissolve the salt and tartar emetic in the water : of this solu- tion a wine-glassful may be taken every hour, until purging is produced,* or the purgatives senna, scammony, dec. may be re- sorted to for the like purpose (see same). When their full effect has been procured, it will be prudent to repeat them, in divided doses, so as to procure two or three gentle evacuations daily. The secretion of bile being often irregular or deficient, 10 grains of blue pill or 6 or 8 grains of calomel may be given a few hours before the purgative as above directed is administered. The skin being usually hot and dry, gentle diaphoretics, (see James* Powder, Antimonial Powder, Mindererus Spirit, dec.,) repeated every 4th or 6th hour, are recommended. The following is a good formula: " half a grain of James' Powder and 12 grains of * Dr. Eberle's Practice of Medicine, vol. i. p. 143. 219 nitre every two hours." " The James' Powder may be given either alone or combined with the nitre as above." Sponging the surface with cold vinegar and water, or cold water with a little spirit of rosemary or lavender, is also recommended. If the weather be very cold, tepid sponging will be preferable. Watery drinks, as toast water, barley water, lemonade, whey, apple water, raspberry vinegar, solutions of tamarinds, currant, blackberry, or strawberry syrups form very pleasant and useful beverages in febrile affections. In general the drink should be cool in summer, tepid in winter, but when the surface is moist with perspiration, the drinks should be tepid. If much headach or delirium, the head should be shaved, and cold lotions applied frequently by means of folded cloths, or a bladder half filled with ice water may be laid on the bare scalp. Bleeding is proper where there is determination of blood to any organ. Repetition of bleeding requires great judgment. Leeches in these cases are often highly useful. If light or noise be offensive, they should be prevented reaching the eyes or ears. Cleanliness should be strictly observed, linen frequently changed ; the face, chest, and arms, washed. Free ventilation is of the highest importance: unnecessary furniture should be removed ; walls, floor, dec. kept clean. When several days have elapsed, and real debility comes on, it may be necessary to give stimulants. Perhaps only professional men can distinguish real debility from that languor that attacks even strong men in the commencement of fever; here camphor mixture, joined with ammonia and aether, repeated every fourth hour, may be proper, or wine and water, wine whey, or even pure wine, the quantity varying according to the debility, and as we find it to agree with the patient. If it increases the action of the pulse or produce flushing and delirium, its use is improper. If the feet be cold, hot bricks, or ajar of hot water wrapped in flan- nel, should be applied to them. Steeping the feet at night some- times relieves headach or raving and procures sleep. Blisters to the back of the head and neck, may be useful with the same view ; they are often used to the calves of the legs or between the shoul- ders, to excite from extreme prostration. " In all cases of general fever, it is of the utmost consequence to attend carefully to the state of the internal organs ; firm pres- ;'20 sure should from time to time be made on different parts of the abdomen. If the patient complains of much tenderness or pain when pressure is made, there will be reason to apprehend the ex- istence of inflammation ; and if, in addition to this sign, the tip and edges of the tongue are red and clean, the presence of mucous inflammation of the bowels may be deemed certain. Frequently, on examination, the abdomen is found so tender that even slight pressure gives rise to the severest suffering; although without pres- sure the patient does not complain of any pain." When the in- flammation is seated in the alimentary canal, leeching succeeded by a large blister should be applied to the abdomen ; and nothing but the blandest mucilaginous drinks (such as barley water, flax- seed tea, dec,) allowed, with occasional laxative clysters." In- stead of cold, warm fomenting applications ought to be employed: in this latter inflammation, the usefulness of cold applications be- ing nearly altogether confined to inflammation of the brain. Animal food, meat, broth, jellies, dec should be excluded ; flummery, biscuits, gruel, arrow root, or sago, without wine, should be only allowed in the treatment of fever (except as before men- tioned in cases of real debility, where stimulants, are indicated). Even when convalescence has taken place, the too early or too abundant use of solid animal food has frequently caused a relapse. Farinaceous liquids, and weak animal broths, taken in moderation will in general be quite sufficient for the first four, or five days of convalescence. Causes of Fever. An unknown constitution of atmosphere, insufficient or bad food, much watching, grief, anxiety, toil, intemperance in food and drink; sudden chills, sitting in wet clothes; currents of air where the body is overheated and languid ; particular disposition of indi- viduals to be affected; animal effluvia. When many persons are closely crowded in ships or buildings, fever is apt to be generated, lastly contagion or infection. A few words on this last course, may not be deemed improper. A certain train of symptoms not only marks particular diseases* but matters are eliminated from the diseased body, which will communicate a similar disease to a healthy person. Thus scarle 221 fever, small pox, measles, dec, are propagated. In small pox, the disease may be communicated, either by matter taken from a pustule being introduced into the blood, or by a person being brought near to and breathing the same air, with one labouring under the disease; the former means has been by some writers defined as contagious, the latter infectious; "these are rather distinctions than differences, since the same disease is often both contagious and infectious." In this view it has been, and no doubt fairly held, that fever, at least in many instances, is infec- tious. That class of fevers, however, that accompanies or follows on inflammatory complaints, or that class that follows on slight occa- sional causes, are rarely infectious." Precaution however should be always used, if the disease be severe or last beyond a few days. The efficacy of contagion has been held not to extend beyond a few feet from the diseased, or from things infected by coming close to their bodies. Dr. Eberle states that in a pure and free air the typhus miasm extends but a short distance, perhaps not more than three or four feet from its source, in a sufficient degree of concentration, to infect a healthy individual ; the same author quotes Dr. Rush, who states that he has known typhus produced by the contagion which was left in a room six months after it had been occupied by patients ill with this disease, and further quotes Hildebrand, who thought that the typhus seldom retained its acti- vity more than three months,—all authors, however, agree that free ventilation and cleanliness are the essential agents in modi- fying, if not altogether destroying the miasms or contagious prin- ciple of fever. If the room be close, crowded, unventilated, un- clean, infection becomes more virulent. If proper ventilation and cleanliness be observed, none but the very timid need fear to approach one in fever; but nevertheless it is wrong to remain close to him for a long time, or to inhale his breath. Several methods have been used to destroy infection; ventilation and cleanliness are among the best, whitewashing the walls, scra- ping the floors of the poor, letting in air through the windows, doors, and chimneys. The patient however should not be placed in a current of air. The discharges from the patient should be in- stantly removed, as also all unnecessary clothes, curtains, furniture dec, the body linen, frequently changed, and soaked when taken off, in water. 222 " Visiters ought not to go into the patient's chamber with an empty stomach; and in doubtful circumstances, on coming out, they should blow from the nose, and spit from the mouth any con- tagious poison which may adhere to these passages." Other means, much recommended for destroying infection, are, the fumes of nitric acid, of muriatic acid, or of chlorine; aro- matic vinegar; some of these are injurious when breathed, and cannot be used unless the patient be removed from the chamber. Hot air has been suggested by Dr. Henry, but the easiest, simplest and most effectual is by sprinkling about solution of the chloride of lime or of soda. This effectually destroys foul smells, and is not detrimental to the patient.—See article under head of chloride of lirne and of soda. Ague or Intermittent Fever, Is a fever in which there are intervals of freedom from the dis- ease. It has a cold, a hot, and a sweating stage. The first com- mences with chillness, shivering, chattering of the teeth; the skin is pale, cold, and contracted; the pulse quick, small, irregular; drowsiness is common, together with many of the symptoms already mentioned as indicative of fever. It lasts more or less time, when the second or hot fit comes on. In this there is flushed face, dry, hot skin, vomiting, dec. The third stage commences by sweat breaking out on the forehead, and spreading from thence over the body; all the symptoms abate, and the patient is left languid, but free from fever. The chief kinds of fever are the quotidian, in which the fever comes on every day, the fits attacking generally in the forenoon; the tertian, in which its fits attack on the first and third, leaving an intermediate day free ; the quartan, where the fits take place on the first and fourth. TREATMENT.—" The treatment of intermittents must be considered under two distinct heads : namely, that which is proper during the paroxysm, and that which is to be employed during the intermissions, and upon which the radical cure of the disease de- pends." " Various means have been adopted for the purpose of curtail- ing the cold stage ; and of these emetics and opium, or laudanum 223 appear to be the most efficient. An emetic administered at the beginning of this stage will frequently put a speedy termination to its progress, and a full dose of opium, taken a short time before the occurrence of the chills will generally have the same good ef- fect."* We may therefore in the cold stage begin with an emetic followed by warm cordial drinks, from one to two grains of opium or 30 or 40 drops of laudanum, a drachm of either or both combined with camphor julap ; external heat to the pit of the stomach and extremities. Bleeding has been recommended, and should not be neglected if there appears to be any determination of blood to the chest, abdomen, or heart. Dr. Mackintosh states, that he has seen men in the most severe sufferings from the chills relieved after the abstraction of six, eight, and ten ounces of blood, and he has known three ounces to suffice. The relief, which is the most perfect that can be conceived, is so sudden, when a good orifice is made, that it has surprised and delighted every one who has seen this practice." Dr. Mackintosh had this practice tried on himself in 1810, and although bark and other remedies en- tirely failed, he found that before twelve ounces of blood were drawn, the rigors ceased with all their unpleasant accompani- ments," and neither the hot nor the sweating stage ensued. A pleasant sense of heat succeeded the painful one of cold; and, instead of weakness, he was sensible of an acquisition of strength. Dr. Eberle very properly remarks "when we advert to the circum- stance that bloodletting has been strongly recommended and suc- cessfully employed, to remove the internal congestions which occur in typhus fevers, where there is generally an actual defi- ciency or impairment of the vital energies, it does not appear so very extraordinary that the same means should be adequate to re- store the equilibrium of the circulation, or to remove the internal congestion in an ague, where the vital powers are not impaired, but only oppressed. In the hot stage, where delirium or other alarming local deter- minations take place, it becomes necessary to moderate the vio- lence of the febrile excitement. Bloodletting is of course the most direct and efficient means for this purpose, and should be promptly employed. Opium or laudanum, as in the cold stage, .may be administered, diluent drinks, warm or cold, according to * Dr. Eberle, Dr. Trotter, and other eminent physicians have given their testimony in iu favour. 224 the patient's fancy. Saline draughts, lotions to the surface as ad- vised under the head of fever, steepes to the feet and legs. But it is in the interval we should exert ourselves to prevent a recurrence of the fits. If the bowels be costive, purgatives, as calo- mel and jalap, of (10 grains each), blue pill followed by the black draught, (see Senna); afterwards bark or its elegant extract, quinine, should be taken every second hour in the intermission, or if this be short, every hour; the former in drachm or two drachm doses, the latter in pills of from one to five grains; when the intermission is very long, we may delay the bark/until within a few hours of the expected fit. The most convenient and elegant form for exhibiting the Qui- nine, is perhaps, the following: Sulphate of Quinine, grains 16 Elixir of Vitriol, drops 16 Syrup of Lemon, one ounce. Mix. Dose. A tea-spoonful every hour, or two for an adult. " As this mixture though a very neat and concentrated one, is sometimes much dbjected to on account of its bitterness, espe- cially by children. I have generally prescribed it according to the following formula, by which almost all the bitterness is wholly removed: Sulphate of Quinine, grains 6 Elixir of Vitriol drops 10 Ex. of Liquorice (powdered), 3iss Fountain water ^ij Mix. Dose. A tea-spoonful for a child between two and five years of age.* Different substitutes have been recommended for the bark or quinine, as several species of willow and other barks, tormentel root, chamomile flowers, (powdered), Rhatany dec. dec ; and Doctor Louis Frank, Principal Physician to her Majesty, Maria Louisa Duchess of Parma, speaks in the highest manner of black pepper being a cure for ague. He prescribes from ten to twelve whole grains to be taken twice or thrice a day, and asserts that it almost invariably cured the disease : but not one of these last mentioned • Eberle'i Practice of Medicine, vol. i, p. 90. 225 specifics is to be much depended on. Carpenter's Compound To- nic Extract has been much extolled by the most respectable prac- titioneis, as a certain and efficacious remedy in the treatment of intermittents. See catalogue of drugs, and also advertisement of the stated properties of this invaluable preparation. As is truly observed by Dr. Eberle, "There are few dis- eases over which the imagination exercises a more powerful con- trolling influence, than intermitting fever. In all countries and ages, this malady has been peculiarly favourable to the extrava- gant pretensions of superstition and imposture. Amulets and the most absurd practices have been always more or less in vogue, among the common people, as means for arresting the progress of this disease; and the reality of a mysterious power in these spells, is sufficiently demonstrated to the minds of the vulgar, by the oc- casional disappearance of the disease under their occult influ- ence." In situations and seasons where ague abound, persons should live rather above than below par, and have comfortable clothing: wine not taken to excess, and quinine or bark, especially the pre- paration called " Carpenter's Precipitated Extract," will be proper as preservatives. After agues have been apparently cured, they may recur. The treatment should be protracted a fortnight after the apparent cure. Inflammation. When we see a part preternaturally red and swollen, and find it is hot and painful, we say it is inflamed. If the inflammation be extensive, or of an organ, the functions of which are very im- portant, it is sure to be accompanied by fever, or a general dis- turbance of the system. " The susceptibility of the body for inflammation is of two kinds ; the one original, constituting a part of the animal econo- my, and beyond the reach of human investigation; the other ac- quired from the influence of climate, habits of life, and state of the mind over the constitution."—Hunter. "The first kind of susceptibility being innate, cannot be di- minished by art; the second may be lessened by the mere avoid-. 29 226 ance of the particular causes on which it* depends."—Cooper's Surgical Dictionary. Inflammation has been divided into phlegmonous and erysipe- latous, into the acute and chronic—simple and specific. The term phlegmonous is usually applied to a circumscribed tumour, attended with heat, redness,tension,and a throbbing pain ; and often ending in the formation of pus or matter. The erysi- pelatous, by the affection being most confined to the skin and immediately under it, and spreading widely over them. In acute inflammation the symptoms are severe, and the disease quick in its progress; the colour of the affected part is bright red, and the fever strong. In chronic the disease is of long and uncertain duration, the symptoms milder, the redness of a darker hue, pain not great, little or no fever. Inflammation of internal parts are marked by pain, derangement in the offices or functions of the part, fever. Under different heads these inflammations will be more particularly described. Inflammation ends in resolution, or the gradual return of the natural state—in suppuration or the forming of matter—in ulcera- tion, or forming an ulcer—in mortification, or the death of the part. In some places the action ceases by parts in contact with each other becoming adherent; at other times by the effusion of watery fluid. CAUSES__Wounds, bruises, sprains, great heat or cold,sor quick changes from one to the other, corroding or irritating matters ap- plied to a part. When the cause is not discovered it is said to be spontaneous. TREATMENT.—"In every inflammation, the first object of the surgeon should be to procure resolution; and this may often be ac- complished by removing the exciting causes of the disease. Two classes of remedies may be resorted to—constitutional and local. Among the former are bloodletting, purgatives, diaphoretics, and low diet. Among the latter, topical bloodletting, blisters, and various external applications." " General bloodletting need only be employed where the in- flammation is high and attended with disturbance of the system. The quantity to be drawn will depend upon the violence of the disease, and the constitution of the patient. Much will depend, 227 also, upon the part in which the disease is seated. Vital parts suffer more readily than others, from depression being induced; but all vital parts are not equally liable to suffer. A good gene- ral rule to observe in all inflammations of the vital organs, is to repeat bloodletting frequently, and to draw only a small portion at a time. In this way depression will be obviated. With respect to tha continuance or omission of bloodletting, the pulse will, generally, be found a good guide. If it be full, and hard, and frequent, and rise .after the operation, a repetition, may, perhaps, be necessary." " Perhaps the most certain indication of the pre- sence of inflammation, is the continuance of pain ; and so long as this remains severe, we can scarcely go wrong in the detraction of blood." (Gibson's Surgery.) Purgative Medicines, (such as epsom salts and senna, Seidleitz powders, dee,) are recommended. After they have acted, dia- phoretics, such as tartar emetic, and James' powder, or a combi- nation of them with calomel; nitre; mindererus spirit, dec When the pain is excessive, opiates are sometimes given, combined with the diaphoretics, especially when the bleeding has been premised, and the full effect of evacuations has been obtained. The warm bath will, in particular cases, be found extremely serviceable. But on using it, strict attention should be paid to the degree of tem- perature. " Among the local remedies for inflammation, topical bleeding holds the first rank. It may be performed by scarification, cup- ping or leeches. The first is employed only in certain cases; the second is, generally, applied to parts loose and yielding, and not very sensitive ; while the third is adapted to almost every external inflammation, and often proves of immense value. The number of leeches must be proportioned to the size of the animals, to the quantity of blood necessary to be drawn, and to the part affected." Blisters are very efficacious in most inflammatory diseases. They should sometimes be applied directly over the part, and sometimes in its vicinity: when small, and frequently received, they generally produce better effects, than when large, and applied at long intervals. Sinapisms and Issues, are both, occasionally, used in the reduction of inflammation, and will frequently be found useful. " Cold applications, such as the acetate of lead dissolved in wa- 228 ter, cold water itself, ice water, a solution of muriate of ammonia" in spirit and vinegar, and other similar medicines, kept to the in- flamed part by linen rags, and changed as often as they become warm, will prove eminently beneficial." " Strange as it may ap- pear, in certain constitutions, and in inflammation of particular parts, cold applications do mischief, and the disease is only bene- fitted by fomentations and warm poultices. Whenever such effects are found to follow, the cold should be discontinued in- stantly, and warmth substituted in its place." (Gibson's Surgery.) If there be swelling, friction, either with the hand dry or some oily or stimulant lineament, is sometimes found serviceable. A regulation of the digestive organs, low diet, or a strict atten- tion to regimen ; also rest and position are of immense conse- quence in the treatment of inflammation. Suppurative Inflammation. The formation of matter is denoted by slight chills or shivering; the pain becomes more dull and throbbing, the swelling more conical or pointed, yellowish at the summit; finally by pressing the tumour between the fingers of both hands, a fluid is felt mov- ing between them. This collection of matter is called an abscess. TREATMENT.—" As soon as it is ascertained that inflamma- tion must terminate in suppuration, the remedies employed for its reduction should be abandoned at once, and those substituted which promote the purulent secretion. For this purpose, local applications, fomentations and warm poultices are indispensable. Poultices are more useful than fomentations, as they retain their heat longer and are more easily applied and removed. The heat of a poultice should somewhat exceed that of the inflamed part." (Gibson's Surgery.) Abscesses if left to themselves under the poultice, usually break; but it is often necessary for the surgeon to open them— after the discharge of the matter, the poultice should still be con- tinued for a few days, when the cavity may be treated as a simple ulcer. Ulcer a fed Jjleers May be classed, as simple, irritable, and indolent. To these may be added malignant and specific ulcers. 22 & The simple is marked by the discharge being of a consistence much like cream, with little smell ; by its surface being studded with small pointed red grains of flesh; on which, at the edges, which slope even with the skin, a thin filmy scarf-skin is seen. There is little pain in this ulcer. In the irritable, the discharge is often thin, or greenish, or tinged with blood, often very fetid ; the surface is not red or clean, with the little grains appearing, but either covered with a dirty, grey, or ash-coloured slough. Sometimes it is clean, smooth, glased, and of a dark or fiery red ; the pain is generally conside- rable, often very great; and the ulcer, instead of skinning, is per- haps ulcerating, or eating its way on. In the indolent ulcer, the surface is often pale, the discharge thick and adherent, or it may be thin and watery ; the little grains of flesh, if any, are not so compact and pointed as in the simple ulcer ; but larger and more flabby. The surrounding parts are often thickened and hard; there is not in general much pain. These ulcers may last for many years. The character of ulcers are often mixed and changeable. An in- dolent may become an irritable ulcer, and vice versa. A simple ulcer may, by neglect, end in either. TREATMENT must be modified according to symptoms. The simple may be dressed by putting a small bit or bits of lint on the surface, and over this some mild ointment, as that of wax or sper- maceti, with a few folds of soft linen or lint above it to soak the discharge, and a bandage over all to retain the dressing. In some instances, a poultice of bread and milk or water, or linseed meal will answer better. Occasionally a gentle astringent lotion of white vitriol, alum, or decoction of oak bark, applied by means of dossils of lint. Once a day will in general be enough to dress with ointments. A poultice should be changed thrice a day. Irritable ulcers require more varied means. Poultices are often useful; they may at times be impregnated with different matters, such as decoction of poppy, watery extract of opium, sugar of lead: lotions applied on dossils of lint of the above descriptions. Some- times other lotions, as acids much diluted, solutions of mercurial acid, other salts, lime water, chloride of lime or soda. When they are making rapid progress, the application of strong acids or caustics may be necessary, for which purpose the surgeon should be consulted. Occasional purgatives, and sometimes anodynes 230 are recommended. Besides the ordinary poultices, those of car- rots, turnips, hemlock, charcoal, dec, are sometimes employed. The indolent ulcer requires something to stimulate the dull ac- tions of the part. Many stimulants are in use, as basilicon, elemi, citron or diluted citron, verdigris, and other ointments; red preci- pitate, sprinkled on the surface ; different washes ; occasional use of lunar caustic, blue vitriol, dec, dec. In all ulcers that admit of dressing, the proper application of a bandage is of the greatest importance; ulcers of the leg especially require it, unless the leg be constantly kept up on a level with the body, a position by much the best for it. The proper application of a bandage is difficult except to the surgeon ; it requires experi- ence to be able to affect it. Sticking plasters or soap plasters are often used for ulcers on the limbs; they give the firmness of a bandage, in some degree, and narrow the ulcer. Malignant and specific ulcers must be left to the surgeon, as it would be impossible to give proper instructions regarding their very various forms and modes of treatment. Gangrene, or mortification follows, now and then, on very severe inflammation. Its presence is shown by the dark or livid colour the part assumes; large, dark blisters rise on the skin, the part becomes cold, putrid effluvia arises from it, it is in fact dead: the pain of course ceases in it. If the disease has been extensive, the inflammatory fever changes to one of the low typhoid type, the pulse is weak, quick, fluttering. Hiccup comes on, mostly indicating the approach of death. When a part has mortified it must be removed. This is some- times done by a natural process ; a line of separation is formed by the absorbing vessel, between the living and the dead parts : when the surgeon sees this he often completes the process begun by nature : if gangrene has followed quickly after a severe contusion, it is not necessary to wait for this. When gangrene has taken place, the strong inflammatory stage has passed; the patient now requires support, and may have wine, bark, broth, dec. The local applications may be, the fermenting poultice ; poultices made on porter grounds, or with yeast; warm spiritous applications ; bal- samic applications ; or ointments mixed with spirits of turpen- tine. Chloride of Lime will correct the smell. In old persons a slow and painful kind of gangrene sometimes 231 occurs, commencing on one of the toes, and spreading to the feet and leg. It is mostly ascribed by the sufferer to some slight hurt, as from cutting a corn too closely. It is a very painful and dan- gerous disease : opiates and tonics are the best remedies, with un- irritating local applications. Erysipelas is marked by redness of the skin, which terminates abruptly: it becomes pale for an in- stant, if the finger be pressed on it. There is a diffuse swelling, which is often considerable when it attacks the face, closing up one or both eyes. The pain is hot and pricking, small blisters frequently rise about the third or fourth day on the part. The face, feel, legs, or arms are most commonly attacked. Fever either accompanies or precedes the local affection. CAUSES.—Such as in general excite inflammation, peculiar atmospheric constitution, particular individual disposition. Its duration is uncertain; but may be said to be commonly from ten to fourteen days. Some cases are very slight and end without the small blisters; while in others the affection is very severe and dangerous, either from the extent, for it sometimes gradually traverses the whole surface, the nature of the accompa- nying fever, which may be of the worst typhoid type; and in this the parts attacked may run into gangrene ; or from the local situation, erysipelas of the head, sometimes, indeed, that of other parts, suddenly leaving the skin, and the brain becoming affected as marked by delirium or stupor, dec. ; this is very dangerous. When once erysipelas has attacked, there seems to be left in the constitution, a disposition to be again affected. Erysipelas com- monly ends by casting off scales from the surface of the skin ; but sometimes causes the formation of an ill-conditioned matter, or sloughing under it. T REATMENT, general and local. The general consists in bleeding if the patient be young and strong, and the affections have much of the character of common inflammation; emetics,. and purgatives. Tartar emetic has been highly extolled in divk ded doses, at intervals of two or three hours ; a grain or two or more in the day. This, frequently, besides lowering the action of the vessels of the part, induces perspiration, which is another object to be sought for. Its use may be continued for one, two, or three days ; low diet, saline draughts, and in general the same treatment that is adopted for fever; being 232 guided by the type of the fever that accompanies the local affection. In fact, if the fever be considerable it is a dan- gerous disease, and should be left to the physician. Local treat- ment consists in warm fomentations and light poultices. Some recommend cold applications, such as diluted solution of sugar of lead. Leeching is highly recommended by Lawrence and others. Some advise the moist surface to be strewed over with light powder, as oatmeal, chamomile, chalk, starch; almost all for- bid ointments. With regard to cold applications, they are not always the safest; for they have a tendency to repel the disease suddenly. The powders are apt to form an unpleasant crust over the part. Deep and large incisions made into the part, are often extremely serviceable. If the inflammation recede and the brain be affected, we must seek to bring it back to the skin by blister- ing or sinapisms. Small Pox Is a fever attended with peculiar symptoms ; the chief is the erup- tion of pustules on the skin. The disease commences with a feel- ing of languor, weariness, aching pains in the back and lower ex- tremities, slight creeping chills, with flushes of heat and pain in the forehead, more or less nausea and vomiting, attended with great thirst. Besides the chills, vomiting, dec. a remarkable pain is often felt at the pit of the stomach, and there is an increased flow of saliva ; young children are apt to be attacked with con- vulsions. " When the fever is completely developed, the skin and face are dry, the tongue white, and generally red at the point, the bowels torpid, and the urine scanty and of a deep red colour. Du- ring the first and second days of the fever, slight hemorrhages from the nose are apt to occur; the mind often becomes dejected and confused, and towards the end of the third day, the tongue usually acquires a bright red colour. Shortly before the appear- ance of the eruption, an unusual tendency to perspiration gene- rally occurs in adults, and frequently much drowsiness, and some- times coma supervene at this peiiod." "In many cases the hands and feet are cold throughout the whole course of the disease, more especially in very young children."—Philip. Febrile dis- eases. " Towards the end of the third, or beginning of the fourth day 233 from the commencement of the disease, the eruption begins to make its appearance. The pustules appear first on the forehead and on the parts about the mouth and nose, next on the forearms and upon the breast and abdomen, and last of all on the lower extremities; so that in about twenty-four hours the eruption is completed;* the fever is then sometimes mitigated sometimes aggravated. On the apex of the pimples, small, clear vesicles form, which increase in size and get yellow, or maturate about the eighth or ninth day. A little before, or about this time, the face often swells so that the eyes are closed; subsequently the pustules decay, and at length form crusts, which gradually fall off, leaving either dark red spots which remain for a considerable time, or pits which are permanent. There is a great diversity in the number of the pustules; when they are numerous ihere is usually much fever and iiritation. When the pustules on the face run together, the disease is conflu- ent and very severe; where they do not, the disease is simple. The accompanying fever may present every shade f.om the simple to the worst form of typhus. TREATMENT.—The patient must be managed according to the nature of the accompanying fever. (See Fever.) Gentle pur- gatives, repeated as often as necessary, mild refrigerant diapho- retics, (such as Nitre with small doses of Tartrate of Antimony, the saline effervescing draught, sweet spirits of nitre, with antimo- nial wine, dec. may be used for this purpose,) cool air, cool drinks, light covering, low diet, will be sufficient in mild cases. " If the fever continues after the eruption is completed in the distinct variety of the disease, it will still be proper to go on with the cooling treatment; together with mild laxatives, diaphoretics and antimonials." Adults suffer more and escape worse from this disease than children. For the convulsive fits, see Convulsions. Convulsions often precede a mild disease. Great care should be taken of the eyes, as the pustules some- times affect the globe of the eye and injure the sight; to prevent this pieces of folded linen, wet with cold water, should be kept applied to the eyes during the eruptive fever. • Dr. Eberle's Practice of Medicine. 30 234 To open the pustules and touch them with lunar caustic, in substance or strong solution, may prevent the pitting. In 1825, M. Velpeau read a memoir before the Royal Academy of Medi- cine, of Paris, tending to prove that if the pustules of small pox are cauterized during the first two days with lunar caustic, their progress will be arrested. This practice was sometime after tested by Dr. Meyreux. According to his report it appears, that if the various pustules are opened with a lancet and touched with a pointed piece of lunar caustic, on the first or second day of their appearance, they will be wholly destroyed, and leave no marks; but on the third day it will be quite useless. If the eruption soon after it has appeared retrocedes, immediate recourse should be had to means that have a tendency to terminate the circulation to the surface, such as camphor and opium, carbo- nate of ammonia, warm bathing, sinapisms to the extremities, and gentle frictions with dry flannel or the flesh brush. When the retrocession arises from cold, an emetic, with stimulating fric- tions, will often promptly recall the eruption to the surface-" Dr. Eberle's practice of medicine. Measles Are preceded by fever, by soreness, redness; and watering ot the eyes ; short, harsh, dry cough ; sneezing, hoarseness, and run- ning from the nose ; on the third or fourth day an efflorescence takes place on the face and breast, and spreads thence to the arms, legs, and rest of the body. The eruption is rough on the arms, and consists of very minute pimples, with general redness between them making up spots: these spots assume a semi-circular or ser- pentine figure, leaving interstices of natural skin. The fever, cough, hoarseness, and other symptoms are rather aggravated by the eruption ; on the fifth or sixth day the spots on the face begin to dis- appear: the scurf skin fallsoff in branny scales; this process spreads in two or three days over the entire body. TREATMENT.—The degree of danger depends in gen- eral on the nature of the accompanying fever, which may be simple or typhoid. The disease must be treated according to this. 235 The following paragraph is taken verbatim from Dr. Eberle's excellent treatise so frequently before referred to. " In relation to the treatment of this disease (measles), the prac- titioner will do well to bear in mind the important truth contained in the following observations of Dr. Armstrong. ' From an im- partial consideration of the facts, which have come before me,' says this writer, ' I am convinced that our plan of treating mea- sles (in its regular form) is too uniformly active when the eruptive fever is developed ; and that we should be more fortunate in the main if we interfered less with the operations of nature in cases of a mild and regular character.' Of the importance of this obser- vation I am thoroughly persuaded, both from my own experience and from what I have had occasion to witness in the practice of others. Even where the general febrile excitement is considera- ble during the eruptive fever, an active antiphlogistic or depletory treatment is not only generally unnecessary but sometimes de- cidedly injurious, provided no local inflammations be present. We must view the eruption in this, as in other exanthematous af- fections, as a sort of critical or metastatic deposition on the sur- face, by which the animal economy endeavours to relieve itself from some internal morbific irritation. The appearance of the rash is essential to the perfect and safe resolution of the disease, and whatever greatly interferes with the regular progress of the precursory fever, has a tendency also to interrupt the regular ap- pearance and character of the eruption. When, therefore, the eruptive fever is regular, not very violent and unattended with internal inflammations or congestions, the remediate treatment should be gentle. In general all that is required in such cases, is to keep the bowels open by mild laxatives, and to allow the pa- tient the free use of tepid diluent drinks; and in instances atten- ded with a moderate degree of febrile reaction, some of the mild- ly stimulating diaphoretic ptisans, such as infusion of sage, elder blossoms, marjorem, balm, or eupatorium, should be ordered. In cases attended with a high grade of fever, moderate abstractions of blood are, without doubt, proper, and ought certainly not to be neglected. The refrigerant diaphoretics, also, are decidedly indi- cated and often suffice, without bleeding, to procure an adequate reduction of the general excitement. Small doses of antimonial wine with sweet spirits of nitre, the saline effervescing draught 236 and particularly the following mixture* maybe usefully employed for this purpose." The chief accidents that are to be guarded against or met with, are inflammation of the lungs, and its consequences 5 diarrhaea; dropsy ; obstinate and dangerous ophthalmia. For each of these, see under the different heads. Sometimes the eruption will sud- denly recede, and alarming symptoms arise ; such as spasms, con- vulsions, fainting, difficult breathing, coma, or delirium. In this case the warm bath should be immediately resorted to ; blisters applied between the shoulders; stimulating frictions of the skin; hot flannel, or bottles filled with hot water applied to the body and extremities; sinapisms to the epigastrum; together with the use of warm and gently stimulating drinks, are the principal means upon which our dependence is to be placed—injections may be also serviceable. " Camphor is a valuable remedy where a retrocession of the rash occurs." Armstrong speaks favourably of a large dose of calomel, in union with camphor, the powder of antimony and a few drops of laudanum, in this congestive condi- tion of the disease. When this accident is produced by excessive diarrhaea or vomiting, opium in union with camphor is the appro- priate remedy. One grain of the former with two of the latter may be given every hour or two, according to the violence of the symptoms. " It should be observed, however, that moderate diarrhaea, except in very feeble subjects, is rarely attended by any unfavourable results ; and in most instances procures very consi- derable relief. In robust and plethoric subjects especially, a mo- derate looseness of the bowels should not be interfered with, unless symptoms of its injurious influence upon the regular appearance and course of the rash supervene." (Armstrong.) It is of great importance, in the remediate management of mea- sles, to guard the patient against the influence of variable temper- ature. Neither a very cool, nor a warm and confined air is proper in this disease. An equable temperature, which produces neither a feeling of much warmth nor chilliness is the most suitable. * Mindererus Spirit 6 ounces. Sweet Spirits Nitre 1 1-2 ounces. Antimonial Wine 11-2 drachms. Syrup of Lemon 2 ounces. Mil.—Dote for an adult a table-spoonful, every two or three hours. 237 When the eruptive fever is very moderate, and the patient of a feeble and irritable habit, the temperature of the sick chamber should be such as to communicate a moderate sensation of warmth, and this is more especially proper in congestive cases. (Dr. Eberle's Practice of Medicine.) Various disagreeable and dangerous affections are apt to ensue during convalescence from this disease, arising from the injurious effects of cold during this period. To obviate such consequences from this source, the patient ought to remain within doers, and to avoid every other exposure to the influence of a cold and damp atmosphere. " Even in summer, convalescents should not be suffered to go out of doors, except in the middle of fine days, and not without additional apparel."—(Armstrong.) " The diet, dur- ing the declension of the disease and period of convalescence, should be mild and unirritating, and all kinds of stimulating drinks be carefully avoided." (Dr. Eberle's Practice of Medicine.) ' Scarlatina, or Scarht Fever. Scarlet fever appears under every grade of violence, from the simplest and least dangerous, to the most severe and malignant forms of disease. Generally within the first forty-eight hours after the commencement of the fever, a scarlet eruption comes out sometimes not until the third day of the fever, the efflorescence is diffused generally, not figured as in measles, and of a bright red colour. The eyes are often red and tender, but scarcely over- flow, as in measles. The tonuge is white, with prominent red pimples about its tip, resembling the points on a strawberry : sore throat attends or forms the worst symptom ; cough also is present. The eruption keeps out three or four days; as it decays the fever subsides, the scurf skin falls off in scales or peels off in flakes. Scarlatina has been divided into the mild, the anginosa, and the malignant. In the first, the fever is moderate, and the treatment simple. Mild purgatives, as senna, rhubarb, dec, or enemata ; a mild unirritating liquid diet, cool or tepid drinks, such as barley water, toast water acidulated with lemon juice, or muriatic acid, or lemonade ; confinement in a moderate and equable tempera- ture, with the use of slightly astringent and emollient gargles, such as sage tea with a small portion of alum, and sweetened 238 with honey, or an infusion of green tea, is all that it is in general necessary to resort to in cases of this kind. A piece of flannel with liniment put round the neck is sometimes useful. If consi- derable febrile excitement becomes strongly developed, it should be moderated by purgatives, tepid effusions, cooling drinks, rest, ventilation, and some of the milder diaphoretic remedies; such as mindererus spirit, sweet spirits of nitre, or small doses of ni- tre and antimony. In the anginosa, the fever is severe, and the soreness of the throat considerable; whitish or ash-coloured spots are seen on looking into it on each side of the root of the tongue, under which are sometimes foul ulcers, breath fetid; the spots and ulcers may spread down the throat and air passages. It is a dangerous affection. In the malignant the fever is of the worst typhoid type ; swal- lowing very difficult; fetid and gangrenous ulcerations spread over and down the throat. In some cases of this disease, espe- cially in persons advanced in life, the eruption either disappears or never appears. It is highly dangerous. TREATMENT must be guided by the kind of fever accom- panying. In the two latter species, gargles are especially called for ; those made of chloride of lime or soda will be found particu- larly useful ; or with decoction of bark and muriatic acid ; that of cayenne pepper, made moderately stimulating, has been much praised. Where the ulcerations spread down, the chlorides may be given internally. The treatment of scarlatina, especially these two last forms of the disease, should be left to the physician. Scarlatina is often followed by dropsical swellings of the legs, they usually subside in a short time by purgatives, cream of tar- tar, and diuretics. Other febrile eruptive diseases are the Chicken Pock, Shingles, Nettle Rash, Red Gum. In all the bowels should be attended to ; if the stomach be out 239 of order, give an emetic, afterwards purgatives and diaphoretics. They are mostly slight affections. The Chicken Pock might sometimes be mistaken for small pox; the preceding fever is, however, slight or irregular, the vesicles are limpid, and do not maturate, and thus have less inflammation surrounding them. Nettle rash is like that produced by the stinging of nettles; there is itchiness, and the eruption comes and recedes with quickness ; rubbing or scratching brings it out. Antacids, joined to purga- tives, such as magnesia and rhubarb, are useful. The eating of some kinds of food, such as shell fish, occasionally causes it. Shingles Is sometimes a more severe affection, a number of watery blobs, surrounded by inflammation, appear on the sides of the body, somewhat like a belt: the word is probably a corruption of cingle. It is said when the belt is complete, (a rare occurrence) that there is considerable danger. Cow pock matter taken originally from the cow udder, being innoculated into the human body, induces a mild disease, which, although not an infallible preservative from Small pox, must still be regarded as an invaluable means for lessening the amount of mortality, and as deserving all confidence as a pro- tecting power against small pox. " For although it may not, in many cases, render the system wholly insusceptible to the vario- lous infection, yet the number of instances in which it affords perfect immunity from small pox, is beyond all comparison greater than that in which it fails to afford complete protection ; and even where it does not entirely subdue the susceptibility to the small pox, it almost invariably lessens it to such a degree as to render this latter disease so mild and simple as in most instances scarcely to require any remediate attention."—(Dr. Eberle's Practice of Medicine.) After innoculaticn, on the third or fourth day, the point is seen inflamed ; by the eighth or ninth the vesicle is complete, its surface flat, its circumference not quite regular. A red efflorescence surrounds the vesicle. In a few days it scales and falls off, leaving an irregular mark. Red Gum, Or Red Gown, consists of scattered spots of minute pimples 240 and efflorescence, frequently seen on the face, arms, dec. of in- fants, or children when teething, dec. Miliary Fever. This fever is characterised by an eruption of acuminated vesi- cles of the shape and size of millet seed, more or less thickly scattered over the surface of the body ; this fever has been named Miliary, because the vesicles resemble millet seed. The erup- tion is by some attributed to over sweating, occasioned by violent exercise during the heat of summer, especially when it occurs in persons in good health ; by others it is considered as a symptomatic eruption " in continued, remittent, inflammatory, and contagious, as well as other diseases;" and this would seem to be the general sentiment at the present day. TREATMENT.—" The attending fever must be treated ac- cording to its character and symptoms, without any regard to the miliary exanthema." " In short where the eruption is symptom- atic, we must prescribe for the original malady, and not for the cutaneous affection."—(Eberle.) When the affection arises from over exercise, as before stated, the treatment required consists in little more than gentle aperients, cooling drinks, a mild and unir- ritating diet, and free ventilation, without, however, exposing the patient to a cold or humid air. In cases where the stomach is deranged, a gentle ipecacuanha emetic may be given with advantage. When the eruption recedes and unfavourable symptoms ensue, we should endeavour to recall it to the surface by warm bathing and mild diaphoretics—such as Dover's powder; and where the arterial action is low, by the in- ternal use of Carbonate of Ammonia, infusion of Virginia Snake Root, Camphor, and Opiates. Hectic Fever Is a kind of remittent fever, that comes on along with or attends consumption, and also some other severe diseases (such as those of joints) which the powers of the constitution are insufficient to overcome.—See Consumption. 241 Rheumatism Is a painful affection that attacks joints, muscles, and other struc- tures. The larger joints as the ankles, knees, wrists, elbows, are most subject to it, as also the loins, back of the thigh, dec It is acute or chronic. The acute generally commences with the ordi- nary initial symptoms of febrile affections, from cold or atmospheric vicissitudes. A sense of chilliness, alternating with flushes of heat, with general lassitude, loss of appetite, and depression of spirits, great pain and restlessness, are the usual symptoms which attend the developement of the disease. The parts affeGted are swollen, red, and extremely painful; the slightest pressure or mo- tion causing the utmost degree of suffering; when perfectly at rest the patient often experiences some abatement of the knawing and tearing pain during the day ; but at night, intense exacerbations usually take place. " Among the most common and powerful accidental predispo- sing causes of rheumatism, are, derangement and irritation of the alimentary canal, the inordinate use of spiritous liquors; fatiguing exercise, accompanied with protracted and copious perspiration, and the habitual use of high seasoned and heating articles of food; and the abuse of mercury."—Eberle. CAUSES.—Suppressed perspiration, from exposure to cold or wet; to partial currents of air, damp beds, dec. TREATMENT, general and local. The first consists in bleed- ing, laxatives not carried too far, as motion is so painful; as a ge- neral rule, the saline purgatives are to be preferred. Dr. Eberle usually directs from six to eight grains of calomel at night, to be followed next morning by a small dose of Epsom or Glauber's salts, and this practice is adopted by numerous leading practi- tioners. "When rheumatism is complicated with functional disorder of the liver, emetics are particularly useful. In instances of this kind, the local pain will almost entirely disappear for a time; and if full doses of calomel and opium are administered soon after the vom- iting has ceased, convalescence will sometimes speedily ensue." (Eberle.) Diaphoretics may be employed with advantage, although little 31 242 or no benefit is usually derived from profuse sweating excited by remedies of this kind. A gentle and uniform diaphoresis is al- ways serviceable. For this purpose small doses of tartar of anti- mony, in union with calomel and opium,* or Dover's powder with calomel, may be advantageously employed, also the saline draught with antimonial wine, colchicum wine, or tinctuie.—(For each of these see under the different heads.) Most practitioners are in the habit of employing opium, in com- bination with calomel, in rheumatism. Dr. Armstrong observes, that after prompt venesection followed up by purgatives with ca- lomel and opium, recovery is often surprisingly rapid. Many highly respectable authorities might be cited in favour of the united employment of these two articles in rheumatism. Dr. Eberle states that after venesection and the free operation of a cathartic, he generally resorts at once to opium and calomel, in the proportion of one grain of the former to two of the latter every three or four hours, until the gums are slightly affected : after which he continued with half a grain of the opium, at first every three hours, and gradually prolongs the intervals in proportion as the disease subsides. Dr. Chambers, of St. George's Hospital, London, gives ten grains of calomel, with two of opium every night, or night and morning, with a daily dose of black draught to evacuate the bowels. He states, that as soon as the mouth becomes affected the symptoms usually subside. He does not push the medicine to the extent of producing salivation. The slightest evidence of the mercurial action in the gums, is in general sufficient. LOCAL TREATMENT consists in leeching ; steeping, some- times the application of cold stimulant or spiritous liquors, proves serviceable ; blistering is also much recommended. " Very little advantage is in general to be obtained from local treatment during the active period of the disease. After the general inflammatory excitement has in a great degree subsided, benefit may be derived from leeching or blistering the affected parts. Flannel is sometimes used wrapped round the joints; but too much heat is injurious. R. Tart of antimony gr. i Powder of gum opium gr. iii Calomel gr, iv Powdered loaf sugar gr. xii Mix,—Divide into 8 equal parts. Take one every two hour*, 243 " The diet should, of course, consist of the mildest liquid fari- naceous articles of food. The drink may be cool and acidulated, except when diaphoretics are administered, when tepid diluents should be used. The temperature of the sick chamber should be kept comfortable and uniform."—(Dr. Ebeile's Practice of Me- dicine) Chronic Rheumatism Is a very common disease, independent, or forming a sequel to the acute. It frequently occurs as a direct consequence of expo- sure to cold and damp air, more especially when the system is under the influence of mercury. The affected parts are commonly neither swollen nor red, nor is there much fever attending this va- riety of the disease. The disease is apt to leave one part suddenly and to be transferred to another, fixing itself, by turns, in the head, shoulders, knees, wrists, fingers, hips, loins, dec. In some instances the pain is seated in the joints ; in others, in the mus- cles and parts situated between the joints. After remaining at rest for a while the patient feels stiffness and pain on attempting to move the affected limb ; but on using exercise, until the body he- comes warm, both the pain and stiffness are apt to disappear. Those who are subject to this form of the disease, generally feel a dull aching pain in one or more joints on the approach of stormy and rainy weather. When the disease affects the muscles of the loins, it is called lumbago, in which case great difficulty and pain is experienced in bending the body forwards on the hips. Once rheumatism has attacked, returns are to be dreaded. Those liable to it are not usually subjects for much depletion. General bleeding is therefore unnecessary or worse. Attention should be paid to the state of the digestive functions and to the bowels. Where the appetite is weak and variable, and the bowels inactive, five or six grains of the blue mass should, occasionally, be taken at night, followed in the morning with some gentle ape- rient, such as the aromatic tincture of rhubarb, or a small dose of the compound infusion of Senna. Different diaphoretics have proved useful, as gum guiacum, Dover's powders;—antimonial powder combined with calomel and opium. Of these the gum guiacum has held by far the highest rank. The volatile tincture 244 of guiacum has been also much employed ; but an aqueous mix- ture after the following form is peihapsthe safest mode of admin- istering it. Powdered Gum Guiacum ^j ---------Gum Arabic 3iij Triturate them together in a mortar, and add gradually ten ounces of cinnamon water. Of this three or four table-spoonsful may be taken daily. It should be remarked, that when profuse sweating takes place in rheumatism, without any perceptible advantage, it should not be encouraged. " In chronic rheumatic pains of the hips (sciatica), and muscles of the loins (lumbago), the spirits of turpentine is among our most efficacious remedies." Dr. Eberle states that he succeeded com- pletely in removing a violent and protracted case of sciatica by the turpentine, given in doses of 20 drops with a scruple of milk of sulphur three times, daily, and other eminent practitioners have employed this article with like success. The tincture of stramonium seed, and also the extract of stramonium are much employed in chronic rheumatism, and frequently successfully. Dr. Eberle states that the tincture has been, in some parts of the United States, long used as a domestic remedy. Caution, how- ever, is necessary in the administration of it. " Colchicum is also a remedy of considerable powers in chronic rheumatic affections." —(Eberle.) Quinine and tonics ; warm baths ; vapour baths, va- pour of sulphur ; vapour of camphor : baths and douches of artifi- cial sulphureous waters; local applications; frictions with flesh- brush, continued for a quarter of an hour at a time, and afterwards with stimulating embrocations or liniments, such as camphor dis- solved in ether; hartshorn and sweet oil, dec. ; blisters repeated if necessary, tartar emetic ointment; mustard poultice ; spirits of turpentine ; acupunturation and moxa; are resorted to by physi- cians of late years. Sweating induced by muscular action, parti- cularly by walking with an additional quantity of clothing, rarely fails to give temporary relief, and has been known to remove the disease altogether by frequent and regular repetition of the exer- cise. 245 Goid Is a painful inflammatory complaint, much akin to rheumatism. It generally attacks the smaller joints, as those of the toes, fingers, foot, dec.; yet it sometimes affects the knees, ankles, wrists. Gout has been divided into the regular, misplaced, retrocedent and atonic. The regular is usually preceded for some weeks or days by lan- guor, flatulence, and other dyspeptic symptoms, which often remit a little before the disease declares itself. The patient may have unusual appetite on the eve of the attack; he goes to bed and sleeps soundly, but is awakened after midnight by a severe throb- bing pain most frequently in the ball of the great toe, or some part of the foot; smart shiverings and other febrile symptoms suc- ceed. The part is found red, swollen, and shining; and the least motion or touch aggravates the pain exceedingly. There is at the same time, great restlessness. This state lasts about 24 hours, when a gentle perspiration comes on, the pain begins to release, and sleep follows. On the subsequent evenings the pain returns, remitting towards morning. A fit of gout is composed of several of these smaller fits; it may last a fortnight, or even for months, the violence of the dis- ease yielding by degrees ; itchiness succeeds to the pain, and the scarf-skin scales off; slight lameness remains for a time. When the fit of gout has passed, the patient is usually left in a much better state of health than he enjoyed previously to the occurrence of the attack. His mind and body are, as it were, renovated ; his appetite and digestion good, and his powers, both mental and cor- poral, are more lively and energetic. " At first, the return of the disease is generally at long inter- vals ; in some instances, only after a period of three or four years; though more commonly, its first visits are annual. The intervals of its recurrence gradually become shorter, in proportion as the constitutional energies are enfeebled by its attacks, until at last, the patient is hardly ever free from it, except perhaps for two or three months in the summer."—Cullen.—Eberle. CAUSES.—Luxurious living ; drinking fermented liquors, es- pecially such wines as are acid ; indolence ; sedentary or literary 246 pursuits; hereditary constitutional disposition to gout. In those disposed to it, a twist, sprain, or other injury, wet feet, excess in food or drink, or any cause that speedily induces debility, may bring it on. Few persons under thirty years, few women, and few of the labouring classes are attacked. It is very common for gout to leave one limb or joint suddenly, and fix on another; re- peated fits of the gout are apt to end in permanent lameness of the joint, or in chalky concretions. Gouty people sometimes die suddenly, yet the disease is not very dangerous, except where sud- den translations take place to internal organs (retrocedent gout), or where those parts are primarily affected (misplaced gout). The Atonic Gout is characterized by languor, great depression of spirits, peevishness, fits of anger, and symptoms of dyspepsia; coldness, numbness, or cramps of the legs and feet, emetic pains; urine pale, often very turbid on resting. Should the force of the disease be directed on any particular internal organ, the symptoms will declare it, if to the head, by giddiness, headach, apoplexy ; if to the chest, by asthmatic affections, palpitations, fainting, dec.; if to the stomach, by pain, coldness, cramp, nausea, d:c TREATMENT.—If regular gout attacks for the first or second time, and the patient be young and vigorous, we may bleed from the arm. This may, in some instances, be repeated if found ne- cessary ; yet bleeding, except when internal parts are affected, is discouraged by many. About purgatives there is great doubt, they sometimes have removed the disease speedily, but they often ag- gravate it, or bring it back when it had nearly disappeared; to re- move costiveness is always proper ;—Scudamore recommends the following pills, and Dr. Eberle states that he has used the combi- nation with very good effect. Compound Extract of Colocynth, 3ss. Calomel, ... grSj XVt Tartar of Antimony, - grs. 1. Mix. Divide into sixteen pills. Two or three to be taken on going to bed. Scudamore also advises the exhibition of cathartics and diuretics conjointly, as particularly useful in the gouty paroxysm. The following draught he recommends as paiticularly useful: Magnesia, grs. xx. Epsom Salts, 3iss. Wine of colchicum 3iss. With a little sweetened water. 247 This draught to be taken at once and to be repeated at intervals1 of four, six, or eight hours, according to the freedom of its opera- tion, and the urgency of the symptoms. Colocynth, with ant'imc nial powder and calomel, may also be administered, repeated at intervals; diaphoretics assisted by diluent drinks; for a few days it will be necessary to abstain from animal food, and also from fermented liquors. When the use of these is resumed, it should be done gradually and sparingly. If there be acidity, the mag- nesia or the carbonate of soda may be given twice or thrice a day. Opiates to ease pain is considered by several eminent physicians as a highly useful medicine ; they do not, however, always answer when they are administered, they should perhaps be combined with diaphoretics, and calomel preceded by purgatives, such as rhubarb and magnesia. Dr. Eberle has administered opium with the happiest effect in this affliction; he says that not only is the extreme pain allayed, but the sympathetic febrile excitement also is generally conspicuously moderated by full doses of this narcotic Other eminent Physicians bear similar testimony to its good ef- fects. A grain of opium with the same quantity of calomel, and one-tenth of a grain of tartar of antimony may be given every hour or two until the local pain is allayed, or the opium by itself may be administered. Leeches to the part affected are sometimes used; some have plunged the limb into cold water—a very dange- rous experiment: others have recommended steepes with spiritous mixtures, and oiled silk to envelope the part. Flannels, eau de luce, and many other specifics have been vaunted ; in some cases they have appeared to succeed, but in general to be useless or dangerous. " Flannel and patience" have been most highly re- commended by Sydenham, a learned physician, himself a martyr to gout. Dr. Eberle says that they have very properly gone out of fashion. " During convalescence, after an attack of gout, a temperate and moderately nourishing diet, with regular exercise and the oc- casional use of mild laxatives, should be enjoined. All suddenly debilitating causes should be shunned, as watching, overfatigue, anxiety, mental labour, exposure to damp. Should the stomach get out of order, this should at once be corrected, Warner's gout cordial will in such case prove serviceable. If the biliary and digestive functions remain disordered, an occasional dose Of blue ^48 pill taken over night, followed in the morning by a gentle aperi- ent, should be taken. To remove the protracted swellings which sometimes remain, stimulating linements may be used, such as soap linement, dec In those subject to atonic gout, strict atten- tion should be paid to the state of the stomach, and to those things in general which preserve health, simple diet; regular, full exer- cise, occasionally antacids, bitters. Stimulants, as wines, high spiced food, are injurious, yet habit often occasions a necessity for perseverance in those hurtful arti- cles; they cannot, and should not be left off, abruptly. In the misplaced or retrocedent gout, the treatment should be prompt; it requires judgment. Inflammation of vital parts should be treated as common inflammation, but we would be rather more sparing of blood. When cramp or coldness and great pain of stomach attack suddenly, which is often attended by great pale- ness and sudden fainting, to give 30 or 40 drops of laudanum, with a spoonful of ether or lavender drops, will be the best practice : if laudanum be not at hand, burnt brandy, or any strong cordial, must be substituted. A tea-spoonful of the oil of cajeput in water would be a good cordial. Frictions or hot steepes over the stom- ach. " When the brain becomes the seat of the translated dis- ease, stimulants and opiates are inadmissible. In such cases our principal reliance must be placed on the speedy and copious ab- straction of blood, together with the use of active mercurial ca- ^ thartics, cold applications to the head, and mustard sinapisms to the feet. In all instances of translated gout, stimulating or rube- facient applications to the feet are decidedly indicated. Irritating purgative enemata also are useful, as well as cupping or leeching over the effected organ."—(Eberle). The physician should, if possible, be at once called in. Scrofula. " Scrofula appears in a great variety of forms and grades of vio- lence—varying from the slightest habitual deviations from health, to the most distressing, rapid, and fatal forms of local and general disease-"—(Eberle). When a person has such a constitution, as renders him subject to glandular swellings ; to slow inflammations; to abscesses which contain a thin matter, mixed with flakes of a 249 cuidy look; to flabby, unhealthy ulcers; to diseases, bones, and joints ; he is said to be of a scrofulous habit. Some have those tendencies very shortly ; few, if any, are so altogether exempt, but that scrofulous diseases may be called into action by accident, or long exposure to debilitating causes. Moist, cold, and temperate climate, impure air, bad or insufficient food and clothing, crowded cities, want of regular healthy exercise, hereditary disposition, favour its development. The scrofulous habit is said to be marked by very delicate fair skin, light hair, blue eyes, thick upper lip; yet those, with dingy skin, and black hair and eyes, are often highly scrofulous. Children are most frequently the subjects of it, though adults are not exempt from some of its attacks. The chief forms of scrofula in children are swellings and in- flammations of the glands, seen most frequently on the sides of the neck and arm pits ; glands in the abdomen, called mesenteric, are often enlarged, making the belly hard and tumid ; chronic in- flammations of the eyelids and eyes ; purulent discharges from the ears; chronic abscesses in different situations; ulcers; diseases and ulcerations of bones; the bones most frequently affected are those of the spine; these are followed by large abscesses in the loins or groins, and by hump back ; the shin bone also is often affected. Another aflectio is the yielding of bones, rickets; here the joints appear large, and the long bones, as the thighs and legs, get a bend, the ribs are often twisted, and the breast bones pro- trude, forming chicken breast; these deformities, if considerable, remain for life. TREATMENT.—There are two very different characters ob- served among scrofulous persons, the one irritable, lively, easily excited ; the other dull, phlegmatic, pale. Health consist in the due admission of the elements; whatever is too much should be re- trenched, whatever too little be added to. In the former class, excitement should be moderated ; in the latter, applied. Wine will excite the one too much, will be useful to the other, in the same way stimulant food. The hours of sleep should be put under con- trol ; the one should not have too little, the other too much: men- tal affection should also be regulated ; among the lively rather checked ; new objects of interest sought for the others. A want of tonic or strength pervades all scrofulous affections. We must strain to supply it by good diet, good air, proper exercise, dec. 32 250 The bowels should be regulated by mild laxatives and antacids, now and then given. Tonics, such as bark, quinine, preparations of iron, are often useful, the cold sea bath, sometimes tepid bath. Several medicines have been advocated, as muriate of lime, muri- ate of barytes, carbonate of soda, lime water, hemlock, burned sponge, iodine ; they require patience, perserverance and skill in their administration, some of them being very poisonous. The local treatment must wary very considerably : leeching from time to time, spirituous stimulating lotions, cold or tepid poultices; sea weed and hemlock poultices, friction, simple, or with iodine ointment, blisters, issues, moxa,are occasionally requisite. Scro- fulous affections of the joints and bones are too serious to be meddled with by unexperienced persons, for they often end' in irremediable deformity or loss of life, after prolonged suffering. Observations confined to the early symptoms of curved spine, hip joint, and knee disease. Curved Spine. Languor, peevishness, slight loss of power; if the child has walked, it trips occasionally and falls; disinclination to stand or walk; the legs in sitting, drawn backwards or cross, the toes pointed to the ground : stiffness of the muscles of the legs and thighs; spasms of them, and twitchings. If the back be examined a slight deviation may be perceived from the regular line, or if pressure be made, or slight percussion over different parts, the child will wince or cry when a particular spot is pressed. Hip Joint. Pain, it is sometimes referred to the knee ; disinclination to ex- ercise ; lameness; the weight of the body in standing is thrown on the sound limb; the pain increased by pressure in the groin or on the upper part of the thigh, while the limb is rolled. The limb is wasted, appears larger than its fellow, the buttock on that side is flattened, its fold lower down. If not arrested in the beginning the patient is worn out, or )eft with a crippled limb. Knee Joint. (White Swilling,) continued or occasional pain; swelling at first 251 trifling or soft; joint rounder, less marked than the opposite; lameness; knee slightly bent, rests on the toes; limb above and below emaciated ; the signs of the former disease not present. Scurvy. " This affection seldom occurs in its more aggravated form, ex- cept among, seamen, although slight, and occasionally even veiy severe diseases are met with in individuals deprived of wholesome nourishment and a pure air, who have always resided on shore." (Eberie-.) Some diseases are called scorbutic among the people, marked by blotches of the skin, chiefly of the face, tender bleeding gums, wheals or dark swellings of the skin. Under any treatment, the blotches are tedious, perhaps not to be removed. The diet should be simple, with a large proportion of fresh vegetables; salt and spiced meats avoided; astringent gargles for the gums; a long use of tar water, of Sarsaparilla (see Fluid Extract of Sarsaparilla) and lime water, of nitric acid, may prove beneficial. Dropsy Is an unnatural collection of a watery fluid, sometimes generally diffused through the body, (anasarca), sometimes confined to a part, as ascites or dropsy of the belly ; hydrocephalus, or dropsy of the head ; hydro-thorax or dropsy of the chest, dec. The immediate cause of dropsy is said to be a perversion of the balance of action of those vessels that naturally deposit, and those that remove fluid from the cellular intestines of the body. The particular causes are general debility, whether induced by loss of blood ; long continued intemperance, or slow disease ; obstruc- tions to the passage of blood or lymph Jin apart; these occuring often prove induration and enlargement of the liver, tumours, dec; over action or inflammation occasionally gives rise to dropsy; we must look to its cause, the age and strength of the patient, its seat, its direction. If the cause be a slow, incurable complaint, though the dropsy be palliated, it cannot be cured. If it come on from a debility, that is removable; from disease that is curable; exposure to cold, or inflammation, a good chance of cure exists. 252 Anasarca Mostly creeps on gradually ; the colourless swelling is seen espe- cially at night about the ancles. If it be firmly pressed by the finger, a pit remains for a time ; the swelling ultimately ascends, becomes permanent, occupies the thighs, dec.; the distension is sometimes enormous. The urine scanty, high coloured, muddy ; the skin dry and sallow, the belly costive. TREATMENT consists in, if possible, removing the disease, or cause giving rise to the dropsical affection, on the principal fitted to each case; removing the accumulated fluid. This is sometimes done by operation, oftener by medicine. The medi- cines used are active purgatives, as jalap and cream tartar, elateri- um, dec, dec.; diuretics, as squills, digitalis, calomel, sweet spirits nitre, decoctions of broom, (sparticum scoparium,) juniper, dec, dzc; sometimes emetics, sometimes diaphoretics. Bleeding is often called for, but it is to the physician the treatment should always be left. Dropsy of the Belly May come on without general dropsy ; the belly swells enor- mously, and fluid can be felt rolling in it by laying one hand on one side, and suddenly striking the opposite side with the other. Beside the general treatment, tapping the belly is often had re- course to, and frequently prolongs life. Diuretics have a better chance after tapping. Diseased liver or spleen are its most fre- quent causes. Dropsy of the Chest Is very dangerous ; its symptoms are swelling about the ancles ; embarrassment of breathing ; impossibility of sleeping, unless the head and chest be raised; frightful starting, and sudden want of breath ; faintings; frightful dreams and moaning; pale or livid lips ; general dropsy. It often depends on disease, or change of situation of the heart or lungs; hence the great danger. 253 Hydrocephalus, OR WATER ON THE HEAD. This requires a more detailed description ; for a removable dis- ease, one that might be prevented, often becomes fatal from neg- lect in the commencement. There are two forms, the acute and chronic The acute is a very dangerous and not uncommon disease among children, often successively attacking several of the same family. Inflammatory action of the brain seems to form its first stage effusion of watery fluid, its second. The early symptoms are fever, quick pulse, throbbing temples, flushed face, but sometimes pale ; pain and heaviness of the head, unusual sensibility to light and sound, occasional vomiting, the child can scarely move the head from the pillow without increasing the pain ; the pupils of the eyes are often contracted: the nose dry, there is sleeplessness, uneasy sleep, grinding the teeth, bowels costive. These symptoms are irregu- lar in intensity ; the fever appears to be rather remittent, being commonly aggravated towards evening; as it advances, the quick- ness of pulse abates, or it becomes unnaturally slow ; often inter- mittent ; the face is pale, sometimes with a hectic flush, delirium, drowsiness, stupor comes on, interrupted by moans, sometimes by wild screams : the hand is frequently carried to the head, the pu- pils become dilated, the eyes insensible to light, the ears to sound : squinting is often remarked. Towards the end, the pulse be- comes very rapid, the child quite insensible, the eye covered by a film, the limbs paralysed or convulsed, the whole surface bathed, not uncommonly, in sweat. The duration is very uncertain, as it often partakes of the chronic form ; it usually extends from two to four weeks ; much may be effected in the first stage by the active and judicious treatment of an intelligent physician. Bleeding from the system and by leeches from the head ; active purgatives repeated frequently, the strength of the pulse should be reduced by the depletion, or the pain overcome. When the purgatives have acted fully, calomel and antimonial powder, repeated every second hour until some effect is produced on the mouth or system : diet rigidly low. The head should be shaved: cold lotions or ice applied constantly, blisters to the back of the neck. 254 When many children of a family have perished by this disease, setons and issues in the arm appear to have saved others from an attack. In the chronic hydrocephalus, the disease is not so easily dis- tinguished, until such progress has been made as renders cure al- most hopeless. The fever is for a time of little intensity, remitting, almost intermitting ; the pain of head only occasional, the size of the head in some cases becomes enormous; the bowels are usually obstinately costive, sometimes very loose, with fetid unnatural discharges. TREATMENT.—According to its intensity : leeching blisters, frequent purgatives, calomel, antimonial powder, foxglove or digi- talis, and other diuretics ; but the experience of the physician is most essential in the management of such active measures. ReferribU to the Alimentary Canal, and Viscera of the Abdomen. Inflammation of the Bowels Is marked by fever, pain, nausea, vomiting, small quick wiry pulse, great distress and anxiety, costiveness. The pain is con- stant, though at times there may be diminution; and any degree of pressure over the belly increases it, or is intolerable ; the person can scarcely lie with the limbs extended, as in this position the muscles of "the belly are made tense over the inflamed bowels. As it advances, there is, with the tenderness, distension of the belly, hiccough, and frequent vomiting, or rather gulping up of the contents of the stomach ; before death, the pain may suddenly remit. It is very dangerous and often rapid ; and demands the promptest anti-inflammatory treatment rigidly enforced, although even there should be appearances of debility. Bleeding, by re- lieving, may give strength ; and must be persevered in until the pain on pressure is reduced ; the bowels must be evacuated ; the 255 stomach being irritable, pills may rest on it better than other forms of medicine ; full injections, repeated thrice or oftener in twelve hours; warm stupes, calomel and opium, given every 2d hour until the mouth be affected. A large number of leeches, four or five dozen at once, applied over the belly often prove useful; when the force of the disease has been checked, a large blister to cover the abdomen. Small swellings about the groin, or navel, (ruptures) often give rise to this disease; if they be discovered, the surgeon should be called in without a moment's delay. Cholic Is a common disease. The symptoms are, excruciating'pain, twisting about the navel, sickness or vomiting. The pain has re- missions or intermissions; pressure rather alleviates it, hence persons often lie on the belly; the. pulse generally distinct and slow. It is mostly owing to spasms of the bowels, excited by costiveness, accumulation of wind, or acrid matters in the intestines, some- times to ruptures. TREATMENT.—If the stomach be not very sick, a dose of castor oil, with compound tincture of senna, or a drachm or two of spirits of turpentine, repeated every second or third hour. If castor oil be not at hand, some other gentle warm purgative, such as the tincture of rhubarb, or the Gregory's powder in peppermint water. If the stomach be very sick, a pill with a grain of opium and two of calomel, followed by a purgative in two hours. Warm stupes to the belly afford great relief. In young and full subjects bleeding is often very proper. Bilious Cholic May arise from over secretion of bile, spasm of gall ducts, or pass- ing of gall stones. In the first case the vomiting is bilious; in the others not so. In the latter the stools are pale, and the skin and eyes are jaundiced; the pain is fixed, subject to remission, at the pit of the stomach. Nephritic Cholic Arises from stone or spasm in the kidneys or their ducts. Symp- 256 toms—-pain in the loins, striking down the thighs; urine scanty, and high coloured or bloody. TREATMENT.—Warm steeping, warm bathes, castor oil, or other mild purgatives, combined with mercurials, if the biliary discharge be disordered or diminished : opiates to relieve pain and spasm. If much fever, in those of full habit, bleed. Dysentery. SYMPTOMS.—Frequent calls to stool, straining, and pain, with scanty, slimy discharges, griping pains, stools often streaked with blood ; fever ; strong pressure on belly painful. CAUSES.—Heat of weather, and changes to cold and wet, im- proper food, acrid matters in bowels, state of atmosphere, conta- gion. TREATMENT.—In the beginning, a grain of opium, with four or five of calomel or blue pill, followed in a few hours by a purgative of castor oil, combined with the tincture of rhubarb, or four or five drops of the oil of peppermint, may cut it short. If the fever be high, bleeding may be requisite. Emetics, as ipeca- cuanha, to clear the stomach ; purgatives, as compound powder of jalap, senna, Daffy's elixir, Gregory's powder, manna, castor oil, rhubarb, dec, must be given freely, and their action kept up ; this last object may be effected by smaller doses of the ipecac or tartar emetic given every fourth hour: they will probably act on the skin, an effect to be desired. If pain be troublesome at night, 10 or 15 grains of Dover's powder, or 5 grains of extract of henbane and 5 of blue pill may be given, mild diluent drinks and mucilages; arrow root, gruel, rice, dec, without wine ; steepes or warm baths, low diet. In the advanced or chronic disease, mild laxatives ; if necessary mercurial, to affect the mouth. Dover's powder or hen- bane thrice a day, anodyne injections at night, and chalk mixture with laudanum ; astringents, such as kino, catechu, the tincture of rhatany, or the compound tincture of pomegranate, bitters, bark, warm baths, mild, farinacious, vegetable food. Flannel should be worn. Rubbing the abdomen with some stimulating embrocation, such as soap, liniment, dec, might be useful. Dysentery is a dangerous disease, and much depends on its be- ing properly treated in the first few days. 257 Diarrhea, OR LOOSENESS. SYMPTOMS.—Frequent liquid discharges from the bowels, without straining or much griping. CAUSES.—Improper food, as unripe fruit, dec, cold acids, sometimes it follows on severe chronic diseases. TREATMENT.—Some gentle purgative to carry off offending matters, such as castor oil, rhubarb, dec, afterwards astringent mixtures, such as chalk mixture and kino, or catechu, repeated every fourth, sixth or eighth hour, diaphoretics and opiates; Do- ver's powders every sixth hour; flannel swashed round the belly, farinaceous diet, rice and milk, arrow root, dec. Costiveness. Many are subject to it. Habit in going regularly every day may overcome it; but medicine is often necessary, as different pills of aloes, scammony, rhubarb, colocynth. Saline purgatives seem proper in summer, to which the essence of ginger may be added in cold habits; simple injections or liniments; a change of medicine and diet is often proper. Vomiting Is mostly a symptom, not a particular disease ; but frequent vomiting is met with where little other derangement is manifest. TREATMENT.—But little of any thing should be given at a time, whether food or drink. The common saline draught, with or without a few drops of laudanum, mint water, infusions of mint with magnesia; milk and lime water, equal parts, a few drops of the spirit of sal volatile, opium, liniments rubbed over the stomach ; blisters over it, total abstinence for many hours at a "ime, the re- cumbent posture ; a little cold brandy and water, lavender drops. Lead cholic, OR DRY BELLY-ACHE. SYMPTOMS.—Obstinate costiveness, gripes, painful twisting above the navel, vomiting of bile, spasm and stiffness of muscles of belly ; tendency to palsy, or actual palsy of some of the limbs, as of an arm. 33 258 CAUSES.—Exposure to fumes of lead, or handling that metal, hence painters, plumbers, printers, dec, are most subject to this disease, sometimes copper gives rise to it, sometimes it seems to be spontaneous. TREATMENT.—The objects are to remove the spasms ; to obviate costiveness and to guard against inflammation, by nearly the same means as those recommended for common cholic When palsy is present, use local stimulant embrocations; electric sparks or slight shocks, used daily 5 or 10 minutes at a time, supporting the limb on a splint, has been found useful. When the bowels have been got to act, the action should be kept up, the fumes of lead should, if possible, be avoided in future, or at least the patient should change his clothes, and wash himself after work, and not sleep in a newly painted chamber. Cholera Morbus. SYMPTOMS.—Frequent and violent vomiting and purging generally of bilious matters, twisting of bowels, cramps of legs, great anxiety and depression, accompanied with exceedingly dis- tressing nausea, in very severe attacks, the muscles of the trunk, as well as the upper and lower extremities are alike affected with cramps. "The thirst is always exceedingly urgent; but every thing received into the stomach is almost immediately thrown up again ; as soon as the disease is completely developed, the pulse is small, feeble, irregular, or intermitting, the hands and feet become cold ; the countenance pale, shrunk and expressive of great dis- tress, a cold sweat breaks out on the extremities and face; and extreme prostration speedily ensues."—(Eberle.) The disease seldom continues beyond 24 hours, without terminating favoura- bly or fatally ; and in many instances it ends in death in the course of three or lour hours and sometimes in a much shorter period. CAUSES.—Exposure to wet and cold, when heated, unripe or acid fruits, or too much fruit, or other indigestible matters. TREATMENT.—" The principal indications in the treatment of the cholera of adults, are to allay as speedily as possible the ir- ritability of the stomach and bowels ; to restore the action of the skin and liver, and to determine the circulation from the internal to the external parts."—(Eberle.) If there be not much sinking, 259 if the diseases be not extremely severe, our object should be to get rid of the contents of the stomach and bowels, and at the same time to dilute their acrimony ; light broths abundantly given, and mild diluents will best effect this. When the bowels are well cleared, we may give a draught of 30 drops of laudanum in cinna- mon water or a pill of calomel and opium, should this be rejected or not procure ease, it must be repeated in one, two, or three hours. If the depression, however, be very great, as soon as the contents of the stomach and bowels are evacuated by the means before mentioned, from 80 to 100 drops of laudanum should be given at once ; and the same quantity with a small portion of water should be given by way of injection. If vomiting occurs soon after the first dose is taken, the laudanum should be repeated in doses of from 30 to 40 drops every 15 minutes, until its influence on the system is fully obtained. Cajiput oil has been recommended, from 20 to 50 drops in a draught, with magnesia. " Upon the prompt and free use of opium and external pevulsive applications, our chief reliance must be placed."—(Eberle.) To obtain this object in conjunction with the internal administration of laudanum we must apply hot stupes or opiate embrocations to the belly. Dr. Eberle states that he has in several instances derived very prompt benefit from the application of the oil of horsemint to the belly, in conjunction with the internal use of large doses of laudanum, when applied in an undiluted state, it inflames the skin in a few minutes and causes exceedingly severe burning pains in the part. The spirits of turpentine may be also used for the same purpose; but its effects are less prompt and powerful than the oil of horse- mint, acids have been highly spoken of, as the sulphuric and ni- tric, their combination with laudanum will increase their effect. " The practice of giving warm spiced brandy and other powerfully exciting articles of this kind is highly improper. Brandy may be allowed in the latter stage of the disease when the prostration is extreme, and it is absolutely necessary to support the sinking powers of the system by potent diffusible stimulants ; but if it be given during the early periods of the disease, with the view of moderating the excessive vomiting and purging, it will not only generally disappoint our expectations, but often manifestly aggra- vate the symptoms of the complaint."—(Eberle.) Dr. Eberle also states, (and he is supported in his statement by the most eminent 260 practitioners) that the sedative powers of opium are eminently cal- culated to allay the extreme irritability of the alimentary canal, and when promptly and efficiently given, will seldom fail to pro- cure complete relief in the course of 60 or 80 minutes ; the same distinguished author and eminent practitioner further states that in not a single instance in which he has resorted to this valuable re- medy, did it fail to arrest the vomiting and purging within the period just mentioned ; and the only fatal case he ever saw was treated chiefly with warm spice brandy. When the cramps in the extremities are severe, much benefit will generally result from rubefacient frictions, particularly from frictions with a strong tinc- ture of cayenne pepper ; or if this be not convenient, frictions with warm flannels, either dry or sprinkled with the spirits of turpen- tine or soap liniment will be found useful in assisting circulation and relieving the cramps. " When the irritability of the stomach and bowels are in some degree allayed, it will be proper to employ calomel in small, but frequent doses, with the view of stimulating the action of the liver. Half a grain of this article may be admin- istered every half hour, and continued until the alvine discharges become bilious, or the disease is subdued.—(Eberle.) The warm bath may be used with occasional advantage in the commencement of the disease. After the disease is subdued, the patient should take light and nourishing diet, such as animal broth. The bowels should be relaxed by castor oil, magnesia or some other mild me- dicine, and if the digestive powers remain weak, a table-spoonful of the infusion of columbo or of gentian or a wine-glassful of chamomile tea, may be taken three or four times daily. Cholera Infantum. The cholera of infants differs in several essential points from the ordinary cholera of adults. It is almost always distinctly fe- brile, and very frequently commences in a gradual manner, with more or less diarrhea, of several days continuance before the vo- miting supervenes. The evacuations, in the early period of the disease, are wholly devoid of any appearance of bilious matter ; consisting either of a whitish, frothy, or of a watery and almost colourless fluid. If the disease does not rapidly exhaust the vital powers, and terminate fatally during the first few days, the patient 261 begins to emaciate ; the extremities become cold; the head and the surface of the abdomen extremely warm ; the skin dry and harsh; the countenance pale and shrunk ; the eyes dull and sunk ; and the pulse small, irritated, and frequent. If the disease be not vanquished by proper remedial measures, the little patient, by degrees, becomes somnolent; he sleeps with the eyes half open, rolls about his head when awake, and at last sinks into a state of insensibility and coma, and dies under symptoms resembling those of the last stages of hydrocephalus. The cholera of infants is vastly more prevalent in large and crowded cities than in the country ; a circumstance which does not obtain in relation to the cholera of adults.—Eberle. CAUSES—" High atmospheric temperature, and the irritation of dentition, appear to be the principal remote causes of this af- fection."—Eberle. TREATMENT.—Where the pulse is irritated, and the head very warm, leeching at the temples or behind the ears is particu- larly indicated, and will seldom fail to procure very manifest re- lief. Blisters behind the ears are also highly recommended. Mi- nute doses of calomel, varying according to circumstances, from one fourth of a grain to two grains, administered every two, three, or four hours, until the evacuations become mixed with bilious matter. The appearance of bile in the stools, whether green or dark, is a favourable symptom. When this takes place, a mild laxative, such as castor oil, or senna tea, should be administered. Ipecacuanha in minute doses, say half a grain at a time, is in some instances found useful in connexion with the calomel as before directed. Where the head is not affected, small doses of Dover's powders, (say half a grain at a time,) given in union with the calomel instead of the ipecac, will prove beneficial. If cholic pains are present, a few drops of the spirits of turpentine will be found useful. Dr. Eberle states that no remedy has appeared to him so promptly to allay cholic pain, and promote the expulsion of urine from the bowels, as a weak solution of common soot, sweetened with sugar. Various external remedies are also re- commended. Stimulating embrocations to the belly, (as directed in the cholera of adults,) blistering the region of the stomach leeches to the region of the liver, cold applications to the head while the body is immersed in a hot bath ; where exhaustion he- 262 comes very great, the system must be kept up by internal as well as external stimulants. For this purpose, the internal use of wine whey, milk punch, or a weak solution of the carbonate of ammo- nia, are indispensable. The proper regulation of the diet must not be overlooked. If the child be weaned, nothing but the blandest liquid articles of food must be allowed. Boiled milk, liquid preparations of arrow-root, tapioca, sago and rice, thin oat- meal gruel, barley decoction, or a solution of gum arabic, are the best articles of food and drink in every stage of cholera. Dr. Rush says that he has seen many children recover from being gratified in an inclination to eat salted fish, and different kinds of salted meat. In some instances they evince an appetite for but- ter, and the richest gravies of roasted meat, and eat them with obvious relief to all their symptoms. Dr. Eberle states that in some instances of a chronic nature, he has known beef tea, or weak chicken broth, to produce a favourable change in the state of the stomach and bowels ; and, he further states that when the inclination for those articles of food is strongly expressed, it may, and ought to be gratified. Change of air from the town to the country is particularly recommended, where this cannot be ac- complished, some advantage may be gained by carrying the patient in the open air; and still more by frequent rides into the country in an open carriage. " As preventive measures, residence in the pure air of the country; the avoidance of cool night air after a very warm day ; nourishment at the breast during the process of dentition, or where circumstances render this impracticable, a very light liquid diet, particularly milk, and a thin preparation of arrow root, with beaf tea, or weak chicken broth, tepid bathing, and lancing the gums as soon as they become swollen by the protru- ding tooth, are the most important. (Eberle.) Indian or Russia Cholera, CALLED CHOLERA SPASMODICA. This species of cholera differs from the foregoing in the num- hex it attacks, its greater intensity, and terrible fatality; it is therefore much more dreaded than that before treated of and con- 263 sequently deserves a more detailed and direct explanation for its management. The simplest and best way of considering this disease seems to be that of dividing it into three stages. First—A premonitory, where there is little more than a threat- ning of cholera. Second—When cholera is fully formed. Third—A stage of collapse or sinking. The first usually consists in a loose state of the bowels, which may continue several days; but it is often of very short duration; sickness or uneasiness of stomach, gripes, or severe pain at the pit of the stomach are frequently added. The matters passed are such as are observed in ordinary diarrhea and vomiting; slight cramps may also be felt. The second is characterized by frequent vomiting and purging, almost always of a pale whitish fluid, in great quantities ; by pain- ful cramps of feet, legs, hands, arms, belly or other parts; a pain- ful burning at the pit of the stomach; the features aie contracted and sharp ; the eyes sunk and surrounded by a dark circle ; ap- prehension, langour and suffering are depicted in the face ; the pulse scarcely quickened, is feeble ; the surface, especially hands and feet, colder and perhaps of a darker colour than natural; there is great thirst, while drinks of every kind are generally vomited almost as soon as taken ; the breathing is slow or not much dis- turbed ; the voice feeble, whispering husky ; the secretions, in general, are suspended: urine is not apparently formed; hiccough is not unfrequent; there is a great tendency to sinking, and the person seems older than he really is. In some few cases there is not purging: in some scarcely any vomiting or cramp, the dis- ease being chiefly marked by a painful load or tightness of chest and stomach, and a rapid sinking. The third stage, that of collapse, gradually succeeds to the se- cond. In it the person seems to lapse into a state of tranquil heedlessness; he will answer questions correctly, even just before death, but with slowness ; the pulse is lost at the wrist and other parts; the dark or blue color is more decided, yet in many this symptom is not observed ; the vomiting or purging cease, or be- come less frequent; the skin is very cold, and generally damp, giving to the touch the sensation felt from handling a frog; the 264 tongue, which is often furred, is cold; even the breath is cold ; the fingers, hands, and other parts have lost their usual plumpness, and become shrivelled ; the patient tosses about incessantly, the breathing becomes labouring, and death takes place, in most cases without any struggle. Such is the usual course of the disease if left to itself, many varieties occurring in quickness and intensity. The first stage may be so short as to seem wanting, or consist only in pain or cramp at the pit of the stomach. The second stage may not en- dure an hour, or extend to two or three days. The entire may end in death in two or three hours, or not for several days ; a long premonitory stage is not always followed by a mild form of cho- lera. When medicine is administered, in rare instances without it, the progress is not so certainly toward death. In general, a speedy convalescence may be predicted, if attention be given early in the first stage. A large proportion of deaths is clearly owing to want of immediate assistance. If the first stage has been neglected, either by reason of its shortness, or its not causing alarm, not an instant should be lost; the friends of the patient must not yield to the same listlessness that is observed to seize on the person attacked. By proper means, it is still probable that the natural tendency to collapse may be averted, the evacuations checked, the spasms moderated, and health restored. These changes may, as in the first stages, be speedy; the return to health being often preceded by tranquil sleep, and free perspiration. But we must not always expect this termination of the disease. In very many, a febrile disease, more or less severe and protracted will follow on the removal of the symptoms described; reaction arises, instead of the cold, contracted, pale, or livid appearance, the feeble pulse, we may see the face become more full and flush- ed, the surface grow warm, and lose the withered look ; there will probably be head-ach, quick pulse, restlessness, dry or foul tongue and teeth, urine high coloured and scanty, sleeplessness ; the vomiting and purging are mitigated, or there will be copious bilious discharges, sometimes (generally a fatal sign,) these dis- charges are bloody, or resemble the washings of raw flesh. 265 From this fever recovery is very frequent; youth and a vigorous constitution being favourable circumstances. If the third or collapse stage has arisen, the chances of reco- very are frequently diminished; yet reaction will, in some cases the most hopeless in appearance, take place; while life remains we should not altogether despair. If reaction occur, the symptoms will resemble those already described. TREATMENT OF THE FIRST STAGE.—If it consist in purging, with occasional slight vomiting, a pill as below* may be given, and repeated every hour or two to the third time; the per- son should stay at home, and keep himself warm ; have mild drinks, as whey, barley water, light broths, arrow-root, dec, and use plain, simple food, without acescent vegetables. Should it not cease within a few hours by this means, then more direct as- tringents may be employed,-]- and repeated every hour or two ac- cording to the urgency. When there is pain at pit of stomach a dozen of leeches should be applied. Some few hours after the complaint is checked, a gentle purgative should be taken.:{: If the symptoms become more severe still, the treatment will merge into that of the second stage. TREATMENT OF THE SECOND STAGE—If a person has just fallen from a state of health, bleeding will be proper to the extent of from twelve to twenty-four or thirty ounces; this often gives the greatest relief, by assuaging the cramps, and re- moving some of the load of blood that the heart seems, with diffi- culty, to move. Frictions with warm flannels, either dry or * Calomel, two grains. Extract of opium, half a grain. Mix. t Chalk mixture, six ounces. Tincture of Kino, or Rhatany, one ounce. Tincture of opium, one drachm. Compound spirit of Lavender, one drachm. Mix.—Two table-spoonsful for a dose. OR—The same quantity of the lollowing :— Decoction of Logwood, or Pomegranate hark, 9ixou nces. Tincture of Catechu, half an ounce. Tincture of opium, half a drachm. \ Rhubarb in powder, a scruple. Ammoniated Alcohol, JO drops. Compound Tincture ol Senna, one drachm. Common water, one ounce. Mix.—To be taken at once. 34 266 sprinkled with spirits of turpentine, or with some liniment,* are extremely useful in assisting circulation and relieving the cramps. To check the vomiting, we may give calomel and opium as below,-|- every second hour to the third time, and in the intervals, by the effects of some of the mixtures:): every quarter, half, or entire hour, according to the urgency of the symptoms. If one dose of the calomel and opium be rejected, another may in a few minutes afterwards be given, and so repeated until the effect on the sys- tem is perceptible. Calomel is given to quiet the stomach ; but chiefly to bring back the bile to the discharges; very tew persons whose mouths can be made tender with it, are observed to die. Cupping or leeching the pit of the stomach is useful, especially where there is much tenderness or pain, but it is seldom much blood can be thus abstracted. To the scarifications or bites, a grain of the acetate of morphia may be applied, if the vomiting be very severe. Blisters are also useful to the same part, and a grain of the acetate of morphia may be sprinkled on the raw sur- face. If the sinking be rapid, sinapisms will act more quickly than blisters; boiling water or nitric acid smeared on the surface with a feather, are recommended as instantaneous blisters. These means may also tend to check the purging. Mere direct means for this purpose, are injections of two or three ounces of thin starch, with a drachm of laudanum, to which a drachm of alum might be added. Nitrate of silver, in the dose of even 20 grains, dissolved in two ounces of water and half an ounce of syrup, has * Water of Ammonia, half an ounce. Olive Oil, one ounce and a half. Laudanum, half an ounce. OR—Laudanum, one ounce. Tincture of Cantharides, one ounce. Camphorated spirits, two ounces. + Calomel two grains. Opium, one grain. J; Infusion of Mint, one ounce. Magnesia, ten grains. Mix. OR—Equal parts milk and lime water, or milk and seltzer water. OR—Carbonate of magnesia, a scruple. Infusion of mint, one ounce. Immediately after let a spoonful of lemon juice be swallowed. OR—Soda water, a wine glass. Syrup of Poppies, a desert-spoonful. Mix 267 been given in extreme cases, and checked vomiting; the same by way of injection, has checked the purging; with some practition- ers, the same has been repeated at the interval of an hour to the second or third time. To check the tendency to sink, recourse must be had to the application of warmth, which is mostly done by jars of hot water, hot bricks, hot salt in bags, tin stomach warmers, dec, applied to the feet, pit of the stomach, and other parts; at the same time various stimulants* may be used and repeated at shorter or longer intervals from ten or fifteen minutes to an hour or two, until reaction takes place, when their use must cease, or rather be reduced in frequency ; when the skin is warm, the pulse freely established and that there is flushing, they are not indicated; but we must not forget that the tendency to relapse from the state of reaction is frequent. When the thirst is excessive, we may allow for drink small quantities of cold or tepid water, acidulated with nitrous acid, or without it; barley water, tea, coffee, bottled ale or porter, bottled cider, seltzer water, milk and water, dec dec. But if vomiting be brought on by them, it will be better to pro- hibit drinks, or restrain the quantity to a spoonful at a time; a slice of lemon may keep the mouth moist. If the head-ach be severe with flushing, leeching to the temples are proper, and per- haps blisters to the back of the neck. Cold lotions to the head may also be applied. If the vomiting and purging ceases, it will be necessary, after a few hours, to give puigatives by the mtuth or in injection. Rhubarb and magnesia may answer, or a dose of castor oil, or 15 grains of jalap in cinnamon water. TREATMENT OF THE STAGE OF COLLAPSE.—Will resemble that of the preceding; but in it the bleeding must be relinquished, as in most cases it only hurries on the fatal event. Every effort must be urged to restore the warmth of the body, by frictions, external heat, dec ; sinapisms or blisters to the pit of the stomach, or to the legs. The calomel and opium may be given in the doses formerly mentioned; also the stimulants, the carbonate of ammonia and cayenne pepper are recommended every » Carbonate of ammonia, four grains. Cayenne pepper, one grain. Made into a pill with conserve of roses. Spiced spiritous mixtures, as brandy, whiskey, rum, punch, in doses of one or two table spoonsful, wine whey, negus, port or cherry wine, champaigne wine, bottled ale. Stimulating enemata, made by adding a table-spoonful of the tincture of assafcetida, or the spirit of tur- pentine, are also indicated in tke sinking stage, or where the spasm exists. 268 quarter or half hour. Two ounces of the spirits of turpentine may be given in injection. If reaction takes place, caution should be used that the stimulants be not too hastily abandoned. Other- wise the treatment exactly resembles that already described. In any event the patient should be watched for several days, and not permitted to expose himself too soon to sudden changes of temperature, or to take such food as may disagree with the stomach; the bowels should be regulated by medicine, if this be necessary,* and bitters and tonics be then given twice or thrice a day for several days.f In fact the treatment after the subjugation of the disease should follow as nearly as possible that recom- mended for the common cholera of the country. The treatment ascribed rests for its support on a vast number of cases. To expect that one specific will remove a disease so very variable in its symptoms seems visionary. The mentioning par- ticular articles praised as cures has been heretofore designedly kept out of view ; it is right however to mention some of the chief recommendations. Opiates in very large doses, combined with calomel; or lauda- num with different extremely warm substances; such as several essential oils, cajiput, clove, peppermint, turpentine, dec; also ether, camphor, capsicum, or cayenne pepper. They have, no doubt, frequently removed cholera in its early stage, but perhaps the failures or injury they have caused by the too liberal use of them, more than balances the good which has emanated from them. * Rhubarb—15 grains, Sulphate of Potass—one scruple, Manna—a drachm. Cinnamon or Peppermint water—one ounce. Mix for a draught. OR Electuary of seuua—one ounce, Powder Jalap—one drachm, Cream of Tartar—two drachms, Syrup of Ginger—half an ounce, Mix. A tea-spoonful for a dose ; OR Compound Rhubarb pill—three pills for a dose. t Infusion of Columbo—five ounces, Tincture of Bark—one ounce, Compound spirits of lavender—two drachms. Mix, Two or three table-spoonsful for a dose. 269 Emetics* given in the first stage, sometimes perhaps in the second, have also checked it; seemingly by the shock, they give the system. In the collapse also they have been used, sometimes with success. Purgatives have also been recommended, chiefly two very dras- tic ones, elaterium and croton oil. Some cases of success with them are also mentioned, but they have not got credit with many practitioners, therefore the mode of administering them is omitted. The saline treatment of Dr. Stephens has been highly praisedf but it appears not to be a favourite plan with many. From its seeming inertness it promises but little. A very curious experiment has been made of injecting large quantities of water heated from 105 to 115 farh. to which a little sal soda and kitchen salt were added,:f: into a vein. In England there have been a few successful cases, although the number of unsuccessful ones have been greater. The object is to supply liquid to the blood in place of that drained off by the discharges. Corrosive sublimate has been extolled in place of colomel, for which, with persons not well aware of its poisonous effects, it is a dangerous substitute. Common salt, in doses of a table-spoonful every half hour, to produce vomiting and purging, have also been used. Some recommend cold water freely as drinks ; and also of pour- ing cold water over the surface even in the blue stage. In some British regiments, particularly the Coldstream guards, the use of copious draughts of warm water, till vomitings were pro- duced, has been highly praised. An eminent French physician (Broussais) recommends ice in- * Mustard is much used for this purpose; about a tea-spoonful may be given in water, and repeated every ten minutes until it produces its effects ; scruple doses of sulphate of zinc, or 5 or 10 grain doses of blue vitriol, or the safer medicine of ipecacuanha will answer the same end. + Carbonate of soda—half a drachm, Common salt—one scruple, Oxymuriate of Potash—seven grains, Mix, and let it be taken in half a tumbler glass of cold water. The common seidlitz powder, or soda draught, or a spoonful of the solution of the car- bonate of soda in half a tumbler of water, given now and then, is said to check the vomiting t About a drachm of common salt and a scruple of sal soda to the quart of water. Some add the whites of two or three eggs. 270 temally, while heat is applied to the extremities. Fresh levigated charcoal, in doses of a tea-spoonful in some aromatic water, was tried with some success in Paris, in the early stage of the disease. Musk, in doses, of 10 or 15 grains, has been said to overcome the spasm and check the vomiting. Suppositories of opium, passed up the rectum, have been used to check the purging. Phosphoric ether has been suggested to be used in the stage of collapse, as also has the oxygen ; and the nitrous oxyde, or laughing gases have been recommended to be inhaled in this stage of the disease. In viewing the wards of a cholera hospital the difference in the state of the patients is very striking; a few affected with cramps will cry out with pain ; some, when asked, will say they have a burning or load about the pit of the stomach ; many in the peculiar choleric voice press for drink, drink ; but the greater majority seem tosufferlittle; they were as if overwhelmed with sea sickness, with- out either actual vomiting or purging. The sick appear to regard with indifference the death of those around them, children gener- ally lie in a dosy or stupid state, without seeming to suffer much pain ; cholera in them might easily be mistaken for bowel com- plaint, or a bowel complaint for cholera : the peculiar aspect espe- cially of the eye, with the quickly succeeding drowsiness and dis- charges, mark the disease. Persons from infancy to old age are liable to it: the young and vigorous adult appears to suffer most, but to have abetter chance of escape then others. The same person is rarely seized twic^ ; but there have been several relapses from want of proper care in diet and too early exposure to vicissitudes of weather. Few of the mildest cases can leave hospital under a week or ten days ; some of the severe have a tedious convalescence. The causes that seem to favour an attack, and ought therefore to be shunned, are such as suddenly reduce the tone of the system, as over fatigue, watching, fear, anxieties, intemperance, surfeits, fastings, improper food, either bad in quality, or insufficient in quantity ; raw or acescent vegetables, much fruit, a mixture of many meats, sauces, and wines; perhaps much fish, exposure to damp, wet feet, sudden changes of weather, want of sufficient clothing or fire. 271 It has been suggested that electrical changes may have been the remote cause of the disease ; but no means have been, to my knowledge, as yet recommended for ascertaining the electrical state of the air. It is worthy, however, of inquiry ; since, in re- ference to some peculiar state of the atmosphere, it has been ob- served that wherever the epidemic has appeared, almost every individual has more or Jess experienced some disturbance in the stomach and bowels, such as flatulence, alternate constipation or relaxation of the bowels, indigestion, dec ; that attacks of apoplexy have been more frequent than usual. It has moreover been remark- ed that in every place where the malady has raged, birds and flies have deserted the spot for the time, and many domestic animals have been apparently affected by a similar disease. It cannot be expected in such a treatise as this, that the ques- tion of contagion should be discussed. Sufficient it is to state, that opinion is much divided on it.* The circumstances attend- ing the spread of cholera, generally favour the opinion of conta- gion. As to controvert this negative proof, i. e., that it does not always spread where it should be expected to do so, seems very insufficient. But when once brought into a country, it is extreme- ly doubtful whether the most exact caution can ward off the dis- ease. On the other hand, a person may expose himself freely, if in good health, and without fear, to contact with the sick. The nurses in the hospitals do not feel any repugnance to lie on the beds which have been lain in by the cholera patients, and no very great proportion of them contract the disease. If duty or mercy demand any person's assistance, he should render it freely and without being alarmed. In such a general calamity there is surely a claim upon almost every one for help in one way or other. Water Brash. SYMPTOMS.—A burning pain about the upper part of the * Dr. Henry made some interesting experiments upon the disinfecting power of increased temperature, as a substitute for quarantine. He found tbat exposure to a temperature of 190 farh. materially injured the tenacity of cotton, but that after a few days it recovered its hygrometric moisture, and with it its original tenacity. Articles of silk, wool, &c, even of the most fugitive colours, &c, were not injured by the temperature of 180 farh. for three hours. Vaccine matter was also exposed to the temperature of 140 farh,, and was deprived of its innoculating power. Other experiments went to prove that the contagious matter of ty- phus, and scarlatina, was rendered powerless by exposure to a temperature of 204 or 204 'arh 272 stomach; eructations, followed by a throwing up of a clear, watery, sometimes slimy fluid. It comes on in fits at uncertain times, mostly in the forenoon when the stomach is empty. CAUSES—Improper diet, as too much vegetable food, and depressing agents ; often obscure. TREATMENT. Regulate bowels with rhubarb, magnesia, dec. antacids, as magnesia, lime water,dec, die, are often serviceable ; also tonics, quinine, and iron : if these do not succeed, opium be- comes valuable. Mineral acids sometimes become efficacious, HEARTBURN seems to be a modification of the water-brash without throwing up. Indigestion, OR DYSPEPSIA, Is a symptom, or rather aggregate of symptoms, indicating dis- ordered stomach. Parts contugous and remote sympathize with the stomach; hence after a night's debauch, there will be loss of appetite, clammy mouth, foul tongue, hot dry skin, restlessness, languor, head-ach, flatulence, depressed spirits, constipation or diarrhea. Ordinarily these symptoms pass off by perspiration, ex- ercise, a draught of soda water, or aperient; but if the cause be often renewed, and circumstances occur to favour its develop- ment, such as overfeeding, sedentary employments, grief or anxiety, dyspepsia of a more permanent character will be produced, and other symptoms perhaps arise, as nausea, or disrelish for plain food, acidities, bilious vomitings ; uneasy, unrefreshing sleep ; ner- vous feelings ; chilliness, dec. The countenance loses its fresh- ness; the frame and mind their activity and vigour. Gout and other diseases follow in the train. Dyspepsia is not in itself fatal, though some of its consequences may be so; it may continue for years. TREATMENT.—The courses or causes that produce it must be surrendered; temperance in food and drink; early hours; agreeable occupation, if possible in the open air and country ; proper exercise; cheerful, quiet society; travelling, change of scenery and ideas are useful. Remove the most pressing symp- toms. If stomach foul, an emetic of hippo ; if acid, the alkalies, magnesia or lime water, these may be combined with bitters. 273 Bitters may be given half an hour before meals three times a day; aperients repeated twice or thrice a week; if flatulence, carmi- natives or aromatics may be joined to the bitters; and mustard, horse radish, red pepper, may be used in moderation with food. It is not useful, however, to stimulate by these means too much, an unwilling stomach. Chalybeate and saline waters, persevered in for some time, are often useful. If the irregularities and dis- ease be of long standing, steadiness and perseverance in the cura- tive means must be enforced, nor should the person be discou- raged; although the first attempts fail, perseverance will in most instances, if not cure, amend. Bile or Bilious Affections Are frequently talked of: they are almost always dyspeptic symp- toms, and should be treated as such. Should the skin and eyes have a yellow tinge, occasional doses of blue pill or calomel may be given, and occasionally succeeded by some mild aperient, as the seidlitz powder, rhubarb and magnesia, dec. Inflammation of the Liver Is acute and chronic. SYMPTOMS OF ACUTE.—Pain of right side, increased on pressure beneath the ribs; a sympathetic pain in the right shoul- der, and sometimes the left; the pain sometimes is felt in the breast; fever; slight dry and troublesome cough, with more or less difficulty of breathing ; yellow or jaundiced hue of the white of the eyes, and skin about the breast, face, and neck ; urine of a deep yellowish brown colour ; the countenance is often sallow. TREATMENT.—" In this disease, as in other inflammatory affections, the abstraction of blood is a primary remedy." As soon as blood has been drawn to an extent sufficient to make a manifest impression on the system, an active mercurial cathartic must be administered. From 15 to 20 grains of calomel, followed in two hours by a full dose of castor oil, or of an infusion of sen- na and manna, constitutes an appropriate and effective purgative in this disease. It is often necessary to repeat the bleeding seve- ral times in the course of the first few days, before the arterial reaction becomes permanently moderated ; and this is particularly 35 27-1 apt to be the case in the disease as it occurs in temperate latitudes^ In warm climates a frequent repetition of venesection is not often necessary or even proper. One or two efficient bleedings in the commencement of the disease being in general sufficient to bring down the febrile reaction.—Eberle. Leeches once or oftener are recommended in case the pain has not been reduced. When the pain is reduced, blisters over the region of the liver; mercurials, as blue pill, dec, given to affect the mouth, mercurial plaster to the affected part; frequent saline laxatives ; bitters. SYMPTOMS OF CHRONIC—Pain very dull; sallowness ; febrile symptoms slight, often irregular. TREATMENT.—" General blood letting is very rarely indi- cated in this variety of hepatic inflammation."—Eberle. Leechings followed by emollient poultices, saline purgatives, mercurials, so as not to produce full salivation, bitters, nitro mu- riatic acid internally and externally. Jaundice and dropsy often follow on chronic inflammation of the liver. Inflammation of the Spleen. SYMPTOMS.—Like those of chronic liver inflammation, but the pain is in the left side. TREATMENT the same. Inflammation of Kidneys. SYMPTOMS.—Pain of loins shooting down to thighs, not in- creased by change of posture, or bending; urine scanty and high coloured. TREATMENT as for inflammation. The mildest purgatives, as castor oil, rhubarb, warm bath, diluents. Jaundice Is rather a symptom than a disease; sometimes depending on biliary cholic, sometimes on chronic inflammation of the liver. See these. % 275 Piles, Are a well known affection: they are either internal or ex- ternal, blind or bleeding. When piles inflame, they are very ten- der and painful. CAUSES.—Sitting on cold or damp seats, when heated; acrid purgatives; enlarged liver; pregnancy, dec. TREATMENT.—If inflamed, apply a leech or two, warm fo- mentations, poppy stupes. Costiveness should in all cases be obviated by gentle laxatives, such as electuary of senna, in union with powdered nitre,* or combined with sulphur, castor oil. Irri- tating purgatives must be shunned; balsam of copaiba is some- times useful. To the part apply ointment of galls, or sugar of lead,f or zinc. "If the piles be inflamed, all astringent applica- tious, with the exception of poultices made with lead water, should be avoided." (Eberle). Temperate living must be enjoined. If the bleeding be not very excessive, it is often very useful to the general health. To check the bleeding, rest; cold to the part; astringent lotions, and injections as of oak bark and alum, applied on soft pads of linen. If an internal pile protrude, it may cause pain and inflammation; it should be pushed back at once. In- flamed piles may cause abscess or fistula. Surgeons sometimes remove piles. Falling down of the Gut. (prolapsus ani.) This affection occurs frequently in children, or with persons afflicted with piles or stone : as soon as discovered the part should be gently pushed back, and kept so by a bandage and pad. Cold astringent lotions, as above. The bowels should be kept free by the gentlest laxatives. * Electuary of senna, one ounce. Powdered nitrate of potash, one drachm. Mix,—Take a tea spoonful once or twice a day, t Lard, one ounce. Sar of lead, one drachm. Mix. 276 OF THE CHEST AND AIR PASSAGES. Inflammation of the Dungs. (pneumonia.) SYMPTOMS.—Pain of side, or under blade bone, often dull, much increased by drawing in full breath, by coughing or sneez- ing; difficult or quick breathing; dry cough ; inflammatory fever. CAUSE.—Exposure to cold or wet. TREATMENT.—Decided anti-inflammatory measures prompt- ly and steadily persevered in; full bleedings; tartar emetic, in doses repeated every second hour; calomel and antimonial or James' powder, repeated every third or fourth hour; blisters. Expectoration becoming free and copious is a favourable sign. It is a dangerous affection. In elderly persons there is sometimes a very insidious and dangerous form of it, (Pneumonia notha;) the pain is but little, but there is a good deal of difficulty of breathing, and fever; assistance should be called for early. Pleurisy, Resembles pneumonia, but the pain is said to be more acute, like a stitch. CAUSES and TREATMENT as in pneumonia. Catarrh, or Cough, Arises from irritation or inflammation of the lining membrane of the lungs and air passages. CAUSES.—Exposure to wet, cold, dec. SYMPTOMS.—Frequent cough; sneezing; thin, mucous ex- pectoration, and running from the nose; sometimes hoarseness; slight febrile movement; at times, there is some general soreness, but not much pain of the chest. 277 TREATMENT.—Bleeding is seldom necessary; abstinence or low diet; gentle aperients; mild diluents; bathing the feet in hot water; diaphoretics; mucilaginous mixtures combined with expectorants ; as small doses of hippo. If the cough last very long, small doses of paregoric elixir, dec ; inhaling the steams of water and vinegar, dec. Whooping Cough. SYMPTOMS.—Violent cough, returning in fits. The cough is composed of several quick expirations, followed by a very full inspiration, giving the peculiar noise or whoop. It is mostly met with among children; it is contagious, affecting a person only once ; its duration is very uncertain. A number of coughs form the fit. A fit commonly ends in the expectoration or vomiting of a slimy mucus. Fever; oppressed breathing; hoarseness; dry cough, usually precede it. When the fit comes on the child ap- pears frightened, and seizes on any support near it; when it has passed, the child quickly returns to its play. When the cough is very severe, there is, (especially in full habited children,) a deter- mination of blood to the head during the fits, and bleeding from the nose is not uncommon. Inflammation of the lungs may also take place. TREATMENT.—Moderate the determination of blood to the head or lungs, by bleeding in adults or full children; leeching either to the forehead, neck, or chest; emetics clear the sto- mach, promote expectoration, and give much relief to children, repeated every day or every other day. Expectorants every third or fourth hour; frictions with anodyne, or stimulating liniments to the spine, chest, and pit of the stomach; laxatives. When the complaint has lasted some time, anti-spasmodics and narcotics ; oil of amber : mixtures with ether, ammonia, lau- danum, extracts of henbane, of belladonna are praised. In the more advanced stage, change of air ; good diet; tonics and absor- bents are required. It is a common opinion that keeping the child exposed to external atmosphere is always useful; this is errone- ous, and the practice has destroyed many. A mild regulated at- mosphere within doors, is more likely to serve the patient. Croup Is a very dangerous affection of the air passages. It attacks 278 children of from 1 to 10 years old, the stoutest are perhaps more liable: once attacked a child gets a disposition to be again affected ; the first is commonly the most severe affection. It occurs mostly in winter or spring, and in damp situations. SYMPTOMS.—It sets in by slight sickness, languor, cough; this gets a peculiar ringing or shrill sound; its violence quickly increases; the breathing is almost convulsive, and hissing; the head thrown back as if in agony ; expectoration usually trifling ; sometimes shreds of a whitish matter are spit or vomited ; at length the lips or perhaps face become livid, and the child may die ex- hausted or convulsed in one, two, three, or four days. Croup is not contagious. TREATMENT.—Must be prompt. Bleeding according to age and strength ; leeches over the windpipe ; blisters ; emetics very useful, repeated often where there is much difficult breathing ; ca- lomel and antimonial powder every hour until some great change is produced on the state of the bowels or breathing; warm bath. Goitre, OR SWELLED NECK. This disease consists of an enlargement of the glands of the neck. It commences with a small tumour on one or both sides of the throat and increases considerably in course of time ; in the early stages of the disease it is soft, elastic and spongy to the touch; the colour of the skin is natural and is moveable over the enlarged gland ; in the progress of the enlargement, however, the tumour becomes more and more firm, until at last, in severe cases, it ac- quires great density and firmness in certain parts, whilst some portions retain their original soft and spongy state. No incon- venience whatever is experienced from the disease while the tu- mour remains soft and of a moderate violence: but when it acquires a large size, it generally gives rise to more or less dffiiculty of respiration and a slight change or loss of clearness of the voice. The tumour in some cases remains stationary for a considerable time, then rapidly increases in size for a short period, and again continues nearly in the same state, or decreases until it again ra- pidly augments in violence ; more generally, however, the progress of the tumour is very gradual and regular." " Although indolent or free from pain or tenderness during the early period of its pro- 270 gress, and in many cases of moderate size always so, yet in the majority of instances, where the tumour becomes large and indu- rated, transient pains are at times felt darting through the enlarged gland, at the same time that the skin assumes a slightly red or copper colour and the veins of the neck become large and turgid." TREATMENT.—Frictions with ointment of iodine over the affected part once or twice a day is considered the most effectual remedy in the treatment of this disease. Dr. Manson used the iodine both internally and externally in the form of a liniment, rubbed into the tumour; the liniment he used was of the following.* " The internal employment of iodine will sometimes give rise to unpleasant symptoms, such as head- ach, giddiness, sickness at the stomach, with some degree of nau- sea, languor and inaptitude for exertion." When these symptoms appear the use of the iodine should be suspended for a few days. The internal use of the iodine, however, except in very severe cases of goitre, may be altogether suspended, as the external ap- plication of it will answer every necessary purpose, at least in the hands of the inexperienced. When iodine is used internally, it is generally by way of tincture, which can be made by dissolving 48 grains of the iodine in an ounce of alcohol, ten drops of which may be given twice daily. Blistering ; frictions with stimulating liniments, mercurial ointment; the vinegar of squills, belladona, various stimulating plasters ; cataplasms, or bags of emollient herbs applied over the tumours ; and compression, have all been recommended, and occasionally, it is said, used with advantage in this affection. Inflammation of the Larynx Is occasionally met with in adults; the symptoms resemble those of croup; the distress is great, and referred to the head of the windpipe: on looking into the throat nothing is seen to answer * Soap liniment—one ounce. Fine Iodine—one scruple. Mix. This was rubbed into the tumour once, and in some cases twice daily. 280 the terrible difficulty of breathing. It is a very dangerous affec- tion, sometimes calling for a surgical operation. TREATMENT as in croup, inhaling warm vapour. Hoarseness Is frequent in coughs, or catarrhs. TREATMENT like that of catarrh ; but liniments or small blisters to the throat are often serviceable. Sometimes astringent gargles, or diluted tincture of cayenne pepper. Pulmonary Consumption, In this country is fatal to a vast number. In some families as the children arrive at maturity they are cut off. As Dr. Morton* remarks, " The hereditary predisposition will amply account for its appearance in several individuals of the same families succes- sively ; and in others it can be traced to a constant watching, anxiety, grief and other circumstances which often prey on those who administer to the necessities of protracted disease." The period of life most liable to consumption has been observed to be between the 18th and 35th years. Dr. Morton most satisfactorily illustrates that fact from his own experience." The same author however states, " that he is confident that many children die of real phthisis whose deaths are attributed to other causes." Dr. Eberle states that catarrhal affections are by far the most common exciting causes of the disease. Dr. Morton quotes Dr. Wilson Philip, who remarks that the mildness of the first symptoms of phthisis constitutes a great barrier to efficient practice : for we can scarcely, says this physician, persuade a patient that he is in danger when he suffers no pain, and scarcely any positive incon- venience ; and yet under those very circumstances, a fatal malady may be undermining the springs of life. " Without suspecting every protracted cough to be a harbinger of phthisis, it is. well to remember that not only can consumption ex- cite a cough, but a cough also may induce consumption : whence the importance of getting rid of catarrhal affections without delay."t * Treatise on Pulmonary Consumption, .page 47. t Dr. Morton's Treatise on Pulmonary Consumption, page 123. 281 These highly respectable authorities are here quoted for the purpose of exciting those persons labouring under protracted ca- tarrhal affections, to consult a respectable and well informed phy- sician without delay, and not to exhibit such palpable recklessness towards themselves, as is so often evinced, by depending on the absurd recommendations of ignorant quacks. The progress of pulmonary consumption is very insidious, slight cough, and pain in the chest, recurring at times, at first little or no expectoration. As the cough continues, there arises shortness of breathing, a wasting of the flesh, and paleness, languor, lassi- tude, loss of sleep. Hectic fever comes on; this is of a remittent kind, having an exacerbation about 11 o'clock in the forenoon, which remits about 5. Towards night there is a more apparent exacerbation, which generally lasts till about 2 or 3 o'clock in the morning : the pulse is habitually quick and weak, when slowest from 90 to 100; the skin is commonly dry; a flush is often seen on the cheek, burning heat felt in the palms of the hands and soles of the feet. The cough becomes very troublesome, the spits more copious, often fetid and purulent, or tinged with blood ; sleeplessness and restlessness, especially in the earlier part of the night, copious sweats, sometimes confined to head, neck and chest; towards the end, diarrhoea alternating with sweating ; ema- ciation becomes extreme. The appetite is various, sometimes good ; bowels may be costive or regular; urine high colored, get- ting muddy by rest. At the conclusion apthous ulcers of the mouth ; the hair falls ; the nails of the fingers bend forward ; the eye is pearly, without a blood vessel in it; legs and ankles swell; raving, dec. With all these signs of death, hope rarely deserts the victim. Phthisis sometimes commences by spitting blood ; it is a fearful disease, destroying in a few weeks or protracted even for years. In its course, there is often appearances of amendment, followed, as the person supposes, by fresh cold and deteriora- tion. The best directed Efforts, almost constantly fail to cure, though they alleviate and protract. But proper treatment may • prevent its development. If the earliest stage be neglected, the case becomes hopeless, for it will be difficult indeed to arrest the progress of the disease. When the tendency is suspected, every pectoral symptom, every delicacy should be carefully watched. If pain in the side, moderate bleedings, laxatives, .expectorant^ ue- 36 282 mulcents, blisters. A great part of what is practicable consists in removing or preventing causes manifestly injurious to general health, as confinement, sedentary and stooping employment, anx- iety toil, dissipation, crowded rooms, cities, exposure to wet, cold, damp, or variations in temperature, light clothing, and at the same time, invigorating by regular exercise, that on horseback is considered particularly useful; plain nutritious diet; cheerful company; early hours; pleasant occasional occupation. Travelling,. especially to warmer climates, sea voyages. Towards the end, it is cruel to send a person to foreign climes, or even to excite hope in the patient by suggesting a removal from the comforts of home. In the confirmed disease, the symptoms must be individually met ,- the cough by proper demulcents, Iceland moss, opiates, the sweat- ting by elixir of vitrio1, or nitro muriatic acid, repeated thrice a day ; the diarrhoea, by chalk mixture and astringents. Milk diet has been recommended, rice, arrow root, dec, and the ordinary farinaceous foods; but as Dr. Morton remaiks, it is not easy to prescribe a diet that shall meet all the emergencies of a con- sumptive habit, for what agrees with one, may entirely disagree with another. Thus, this learned physician observes, I have had patients who confined themselves of choice to a milk diet, the use of vegetables and a raw egg every morning: some could take little else than gum Arabic water; while t/> others meat was obviously indispensible." The patient himself is generally able to judge what suits his own stomach best. In some instances, full diet, with porter, or even ale well hopped, and a little wine, appear to answer the best. The body may be sponged with some spiritous lotion, or with vinegar and water, when the skin is hot and dry. Vaiiois medical treatment is directed, such as iodine, prussic acid, dee, and, in the hands of the practitioner, has been found highly beneficial, as also the inhalation of chlorine and iodine have been recommended ; but the tar fumigation, is in the hands of the unlearned, the simplest and safest. The skilful physician may sometimes be mistaken as to the ex- istence of consumption, so that in all cases the means of improv- ing the health should be sedulously pursued. Asthma. "Asthma is a paroxysmal affection of the respiratory organs. 283 characterized by great difficulty of breathing, tightness across the breast, and a sense of impending suffocation, without fever or local inflammation." The evening before a fit, there is generally heaviness, headach, flatulence, low spirits, and other dyspeptic symptoms. " The paroxysm generally comes on at night during sleep. The patient is seized with great anxiety ; difficulty of breathing, and stricture across the breast, and a short dry cough." The breath- ing at length becomes so bad, that the person must set up in bed, where he gasps for breath, scarcely able to speak. The counte- nance is expressive of great anxiety and distress, and the heart generally palpitates violently. Towards morning, the symptoms abate, and sleep follows. The fits recur for several nights, gradu- ally losing their violence. When they have gone, there is no remarkable difficulty of breathing, though there is often short breath. There is not much danger in asthma, some of the French have called it a patent for long life, (brevet de longue vie,) yet some dangerous affections of the heart, dec, may be confounded with it. Two kinds are described ; the humid, in which there is copious expectoration ; and the dry or spasmodic. TREATMENT.—To prevent asthmatic fits, avoid improper or too much food, especially suppers, exposure to damp, cold air, fogs, great heat, or to sharp vapours of any kind. When a fit is expected it may be warded off by emetics ; expectorants should follow, as hippo, squill, fetid gums, as assafoetida, ammoniac; or combinations with ether, ammonia, paregoric elixir, garlic, dec. The bowels should be kept rather free ; bleeding is not often ser- viceable ; blisters or rubefacients, or tartar emetic ointment. Strong coffee, smoking stramonium, tobacco, hops, dee, have been recommended. Some asthmatics breathe more freely in the most confined situations in cities, than in pure country air. •2«1 OF THE HEAD AND NERVOUS SYSTEM. Apoplexy. " Apoplexy may be defined a sudden loss or suspension of the animal functions, with a slow and full pulse, laborious breath- ing, generally attended with sterlot; whilst the organic or vital functions continue with little or no perceptible disturbance." It is generally sudden in its attacks; " occasionally, indeed, patients feel unusually well, for some time previous to an attack of this affection, and this is most apt to be the case in individuals of a gouty habit."—Richter. It arises from an increased flow of blood to the head, or to the giving way of a blood vessel in the brain. Headach, giddiness, flashes of light before the eyes, noise in the ears, especially when stooping, or if any thing tight about the neck, often precede. The person falls down and is deprived at once of sense and mo- tion; the breath is slow and snoring; the pulse full and slow. Those rather advanced in life, of full habits and short necks, are most liable to it. It often ends, within a few hours in death ; or the insensibility gradually yielding, some parts are said to be pal- sied ; the face drawn to one side ; speech imperfect; or it goes off in a short time leaving little permanent derangement. Those once attacked should feel that they are liable to a repetition of the fit and, avoid every thing that is likely to induce it. CAUSES.—Luxury and over feeding; intoxicating liquors ; suppression of accustomed discharges, as of blood from piles; stooping or lying with the head lower than the body ; tight neck cloth; exposure to too much heat, dec A variety of circum- stances, however, both in relation to the constitutional habit of individuals, and extraneous influences, appear to predispose to this affection. TREATMEMT.—Full bleeding on the instant; if able to 2b.") swallow, the most active purgatives, repeated frequently ; if not, enemata with turpentine, dec. Shave the head and apply blisters ; sinapisms of mustard, or the valuable chemical called " Sinapine," the discovery of G. W. Carpenter, to the feet and legs. Should palsy remain, stimulating liniments, blisters, electricity to or near the part, may be proper ; but the physician's aid should be had if possible. See article under the head of Antimonial Pow- der, which shows the utility of that article, where there is an ha- bitual tendency to an overflow of blood to the head. Epilepsy, OR FALLING SICKNESS. The person falls; loses the consciousness of surrounding im- pressions ; some parts of the body are convulsively agitated ; there is foaming at the mouth; the jaws fixed; sometimes the tongue is thrust out and wounded by the teeth. When the fit has lasted some time, the convulsions subside, and the person awakes, not knowing what passed during the fit. Drowsiness and languor succeed. The fits vary in intensity, duration and number; some- times there is a warning of their invasion by head-ach, noise in the ears, dimness of sight, flatulency, palpitations, a sense of cold air or vapour rising towards the head, more frequently not. The fits may recur every day, or there may be considerable intervals, which are often very exact, so that the recurrence is foreseen. CAUSES.—Injuries of the head ; tumours of the brain; deter- mination of blood to the head ; various mental excitements, as strong passion ; irritation of other parts, as some wounds ; worms in the bowels. Sometimes it appears to be hereditary, or it may depend on too full or too weak a habit. It is most frequently be- fore maturity ; when that period arrives, it may cease, although previously attempts to cure were useless. TREATMENT.—If possible remove the cause. If great full- ness, bleed freely, purge, leech or cup : if we can guess at the ap- proach of the fit, these measures should be taken just before it. Emetics are sometimes useful. When the fullness is reduced or it depends on debility or want of tone, tonics are recommended; quinine, nitrate of silver, preparations of copper, zinc, steel, dec. Antispasmodics, in full doses, may ward off an expected fit, 286 as combinations of opium, ether, ammonia, camphor, musk, dec' Salt put into the mouth of an epileptic person, during a fit, has sometimes aroused him to consciousness. St. Vitus' Dance. (chorea.) SYMPTOMS.—An^almost constant, restless, spasmodic action of some parts of the body ; the arm and leg of the same side are most frequently affected. The movements are almost ludicrous. It generally attacks those between 10 and 14 years old, of a weak constitution. CAUSES.—Constipated bowels, worms, or other irritations, acting in persons of a particularly nervous susceptibility. TREATMENT.—A steadily persevering course of active pur- ging, followed by or accompanied with tonics and antispasmodics ; shaving the head, with cold affusions daily ; blisters to the back of the neck ; electricity. It is often obstinate, rarely dangerous, but fatuity has followed in protracted cases. Tic Doloureux (neuralgia.) Is a most painful affection. It for the most part oecupies the nerves of the face, although, it occasionally appears in other parts of the body. During the paroxysm the patient suffers the most excruciating agony. The disease more commonly arises in per- sons of an irritable constitution, especially when the strength has been broken down by any particular cause. It may be brought on by cold, damp weather, fatigue, injury of any part of the body, long sickness, mental uneasiness. Dr. Macculloch insists on the malarious origin of neuralgia; and Dr. Eberle says that there can scarcely exist a doubt, that in many instances, neuralgic affec- tions are nothing more than masked agues. The true nature of the disease, however, has not been satisfactorily ascertained. Some Practitioners have considered it of a cancerous character; others have supposed it to be a diseased state of the nerves 287 themselves, whilst more havecome to the conclusion, that it is depending on gouty and rheumatic irritation. TREATMENT.—Blisters; local bleeding; stimulating embro- cations ; anodyne, liniments, of laudanum, tobacco, belladonna. Cold applications have been also used with temporary success, as ice, Goulard's extract undiluted. The internal means which have been found most useful are, opium; black drop; acetate of mor- phia; belladonna; hemlock; bark; quinine; the carbonate of iron ; the nitrate of silver and the solution of arsenic : but these remedies should not be resorted to unadvisably. Hysteria Generally attacks females between 16 and 40 years. Sometimes delicate persons of the male sex. The most constant symp- tom is the sensation of a ball rising up from the abdomen to the throat, where it becomes fixed, and causes a feeling of suffo- cation ; to this are generally joined depression of spirits; palpi- tations; weeping without sufficient cause, alternating often with laughing ; insensibility to outward impressions ; convulsive writh- ings ; screaming; frothing at the mouth; grinding the teeth: delirious raving, dec. More or fewer of these symptoms may consist, and the intensity and duiation of the fit is very doubtful; it may last for some days. As it declines, sensation and volun- tary motion gradually return ; frequent eructations from the sto- mach take place, and the patient recovers, sore, languid, and with a headach. Other strange symptoms occasionally occur, as vio- lent pains, hiccough, profound sleep, spasms. CAUSES.—Different emotions, as joy, fear, anxiety, acting on irritable constitutions; the seeing or hearing others similarly af- fected, late hours and debilitating causes. It is not dangerous; but in some rare instances it ends in epilepsy, or insanity. TREATMENT.—When the fit is present, if the pulse be very full, bleed; excite by applying smelling salts or other volatile smelling substances to the nose ; rub the temples and pit of the stomach with vinegar, ether, spirits ; hot stupes to the feet; some- times sprinkling or dashing cold water against the face is useful. Injections with turpentine mixed, or assafoetida; when the patient can swallow, ether, volatile tincture of valerian, assafoetida, cam- 28* phor, and other anti-spasmodics and carminatives. When the fit is over, remove all disposing causes : attend to digestive organs, use chalybeates : tonics : exercise. Convulsions Are most frequent in infants; they often depend on acidity of the stomach and bowels, flatulence, worms, teething, the sudden stri- king in of a rash, wounds and other irritations. Frequent intox- ication. Small pox is sometimes preceded by them. TREATMENT.—When the cause is known remove it: if crude food, or foulness of the bowels, emetics, followed by injec- tions and aperients; if acidity be suspected, magnesia with rhu- barb ; if from cutting teeth, the gums may be scarified over the prominent tooth ; if from eruption striking in, blisters or rubefa- cients. Warm baths are often serviceable ; anodyne liniments to the spine and pit of the stomach; carminatives, combined with anti-spasmodics. An approach to convulsions is often seen in infants; the eyelids are half closed; the eyes turn up; the mouth drawn, as if in a smile ; slight trembling of the muscles of the face; drawing up of the legs ; here the bowels should be freed; carminatives and anti-spasmodics given; warm bath used ; ano- dyne liniments rubbed in. Convulsions sometimes depend on fulness of blood in the head; here bleeding is indispensably requisite. Hickup Is mostly a symptom of some other affection : it is a spasmodic action of some of the muscles of breathing, especially the midriff. Common hickup is usually removed by drinking c Id waler, by exciting surprise or fear; where it is more obstinate, a spoonful of lemon juice may relieve it; occasionally ether and other anti- spasmodics are necessary. As a symptom, it may occur shortly before death in several diseases. Locked Jaw, OR TETANUS, Is a violent spasmodic disease, fortunately rare- 289 CAUSES—Any wound, particularly of a tendinous part; expo- sure to cold and wet, especially in hot climates. SYMPTOMS.—Stiffness and soreness of muscles at the back of the neck; difficulty of swallowing. As the disease progresses, the stiffness invades other parts ; the jaws become rigid ; the muscles of the spine and limbs are attacked with painful convulsive mo- tions ; pain shoots from the pit of the stomach towards the spine; the face has a peculiar expression—the angles of the mouth and eyes being drawn outwards. Persons attacked generally die con- vulsed, or shortly after a convulsion, on the fourth day ; if they survive the ninth they may recover ; that from wounds is the most dangerous. TREATMENT.—Opiates in large and repeated doses ; bleed- ing ; frictions with mercurial ointment. Caustic potash applied over the course of the spine ; large quantities of wine ; tobacco in- jections, dec, dec. The disease is so desperate that none but the instructed should intermeddle. Hydrophobia. This disease in the human being has never, so far as is known, arisen from general causes. In man it is always the result of a specific virus or contagion derived from an animal labouring under the disease. The hydrophobia virus appears to be exclusively attached to the saliva: and hence almost the only mode in which it is propagated, is by wounds inflicted with the teeth of a rabid animal. The disease, however, may be communicated by bring- ing the contagious virus in contact with an excoriated or wound- ed surface, in any manner. This has been verified by direct experiment. Magendie and Brechet innoculated two dogs with the saliva of a rabid man ; one of these dogs became rabid, and bit two others, which also became mad. Instances have moreover been recorded of the propagation of hydrophobia by the accidental contact of the morbid saliva with wounds, or excoriations on the lips, hands, or other exposed parts of the body. Fortunately, how- ever, but few comparatively of those bitten by rabid animals are seized with the disease. The interval between a bite and the ap- pearance of hydrophobia varies from twenty to forty days, in some instances several months. If a year elapse, the person is in all 37 250 probability safe. In animals the interval is usually from one to six or seven weeks. Hydrophobia is nearly of a kin to locked jaw. SYMPTOMS.—The first symptoms are lowness of spirits; love of solitude; disturbed frightful dreams; anxiety, sighing; irregular shooting pains; especially in the bitten pait. Then comes on difficulty of swallowing; horror at the sight or noise of liquors, or the least breath of air passing over the face; or the sight of a mirror; convulsive startings, dec dec. Persons affected die from the 2d to the 4th day ; they do not often lose their rea- son, except in the convulsive fit, when they may make efforts to bite. TREATMENT.—As soon as possible after the infliction of the bite, the wound and surrounding surface should be carefully washed with warm or cold water, and immediate efforts made to prevent the further passage of the virus into the system. If the bite be of a character, and in a part which admits of its entire ex- cision, this, if speedily done, affords the most certain protection against the occurrence of the disease. If the bite be on the hand, particularly if the teeth of the animal have penetrated deeply be- tween the bones, it will be best to amputate : and this is especi- ally proper if only the fingers are wounded. Some have preferred destroying the wounded part by a red hot iron, or by caustics. The application of cupping glasses, as is recommended by Dr. Barry,* for the purpose of arresting the effects of poisoned wounds, would perhaps in most cases be sufficient to prevent the occur- rence of rabies ; in slight wounds there can exist no doubt of their efficacy. The application of a tight ligature a short distance above the wound, if its situation will admit of it, is recommended by Dr. Good. No medicine as yet discovered merits any confidence as a preservative. The constitution should be attended to in those * In the year 1831 or 32 a memoir was read before the academy of medicine at Paris, giv- ing an account of a series of experiments made by Dr. Barry, by which he has ascertained, 1st, that the immediate application of a cupping glass to a poisoned wound, will prevent the absorption of the poison ; 2dly, that a cupping glass, applied even after the poison has be- gan to be absorbed, will arrest the progress of the absorption ; and 3dly, after the cupping glass has remained a certain time the poison may be removed from the surface, and all un- pleasant consequences arrested, by simply washing the part with a little water. The experi- ments were repeated before the committee of the academy and succeeded to their satisfaction. Arsenic, strychnine, prussic acid, and the bite of the viper, &c., were tried on dogs, rabbits, &c. 291 bitten by a suspicious dog. The suspected dog instead of being destroyed should be kept by the friends. Cramps of the Legs Occur often to pregnant women, and to others. CAUSES.—Over exercise, as in walking, dancing; going to bed with cold feet; sudden motions, dec They generally come on when the person is in bed. TREATMENT.—Avoid cause; use friction, simple or with anodyne liniments; getting up and pressing on the cramped leg, or walking on a cold hearth stone. A slight ligature beneath the knee may prevent the recurrence;—hence eelskin garters have been recommended to swimmers. Quinsy Is an inflammation of one or both glands at each side the throat, at the root of the tongue, called tonsils. SYMPTOMS.—Difficulty of swallowing, sometimes of breath ing; pain ; swelling and increased redness ; fever. TREATMENT.—Leeches to the throat outside; hot poultices; liniments or blisters to it; inhaling the steam of water, or vine- gar and water, dec. An emetic followed by aperients, diaphore- tics ; bathing the feet in hot water. Sometimes it ends in ab- scess which may be large enough almost to choke the patient, or by suddenly bursting suffocate him. If possible the surgeon should be seen when the disease is so severe. Ulcerated Sore Throat Is not unfrequent. The ulcer is on the tonsil, or at the back of the throat: it causes pain and difficulty of swallowing, sometimes nasal voice. If this be not a secondary symptom of some other (a common occurrence,) it may yield to some astringent gargle and liniment, with flannel to the neck, &c. (See Scarlet Fever.) Mumps. Inflammatory swellings of the paroted glands, situated before 292 and beneath the ears. It should be treated on the same principle as quinsy. Flannels applied. It rarely ends in abscess, and is scarcely ever dangerous; though in some rare instances, when the brain has become engaged, death has followed. It is a con- tagious disease. -------:o:------- The eye is a very delicate organ, and subject to a vast variety of diseases. The chief arise from inflammation, which may be of the eye ball, or of the lids;—when of the lids it is usually chronic, and of less consequence. Inflammation of the ball is often very acute. Great pain, intolerance of light, headach, red- ness, gushing of hot tears, dimness of vision, and fever, mark a dangerous inflammation ; if these symptoms be mild, or many of them be absent, there is little to fear. TREATMENT.—If the disease be very severe, full bleeding and anti-inflammatory means; afterwards leeching to the temples or behind the ears ; fomentations of poppy or chamomile. Should cold applications be preferred, bread and water poultice; dilute vegetable water on linen pads. When the acute stage is over, eye washes of zinc, sugar of lead, dee, dropped thrice a day into the eye. Blisters behind the ears, or to the back of the neck. It frequently arises from suddenly drying up discharges from behind the ears. Bleared Eyes. The eye lids frequently adhere in the morning by a thick mat- ter. TREATMENT.—Steep them well, so as to remove the matter, and anoint them night and morning with dilute citrine or zinc ointment; let gentle aperients and antacides be taken occasionally. 293 Stye. A small inflammatory tumor on the edge of the eye lid. TREATMENT.—Poultice ; aperients and antacides. It most invariably forms matter, but goes off without leaving a mark. Pustules, Ulcers, or Opacities, Often form on the clear, transparent part of the eye: these ought to be narrowly watched; many lose their eyes for want of a little timely advice. These complaints may depend on the hairs of the lids turning in on the eye, or various causes; if from hairs, they should be carefully pulled out as often as they appear. A very desperate form of Ophthalmia is the purulent; the inflam- matory symptoms are particularly severe, and there is much swel- ling of the lids. In a day or two great quantities of matter are secreted from the eyes and lids, the globe of the eye may at length burst, and vision be gone for ever; or the transparent part he ren- dered opaque. Prompt and skilful advice is necessary. In mild cases, where the swelling, pain, and purulent secretion are not great, general bloodletting is not often necessary. In the severer form of the complaint, however, prompt and very decisive bleed- ing is indispensible to success. A solution of lunar caustic has been praised highly as an application in its commencement. Purulent ophthalmia often attacks infants; it is more managea- ble than the former, a few leeches should be applied to the exter- nal angle or under lid of the eye or to the temple; and the eye should be frequently fomented with a decoction of poppy heads, a portion of which is to be injected under the lids to wash away t'he purulent secretion. Minute portions of calomel in union with Ipecacuanha or powder of antimony, with an occasional dose of castor oil, should be given to children labouring under this affec- tion. A weak lotion of zinc thrown by a syringe over the eye is recommended. Various other astringent lotions have been em- ployed. Diseases of the eye if only moderately acute should not be neglected, or treated by the inexperienced beyond a few days unless they manifestly improve. In those that are chronic, ox in which there is but little pain, advice should be had, espe' cially if the transparent part of the eye be affected. 294 ----:o:---- Inflammation of the Ear Is marked by deep seated pain, often very severe ; in rare instances the inflammation may spread to the brain. TREATMENT.—Leeching behind the ear ; dropping anodyne liniment into the ear ; warm stupes and poultices ; blisters behind the ear. When matter forms the small bones of the ear may come away, and a discharge be kept up for a long time, followed by deafness. The ear should be washed by means of a syringe 3 or 4 times a day with warm water ; afterwards a gentle astringent lotion. Deafness Arises from several causes. It is often irremediable, or at least demands long—continued scientific treatment. Sometimes it arises from cold, and gets well or returns as the person gets rid of or catches cold—this is easily treated. Sometimes on a dry state of the ear tube, or hardened wax. TREATMENT.—A little camphorated oil or gall, garlic juice, weak liniment dropped into the ear, or put on wool and introduced into the tube ; or a piece of fat bacon may be used. The ear should be frequently syringed with warm water. In deafness coming on in old age, an ear tube will be found useful. For ulcers near the ear, see excoriations and herpes. There is a peculiar form,called white blisters; they occur generally in un- healthy, ill nursed children. When the blisters burst, a deep, foul, jugly ulcer is left. TREATMENT.—Attend to the bowels and general health; use lotions of chloride of lime. Elder ointment is recommended for dressing. 295 Tooth-Ach Arises from decayed teeth. The nervous pulp being uncovered, probably inflames. TREATMENT.—A leech or two to the gum may relieve ; or six or eight to the jaw ; steeping ; blistering jaw ; laxatives. To the hollow of the tooth camphorated tincture with laudanum; ni- tric acid carefully applied. A drop or two of kreosote on lint or cotton, placed in the cavity of the tooth, will immediately relieve the most inveterate tooth ach. Sometimes a small plug of opium introduced into the hollow affords relief. Mr. Snell an, eminent dentist usually introduces a small portion of sulphate of morphia into the decayed tooth, and secures it there by mastich. He states this to be a most effectual remedy. Decayed teeth frequently cause the formation of gum boils. These should be opened with a lan- cet when they contain matter. When forming the mouth should be frequently rinsed with warm water. Apply hot fig, saline ape- rients. Spongy Gums. They often bleed at the slightest touch. Use astringent lotions, such as the tincture of myrrh, and benzoin ; if there be a crust of , tartar round the teeth, it must be removed. If breath fetid, use camphorated tooth powder. Lotions with chloride of lime may also be used. Thrush. (APTHyE.) Small pimples or vesicles at the angles of the mouth, spread- ing to the inside of the cheeks, tongue, throat, dec. Sometimes* they have the appearance of whitish or greyish patches en those parts ; they may extend down the throat and alimentary canal. This disease is most common in infants and children ; it also arises in adults in the last stages of consumption, dysentery, dec. When apthae are very extensive, a purging of acrid matter is apt to take place. Sometimes they end in gangrene. In infants they are attended with fever, fretfulness, dec When mild, they may in general be removed by attention to the bowels, good diet, exercise 296 and air ; a few doses of quicksilver and chalk; rhubarb and calo- mel; antacids. For local applications borax and honey; borax lotions. If the person be feeble, quinine ; gargles of chloride of lime, of bark and muriatic acid, dec. It is sometimes a very dan- gerous affection. The nurse's milk may be in fault. Sometimes children with thrush may excoriate the nurse's nipples. Tetters. (herpes.) Very small irregular blisters clustered together, containing at first a clear fluid, and surrounded by efflorescence ; afterwards they become opaque, or dry up and form an ulcer. Herpes are fre- quently seen on the lips after a cold, on and behind the ears of children, near the nose, dec. dec. If the vesicles burst, there is much watery discharge. TREATMENT.—Laxatives and absorbents ; to the part, cold cream, with a few drops of Goulard's extract; fine calamine pow- der ; dilute citrine ointment. Avoid picking or friction. Scald Head Is often obstinate. The head should be shaved and poulticed till the crust is removed; washed with yellow soap and water ; equal parts of tar and citrine ointments form a good application ; some- times it will be found too stimulating, when simple ointment might be mixed with it. If much moisture, dust with calamine powder. Different lotions, as infusion of tobacco, of zinc, of sulphuret of potash, oiled silk cap, dec, dec. The disease spreads from one to another by the use of the same combs, or towels. The bowels should be attended to, and alteratives, as sarsaparilla, mercurials, dec. will assist in the cure. Itch A well known affection. Small vesicles observed chiefly on hands and wrists; being very itchy, they are frequently scrathed and broken. On infants it is sometimes, very severe, spreading over 297 head and other parts of the body. If in doubt as to the disease look to the nurse. TREATMENT.—Friction with sulphur ointment once a day for a few days ; cleanliness ; laxatives. If it be very extensive, it is not quite safe to cure it very quickly. Baths, or lotion of sulphuret of potash, lotions of tobacco, of digitalis, of muriate of mercury ; ointments, with these substances or sulphuric acid, will cure it also; but the sulphur is decidedly the safest and most ef- ficacious, although not so pleasant in its application. Scaly Diseases of the Skin Are frequent and obstinate. Their forms are many. TREATMENT.—Purgatives often repeated ; acids, as the sulphuric, given thrice a day ; sometimes alkalies ; mercurial al- teratives ; Carpenter's Extract of Sarsaparilla ; warm baths ; vapour baths ; sulphur baths ; lotions of lead, of zinc, of corrosive subli- mate very much diluted ; emulsion of bitter almonds; Goulard's lotion; ointments, citrine, tar, sulphureous, dec; repeated leeching. Excoriations Arise in different parts from acrid discharges, frictions, and irrita- tion of tender skin. Excoriated parts should be kept extremely clean and dry ; be washed occasionally with tepid milk and water, dilute lead, alum or zinc lotions; dusting with fine calamine, starch, or hair powder; dilute spirituous lotions ; cold cream with Goulard's extract. When the nipples of nurses are excoriated, the breast shield should be used. Burns and Scalds Sometimes are so slight as to produce redness and smarting only; in the next degree blisters form on the skin ; in the last, the skin and sometimes deeper parts are destroyed. There are two methods of TREATMENT, each of which has its partizans; the cold or sedative, the hot or stimulant. In slight cases, plunging the part, if it can be done, in cold water till the pain is reduced, or using cold lotions, or even ice ; the lotions may be water, vinegar and water, spirits and water ; dilute lead lotions, as Goulard's. They must be continued till the pain and smarting 38 298 cease ; then, if the surface be excoriated, use liniments of olive oil and lime water, or calamine cerate spread on lint. If the blis- ters are large they may be punctured by a needle, and the water be suffered to drain away. In severe burns, steeping and poulti- cing are employed till the dead parts are cast off, when they must be treated as common ulcers. In the hot practice, the parts are bathed with the spirits of turpentine, warmed by standing in a vessel in hot water, two or three times, and afterwards dressed with one part of spirits of turpentine and two of simple ointment; in a day or two the calamine cerate may be used. Camphorated spirits of wine and vinegar have been recommended in lieu of tur- pentine. It has also been recommended to rub lunar caustic over the surface, or a strong solution of it. Extensive burns are very dangerous. The patient is often very low, and may require gene- ral stimulants or opiates. Bleeding is rarely practised. Carpen- ter's Compound Cerate of Copaiva if immediately applied will re- move inflammation and will heal in a few days. It frequently requires extreme patience and skill to prevent un- seemly scars, contractions, and unnatural adhesions. These often produce frightful deformity. Whitlow Is a painful inflammation, usually at the extremity of one of the fingers. It may be of the external surface of the skin just under the cuticle; under the skin; or deeper seated, near the bone. The first is a slight affection, the cuticle raises in a blister, or matter is formed under it, when this is let out, it gets well; yet some- times the nail falls. The others, especially the last, are very se- vere, perhaps dangerous. Great pain, shooting up the arm, and fever, with little local change, mark the severe kind. TREATMENT.—Hot stupes, poultices, laxatives: in the se- vere cases, leeches. Early incisions through the parts is some- times indispensably necessary to prevent much pain and trouble, perhaps the loss of a finger, or^even worse. Opiates relieve pain. Corns Are an excessive thickening of the scarf skin over the prominent 299 parts of the toes, produced by pressure, and kept up by it. In the centre, on being cut a small white spot is seen, which seems to penetrate the skin. The pain is increased by tight shoes, change of weather. TREATMENT.— Avoid pressure. Put the feet in warm water and pare or rub down the corn frequently ; plasters spread on leather, with a hole opposite the corn, by warding off pressure, are useful ; strong stimulants or caustics, as acetic acid, aromatic vinegar, dec, may, by being frequently and regularly used, remove them. Bunnions Are deeper seated affections, being small fluid collections under the skin. CAUSE.—Pressure. They might be removed by puncturing the sack, and irritating it so as to produce inflammation. Med- dling with the toes is not safe, especially in elderly persons. See gangrene. Warts May be cut off with a scissors, or a thread tied tightly round them, and caustic rubbed on the base. Different caustic or stimu- lant applications, frequently applied, will cause their removal; as acetic acid, strong solution of corrosive sublimate, lunar caus- tic, dec.; the milk of wart weed, a species of euphorbium, is also a good application. Chilblains Are painful, itchy inflammations ; generally of the feet or hands. CAUSE.—Exposure to cold, or rather quick changes from cold to heat. Winter is their season. TREATMENT.—Avoid the cause by warm clothing, dec; rub the part with stimulant lotions, as camphorated spirit of wine ; liniments, that of olive oil 7 parts, and sulphuric acid 1 part, is recommended. If the surface blisters, foul ulcers are often the consequence; these should be poulticed, and dressed with basili- con ointment or Deshler's salve, to which spirits of turpentine will form a useful addition. 300 Wounds, Bruises, Bleeding. If a wound be slight and made with a sharp instrument, the best way is to bring together its sides, and keep them to each other by adhesive plaster cut in strips, so as to leave small interstices be- tween. If adhesive plaster be not at hand a bandage will answer, but it should not be bound too tight, as it is liable to induce swell- ing, and increase the pain ; in two or three days it will be nearly healed. If any glass, gravel, or other matter have penetrated, these should be carefully removed before its sides are joined, otherwise they prevent the healing. If much pain come on, the bandage or part may be soaked from time to time with cold water ; if it continue the dressings should be removed and poultices ap- plied and continued for a time. When the parts afterwards get clean, they may be dressed as an ulcer.—See Ulcer. If it should be a torn wound, treat it in the same way ; but it will not often heal as the former. Bruised wounds are still worse; they cannot heal, if the bruising be considerable without forming matter. Poultices are necessary, when the bleeding has ceased; the pa- tient's feelings may decide whether they should be hot or cold. Where there is a sprain or bruise, without much injury to the skin, cold lotions of vinegar, spirit and water, of sugar of lead, dec dec, applied by linen pads, and often changed, are proper. In two or three days, warm stupes and poultices may be preferable ; or mild liniments. Where there is blood effused under, or in the skin, known by the black and blue colour, the same treatment is best. If a person get a heavy fall or severe bruise, it is a common practice to bleed him at once, although he may remain insensible without a pulse at the wrist. This is very wrong ; bleeding is not proper until the powers rally ; before this it may depress further and destroy. Afford free air; if warm, sprinkle the face with cold water; apply hartshorn to the nostrils at intervals; rub the sur- face or pit of the stomach with spirits, or something warm; if he revive, ten or fifteen drops of spirits of hartshorn may be given in a glass of water ; when he has rallied, bleeding may be necessary. If bleeding from a wound be considerable, use pressure; if you find this not answer, open the wound, and press with the finger or some dry substance, as lint, sponge, dec, firmly on the bleeding 301 point, and do not remit until the surgeon is brought. Burnt alum, spirits of turpentine, dec, are recommended as styptics, where the bleeding is rather from a general surface than from a bleeding vessel. The solution of kreosote has lately been applied with more success than any other remedy yet introduced. Bleeding (hemorrhage) Often arises also from surfaces, or from the breaking of blood vessels. Much alarm is created, though frequently there is little danger. The most common examples of bleeding are from the nose, tho lungs, the bowels, the stomach, piles, dec That from the nose often takes place in youth, sometimes so slightly as to cause no great inconvenience ; sometimes by its frequent recurrence to wear down the person. Sometimes the quantity suddenly lost threatens death. Cold applications to the head, as vinegar and water ; cold air; snuffing up cold lotions of vinegar and water, alum and water, common salt; putting the whole head in cold salt water. Plugging up the nostrils and bleeding from the arm may be requisite. Blistering the back of neck is highly recommended. Every thing taken should be cold ; the bowels should be freed with saline medicines, as Seidleitz powder, salts in infusion of roses and sulphuric acid added, given every second hour; sugar of lead made into pills containing from one to two grains each pill—one of those to be taken every hour or two has been found effectual. In these extreme cases, however, the physician should be consulted. Bleeding from the lungs is often the forerunner of consumption; in it the blood is usually florid and mixed with air bubbles as it is coughed and spit up ; this deserves serious attention. Bleeding from the stomach is often in exceeding great quantity; it is vomited up, usually of a dark colour, and half coagulated, mixed with the food. In these cases the physician should be called. Before his ar- rival several things should be tried, as a table spoonful of common salt; cold acidulated or iced drinks; sprinkling or dashing the surface with cold water; absolute rest; no talking; alum, in doses of 10 grains, often repeated ; muriated tincture of iron. In 302 bleeding from the stomach, spirits of turpentine. If the pulse in- dicate it, blood should be taken from the arm. Whiles, OR FLUOR ALBUS. Delicate females are especially liable to this complaint. It is characterized by a whitish or yellowish matter being discharged from the vagina, dec, attended with pain in the back, wasting of the body, and extremely pallid appearance, with swelling and dark- ness round the eyes. It is a disease of debility, often the conse- , quence of frequent miscarriage, immoderate discharge of the men- ses, bad diet, and whatever tends to produce weakness of the con- stitution ; sometimes by neglect it assumes a most serious and alarming character; hectic fever; atrophy ; dropsy; and many other truly distressing symptoms terminate existence. TREATMENT.—The primary object is to correct and dimin- ish the discharge ; this must be done by astringents, administered both by the mouth, and by injections into the passage. The me- dicines most recommended for this purpose are myrrh, kino; catechu; alum; the balsams of copaiba, Canada; the chio tur- pentine ; the infusion of buchu : cubebs, dec Vide Carpenter's Concentrated Compound of Sarsaparilla, Cubebs and Copaiva, an invaluable medicine in this disease : for injections, the solution of alum ; white vitriol; Goulard, the decoction of oak bark, galls, dec. Nutricious diet; strengthening medicines, such as bark, qui- nine, chalybeates, and whatever invigorates should be carefully enjoined; every thing that relaxes should be avoided, such as fa- tigue, crowded rooms, late hours, sensual indulgence, too much bed, the patient should sleep on a mattrass, and when the season admits, sea bathing may prove serviceable. Strengthening plasters to the back will relieve the pain, and assist in giving support to the body. Chlorosis. Females, at or approaching to womanhood are subject to this affection. SYMPTOMS.—Pale, sallow, or greenish shade of countenance; 303 pale lips; eyes with a livid circle round them ; languor; fatigue and hurried breath on the least exertion ; palpitations ; deranged appetite and bowels; flatulence; costiveness : acidities; pains of back and loins ; irregular febrile symptoms ; disturbed sleep; a morbid desire for out of the way substances, as chalk, ashes, coffee grounds, tea leaves, dec.; debility advances ; the feet and ankles get dropsical; other dangerous diseases may supervene. CAUSES.—Debility or want of tone in the system, however in- duced ; deficiency or suppression of the regular courses, if not a cause, is almost always a constant attendant on it. TREATMENT.—The bowels must be kept free by the fre- quent use of medicine. It is observed, however, that active ca- thartics, or such as excite copious liquor stools, are calculated to do much mischief. Moderate doses of aloetic aperients are con- sidered the best remedies for this purpose. From three to four grains of rhubarb, in union with one or two grains of aloes taken in the evening, will in general answer the purpose very well; and this dose may be given every third or fourth evening until there is reason to believe that the bowels have been freed of their vitiated and accumulated contents. Small doses of blue pill or calomel may also be taken at bed time occasionally,—say every 10 or 14 days, so as to correct the biliary organs, followed the next morning by a Seidleitz powder or a tea-spoonful of salts; a tepid bath occasionally, or bathing the feet in hot water; the warm hip bath; the different preparations of iron are highly re- commended. Dr. Eberle particularly recommends the black sul- phuret of this metal. From 7 to 10 grains may be given 3 times daily. The tartrate of iron is also highly recommended on account of its tendency to keep up a regular action of the bowels. The chalybeate mineral waters, taken at the wells if possible, are es- pecially beneficial. The use of these chalybeates should be con- tinued until the health of the patient is completely restored. Previous to the use of these tonics, the bowels should be, by the means before mentioned, put into proper order, otherwise injury may result from their administration. The diet ought to be nutritious, but simple ; unless there be much fever, wine may be allowed ; exercise taken every day, without omission, and gradually increased; over fatigue should however be avoided; horse exercise, swinging, walking, sailing ; 304 bitters, combined with alkalies; tonics, as quinine, valerian, myrrh, assafoetida: country residence ; early hours; agreeable society. The change of life and occupation which follows on marriage usu- ally puts an end to the disease, although married females are some- times affected with it; too long lactation is one of the causes as- cribed to the disease in them. Worms Are generally [found in children or people of relaxed frame. There are 5 distinct species of intestinal worms, of these the fol- lowing kinds are most commonly met with, viz : Ascarides, THREAD OR MAW-WORM. These worms are found only in the large intestines, and princi- pally in the lower part of the rectum, where they are often collected ihalmost countless numbers. In females, these worms sometimes pass into the vagina, and give rise to very great uneasiness. During the day they seldom give rise to much inconvenience, but in the evening, and particularly soon after lying down they usually occasion a very distressing, and indeed an almost insupportable itching and titillation in the lower part of the rectum, and the anus. Nervous children are sometimes thrown into convulsions by the distressing sensation which they cause in these parts. They are generally most troublesome during damp weather. Lumbrici, WHICH RESEMBLE COMMON EARTH WORMS. These worms inhabit the small intestines, and occasionally as- cend into the stomach. Jointed Tape Worm. This worm often acquires a very great length, from 30 to 40 feet and more. It is from 4 to 10 lines in breadth, flat, white, and com- * 305 posed of a series of concatenated joints, resembling a piece of white tape. The head is armed with two processes, by which the worm attaches itself to the intestines. It inhabits the upper por- tion of the bowels and stomach. SYMPTOMS.—Fullness of belly ; irregular bowels; pains of belly; itching; variable appetite ; paleness of countenance ; lead coloured with occasional transient flushes; eyes dull; pupils dilated with a bluish semicircle around the lower eye-lid; picking the nose, tumid upper lip; occasional head-ach and humming in the ears ; foul breath ; lassitude ; peevishness ; slight remitting fever; uneasy sleep ; grinding the teeth, sometimes convulsions. Worms have caused death by perforating the bowels. These symptoms mark high probability, but to have a certainty of their presence we must see a specimen. TREATMENT.—In prescribing for the removal or destruction of intestinal worms, it is of considerable consequence to confine the patient to a spare and liquid diet, and to exhibit two or three mild purgatives a few days previous to the exhibition of the pro- per anthelmintic remedies.—(Dr. Eberle's Practice of Medicine, page 348. As car ides. " The removal of these little worms is often attended with great difficulty, for although the inconvenience which they create may be removed for a time, they almost always recur, again and again, in those who are once infested with them." Aloes from its de- cided tendency to act on the lower portion of the bowels will occa- sionally expel them in great quantities, particularly when assisted with proper enemata. Dr. Eberle states that his usual mode of proceeding for the expulsion of these troublesome worms, is to prescribe 3 or 4 aloetic purgatives every second day, together with two or three enemata composed of a mixture of lime water and milk, in equal proportions, daily. An injection composed of a tea- spoonful of turpentine mixed with a cup-full of milk is an excel- lent injection and frequently brings off vast numbers of these little worms. The introduction of a bougiesmeared over with mercurial ointment has been employed with success for the destruction of ascarides; and injections of a drachm of refined sugar dissolved 39 306 in warm milk has been found useful. When these worms have passed into the vagina, injections of cold water, with a small por- tion of vinegar, is, according to the experience of Dr. Brauser, the best remedy we possess. Dr. Van Vert, asserts, that flour of sul- phur taken in the morning on an empty stomach, is one of the most efficacious remedies for the destruction and expulsion of these worms. Lumbrici. A vast number of remedies and modes of treatment have been recommended for the expulsion of this species of intestinal worms. The simplest mode for the expulsion of these worms is that recommended by Dr. Eberle. After the exhibition of a small dose of Epsom Salts every morning for 3 or 4 days, on the 4th morn- ing he directs a decoction of the root -of spigelia, in the pro- portion of an ounce of the root to a pint of water boiled down to half a pint. This being sweetened is to be drunk in the course of three or four hours, by a child of from five to ten years old, commencing in the morning after having taken a little milk and water into the stomach. Carpenter's Compound Fluid Ex- tract of Pink Root will answer the same purpose, and is a much more convenient preparation for families. As soon as the whole of the decoction is taken, or the extract, an active dose of calomel and jalap is to be administered, or a dose of castor oil and turpentine, in the proportion of half an ounce of the former to two drachms of the latter, given in doses corres- ponding to the age of the patient. The same eminent phy- sician states that he has rarely failed by this plan to procure the discharge of worms where they existed in the bowels. Calomel in connection with the powdered roots of spigelia and valerian in small doses have been resorted to with advantage ; but as this remedy requires to be continued for several days, there is much danger, especially to children, of producing salivation. Tin filings; garlic; spirits of turpentine; camphor; different bitters, such as tansy, rue, pomegranate, bark, dee, are recommended as good re- medies against this species of worm, but the .simple directions above given should be first tried before other specifics are re- sorted to. Jointed Tape Worm. For the expulsion of the tape worm a very great variety of re- 307 medies and modes of treatment have been recommended. The anthelmintics that have been found most effectual against this spe- cies of intestinal worm are male fern; spirits of turpentine; tin filings; valerian, garlic, the bark of the pomegranate root; cow- hage, dec A cup of a decoction of garlic in milk is to be taken every morning on an empty stomach, and a table-spoonful of cas- tor oil, every morning, noon, and evening, with half an ounce of tin filings daily, and frictions on the belly with Barbadoes tar twice every day. The patient is to eat salted food. This method must be pursued for several weeks, or until the head of the worm is expelled. Cowhage is safe and generally effectual. Spirits of turpentine is perhaps the best remedy for the expulsion of this species of worm. For the modes of administering cowhage, spirits of turpentine, dzc see articles in catalogue. The root of the pomegranate deserves great attention. Dr. Ruggia a physician in Naples, and several other physicians of eminence employed it with great success ; two ounces of the fiesh root are to be sliced finely and slowly simmered in a pint of water down to half a pint: of this decoction one-third must be taken early in the morning on an empty stomach, and another third every two hours. If this does not expel the worm, the same is to be repeated next day, and so on. The diet should be liquid, and an active purgative given after the third portion is taken. It is observed that the doses above specified are for adults; therefore the table regulating the doses according to the age, dec, must be resorted to. It is before observed that to have a certainty of the presence of worms, we must see a specimen, and without which we will not be able to judge of the kind of worm that is in the intestines ; the symptoms however to a discriminat- ing observer will be a pretty certain guide as to worms generally; and the safest course will be to use frequently the most simple, and at the same time the most effectual method of treatment; for this purpose the Compound Fluid Extract of Pink-root, prepared by G. W. Carpenter, will be found the most effectual and valuable remedy. Numerous medical certificates are in his possession of the expulsion of worms resulting from this preparation. See Carpenter's Essays on the Materia Medica, 2d edition, p. 301. Rupture, Beinc a complaint which is frequently unattended with pain and therefore allowed to increase before surgical advice is taken, it 308 may be well to point out the leading features of that disease. It consists in the protrusion of some part of the bowels, or other con- tents of the abdomen, chiefly in the groin, though it occasionally takes place in other parts, as the naval, dec. It appears as a tumour, which when early taken notice of is easily compressed, but if neglected is liable to become of very serious consequence. TREATMENT.—Return the protruded part by gentle pres- sure into the cavity, and retain it theie by means of an instrument called a truss, of which there are several kinds, applicable to par- ticular cases. Persons having this disease should be careful in attending to the state of the bowels, by castor oil, or any other mild aperient. OF THE KIDNEYS AND BLADDER. Gravel and Stone. The diseases known by the names of gravel and stone are so nearly allied, that they may be described under the same head. Gravel consists in very small granular concretions, which are formed in the kidneys, and passed with the urine. During the passage of these concretions from the kidneys into the bladder, more or less pain is felt by the patient according to the size, smoothness, or sharpness of them. When any portion too large to be expelled is retained in the bladder, it becomes a nucleus for the smaller particles to adhere to, and what is denominated stone is the result; which in the process of time, becomes often so considerable, both in magnitude and weight, as to cause great distress and inconvenience, especially if its surface be rough or angular. A fit of gravel is known by pain in the loins, nausea 309 vomiting frequently ; the urine is suppressed; there is pain in the thigh on the same side as the affected kidney. During the passage of the gravel from the kidneys to the bladder, such violent pain is usually felt as to cause faintings, and not unfrequently convulsions. An attack of gravel may sometimes be mistaken for inflammation of the kidneys, but the deposit from the urine, when cold, will mark the character of the disease. C\USE3.—Some writers have supposed that the disease is the result of using hard water, and have instanced Paris in proof of these notions; the inhabitants of which city being peculiarly lia- ble to gravel and stone. Others have attributed the disease to too free a use of acids; again it is thought to be the result of bad digestion ; and further a peculiar and deranged state of the secretory powers of the kidneys. Others again assert that an he- reditary predisposition to the disease exists. TREATMENT.—During a fit of gravel, the first object will be to relax the parts affected, which must be done by every means which will effect that generally ; the warm bath ; if great pain, bleeding; laxative medicines, as castor oil; emollient and ano- dyne injections ; fomentations. The diet should be low, and the patient should drink barley water ; almond emulsion ; linseed tea; and thin mucilaginous beverages, as of gum arabic, dec. When the fit is over, avoid every thing that is likely to irritate the kid- neys; use soft or distilled water; take occasionally the alkaline salts, as soda, potash, Brandish's alkaline solution, Castile soap, or pills composed of equal parts of castile soap and soda. A patent medicine called Hickman's pills, is very much used in England. Soda water is extolled by many. Tar water has been also used with benefit. The infusions of buchu and soda may also be tried ; as also the infusion of buchu and juniper berries; turpentine ; the balsam of copaiva should also have atrial ; Carpenter's Compound Fluid Extract of Buchu (Diosma Crenata) has been of late used with peculiar advantage in this country, and has been found to afford decided relief when the ordinary class of medicines had been ex- perimented upon. The numerous certificates of the highly re- spectable practitioners who used this valuable preparation are found set forth in "Carpenter's Essays on the Materia Medica 2d Edition, 1834," under the proper head. When stone is suspected, the same remedies will be required 310 as well as the demulcent and mucilaginous drinks; but when this latter description of concretion has become insupportable, relief can only be had from extraction. Inconlinency of Urine. Inability to retain the urine may arise from various causes ; as relaxation, or palsied state of the bladder; from contraction, the result of inflammation; from pressure of parts contiguous; from pregnancy, stone, dec. TREATMENT.—When from relaxation, cold bathing, espe- cially to the part; tonics, as bark, quinine and chalybeates; the infusion and tincture of buchu ; the bear berry, dec.; lime-water may also be used ; and blisters near the orifice of the bladder are often serviceable. When the disease is the result of paralysis; blisters, electricity, and remedies of a stimulating kind, as tinc- ture of cantharides. When from pressure by mechanical means, there can scarcely be done any more than palliate the disorder, or procure temporary relief; delivery only relieves when the result of pregnancy ; and extraction of the stone, when from that cause. To avoid excoriations, when the disease cannot be cured, vessels contrived for the purpose are worn by the patient: Vide Carpen- ter's Materia Medica. 2d edition, page 301, as to the value of the Compound Fluid Extract of Buchu in this affection. Stranguary, OR STOPPAGE OF URINE, Occasionally succeeds the use of blisters; but in such cases, it is generally relieved by diluent drinks, as barley water, linseed tea, mucilage of gum arabic and sometimes by a few grains of nitre taken occasionally. Sometimes it occurs during pregnancy ; this will be alleviated by keeping to the horizontal position as much as possible, and by occasionally using laxatives ; when from spasms or stricture, dec, stimulants as spirits of sweet nitre, in conjunction with the free use of flax-seed tea, and an opiate enema will rarely fail to allay the suffering very materially. The muriated tincture of iron, in doses of from 6 to 10 drops, diluted with water, every 10 or 15 minutes, till some effect is experienced, will be found to 311 act advantageously. The warm hip bath will also be found service- able. Sometimes the practitioner is obliged to have recourse to an operation when other means fail; in this case as well as the two preceding cases, and before any operation should be had re- course to, a fair trial should be given to the Compound Fluid Ex- tract of Buchu, prepared by G. W. Carpenter, at his Chemical Warehouse, 301 Market-street. Fractures, Dislocations, Sprains. In furtherance of the object of this work, which is to give good ad- vice on such emergencies as when skilful assistance cannot be had, the subjects under this head will be treated of. These are disa- greeable, sometimes very serious accidents ; and are often egre- gious ly mismanaged for want of a little information. They are always sudden occurrences, and invariably excite confusion and hurry in the patient and bye-standers. It is of consequence how- ever to avoid this hurry, where any injury of the kind is suspected. Fractures. Pain is the first notice of fracture, sometimes however the bone is heard to snap. If from any accident likely to produce it, frac- ture be at all suspected, the person should avoid sudden exer- tion, and move the limb cautiously until he is assuied it is unbro- ken; but if it be found broken, he should remain as quiet as pos- sible until a proper method of removal is arranged. Besides pain, where a bone is fractured, there may be felt a grating together of the broken parts when a person handles or moves the limb; this grating may not only be felt, but often heard. There is also mobility in a part of the limb which should be in- flexible ; and more or less deformity generally exists. The deformity observed where a limb is fractured, is of three kinds. 1st. The limb is frequently shortened. 2d. There is an unnatural angle or crookedness. 3d. It may be twisted trans- versely, sometimes nearly half way round : for instance, suppose a person whose thigh is broken be laid fairly on his back, while the toes of the sound limb point directly upwards, the foot of the fractured side will lie on its side, and the toes be turned out: some- times these deformities are combined. 312 A common notion is, that where a limb or a part of a limb is moveable, there can be no fracture. It is quite erroneous ; the fingers or toes, hand or foot, can be moved when the leg or arm is broken ; motion is painful, but not impossible. There are two chief divisions of fracture, simple and compound. In the latter, beside the fracture the broken bone protrudes through the flesh. This is a very serious accident, and as it often happens that a simple fracture becomes compound, through sud- den exertion or rude handling, particular care should be taken in this respect. In treating simple fractures, all that the most enlightened sur- geon can do, is to place the enJs of the bone as nearly as possible in their natural position, and maintain them so for a sufficient pe- riod ; attending at the same time to the general health, ease and comfort of the patient: nature effects the remainder. When a fracture is displaced, or there is deformity, it is the lower portion of the limb which is displaced. To reduce it to its proper situation our aim should be to extend the lower part of the limb steadily, without checking or jerking, until, as compared with its fellow, the natural shape is restored. In effecting this it will sometimes be necessary to turn the lower part from its faulty direction. It is to the lower portion of the limb, only, that the extending force should be applied, the upper should merely be retained by gentle means in statu quo. When the limb has been reduced, the object is to retain it in posture; this will be more or less difficult according to the parti- cular bone broken and the direction the fracture takes. If the direc- tion be transverse, it is easily kept in its place; if it be oblique there will be a constant tendency to have the lower end drawn upwards and the limb shortened. The bones most liable to fracture are the collar bone, the thigh and leg bones, the bones of the arm and fore arm, the ribs and lower jaw. If the collar bone be broken, the shoulder droops and hangs forward, and the patient is seen to support the hand and arm of the injured side, with the other hand. On running the fingers down along the line of the bone, the nature of the injury is in general palpable. TREATMENT.—Bend the elbow-joint, and support hand and 313 arm in a scarf, so tightened that the shoulder be brought to the natural level. The arm should at the same time be bound, by bandage, to the side. If any thing further be required, it will be some contrivance to keep the shoulder back. If the thigh bone be broken, the first care should be to remove the patient, without doing further damage, or causing unnecessary pain. For this purpose, a bier, a door, or shutter, with a mattrass on it, is the most easily had. Being brought close to the person, he is to be lifted on it, taking care that no motion takes place in the seat of the fracture. When removed, the lower part of the limb should be gently extended, and at the same time raised, till it be of its usual shape. A bed, fitted with pillows or cushions, having been prepared, the limb should then be gently laid down. The most convenient posture for the person, is to lie on his side, the broken limb under, and the hip and knee joints slightly bent. Sometimes it is preferred to have him on his back, the limb extended, with a pillow, if necessary, under the head. Being in fit posture, patients are anxious to have the splints on, or, as they suppose, to have the bone set. The use of the splints is to give fixedness to the limb ; if this could be otherwise at- tended, it would be desirable. For the purpose of removal or in- deed as application, for the first few days, splints may be well relinquished and pillows substituted. The bandaging which is put on with the splints, and the tightness which is requisite in this apparatus are often highly detrimental. A broken limb usu- ally swells within a day or two, and the splints, which, if of any use, must have a certain degree of tightness, are thus made so tense as to cause great pain and inflammation. If such tension occur, at once, loose any splint or bandage. The bed should be firm and unyielding, but soft; a hair mat. trass is best, and as excoriation from long lying, is to be feared, great attention will be required to keep the person dry and clean. (See Excoriation.) From 6 to 8 weeks are commonly enough to consolidate the fracture of the thigh. In both the leg and fore, arm, there are two bones. A single bone may be broken in either. The lesser bone of the leg often gives way about two inches above the outer ankle; here the sole of the foot will be turned rather to the qutside ; still it is possible or the person to walk, though to do so is dangerous, for it has 40 314 often complicated the simple fracture, with dislocation ot the ankle joint. When one bone is alone broken the case is easily managed for there cannot be any shortening of the limb, as the sound bone guarantees its proper length, the only fault possible is in the direction ; if this fault exist, it should be corrected. Fractures of the Arm or Fore-arm Scarcely demand confinement to bed ; they unite in from 4 to 5 or 6 weeks. Bandage and splints are necessary to keep the limb in posture. The whole may then be supported in a scarf. The fracture of the small bone of the leg requires the application of a single splint only on the*outside of the leg. It commonly unites in four weeks. Fractures of the collar bone, lower jaw, or ribs, unite in three or four weeks. TREATMENT of fractured ribs. Pin a broad firm bandage tightly round the chest, to restrain the motion of the ribs; a strengthening plaster may also be applied over the seat of fracture. Bleeding, once or oftener, is proper, as the lung is apt to suffer injury and be inflamed by the ends of the broken ribs. Fracture of the Lower jaw * Is easily recognized by examining the level of the teeth, and feel- ing the outside of the jaw. The parts should be reduced by gentle extension. Pasteboard, softened in vinegar, should be modelled on the part, and secured by a bandage passing over the head. As this dries, it forms a case fitted to the jaw. Liquid food only can be taken for 2 or 3 weeks. The Knee Cap Is sometimes broken by direct force, as from a kick: it has even happened that it has snapped by a sudden or false step, or in the exertion made to avoid a fall. Here the power of stretching the leg is lost or lessened, and a vacuity felt, with a piece of bone above it in place of the natural prominence of the knee cap. The plan is to bring the upper piece, which is the one drawn up by the muscles, as close as possible to the lower; this is done by keeping 315 the knee joint constantly and fully extended, and having the upper ■ fragment bound down by bandage. From 6 to 10 weeks will be necessary to repair this accident. A portion of the elbow at the back of the joint suffers occasionally in a similar way ; the treat- ment is similar. In common fracture bloodletting is not very necessary ; but if there be much pain or inflammation, or the person be very full and strong, it is better to bleed, but not too freely. Cold lotions are proper to soak the bandages, especially in summer, and during the first week. Should much starting occur in the broken limb, an anodyne draught at night will be proper to check the spasms, and the hand of a nurse or attendant may be softly kept over the frac- ture. An occasional laxative, but not a purgative may be useful. When fracture is not clearly ascertained, but strongly suspected, it is the safest and best way to act as if it were known that frac- ture existed. In treating compound fractures, the aim is to reduce the frac- ture and heal the wound as quickly as possible ; thus the com- pound fracture is changed into a simple one. Lint soaked in the patient's blood, is a good application to the wound; a light ban- dage may be applied over it. Splints are not here so easily man- aged as in simple fracture, and it would, in general, tie better to trust to position on pillows. Should there be no great pain, the lint may lie on for many days ; but inflammation, great swelling, and forming of matter, are apt to arise ; here we must diligently use the means pointed out in another page for subduing inflamma- tion, except that large bleedings are improper, and purging is very inconvenient. Splints may be made of any substance, sufficiently long, broad, thin and firm ; pasteboard, thin board, or lath, sheet iron are often used. Applied to a limb they should steady the joint above and that below the fracture ; they should not make inconvenient pres- sure on any point, but the support they give should be equally diffused by means of padding. It is usual to scoop out cavities in splints for prominent parts, thus a space is always cut out of the splint where it comes over the ankle. Dislocations occasion de- formity as fractures do. Sometimes the limb is shorter, sometimes longer than it should be. In dislocation motion is always impeded, and frequently a hard swelling is observed near a joint. The most 316 frequent dislocations are those of the shoulder, of the elbow, lower jaw, wrist, ankle, and hip. In dislocation of the shoulder, there is but little motion at the shoulder joint; the shape of the joint is flattened and the head of the bone may be felt in an unnatural po sition. The aim is to extend the limb gradually, uniformly, ard steadily; and when this has been effected, to draw or push the head into posture. The shoulder blade should be fixed while the extension is made. It is upon the same principle that all dislocations should be treated. If the surgeon can at all be had, nothing should be done till his arrival, for a knowledge of anatomical stiucture is most ne- cessary to fit a person to treat fracture or dislocation. It is well to know that dislocations may be reduced after several days, nay weeks; but sooner they are attended to the better. There is, however, always time to send for proper assistance. Joints are sometimes strained or sprained when there is neither fracture nor dislocation. Sprains are sometimes serious accidents. TREATMENT.—Absolute treatment of the part affected for several days; cold lotions, constantly renewed for the first three or four days, afterwards liniments may be rubbed on them several times a day. If the accident be severe, cooling laxatives and the application of leeches to the part, once, twice, or oftener, at inter- vals of a day or two, should not be neglected, in addition to the preceding measures. If the pain ceases to be acute, and the in- flammation continue, but in a chronic form, strong liniments or occasional blisters may be necessary. -------:o:------- RESPECTING BLEEDING, AND DIRECTIONS FOR THAT PURPOSE. " Bleeding. By this operation is understood the taking away of blood for the relief of diseases. Bleeding is called general 317 when practised with a view of lessening the whole mass of circu- lating blood ; topical when performed in the vicinity of the disease, for the express purpose of lessening the quantity of blood in a par- ticular part. General Bloodletting Is performed with a lancet, and is subdivided into two kinds, viz : the opening of a vein, termed phlebotomy or venesection ; and the opening of the temporal artery, or one of its branches, termed arteriotomy ;" but as the directions which follow are solely for the guidance of the nonmedical part of society, they will be con- fined to the operations of venesection, as we must leave the oper. ations of arteriotomy to the surgeon himself. Topical Bloodletting Is performed either by means of a cupping glass and scarificator, or leeches, or by dividing the visibly distended vessels with a lan- cet, as is frequently done in cases of ophthalmy; the dividing of the vessels, dec, must likewise be left to the surgeon,; but the operation of cupping will be spoken of: leeches having been before introduced into the catalogue, and directions for applying them given. See Leeches. The'spri ng lancet is recommended by some as the safest lancet to bleed with, and the thumb lancet is recommended by others; the choice, however, of either of those instruments must be left to the operator himself; the spring lancet is not considered so sur- gical an instrument as the thumb lancet. The mode of bleeding most frequently practised is that of opening a vein ; and it may be done in the ankle, jugular vein, frontal vein, veins under the tongue, on the back of the hand, dec. In whatever part, however, venesection is performed, it is always necessary to compress the vein between the place where the puncture is made and the heart. Thus the return of blood through the vein is stopped, the vessel swells ; becomes conspicuous, and when opened bleeds much more freely than would otherwise happen.—(Cooper's Surgical Dictionary.) All the apparatus essential for bloodletting is a bandage or fillet, two or more small pieces of folded linen for compresses, a basin to receive the blood, and a little clean water and towel. The 318 bandage ought to be a yard in length and nearly two inches broad, a common ribbon, or gaiter being frequently employed. The compresses are made by doubling a bit of linen rag about two inches square. In bloodletting the patient may lie down, sit down, or stand up, each of which positions may be chosen according to circumstances. If the patient be apt to faint from the loss of a small quantity of blood, and such fainting can answer no surgical purpose, it is best to bleed him in a recumbent posture; but when the person is strong and vigorous there is little occasion for this precaution, and a sitting posture is to be preferred, as the most convenient both for the surgeon or operator and patient. The arm is generally the part from where blood is drawn. The tape or ribbon being put round the arm twice, about two inches above the elbow joint) and fastened with a double running knot, draw the bandage as tight as possible, without stopping the pulse, which may be known by applying the finger to the wrist. In choosing a vein, take that which is the most prominent, and the less liable to roll under the finger. The vein in the middle of the arm is preferred by phlebotomists, but as the artery runs just be- neath it, the unskilful operator had better avoid that vein, under which the throbbing is felt. The arm is next to be turned towards the basin which is to receive the blood, and the operate grasping the arm, places the thumb of his left hand a little below the spot where he intends to puncture ; the lancet is next to be bent into rather an acute angle, and held between the thumb and the fore- finger of the right hand, the other fingers resting on the arm of the patient, so as to steady the hand during the operation. The lancet is next to be introduced in an oblique direction, into the vein, and then raised as straight as possible ; the thumb of the left hand is now to be removed, so as to allow the blood to flow. When enough of blood has been taken (which should vary according to the strength of the patient, or the degree of inflammation or injury, from two to three or four tea- cups-full) the thumb of the left hand should be pressed upon the orifice, and the bandage removed. To secure the part from further bleeding, the edges of the incision should be brought together, and a small compress of lint, or soft linen rag, is then to be applied over the wound, which may be fixed by a strap of adhesive plaster, 319 and further by a bandage applied over these, in the form of a figure of 8, the centre of the figure being made always to cross the centre of the compress. Topical Bleeding. CUPPING. This is done by means of a scarificator, and a glass somewhat like a bell. The scarificator is an instrument containing a number of lancets, sometimes as many as twenty, which are so contrived that when the instrument is applied to any. part of the surface of the body, and a spring is pressed, they suddenly stand out and make the necessary punctures. The instrument is, so constructed, that the depth to which the lancets penetrate may be greater or less, at the option of the practitioner. As only small vessels are thus opened, a very inconsiderable quantity of blood would be dischar- ged, were not some method taken to promote the evacuation. This is commonly done with a cupping glass, the air within the cavity of which is rarified by the flame of a little lamp containing spirit of wine, and furnished with a thick wick. This plan is preferred to setting on fire a piece of tow dipped in this fluid, and put in the cavity of the glass ; " a clumsy expedient, adding unnecessarily to the sufferings of the patient by cauterizing the skin ; doing harm also by rarifying the air more than necessary within the glass in consequence of which the edges of the cap compress the cu- taneous vessels so much as to obstruct the influx of blood. The larger the glass, if properly exhausted, the less pain does the pa- tient suffer, and the more freely does the flow." See maplesons Treatise on the Art of Cupping, page 63—65,12mo. London, 1813. When the mouth of the glass is placed over the scarifications, and the rarified air in it becomes condensed as it cools, the glass is forced down on the skin, and a considerable suction takes place. This professor of the said art remarks, that when Ihe operation is about to be done, a basin of warm water, a piece of fine sponge, and a lighted candle should be provided. As many of the cup- ping glasses as may be judged necessary are to be put in the basin. If sixteen or twenty ounces of blood are to be taken away, four glasses of a size adapted to the surface to which they are to be applied, will generally be required. Each glass is then to be held for an instant over the flame of the spirit lamp, and imme- 320 diately placed upon the skin. Upon the quickness with which this is done, the neatness and efficacy of the operation will de- pend. If dry cupping be only intended, the glasses may be al- lowed to remain on the skin for a few moments, and be replaced five or six times, with a little variation of their position, in order to prevent the skin from being hurt by their pressure. If the in- tention be to scarify and take away blood, the glass ought not to re- main more than a minute, when the scarificator is to be instantly applied; for by the quickness with which the application of the scarificator succeeds the removal of the glass, the patient is saved a degree of pain, which he would otherwise suffer from the making of the punctures. When the glasses are so full as to be in danger of falling off, or the blood is coagulated in them, they should be removed, emptied and applied again. For the sake of neatness, care should be taken to insert the nail under the upper part of the glass, and remove it so as to keep its bottom down- wards, the scarifications being at the same time wiped with a sponge wet in warm water. The glasses, also, previously to each application should be rinsed in warm water, but not dried.—Ma- plesons Treatise, page 64. Syringes have been invented, and now much used, calculated for exhausting the air from cupping glasses ; and the plan is an excellent one, and saves the patient a vast deal of pain, and the operator a great deal of trouble. The syringes, however, must be accurate; and when they are, they answer much better than the preceding mode. These syringes have, no doubt, failed ; but their failure no doubt must be attributed either to the inaccuracy of the syringe, or to prejudice or ignorance of the operator. A common pledget or bit of rag is usually applied as a dressing for the punctures made with the scarificator. If a little smarting be not minded, Mr. Mapleson prefers the application of arquebusade water, or spirits of wine, as it imme- diately stops the oozing of blood, and prevents subsequent itch- ing, page 69. GENERAL INDEX OF DISEASES, REMEDIES, &c. [Note.—The first reference attached to each disease, in the following Index, refers to the disease itself, and the follow- ing references are the most approved remedies (as selected from the Catalogue of Drugs) applicable to the disease referred to : and where but the one reference is made (that is the reference to the page where the disease is set forth) the proper treatment is invariably given. But inasmuch as in most instances several other articles, besides the one referred to in the Catalogue, are on the same page, the reader must himself seek out the proper article applicable to the disease treated of.] Absorbent Vessels—215. Acidity—272—30—45—48—97—99—143—172—173. Ague, or Intermittent fever—222—61—62—63—71—124—131. Alimentary Canal and Viscera of Abdomen, diseases referrible to —254. Anatomy and Structure of the Human Body, a short description of the—212. Animation Suspended, methods of treatment for—188. Apoplexy—284—105. Appendix to this work—212. Appetite, loss of—272. Asthma—282—60—72—77—82—121—139—149—150—164. Bathing and Baths—206. Belly-ach (dry) called Painters' Cholic—257—47—159—162 —163. 41 322 Bile, or Bilious Affections—273—23—40—42—63—90—125. Bladder and Kidneys, diseases of—308. Bleeding or Hemorrhage—301—91—151. -------from the Nose—301—91—151. -------from the Lungs—301—91—151. -------from the Stomach—301—91. -------from a Vein, or Phlebotomy—317. Blisters—128—104—113. Bowels, inflammation of,—254. Body, short descriptions of the Anatomy and Structure of—212. Breasts, applications for—142—118. Bunnions—299. Burns and Scalds—297—173—95. Catarrh —276—32—45—57—65—69—77—82 bis—83—84— 85—87—97—107—130—145—146—149—154 bis. Cancer—89—71. Carminitive for Infants—31—47. Cartilage—216. Chambers infected, most approved methods for fumigating—183. Chopped hands, vide Excoriations. Chicken pock—238. Chilblains—299. Cholera Morbus, common—258. ------ Indian or Russian—262. ------ Infantine—260. Chorea or St. Vitus' Dance—286. Chlorosis or Green Sickness—302. Circulation—215. Cholic, Common—255. ------ Bilious—255. ------ Nephritic—255. ------ Lead or Painters'—257—28. Convulsions—288. Consumption, Pulmonary 280—45—64—65__85__151. Contagion—221. Corns—298—21. Costiveness—257—126. Cowpock—239. Cramp—291. 323 Croup—277—81. Cupping, mode of 319." Curved Spine—250. Cuts, vide Wounds—300—127. Deafness—294—47. Delirium tremens—149—161. Diarrhoea—257. Diet for Invalids—33—39—45—53—77—79—85—89—101— 108—134—135—141—155—156—175—179. Digestion, Organs of—215. Diseases of the Chest and Air Passages—276. ------------Head and Nervous System—284. Dislocations—311. Dropsy, description of different kinds of,—251—139. ------ Causes of,—251. ------ Of the Belly—252. ------ of the Chest—252. ------ of the Head—253. Drugs, Chemicals and family Medicines, select Catalogue of—21. Dyspepsia or Indigestion—272—52—65 bis.-73 bis.—74—131— 138—158 bis.—161—162. Dysentery—256—150. Ear, diseases of,—294. Emetics—40—87—104—155—177—180—181. Enemata or Clysters—136—146—150. Erysipelas—231. Eructations—272—136. Epilepsy—285. Eye, diseases of,—292—95—151—177. Eyes, bleared—292. ---- opacity—293. Excoriations—297—44—170—151—182. Falling Sickness or Epilepsy—285. _____. of the Gut or Prolapsus Ani—275. Females, diseases of,—302. ________Medicines used in the diseases of—27—36—39—83— 58—59—79—113—125. Fever—216. ------causes of—220. 324 Fever Drink—22. ------Inflammatory—217. ------Simple—217. ------Typhus—217. ------Intermittent or Ague—222—62—63—71—124. Fits fainting, medicines used in—145 bis__146. Fomentations—52—130. Flatulence—272—60 bis.—73—159. Fluor Albus or Whites—302—39. Fractures, dislocations, sprains—311. Freezing Mixture—30. Gangrene—230. Glossary of Medical terms—209. Gleet, remedies for—41—36—160. Gout, misplaced, retrocedent and atonic—245. Goitre or swelled neck, 278—84—86—149. Gravel and Stone—308—41—97—90—138. Griping pains, remedies for—47—73. Gum Spongy—295. -----Boils—295. Head, determination of blood to, treatment for—32. Head-ach—272—61. Heart-burn—272—17 3. Hectic fever—240. Hemorrhage or Bleeding—301. Hiccup—288. Hip Joint disease—250. Hooping Cough—277—109—149—180—181. Hoarseness—280—25—73. Hysteria—287—35—44—60—82—93—109—115—145—170. Hydrocephelus—253. Hydrophobia—289. Indigestion, vide Dyspepsia. Inflammation—225. -----------acute—273. ■------■■-----chronic—274. ---------— of the Bowels—254. ----------— of the Lungs—276 ■---—■----- of the Liver—273. 325 Inflammation of the Kidneys—274. -""----------of the Larynx or Windpipe—279. ------------of the Spleen—274. ------------Suppurative—228. Ink, mode of making—72. Imperial, do. —56. Kidneys, diseases of—308. King's Evil or Scrofula—248—67—45. Kreosot, properties of—91. Larynx, inflammation of—279. Leeches, mode of applying—95. Liver, inflammation of—273. Lowness of spirits—145—146. Looseness, or diarrhoea—257. Locked Jaw—288. Lungs—215. -----, inflammation of—276. Measles—234. Medicine Chest, Carpenter's, No. 1—9. -----------------------No. 2—10. -----------------------No. 3—11. -----------------------No. 4—12. -----------------------N0. 5—14. Medicine, table exhibiting the doses of, (adapted to different ages)—18. Mineral Waters, Great Britain, most celebrated—191. --------------United States, most celebrated—197. Miliary Fever—240. Milk, observations on—101. Mortification—226. Mumps—291. Muscles—215. Nerves—214. Nettle Rash—238. Neuralgia, or Tic Doloreaux—286. Nipples, sore—(Vide excoriations.) Ophthalmia—293. Palsy—284. Piles—275—117—152. 326 Poisons, the best means of obviating the effects of—184. Poultices—49—69—76—80—175. Pleurisy—285^-276. Proud Flesh, remedies for—40—48. Pulse—215. Pustules, Ulcers, or Opacities—293. Quinsy—291. Red Gum—238. Respiration—215. Rheumatism—241—54—78—161—158—161. Rickets—249—45. Rupture—307. Scarlet Fever—237—32. Scald Head—296—117. Scrofula—248—67—45. Scurvy—251. Scalds and Burns—297. Skin, scaly diseases of—297—64. St. Vitus' Dance—286. Stye—293. Shingles—239. Secretions—215. Stings and Bites of Insects, applications for—94. Swellings, Glandular—249—84—86. Spleen, inflammation of—274. Spiral Marrow—214. Small Pox—232—32. Sprains—119. Spitting of Blood, remedies for—91—151. Sleep, procuring of—-82. Spasms, remedies for-44-60-93-145-6-159-164. Stranguary—310—128. Sore Throat, ulcerated—291. Suspended Animation, methods of treatment—188. Teas, properties of—156. Tic Doloreaux—286—88. Teeth and Gums—295—91. Tetanus, or Locked Jaw—288. Tetters—296—64. 327 Tobacco, observations on—164. Tooth-ach—295—91. Thrush—295. Ulcers, remedies for—22—36—40—49. Urine, incontinency of—310. ------stoppage of—310—97. Veins—215. Vomiting—257. Warts—299—21—48. Waters, Mineral—191. Water on the Head—253. Water Brash—271. Weights and Measures, description of—17. Wines, medical opinion entertained of—179. Wounds—300—91—127. Worms—304—66—126. Wheat Flour, properties of—175. White Swelling—250—64. Whites, or Fluor Albus—302. Whoopi ng Cough—88—277—109—149—180—181. Whitlow—298. ERRATA. Page 284, Stertor for Sterlot, «' 233, Sit for Set, Eramenagogue is throughout the work spelled Emenagogue. Page 111, Farther for Further. " 41, Apthous for Apthory. " 71, Excitant for Esculant. " 272, Contiguous for Cojitagiou " 295, Stuping for Steeping. " 298, do. do. " 242, do. do. " 256, do. do. " " Baths for Bathes. " 295, Acetate for Sulphate. " 194, Malvern for Maluem. " 197, Derivable for Desirable. " 228, Ulcerative for Ulcerated. " 289, Hydrophobic for Hydrophobia. " 249, Tone for Tonic. '\ % -» ^/N1^ •**• . ov ti «-, ^ i v ^ ^ ^-^ *✓ # r o* *-. \ & 4? J^ V % \' r~~i ^ ■NT ^ R-----' V7 j."* I. X\f . ____1 X1 . ^ S\ L -^ it 5j* AUG *£-.. J**ys2&&=r*f^~ NATIONAL te^ir NLM 03f274451 fa NLM032744216