,  *
V
SURGEON GENERAL'S OFFICE



    LIBRARY.
Section,
JVo.
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  f     J __3—1G39_ 
        v BRIEF-






MEDICAL  DIRECTIONS



            FOR THE





   TREATMENT OE ACCIDENTS,



    AND THE COURSE TO BE PURSUED IN CASES OF




POISON, THE BITE OF VENOMOUS INSECTS,




      AND DIRCTIONS FOR PERFORMING




SIMPLE SURGICAL OPERATIONS,




       TO WHICH ARE ADDED, A FEW




   USEFUL MEDICAL RECIPES,



        AND INSTRUCTIONS FOR
SICK COOKERY.
 
  WB
1^5 5 
PREFACE.
     In the course of a short medical career, having fre-
   quently witnessed the hesitation and misdirected efforts
   of friends and attendants, in cases of serious accidents,
   at a time when the slightest medical knowledge would
   prove invaluable, and be the means, perhaps, of saving
   a human life, I have been induced to compile a few
   brief medical directions to be used  in emergencies of
   this kind;  and as a result of my labors, I, with great
   diffidence, offer this little volume.   When  accidents
   occur, it frequently happens that the very few moments
   in which medical aid would be available, are either lost
   in indecision, by not knowing the proper remedies to be
   used, or in uselessly searching for a physician ; and
   with a view  of  placing this very essential knowledge
   within the reach of every intelligent person, of ordinary
   judgment, I  have  preferred a  very concise form for
   the directions I have submitted : that no valuable  time
   may be lost in searching through  large volumes, for
P  what I have  endeavored here to express in a  very few
   words.   The emergencies to which I  have alluded, 
4
often occur in families residing in the country, in places
at a distance  from physicians ; and  it is by no means
unusual, that  a patient dies, either because those about
him are ignorant of the proper remedies to be applied,
or because they have administered  wrong ones.  To
guard against occurrences of this kind, has been anoth-
er aim of the author.
                                        H. P. R.
  Washington City, Jyly 1st, 1852, 
CHAPTER  ElftST.
ON THE TREATMENT OF  SOME OF THE MOST COM-
     MON ACCIDENTS REQUIRING IMMEDIATE
                 ATTENTION.
                 Hemorrhage.

   There  is nothing more calculated to alarm an
unprofessional person than the profuse flow of blood
from a wound, and  the  spectators are generally so
disconcerted as to be unable to render any assist-
ance.  I now desire  to point out the expedients to
be resorted to for  the purpose of restraining the
hemorrhage till a surgeon can be procured.
  When arteries are wounded the  bleeding is more
dangerous and difficult to control.  The hemorrhage
from an  artery is to be  recognized by the blood
being of a bright scarlet color, and is thrown out in
jets corresponding to  the pulsations  of the heart;
but whether  the bleeding proceeds from a wound-
ed artery or vein, the first thing to be done is to close
the wound, and  to grasp it tightly with the fingers
till other measures can be adopted.   Next prepare a
firm roll of lint, rag or sponge, adapted to the size of
             i 
6
the wound.  This should be soaked in cold water, or
a strong solution of alum; and after the wound has
been cleansed of all foreign  substances  and clots
of blood, this  compress is  to be  inserted into the
wound, so as to press  directly upon the bleeding
vessels, and secured  in its  position  by means of a
proper bandage.   Should the hemorrhage continue
unabated after the above remedies have been used,
we are to remove the dressings and trust to the pres-
sure of the fingers till proper assistance is  procured.
  If an important vessel has been wounded it will
be necessary to have some more  perfect  means of
commanding the hemorrhage.  For  this  purpose a
tourniquet is to be applied around  the  limb.  A
very efficacious substitute can be  made by using a
silk handkerchief, folded like a cravat, with a firm
hard knot tied in the centre.   The handkerchief
is to be tied around the limb, above the wound,
with the knot pressing firmly upon the main artery.
A stick is then to be thrust through the handker-
chief, and twisted around till the requisite degree of
pressure is obtained.
  The actual  cautery, or red hot iron, is another
powerful means of checking hemorrhage.   It acts
by causing the sides of  the divided vessel  to adhere.
The iron had better be used at a black heat, as the
bleeding  is  rendered thereby less liable to return
upon the the separation of the eschar, or burnt por-
tion of the wound.
  Pinching, and twisting with a pair of fine forceps,
will stop the hemorrhage from small arteries.   This
method is called tortion,and is much in vogue with
the French surgeons in their operations. 
(
  But by far the most effectual way, is by surround-
ing the bleeding vessels with a firm ligature.   The
end of the retracted artery is seized with a pair of
fine .pincers having  teeth, and drawn out  of its
sheath a sufficient distance to allow of the ligature
being  applied.   A piece of saddlers' silk makes the
best description  of ligature.   It  should  be well
waxed and secured around the bleeding artery, with
a square or reefer's knot.   Sufficient force should
be used  in  tightening the  ligature to cut  through
the middle  and internal coats of the artery.   The
patient cannot be considered secure until this is ef-
fected.  One end  of the ligature is  then  to be cut
off close to the knot, whilst the other is to be brought
out, and confined  to the  side of the wound with  a
piece of sticking plaster.  Care must be taken that
the nerves  are not included in the  ligature with
the artery, as serious consequences might be the re-
sult.   The  wound is to be  closed with stitches or
adhesive strips.

         Hemorrhage from  Leech Bites.

  This species  of hemorrhage  is sometimes very
difficult to control, and might prove fatal in children.
The bleeding may be restrained by touching the
bite with a  piece  of lunar caustic, or by passing  a
stitch with a needle and silk through the bleeding
orifices.

          Hemorrhage from the  Nose.

  This will  seldom require more than the ordinary
remedies, such  as cold  water,  &c.   Sometimes, 
s
however, it is very profuse, and not easily checked.
In such  cases, bleeding from  the  arm, purgative
medicines, and the avoidance of all stimulants will
constitute the required treatment.   In some instan-
ces it may become necessary to plug the  nostrils
with a piece of sponge.   When this is demanded
a surgeon had better be consulted.

                   Wounds.

  Wounds are of four kinds, viz:
  Incised—or those caused by a sharp cutting in-
strument.
  Lacerated—or torn and mangled wounds, caused
by machinery, <fcc.
  Contused—or bruised wounds, caused by blows,
falls, &c.
  Punctured—or penetrating wounds, caused by
sharp pointed instruments.

                Incised Wounds.

  The first step to take in the treatment of this des-
cription of wounds, is  to apply means to stop the
hemorrhage,  as previously  directed, (see Hemor-
rhage.)  The wound  is to be cleansed of clotted
blood and  foreign substances  by means  of a soft
sponge and lukewarm water.  When this has been
accomplished the lips or edges of the cut are to be
brought in exact contact, and retained in  that po-
sition by  stitches, or strips of sticking plaster placed
across the wound, sufficient space being left between
them to admit of the escape of blood  and  matter. 
9
The parts should then be supported by a bandage,
and kept in such position as will produce the least
strain or drawing on the place.  Cold water, applied
by means of linen cloths, is the best dressing that
can be used.  All ointments or greasy applications
are objectionable.
              Lacerated Wounds.

   In this species of wounds  there is generally but
little hemorrhage.   Whole limbs have been torn off
with the loss of but little or no blood.   The wound
is to be cleansed of  all extraneous substances, as
before directed.  The sides of the wound are then
to be brought together as neatly as possible, and
retained in place by means of stitches, sticking plas-
ters and bandages.
   Cloths, wrung out in cold 01 warm water, as may
be most agreeable to the patient,  are  to be applied
over the plasters.   We  are to afford the wound
every facility for uniting by  adhesion or first inten-
tion, as it is expressed in medical  parlance.   If we
fail in this, the sutures and adhesive strips are then
to be removed, and applications calculated to pro-
mote suppuration used, such as linseed meal or mush
poultices.   If the inflammation be great and the pain
severe, leeches may be advantageously used, togeth-
er with the administration of opiates. It will always
be proper to act  upon the  bowels  by means  of a
cathartic;  castor oil forms an excellent one, or epsom
salts when there is much inflammation.  Blood-let-
ting may become necessary if there should be much
irritation of the system. 
10
               Contused  Wounds.

   Suppuration and sloughing usually ensue in this
kind of wound if the blow has been sufficient to de-
prive  the part of vitality.   The treatment consists
in removing all foreign substances, and the applica-
tion of leeches,  fomentations and poultices to the
part.   Cathartics, together with the use  of opiates,
and antimonials  are recommended.  If  the injury
be extensive, the constitution is to be supported by
tonics and stimulants.

              Punctured Wounds.

   These are considered the most dangerous of all
wounds.  They are liable, owing to their depth, to
injure important parts, and to be followed by hemor-
rhage and lockjaw.  The treatment consists in rest,
low diet, cold applications, leeches, and the admin-
istration of the saline cathartics, as epsom salts.  If,
notwithstanding  this treatment, an excess of inflam-
mation  occurs and matter  is formed, free  incisions
are to be made, for the purpose of evacuating the pus
and relieving the tension of the part; and poultices
or the warm water dressing used.   Any foreign sub-
stance remaining in the wound is of course  to be
immediately  removed  if practicable.   Punctured
wounds of the inner part of the hand  and soles of
the feet, such as caused by nails, glass, thorns, &c,
are to be carefully attended to, however trifling or
unimportant they  may appear, as wounds of this
description are exceedingly prone to lockjaw.   The
wound must be converted into an incised one and 
11
poultices of flaxseed meal or bread and milk applied.
A few drops of laudanum may with benefit be added
to the poultice, and if the patient suffer much from
pain, the internal exhibition of opium in full doses
will be necessary.
               Burns and Scalds.
   The treatment of these accidents would occupy
more space than can be allowed in a work of this
kind, adapted, as it is, only for cases of emergency.
No unprofessional person should pretend to treat  a
severe burn or scald, except in cases where an expe- „
rienced physician cannot be procured.  I shall there-
fore chiefly confine my  remarks to the less serious
kinds of burns, such as may be with propriety treated
without professional aid.
   In slight burns or scalds great relief may be ob-
tained by enveloping the injured part in a linen rag,
previously saturated with warm spirits of turpentine.
This dressing is to remain undisturbed till the sore
heals.  A mixture of sweet oil, or linseed oil and
lime water, also forms an excellent application.
   In  reference  to  burns  of greater  importance,  I
will only  remark, that they should be carefully ex-
cluded from the air; and  this will be best accom-
plished by covering the burnt  part with layers of
raw cotton.   Only a small portion of the burn
should be dressed at a time; the rest remaining pro-
tected  from the  atmosphere till the dressing of the
part first exposed be completed.
     Concussion of the Brain, or Stunning.

   Symptoms.—The patient usually lies in a state 
12
of insensibility for a short period.  This is accom-
panied by a feeble intermittent pulse, slow respira-
tion, sighing and vomiting.
  In our treatment we are not to be hasty in ad-
ministering  stimulants, but should rather wait till
the patient recovers of himself.   Bleeding will gen-
erally become necessary  after  reaction has taken
place, particularly  if there be pain or a sensation of
tightness in the head.  An active purgative,  such
as calomel and aloes,  is then to be administered,
and cold applications  made to the head.  Perfect
quiet is to be enjoined  for several days.   The  dan-
ger in these cases is from inflammation of the brain.

            Compression of the Brain.

  Symptoms.—Similar to those of apoplexy,
  In these cases we are first to shave the head, and
if no  fracture  be discovered, the treatment recom-
mended for apoplexy is to be pursued.   If a fracture
exist, the depressed portion  of bone  is to be raised
by means of an elevator  or trephine.   This opera-
tion will, of course, require  the  aid  of an experi-
enced surgeon.

      Bite or Sting of  Venomous Insects.

  Should there be much depression of the system,
opiates and stimulants are to be given.  If the sting
of the insect remains in the wound, it is to be ex-
tracted by means  of   a  pair of small  forceps, or
pressure made over the wound with the barrel of
a watch key.  The application of  hartshorn, sweet 
13
oil, or salt  and water will allay the pain and itch-
ing.

     Hydrophobia.—Bite of Rabid Animals.

  As there is no certain cure known for hydropho-
bia, our treatment is to  be preventative.
  Its occurrence will be best guarded against by
completely cutting out the whole wound, together
with a  considerable  portion of the  uninjured  sur-
rounding  parts.   Free bleeding is then to be in-
duced from  the wound by immersion in warm wa-
ter and  the  application of cupping glasses.  The
whole surface of the wound should be thoroughly
touched with lunar caustic, (after bleeding has been
promoted,) and poultices applied till free suppura-
tion takes  place.  These means  are to be  resorted
to immediately after the receipt of the injury.

                    Sprains.

  The best application for sprains  is sugar of lead
water, vinegar and water, or cold water freely poured
upon the limb.   The part  is then to be supported
by a moderately tight bandage, wet with a  solution
of sugar of lead.  If stiffness  remains after the ac-
cident it is to be removed  by gentle exercise of the
part, and friction with some  stimulating liniment.
Leeches are serviceable when much inflammation
exists.
              Substances in the Eye.

   Substances getting into the eye can generally be 
14
removed by a soft camel's hair pencil, or a piece of
paper twisted  tight and moistened in  the mouth.
When these efforts do not succeed, the eye is to be
well syringed  with  lukewarm water.   The  en-
gorgement of the minute  vessels of the eye will
frequently lead the patient to suppose that the  for-
eign substance still remains.

           Substances in the Throat.

  Most  foreign substances will be easily expelled
from the throat by producing vomiting,  or by swal-
lowing large mouthfuls of  soft bread.  If this does
not succeed, a large goose  quill  thrust down  the
throat and rapidly  twirled around, may serve to
dislodge it.   But if the substance  be large, and re-
moval  by the  means just mentioned  impossible, it
may be extracted through the  mouth by a pair of
long curved forceps, or by a piece of whalebone,
with a skein of silk attached, so as to form numer-
ous loops.   A piece of whalebone with a soft  sponge
secured  at one end, forms a valuable instrument.
The sponge is to be softened in warm water and well
oiled.  The instrument is then to be inserted into the
mouth  and directed towards  the back of the throat
for  the purpose of avoiding the windpipe, and gent-
ly pushed downwards toward the stomach.

            Substances in the Ear.

  Foreign substances, such as peas, coffee, pebbles,
cherry  stones, &c, frequently  become  lodged  in
the external ear of children.  If the substance can 
15
be seen it  is readily removed  by a pair of delicate
forceps ; but on no account  is violence to be used.
Lukewarm water, pretty forcibly injected  from a
syringe  into the ear, will frequently succeed ; but if
it fail, owing to the parts being swollen or tender, a
few drops of oil and laudanum  are  to be poured
into  the ear, and we are to wait until the swelling
has subsided.

       Leeches escaped into the Stomach.

  When leeches  have escaped into  the throat or
stomach, a  teaspoonful of common salt, dissolved
in water, is to be immediately taken.  This should
be followed by a  glass of wine every fifteen min-
utes, until a sufficient quantity has been taken.  It
is not necessary, however, to intoxicate the patient.
When leeches have escaped into the  rectum, they
may be dislodged by salt water injections.

                   Apoplexy.

  The  patient  is to  be immediately raised  up and
the  head supported in such a manner  as to avoid a
sudden  bend of the neck.   The clothes are to be
loosened, especially  those surrounding the  throat,
and  cold air freely  admitted.   The head  is to be
dashed with cold water, and if the  patient  be of a
stout, plethoric  habit, bleeding will  become  imme-
diately necessary.  This, however,  is generally to
be avoided  in  patients  of a weak and debilitated
constitution. As soon as he can swallow, a brisk
purgative of calomel and aloes or jalap is to be  ad- 
16
ministered.   Irritating injections, and the applica-
tion of heat and mustard plasters to the extremities,
are auxiliaries of considerable  power.  If the fit
arises from an overloaded stomach, and the patient's
face be not very turgid, emetics will prove service-
able.
                    Epilepsy.
  During the paroxysm little is to be done except
to prevent the patient from injuring himself.  The
clothes are to  be loosened, particularly those  sur-
rounding the neck, and the head elevated.  A piece
of cork or india-rubber should be placed between
the patient's teeth, to prevent injury to the tongue.
If the patient is able to swallow, some anti-spas-
modic, such  as asafoetida or valerian is to be ad-
ministered ; if not, they are to be given by injec-
tion.  If the fit arises from indigestion or intemper-
ance, an emetic will give immediate relief.

                   Hysterics.
  Cold water, vinegar or eau de cologne are to be
sprinkled over the face during the paroxysm ; pun-
gent applications made to  the nostrils, and warm
frictions to the extremities.   As soon  as the patient
can swallow, a teaspoonful of ether with ten or fif-
teen drops of laudanum, or  the tincture of asafoeti-
da or valerian is to be given.

        Convulsions, or Fits in Children.

  When a child  is attaked with convulsive fits it
should be immediately placed in a warm bath, and 
17
there suffered to remain till the fit goes off.   A pur-
gative of  calomel  and an injection will  always be
proper.   Leeches  to the temples and blisters to the
back of the neck are useful when there is much tur-
gidity of the face, which indicates a determination of
blood to the brain.  Calcined magnesia in peppermint
water is recommended when there is acidity of the
stomach or  flatulency.   Mustard is  said to possess
some specific  properties  independent of its emetic
qualities.  Emetics act with great certainty, and re-
lief  generally follows free vomiting. If the child
be teething the gums should be freely scarified.

              Fainting or Syncope.

  The person  in  the fit  should be placed on the
back, with the head somewhat  lower than the ex-
tremities,  and cold fresh air freely admitted  into the
room.   The  face  is to be sprinkled with cold wa-
ter, and volatiles held  to the nostrils.   As soon as
the patient can swallow, some slight stimulant is to
be administered.

                     Croup.

  When  a child is  attacked  with this  formidable
disease, free vomiting is to be immediately  excited.
For a child above one year of age, one grain of tar-
tar  emetic,  dissolved in  a  wineglass of water, is
to be given, in teaspoonful doses, every ten  min-
utes, till  its  emetic effects  are  produced.   If the
child be much under the year, give a teaspoonful
of the syrup of ipecac, and repeat if  necessary.  If
              n 
IS
the attack be a violent one, leeches should he applied
to the throat, just above the breast bone: two leeches
will be sufficient for a child of iess than a year old,
and one additional leech for every addiiional  year.
After vomiting, the warm bath  should  be used of
90° or  100° Fah. for  ten minutes.   Cloths, wrung
out in  hot water or turpentine and  applied to (he
throat,  give great relief.   After the violence of (he
attack  has  somewhat abated,  calomel  with  anti-
monial powder is  to be given every hour till the
bowels are opened : this is to be followed by a dose
of castor oil.

      Asphyxia,  or Suspended Animation.

   This  is   produced by  hanging,  strangulation,
drowning, lightning and  intense  cold, or by the
inhalation of noxious gases, such as carbonic acid
gas and sulphuretted hydrogen gas.

 Asphyxia, from  the inhalation of Carbonic Acid
                     gas.

   This gas exists in air which has  been contamina-
ted by respiration.  It is  the product  of combus-
tion, fermentation, and the calcination of chalk and
limestone,  and is found in coal mines under the
name of choke damp, and in old wells and cellars;
it is  also produced by the burning of coal and brick
kilns.
   When a person has been asphyxiated by this gas,
he is to be immediately removed into the open air
and  stripped of his clothing.   The head is  to be 
19
dashed  with cold water, whilst  heat is  applied to
the extremities.   Stimulating frictions are to be re-
soited  to,  and artificial  respiration  made.   This
last remedy is never to be omitted ; as many lives
may be  saved by persevering in  our efforts, even
when to all appearances life  is extinct.   When re-
covery has commenced, the patient is to be put into
a warm  bed, with the windows  open;  and stimu-
lants with acidulated drinks given.
  In entering  a place suspected to contain this gas,
we may protect ourselves from injury by dipping a
silk handkerchief into a solution of potash or lime,
and applying it to the mouth and nostrils.   By this
precaution  the -oxygen is admitted  into the lungs,
and the carbonic acid gas excluded.

Sulphuretted  Hydrogen.—Hydrosulphuric  Acid.

  This gas is  found  in drains, sewers, privies, &c.
The treatment to be pursued in  cases of poisoning
by this gas, is similar to that recommended for car-
bonic acid gas.  Chloride of lime, or soda, is the
proper antidote.   A solution of either of these rem-
edies  is to  be administered internally, and a sponge
soaked in the  solution held to the nostrils.
  A handkerchief soaked in a solution of chloride of
lime,  and held to the mouth and nose, will enable a
person to  enter a place containing  this  gas  with
safety.

   Sulphuric Acid Gas.— The vapor of burning
                    brimstone.

   In  accidents  arising from the inhalation of this 
20
gas, the vapor of ammonia is to be respired, and  a
few drops of diluted hartshorn given internally.

           Asphyxia fro m Drowning.

  As soon  as the body has been taken  from  the
Avater, it is  to be removed to a warm,  dry  situation,
and  laid on the side with the head and shoulders
elevated.   The mouth and nostrils are then to  be
cleansed of the froth and mucous which are in them,
and  the wet clothes immediately removed.  The
body is  then to be well rubbed with hot flannels,
and  placed in a warm bed between  blankets, and
heat applied in every  possible manner.   Injections
of warm salt and mustard are to be given, and warm
brandy and water got into the stomach, by means
of a stomach pump, provided the patient is not able
to swallow.  Artificial respiration is  always to be
resorted to, and should be continued at least two
hours before  the case is abandoned as  hopeless.
Galvanism  and electricity are useful agents.

  Asphyxia from Hanging or  Strangulation.

  The treatment to be pursued must be similar to that
recommended  in  cases of drowning.   Cold  water
is to  be dashed upon the head and chest, and a
small quantity of blood extracted  from the jugular
vein or  arm.   Artificial respiration is to  be made,
and  electricity or galvanism used.

              Asphyxia from Cold.
  The body is to be rubbed with ice water or snow. 
21
then with water  of the usual temperature.   Warm
air must  be breathed into the lungs, and a moder-
ate stimulus administered.  After reaction has com-
menced,  the body should be enveloped in flannels
or furs.
           Asphyxia from  Lightning.

  The clothes are to be immediately removed, and
the  body dashed with cold  water  for ten or fifteen
minutes.   Artificial respiration, stimulants and fric-
tions are  to be used, and a galvanic shock thrown
through the chest.

        Asphyxia of Infants Still  Born.

  The mouth is to be freed from mucous by intro-
ducing the finger into the mouth, then dash the face
with cold water and breathe into  the mouth : this
can be done whilst the child is  placed into a warm
bath.  After the bath, it is to be enveloped in warm
flannels.   If the  face is  very turgid  it is  well to let
a few drops of blood flow from the cord.

  Drunkenness.—(See  Poisoning by Alcohol.)
n* 
CHAPTER  SECOND.
DIRECTIONS FOR THE PERFORMANCE  OF SOME  OF
            THE MINOR OPERATIONS.
                  Bleeding.

   It is  frequently a matter of  considerable mo-
ment that a patient be immediately bled, and as val-
uable time may be consumed in procuring a physi-
cian, it is well for every person to understand how
this  operation is to be performed.   A ligature con-
sisting of a broad piece of tape or linen is to be tied
firmly around the arm, two or  three inches above
the elbow ; the vein will then become distended and
easily recognised.   The operator then grasps the
arm, placing his thumb upon the vein a little below
the intended puncture, the lancet is thrust obliquely
into  the vein, and made to cut its  way out by ele-
vating the point.   The finger should be placed upon
the side of the blade to prevent its penetrating deep-
er than desired.
   Bleeding is generally performed at the bend of
the arm, and the vein selected which runs from the
centre of the bend to the outside of the arm.  A
sharp pointed penknife will answer to perform this
operation when the proper instrument is not at hand. 
23
                   Vaccination.

  This is a simple operation and one that can be
performed with but little instruction.  The vaccine
scab is first to be moistened with a little water on a
piece of glass to  the consistency of thick cream.
The point of the lancet  should  be dipped into the
matter and several slight incisions or scratches made
upon the skin,  care  being taken that the virus is
well introduced into the  wound.   Another method
consists in introducing the  point  of the lancet under
the skin, for a considerable distance, and, if possible
without drawing blood, as  by this the matter would
be washed out; the virus  is  to be put into these punc-
tures and a  piece of sticking plaster put  over the
wound.
  The left arm  should be  selected,  and the opera-
tion performed pretty high  up and towards  the back
of the arm, so that the scar may  not  be perceptible.
The matter should become perfectly dry before the
clothes are resumed.

                     Issues.

  Issues are made by caustic, by incisions, and by
the actual  cautery or red  hot iron.   If caustic be
preferred, it is used by making a paste of equal parts
of caustic potash and soap; the part where the issue
is to be made, is then covered  with several  layers of
sticking plaster,  with a hole in the centre  of them
the size of the intended issue.  This cavity is to be
filled with the caustic paste, which should be per-
mitted to remain till the skin becomes covered with 
24
a black slough. When this occurs, the plasters are to
be removed, and a poultice applied till  the  slough
separates.   The issue is to be prevented  from heal-
ing by binding a pea firmly upon it.  The issue by
incision is made by pinching  up a fold of the skin,
and slitting it with a lancet, a pea is then introduced,
and confined there by a piece of sticking plaster.
The issue made by the actual cautery, is one of the
most efficacious and  least  painful.   The operation
is  performed with an iron rod, terminating  in an
oval knob, the size of a small chestnut; the knob is
made red  hot and  passed over the surface so as to
produce several black lines about an inch apart; a
poultice is then  applied till the slough separates.
The issue must be occasionally touched with the
cautery, to prevent the place from  healing.   Issues
are not to be made  over  projecting bones, or the
bellies of muscles, as obstinate sores might result.

           Use of the Stomach Pump.
   This useful instrument consists  of a powerful
syringe, to which is attached  a flexible gum elastic
tube,  about two or three feet in length.  In using
the stomach pump the tube is to be well oiled, and
a gag, with a hole through its centre, placed in the
mouth between the  patient's teeth.  The tube is
introduced through the hole in  the gag,  and di-
rected towards the  back of  the  throat  to  avoid
the windpipe, and pushed  gently down the oesopha-
gus till it reaches the stomach.  By placing a light-
ed candle at the orifice of the tube we can ascertain
whether it has passed in the  right direction.   If it 
25
has passed into the windpipe the flame of the candle
will be disturbed  by the air rushing out.   Two or
three pints of lukewarm water are to  be thrown
into the stomach  and then withdrawn, and a fresh
quantity  injected.  This process  is to  be repeated
till  the water  returns from  the stomach free from
color or  smell.   Care should  be taken that the
lining membrane  of  the stomach  is not injured  by
being sucked into the pump.  If  an obstruction be
felt the tube is to  be withdrawn an inch or two.
  The stomach pump is not to be used when vom-
iting can be procured by emetics, except for the pur-
pose of injecting fluids into the  stomach, when the
patient is unable to swallow.

            Artificial  Respiration.

    Artificial respiration  is  easily  accomplished  by
making pressure on the front part of the chest, whilst
the diaphram or midriff is at the same time pushed
upwards  by an assistant.   The inspiration will be
effected by the removal of the pressure.  This pro-
cess should  be repeated about twenty times a min-
ute to imitate natural respiration.

              Sutures, or Stitches.

  When the wound is large ami gaping, or in parts
where the  skin is very loose and  movable,  as the
lips, cheeks, and  eyelids, stitches  will generally be
required.  There are several kinds of sutures used
by surgeons, only one of which it will be necessary
to mention,  viz :  the common or interrupted suture. 
26
A needle threaded with a piece of stout silk  (the
kind used  by saddlers) is well  greased and passed
through one  lip of the wound from  without in-
wards;  it  is then inserted at a corresponding  part
in  the  other lip, and passed  through it  from within
outwards.   The sides  are (hen to be brought into
exact contact, and  the  silk  tied with a firm square
or  hard knot.   The  supeifluous ends of  the silk
are to be cut  off.
  The needle should only be passed deep enough to
secure it a firm hold, and never through tendons or
muscles.  It  will be sufficient for it to pass  through
the cellular tissue and  the skin.  A space  of three
quarters of an inch is to be left between the stitches
for the application of adhesive strips and the escape
of matter.  The number of stitches necessary will
depend upon the situation and extent of the injury.
Where there is much dragging  upon the part, of
course more stitches will be  required. 
CHAPTBll  THIRD.
A CATALOGUE OF THE  MOST COMMON POISONS,
   WITH THE TREATMENT NECESSARY WHEN
        THEY HAVE  BEEN TAKEN INTO
                 THE SYSTEM.
        Acids—Hydrocyanic or Prussic.

  The substances which  contain it are oil of bitter
almonds, laurel water, noyau, wild cherries, &c.
  The proper antidote for this poison is chlorine ; a
teaspoonful of chlorine water diluted, or 30 or 40
drops of the solution of chloride  of lime or soda  is
to be immediately administered  in a little water.
Diluted hartshorn is to be given and the vapor of it
inhaled.   A stream of cold  water should be poured
upon the head and spine, and  artificial respiration,
electricity and galvanism  resorted to.
  When this acid has been  taken in its pure state,
it generally proves fatal  in a few  minutes, being
one  of the most active poisons  known.  In these
cases there is hardly time for the administration of
the antidote ; but efforts should be made to  recover
the patient, notwithstanding its activity. 
2S
Hydrochloric, or Muriatic—Spirits of salt or sea
                      salt.
   An  ounce of calcined  magnesia mixed  with a
quart of water is to be given in doses of a wineglass
full  every five  minutes.  When magnesia  is  not
easily procured, whitewash  scraped  from the wall,
chalk,  soapsuds, milk, oil, or the white  of eggs may
be  substituted.   After  the  administration  of  the
antidotes  vomiting is to be excited by  tickling  the
throat  with  a feather.

Oxalic, Acid of Sugar—Salts of Wood Sorrel  or
                  Lemons of.
  Large quantities  of  magnesia, chalk,  or white-
wash are to  be mixed with water to the consistency
of cream and swallowed immediately.  Give  large
draughts of  warm water and promote vomiting by
tickling the throat with the finger. After the admin-
istration of the antidote the stomach is to be emptied
by emetics or the stomach pump.

Sulphuric or Vitriolic—Oil of Vitriol, Spirits  of
                Vitriol— Vitriol.

  Give magnesia, chalk, or whitewash  as before
directed.  When these are not at  hand, soapsuds,
water or wood ashes, oil, milk, or any mild dilutent
is immediately to be administered.

          Tartaric.—Acid of Tartar.

  The treatment for an overdose of this  substance
is the same as recommended for  oxalic acid. 
29
 Arsenic, Oxide of—Arsenious Acid, Relgar, Or-
           piment, or King's Yellow.

  The poison is to be immediately removed from
the stomach by means of the stomach pump, or an
emetic of sulphate of zinc, from twenty to thirty
grains, administered in water.   Demulcent liquids
or sweet oil are then to be given.  But the antidote
upon which  most reliance can  be  placed, is the
hydrated sesqui oxide  of iron ; about four ounces is
to be administered in small repeated doses.  A sub-
stitute may be procured by precipitating the tincture
of muriate  of iron with carbonate of ammonia.

         Phosphorus—Phosphoric  Acid.

  Large draughts of water  or any mild demulcent
liquid  is  to  be  given  immediately, to  envelope
and exclude the phosphorus from the air  contained
in the alimentary canal.   Magnesia should be taken
for the purpose of neutralizing the phosphorus, or
phosphoric acid, which  may be  formed.   Give an
emetic to evacuate the stomach, and  carefully avoid
oils or fatty substances which will increase the activ-
ity of this poison.   The antidotes for phosphoric acid
are the same as recommended in cases of  poisoning
by sulphuric acid.
     Alkalies—Potash Caustic, Pearlash.
  The vegetable acids such as vinegar, lemon juice,
&c, are to be given immediately to neutralize the
poison.  Give large draughts of  demulcent drinks
and oil which will unite with the potash  and  form
             in 
                      30

soap.   While the antidotes are being prepared, large
draughts of water should be taken to  prevent the
poison from corroding the stomach.  After the anti-
tidote, give an emetic.

                 Soda Caustic.
  The treatment directed for caustic potash is to be
adopted in cases of poisoning by this substance.

  Ammonia Carbonate—Volatile Salts.  Harts-
          horn—Spirits of Sal-volatile.

  The antidotes for this poison are vegetable acids,
vinegar,  &c.  Demulcent drinks, such as milk or
flaxseed, are to be given freely.   When  the vapor
has been inspired, the patient is to inhale  the fumes
of acetic or muriatic  acid.

     Chloride  of Lime—Bleaching Powder.

   Give  albuminous liquids, mucilaginous drinks,
and an emetic.  All acids are to be strictly avoided.

                  Quick Lime.

  Give vegetable acids, mucilaginous  drinks, and
emetics.

          MINERAL POISONS, &c.
Tin, Proto chloride and Bi-chloride of—Spwits of
   Tin; Dyers' Spirits.    Tin, Oxide of—Putty
  Powder.

  Milk is the antidote for  this poison, and is to be 
                      31

given in large  quantities; to be  followed by  an
emetic.

Zinc, Sulphate of— White Vitriol,  White Copper-
     as.   Zinc, Oxide of—Flowers of Zinc.

  Milk partially decomposes this poison, and is the
proper antidote.  Large  draughts of warm water
are to be given, to render vomiting easy.

    Bismuth—Pearl White or Face Powder.

  No specific  antidote known.  Emollient drinks,
such as flour and water, are to be plentifully taken.

                    Bromine.

  The stomach is to  be evacuated, and demulcent
drinks, containing  starch, are to  be administered ;
followed by opiates.
                     Iodine.

  Antidote and treatment the same as recommend-
ed  for Bromine.

 Copper, Sulphate of—Blue Vitriol.  Acetate of—
                    Verdigris.

   Albumen is the  antidote  for this poison.  The
 white of eggs, milk or wheaten flour, is to be taken
 plentifully.   Iron filings, mixed with water, will
 decompose  the salts, and  precipitate the  metallic
 copper which is inert. 
32
Lead, Acetate of—Sugar of Lead and Goulard's
  Extract.   Carbonate of—White Lead.   Prot-
  oxide of—Massicot Yellow.   Deutoxide  of—
  Minium Red.

  Poisoning by this substance assumes three forms,
viz:  irritant  poisoning, lead  colic, and  paralysis.
The  two first varieties only will be noticed.
  In irritant poisoning we must give some dilutent
drink, containing epsom or glauber salts, and empty
the stomach by means of the stomach pump, or an
emetic of sulphate of zinc.   In lead  colic, alum is
the proper remedy, which is  to be administered in
drachm doses, in  gruel, every three  or four hours,
to be followed by castor oil and opiates.  The warm
bath  will be found useful, and bleeding is sometimes
necessary.

Mercury or  Quicksilver, Bi-chloride of—Corro-
               sive Sublimate.

  The antidote is albumen, gluten of wheat, and
milk.  The white of an egg is considered sufficien t
to neutralize every four grains of the poison.  Evac-
uate  the stomach, and give epsom  salts and frequent
emollient injections.

  Nitrate of Potash.—Nitre or Saltpetre, Sal-
                   Prunell.

  For this  poison no chemical antidote is  known.
The stomach should be immediately cleansed of the
poison, and milk and mucilagnious drinks given. 
33
Antimony  Tartarized—Tartar Emetic.   Muri-
     ate of Antimony—Butter of Antimony.

  The treatment directed in cases of poisoning by
the mineral acids is applicable in this case; magnesia,
chalk, &c.    Give afterwards some vegetable astrin-
gent, as an infusion of nut-galls.  Opiates will be
required to allay the irritability of the stomach.
                    Creosote.
  Give  oleaginous and mucilaginous drinks to pro-
tect  the mucus coats of the stomach and intestines.
Stimulants, such as ammonia, are to be administered,
and artificial respiration made.

        Poisonous Fishes, Oysters, fyc.
  Give  an emetic of sulphate of zinc one  scruple,
and follow  with an active purgative. Draughts of
vinegar  and water, with thirty or forty drops of ether,
or brandy and water should then be taken.
             Powdered  Glass, fyc.
  Swallow large  quantities of crumbs of  bread or
soft potatoes, to envelope the particles of glass, and
take an  emetic to expel them from the stomach; fol-
low with an active purgative and demulcent drinks.

          Cantharides, or Spanish Fly.

  Remove the poison immediately from the stomach,
and give copious draughts of mucilaginous drinks.-
The effects remaining are to be treated by the warm
bath, bleeding, and injections of oil and mucilage.
                  in* 
34
                Chlorine Water.

  The white of eggs or milk is the antidote, and is
to be taken in large quantities.

 Alcohol.—Spirits  of  Wine,  Brandy,  Whisky,
                    Gin, fyc.
  The stomach  is  to be emptied  by the stomach
pump when emetics will not act.   Cold water must
be dashed upon the head, neck, and spine, and heat
applied to the extremities, whilst artificial respiration
is resorted to.  The aromatic spirits of ammonia or
diluted hartshorn, has a happy effect in  drunken-
ness.
           Nux- Vomica—Strychnia.

  In case of poisoning by nux-vomica, or its active
principle, strychnia, negative electricity is strongly
recommended by M. Duclos; but he says that  the
positive, increases the muscular spasm, and  hastens
death.   The extract of  Indian Hemp has been re-
commended as an antidote.  The inhalation of chlo-
ric ether or sulpuric ether  would  probably answer
better, as  the good effects of the hemp are  attribu-
table to its sedative and relaxing influence over  the
muscular system.   The irritation caused by the  ex-
ternal use of strychnia is relieved by the application
of acetate of morphia to the affected  part.

                    Tobacco.

  Evacuate the stomach immediately, and counter-
act the narcotic effects of the poison by administer- 
35
ing the vegetable acids, the prostration by ammonia,
brandy, and aitificial respiration.

Opium—Laudanum, Paregoric Elixir, Godfrey's
   Cordial, Dover's Powder, Dolby's Carminative,
   Acetate of Opium, Morphine.

   Give immediately an emetic of sulphate of zinc,
two  scruples, or  of sulphate of copper, five  or ten
grains, in a wineglass of water.   If the emetic does
not act, the stomach  pump is to be used without
delay, as the poison is quickly absorbed.  The cold
douche is extremely beneficial, and will rouse the
patient  and promote  the  operation of the emetic.
Keep the patient in constant motion, and give freely
of strong coffee,  ammonia,  or brandy.   Bleeding
will be required if there be cerebral congestion. The
most  reliable antidote, is a strong infusion of nut-
galls.  Electricity is a powerful agent in rousing the
patient.  Artificial respiration is to be continued for
a long time, as by this  the patient might be kept
alive for a sufficient time to allow the narcotic effects
of the poison to pass off.

Colchicum, or Meadow Saffron.    Digitalis, or
   Fox glove.  Cicuta, or Hemlock.   Belladona,
   or  Deadly Nightshade.   Coculus  Indicus, or
   Fishberries.  Aconite, or Monk's hood.

   There is no antidote known for these poisons; the
treatment advised for opium and tobacco is  to be
pursued. 
CHAPTER  FOURTH.
ON THE TREATMENT  OF A FEW OF THE MOST
             COMMON DISEASES.
          Dysentery, or Bloody Flux.

  Symptoms.—The  bowels are generally costive
previous to the attack, which most frequently com-
mences with a chill  and  a sensation of great de-
bility.  The pulse  is quick  and weak, with loss
of appetite, &c.  There is a frequent desire to go
to stool, attended with much  pain and  straining.—
The discharges are scanty,  and consist of slime,
mixed  with  blood; sometimes, however,  large
lumps of hardened foeces  are passed, with marked
relief to the patient.  The symptoms from which
we may infer a favorable termination of the disease
are,  natural stools, procured of the proper color,
smell, and consistency, the lessening of the fever,
with a clean tongue and moist  skin  of the natural
temperature, pain less severe, &c.  The unfavora-
ble symptoms are, a sudden  cessation of the pain,
attended with a cold damp skin, pinched face, hic-
cough, great anxiety and depression,  vomiting  of
dirty, offensive or foecal'matter, discharges of bloody 
37
water, like the washings of meat, and ulcers of the
mouth.
  Treatment.—Our first endeavor should be to
procure  natural stools, then to strengthen the system.
For this purpose, give at  first a cathartic of fifteen
grains of calomel, and follow in the course of a
few hours with a dose of  epsom salts or  castor oil.
This  will cleanse the bowels of all  irritating sub-
stances which are calculated to keep up the disease,
and will also stimulate the liver to action, which is
exceedingly torpid in  this  complaint.  To subdue
pain and check the discharges, give  one grain of
opium and three grains of  camphor every  two hours
until relief is obtained.  If the case is very violent,
a blister should be applied over  the abdomen, and
blood taken from the same part by means  of leeches
or cups; gum arabic water  or flaxseed tea is to be
taken in  large quantities, as free dilution is impor-
tant.  Complete rest, in the horizontal position, must
be  maintained, as this alone  will sometimes cure
the disease.   The diet should be  extremely light,
consisting  of toast  water, arrow  root, or sago;—
these are to be taken warm,  as cold drinks are apt
to increase the pain.   Meats are not to be allowed till
complete recovery has taken place.   In  the latter
stages astringent tonics are  called for.
    Pneumonia, or Inflammation of the Lungs.
  Inflammation of the lungs and pleurisy most fre-
quently  exist in conjunction, and the treatment  is
similar in both cases.
  Symptoms.—This complaint commences  with a
chill, and is followed by a fever and severe pain in 
38
the chest, which is much increased by a full inspi-
ration.  There is a dry,  hacking cough, attended
with an expectoration of white  ropy phlegm, fre-
quently streaked with blood; as the  disease ad-
vances the expectoration becomes thicker, having
more the appearance of matter.   A copious expect-
oration is a favorable sign.  The respiration is hur-
ried and restrained, the tongue is dry and furred, the
thirst great, and the cheeks red.
  Treatment.—The first thing to  be  done  is
to abstract blood freely from  the arm, and repeat
if the inflammation runs high ; cups may also be
applied to the chest and  between the shoulders.   A
large blister must then be put on the chest, and a
brisk  calomel purgative given, to be followed by
salts.  The bowels must be frequently acted upon ;
for this purpose epsom salts is  well adapted.  Tartar
emetic is the remedy upon which most reliance is to
be placed; it should be  given in broken doses, so
as to keep the patient slightly sick at the  stomach
whilst taking the medicine.  The following  is an
excellent  formula for its  administration: Tartar
emetic 8 grains, sweet  spirits  of nitre and  gum
arabic mucilage, each one ounce.  A teaspoonful of
this mixture is to be taken every two  hours.   The
diet must be exceedingly light,  consisting chiefly of
gum arabic water, toast water, or flaxseed tea.   The
juice of a lemon or orange  and apple water may be
allowed.

     Fever  and Ague,  or Intermittent Fever.

   This kind of fever  arises from marsh effluvia. 
39
  Symptoms.—The patient is at first taken with a
chill; a fever then sets  in, which goes off with a
profuse perspiration.  In the course of about twen-
ty-four hours the patient has another paroxysm, and
so on for days, and even months, unless the disease
is combatted  by the proper remedies.   Intermittent
fever is divided into three kinds, according to the
interval between the paroxysms, viz : the quotidian,
the  tertian, and  the quartan.   The most usual  form
is the quotidian, which occurs every twenty-four
hours, coming on in the morning and lasting about
sixteen hours.  The tertian is the next common.
It takes place every forty-eight hours, commencing
about noon and lasting ten hours.  The quartan is
the  least frequent, and has an interval of seventy-
two hours between the paroxysms.  It begins in the
afternoon, and is of about eight hours' duration.
  Treatment.—The treatment consists  in  that
which  is applicable during  the paroxysms, and the
remedies to  be  used to  prevent  a  return of them.
During the attack we are to quiet the nervous sys-
tem, and render the patient as comfortable as possi-
ble.   For this  purpose  it is well to give about ten
grains of Dover's powder, with warm drinks.  After
the  paroxysm, fifteen or twenty  grains of calomel,
with two or three grains of tartar emetic, should be
administered, and  vomiting  promoted  by  large
draughts of warm  water.   This will cleanse the
stomach  and intestines.   The shock given to the
nervous system by the action  of the  emetic is ex-
tremely beneficial, and will sometimes cut short the
disease.  After  the operation  of the emetic, some 
40
 tonic will  be necessary to prevent a return of the
 paroxysm.   Quinine is the remedy best adapted to
 this purpose: two  grains  should  be administered
 every hour, till eight or ten grains have  been taken.
 Sometimes it is well to  give  eight or ten grains at
 one dose, several hours before the expected attack.
 If  Peruvian bark  be preferred, it is to  be given in
 doses of one teaspoonful every two hours, till five or
 six doses  have been  taken.   A change of air will
 effect a cure when all other remedies have failed.

            Billious Remittent Fever.

  Symptoms.—There is  a marked  difference  be-
 tween remittent and intermittent fever.  In the re-
 mittent form, the  chill is  not so violent and is of
 much shorter duration.   The hot stage  is much
 longer, and the sweating stage short or entirely ab-
 sent.   There is no  perfect  intermission as in  inter-
 mittent  fever.  There is pain in the head and  back,
 a yellow furred tongue, offensive breath, bitter taste
 in the mouth, great thirst,  loss of appetite, debility,
 and a costive state of the bowels.
  Treatment.—Give calomel  and tartar emetic,
 as recommended  in intermittent fever.  Keep the
 bowels  open by mild  aperient  medicines, sponge
 the body  frequently with vinegar and  water, and
apply cold water to  the head if the headache be se-
vere.    During the remissions, quinine, Peruvian
bark, or some other bitter  tonic is to be adminis-
tered, to cut short the disease.   Quinine  is the most
reliable agent. 
41
                 Scarlet Fever.

  Symptoms.—The  patient is  first taken with a
chill or sensation of coldness;  this is succeeded by a
fever and sore throat;  there is great debility, and a
feeble fluttering pulse, with sick stomach and vom-
iting.  Upon looking into the mouth, the throat will
be found much inflamed, and  of a  deep red color.
This soon changes to a darker hue, interspersed with
dark brown or livid spots.  On the  second or third
day, large scarlet spots make their appearance upon
the neck and face, and soon extend  over the whole
body, and finally  disappear on the fifth or sixth
day.  In very violent cases, ulcers of the throat pro-
gress with great rapidity, and the patient sinks and
dies in a few days.
  Treatment.—The treatment of this formidable
disease depends much upon the constitution of the
patient, and  the character of the prevaling epidemic.
In some cases there is  a great  tendency to sinking,
and a putrid state of the system ; when this is  the
case,  the strength  has to  be sustained from  the
first  by Peruvian bark, wine,  and  quinine.   The
bowels should be opened with a dose of epsom salts,
and the throat rubbed with a strong liniment, and
a few leeches applied.  Elixir of vitriol is an excel-
lent remedy, and  is to be administered internally in
doses of 8 or 10 drops several times a day.  It is also
used as a gargle for the ulcers of the throat; for this
purpose a teaspoonful of it  is put to half a pint of
warm water.  The throat should gargled with this
wash every  few hours.  A strong decoction of red
IV 
42
pepper also makes an excellent wash for the throat.
In this disease great cleanliness is to be observed.

                   Erysipelas.

  This disease is divided into two  kinds, viz: the
Bilious and the Phlegmonous.
!•  Symptoms of the bilious variety.—The patient is
taken with a chill, which is followed by some de-
gree of fever ; the  tongue is covered with a brown
fur,  and there  is a disagreeable,  bitter taste in the
mouth.  The part which is affected assumes a bright
scarlet color, and is attended with  a burning, itching
pain ;  after a short time little watery blisters make
their appearance, and resemble those  produced  by
boiling water.
  In the phlegmonous, the deeper seated issues are
involved, and the disease is of a much more serious
character.  The symptoms  are a deep seated, in-
tense, throbbing pain ; the redness is of a darker hue,
and the swelling hard, and deep seated ; great thirst
and a dry, red tongue.
  Treatment:  In  bilious  erysipelas  it is well to
open  the  bowels with a calomel  purgative, which
should be followed by epsom salts.  The bowels are
to be kept in a soluble slate during the continuance
of the disease ;  for this purpose epsom salts are ex-
cellent, as, independent of their cathartic  action,
they possess great cooling or anti-inflammatory pro-
perties.   Emetics  are exceedingly beneficial in the
first stages, but are improper in  the latter  part of the
disease.  Tartar emetic, in broken  doses, so as to
keep up a state of nausea, is extremely useful when 
43
the system is much excited.   Promote perspiration,
keep the patient on low diet, and confine him to his
room.   The part affected should be painted with
tincture of iodine as well as the unaffected surround-
ing surface for some distance, to prevent the disease
from spreading,  which  it does with great  rapidity.
Circumscribing the place with blisters will  have the
same effect.
   In the phlegmonous form there is generally a great
tendency to a typhus state ; and though bleeding is
sometimes essential, it should be practiced  with the
greatest care.  In old persons and those  of  a broken
down, debilitated constitution it  must  be  avoided.
When there is a  typhus tendency the strength will
require support  from the commencement,  by wine,
bark,  and quinine.  Early and free incisions are
useful to deplete the part and relieve  the tension;
this course may prevent the further progress of the
disease.   In the advanced stage, when matter has
been formed, incisions are  absolutely necessary to
evacuate it;  if this is not done, mortification and loss
of the limb, or life of the patient, will be the result.
   Erysipelas is very erratic,  and is prone to leave
the part first attacked and to seize upon some of the
vital organs.  In such cases the treatment should be
of the most active character.  Apply blisters to the
former seat of the disease, for the purpose of inviting
it back;  bleeding may be necessary, but the  treat-
ment will in a great measure depend upon the organ
affected.   Such  cases are apt to terminate fatally.
                     Measles.
   Symptoms : The patient  is taken with catarrh 
44
or cold, and has shiverings, alternated with flushes
of heat;  he complains of great  lassitude, pain in
the forehead and eyes, dullness, and  disposition to
sleep.  The pulse is  quick, and the skin dry and
hot; the tongue is covered with a white fur, except
the edges, which are bright red ; sick stomach and
sometimes vomiting.   On the second day all the
symptoms are aggravated and  continue to increase
to the fourth day, when the eruption makes its ap-
pearance  in the shape  of small circular red patches
on  the face, and  extends in a few days over the
whole  body.   On  the third or fourth  day of the
eruption  it commences to disappear: it turns yel-
low, and  the skin is detached in small scales.   The
unfavorable symptoms are when it occurs  in  very
young children, when the eruption disappears be-
fore the third day, or when it disappears suddenly,
a  leaden color of  the spots.  The symptoms are
considered favorable when the catarrh is slight and
the skin moist after the appearance  of the eruption.
   Treatment.—When  the  catarrh is  slight the
treatment consists  of spare  diet, mild temperature,
mild laxative medicines, and Dover's powders.  If
the eruption disappears suddenly, from cold, the pa-
tient should drink freely of warm teas.  If there
be diarrhea, it should be controlled by Dover's pow-
ders, &c.   The cough is apt to remain  sometime,
and must be relieved by expectorants.

                    Mumps.

   Symptoms.—There is  first a chill, then a fever,
attended  with a swelling of the glands lying under 
45
the ears, which produces difficulty  in swallowing,
and stiffness of the neck and jaws.
  Treatment.—The patient should confine him-
self to the house as long as the swelling of the neck
remains, and wear a  flannel bandage  around the
throat and ears, to prevent taking cold, which would
be attended by  serious consequences.  The  bow-
els  are  to  be  kept open by some gentle laxative.
Should  the brain become affected,  very active treat-
ment will be necessary. The patient must be bled
freely and blistered under the ears.  Give  a  brisk
purgative and use a  hot foot bath  with salt and
mustard.

          Inflammation of the Tonsils.

  This  is a disease produced by cold.   There  is
great swelling and difficulty of swallowing; fever,
and profuse expectoration of white frothy phlegm.
The swelling increases with  great  rapidity, and will
sometimes produce suffocation.  The treatment must
be active.   General  bleeding will be proper if the
patient  be  young and robust.   Blood should  be
taken from the neck just under the  ear, by leeches
or cups.  A brisk purgative of calomel and  jalap
must be given, and the bowels kept open by repeat-
ed doses of epsom salts.  In the latter stages of the
disease,  some astringent gargle will  be useful.  A
strong liniment of hartshorn, sweet oil and turpen-
tine, rubbed freely upon  the throat, will soon cause
the swelling to disappear.
IV* 
46
                  Abscesses.

  Abscesses frequently occur after fevers, and may
be caused by blows and other injuries.   They com-
mence with slight fever, pain, redness, and swelling;
in this stage, the patient should be purged and kept
on low diet, and blood taken from the part by leeches;
cold applications, &c.  If matter is formed, it should
be immediately evacuated, lest it burrow and injure
some important part.   After the  abscess is  opened,
poultices should be applied, to favor the evacuation
of the pus; they must not be continued over a few
days, as they will prevent the part from  healing.
Some healing ointment will be the proper  dressing
after the removal of the poultices.

                      Ulcers.

  There are several varieties of  ulcers,  only two of
which will be mentioned, viz: the indolent and the
irritable ulcer.   The indolent is the most common,
and occurs generally  on  the legs and  feet.  It is
characterized by a smooth, glassy, pale appearance ;
the edges are raised thick and white; the discharge
is thin and watery.  It exists generally  in old or in-
temperate and badly fed people.   Poultices of  car-
rots or flaxseed meal should be applied, till the sore
is cleansed, and if any proud flesh springs up, it is
to be touched with caustic or bluestone.   The ulcer
should be washed daily with castile soap, and dress-
ed with simple or red precipitate  ointment.   Strips
of sticking plaster carried over the ulcer  and around
the limb so as to produce a slight compression, are 
4?
of great service.  The limb should be bandaged for
a considerable distance above the sore, and kept at
rest in a horizontal position.
  Irritable ulcers occur generally on the ankle; they
are known by the pain and the red angry  appearance
of the sore; the edges are thin, ragged and turned in;
the discharge is thin, acrid and  bloody.   The limb
should be kept elevated and perfectly at rest. Touch-
ing with lunar caustic is very serviceable.   The treat-
ment varies but little from that recommended for the
indolent kind.  The system should be attended to,
and the blood purified by sarsaparilla, iodide of pot-
ash, and a nutritious but unstimulating diet is ne-
cessary.
                      Colic.
  Symptoms.—A violent shooting pain  is felt in the
region of  the navel; the pain comes on  like cramps
every few minutes, causing  the  patient  to lean his
body forwards, and to writhe about  in  the greatest
agony ; this is attended with sick stomach and  fre-
quent vomiting ; the bowels are generally costive.
  Treatment.—Give immediately  one o» two ta-
blespoonsful of common mustard in half a tambler
of water; this will speedily cause vomiting and re-
lieve the stomach  of any undigested food.  If the
pain still  continues, give thirty drops of laudanum
and twenty drops of tincture of camphor every half
hour until relief is obtained.  A good dose of castor
oil should be given after the administration of the
opiate, for the purpose  of opening the bowels.  A
strong mustard sinapism applied  over  the  seat of
pain will afford great relief.   If  these remedies fail, 
48
 place the patient in a warm bath, rendered  stimu-
 lating by the addition  of  coarse salt  and  mustard,
 and give injections of gruel and castor oil.

          Sun Stroke, or  Coup de Soleil.

   Symptoms.—A severe pain in the head, with in-
 tolerance of light, and a peculiarly wild expression
 of the eyes, turgid face, hard rapid pulse, great thirst
 and delirium.
   Treatment—Free bleeding, frequently repeated
 till the delirium subsides, active purgatives, together
 with the application of cold to the head and blisters
 to the wrists and ankles.

                     Debility.

   Various disorders to which we are subjected origi-
 nate in debility, and consequently it requires a treat-
 ment in unison with the cause  on which it depends.
 The  warm bath  will  generally  prove beneficial.
 Diet must also be carefully attended  to, as weakly
 persons should be extremely temperate  in the use
 of animal food ; but they may freely indulge them-
selves in the use of nutritious vegetables, soups, eggs,
strong broth, and shell fish, all of which are extreme-
ly nourishing.  Clothing  also  should be carefully
attended  to, so as to preserve a moderate temperature
between  heat and  cold.  Invalids of this descrip-
tion should also take more rest than healthy persons,
and be careful not  to exceed in their exercise the
strength they possess.  Their bed  should be clean
but not  too soft;  the apartments in which they 
49
dwell, large and airy; and the mind should be kept
perfectly calm.

                   Headache.

  Headache may be prevented by wearing the hair
short, and by washing the head daily with cold wa-
ter ; a teaspoonful of  prepared charcoal taken twice
or three times a week before breakfast, will correct
the acidity of the stomach  and prevent the attack.
If the bowels are costive, a  mild  laxative is  to be
taken, or  a blue pill.  Avoid indigestion, and take
frequent exercise in the open air.   Thirty or forty
drops of sulphuric ether, in a little water, is an ex-
cellent remedy for nervous headaches.  The burn-
ing of anthracite coal, in confined cast iron stoves, is
a frequent cause of this distressing complaint.

                  Indigestion.

  Persons subject to indigestion, are  of  a weak and
delicate habit, or else  of a sedentary disposition.
The free  use  of  cold water  in  drinking, washing,
and bathing, will frequently effect  a  cure, alone.
Mild  purgatives, light food, early  rising, and  mod-
erate  exercise, will be found  the most certain rem-
edy. 
CHAPTER   PIETH.
useful medical  receipts.
              How to cure a  cold.

  Of all the means of curing colds, fasting  is the
most effectual.   Let whoever has a cold eat nothing
whatever for two days, and his cold will  be  gone,
provided he is not confined to his bed ; because, not
taking carbon into the system by food, but consum-
ing the surplus which causes that disease by breath,
he  soon carries off the disease,  by removing  the
cause.  This will be  found more effectual, if he
adds  copious water  drinking  to protracted fasting.
By the time a person has fasted one day and night,
he will experience a  freedom from pain, and a clear-
ness of mind, in delightful contrast with the mental
stupor and physical  pain, caused  by colds.  And
how infinitely better  is this  method of breaking up
colds, than by medicine. 
51
                    Asthma.

  Procure common blotting paper, and thoroughly
saturate it in a solution of saltpetre, and let  it be
carefully dried in  the  sun.   On retiring at night,
ignite it, and place it on a plate in your chamber.
This will enable an asthmatic person to sleep with
comparative comfort.

               Hooping  Cough.

  Take sub-carbonate  of  potass, 20 grains ; coch-
ineal, 10 grains;  white sugar,  I  ounce; water, 6
ounces ; and mix thoroughly together.  Dose, a tea-
spoonful three or four times a day.

              Swelling of the Face.

  To reduce the  swelling of the  face, caused by
tooth-ache,  make  a liniment of tincture of bella-
dona, two drachms;  laudanum, one drachm; spirits
of hartshorn, half ounce; and rub the face frequendy
with it.
                   Tooth-ache.

  The following is an  excellent remedy for tooth-
ache.  Dissolve one drachm  of tannic acid, in  one
ounce of chloroform, and  apply to the tooth with  a
piece of raw cotton.  A small quantity  should also
be rubbed on the gums and outside of the face.   If
this application be faithfully used, it seldom fails to
relieve the pain. 
52
             Cramp in the Stomach.

   Take a teaspoonful of sulphuric ether, and three
 grains of pulverized camphor.

                   Diarrhea.

   Take of sweet oil, one ounce;  cinnamon  water,
 six ounces; mucilage of gum arabic, one ounce ;
 laudanum, one drachm, and mix well together. Dose
 for an adult, one tablespoonful every three hours.

           Incipient stage of Cholera.
  Take one ounce of tincture of catechu, one drachm
 and a half of laudanum, three drachms of tincture
 of camphor, half a drachm of tincture of rhubarb,
 and half a drachm of oil of anise ;  mix well togeth-
 er in a bottle.   Dose, a teaspoonful in a little cold
 water, every four hours,  or oftener if the symptoms
 be urgent.  Drink rice  water.

           Flatulency of Old Persons.

  Make a pill of asafoetida, one grain, and pulver-
ized aloes, four  grains ; to be taken at one dose.

                  Hiccough.

  This very unpleasant sensation is  instantly stopped
by taking a teaspoonful of vinegar, or a few draughts
of cold water in succession.

                 Scald Head.
  Shave the head, and annoint the scalp  with the 
53
following ointment: creosote, half a drachm, rubbed
up in an ounce of fresh lard.   Wash the head fre-
quently with warm water and castile soap.

           Ointment for Ringworm.

  Sulphuric acid, one drachm, rubbed up  in  an
ounce of fresh  lard.  Apply several times a day.

          Ointment for  Sore Nipples.
  Take two ounces diachylon, one ounce of sweet
oil, and half an ounce of vinegar; boil together and
apply to the nipples on a fine linen rag.

                   Poultices.
  Poultices are made of white lead, corn meal, lin-
seed meal, lily roots, oak  bark, and various  other
substances.  They are simply to be boiled in water
to the proper consistency, and applied while warm.
When they become dry and hard they  are  to  be
removed and fresh ones substituted. Their efficacy
depends chiefly upon heat  and moisture.

                Carrot Poultice.
  A carrot poultice is made by grating the carrots
in water, so as to foTm a pulp, or by boiling.and
mashing them.  This is an  excellent poultice  for
painful ulcers  and cancers.  It cleanses the sore and
removes the offensive odor.

                   Synapisms.
   A synapism consists of a poultice made with vin-
               v 
54
egar instead of water, and  is rendered warm and
stimulating by the addition of garlic, horse-radish, or
mustard.  To make a common synapism, take equal
parts of corn meal and strong mustard, and mix into
poultice with warm vinegar.  These applications
should not remain on  till a  blister is produced, but
should be removed when the part has become red
and well irritated.

                 Fomentations.

  Boil  hops  or chamomile flowers  in vinegar or
water.   Flannel is to be dipped into this  decoction
and applied as hot as the patient can well bear; when
one flannel grows cold another is to be applied ; care
being taken not to  expose the part to the air while
the clothes are being changed.

                  Liniments.

  A very simple liniment  consists of one part of
strong spirits of hartshorn to three parts of sweet oil;
to this, turpentine, camphor, and laudanum may be
added,  making  an excellent application for sore
throat, rheumatism, sprains, &c.

               Camphorated Oil.

  Two ounces of pulverized camphor is to be added
to four ounces of sweet oil, which must be permitted
to stand till the camphor is dissolved.  This is an
excellent application to the  bowels  in chronic diar-
rhea. 
55
                    Gargles.

  'Gargles are made from  a variety of substances.
Sage tea, with the addition of honey and alum,
makes an excellent gargle for sore mouth.

             .4  Clyster or Injection.

  A common clyster is composed  of strained gruel,
to which is added a large spoonful of salt, or castor
oil, or  both.  For an  adult, a pint or quart should
be injected.

                Lime  Water.

  Pour a quart of boiling water on a piece of fresh
quick  lime, the size of a hen's egg, and bottle for
use.   Dose, a wineglassful, several times a day.

                   Tar  Water.

  Pour  half a gallon of water  on  one pound  of
clean tar, and stir it till it becomes thoroughly mixed.
Let it settle, and  pour off the water for use.  Dose,
half a tumblerful, four  times  a  day.  This is an
excellent remedy for asthma, coughs, colds, &c.

                 Onion Syrup.

   Peel and slice three or four onions; put them  in
a saucepan, and cover with a thick layer of coarse
brown sugar.   Simmer  till the onions are  thor-
oughly cooked ;  then drain off the  syrup.  Dose,
Awo tablespoonsful, four or five times a day. 
56
                  Hop Syrup.

  Take a handful of hops, one pound of  coarse
brown  sugar, one pint of water, and simmer  over a
slow fire till the strength of the hops is well extract-
ed ;  then  strain, and bottle for  use.   Dose  for an
adult, a small wineglassful, four times a da)-.   This
is excellent for a bad cough, attended with restless-
ness  at  night.

               Hoarhound Syrup.

  Take a handful of hoarhound, one pound  of the
coarsest brown sugar, one pint of water, and simmer
over  a slow fire for about one  hour; then bottle for
use.  Dose for an adult, the same as of hop syrup.
This, also, is an excellent remedy for a bad  cold. 
         LIST  OF

MEDICINES AND INSTRUMENTS,
            FOR A
  FAMILY MEDICINE  CHEST:
          TOGETHER WITH
      THEIR DOSES, USES, &c. 
A List of the Medicines necessary for a FamIly Medicike Chsst :  arranged for a family of eight persons,
                      or less—to be increased in the same ratio for a larger family.
No

 1
 2
 3
 4
 5
 6

 7
 8

 !)
10
11
12
13

14
15
16
17
18
Names of Medicines.
Doses internally given.
Alum, ------
Aloes,     -       -      -      -      -
Asafcetida tincture,   -      -      -      -
Antimony, (or tartar-emetic) in 3-gr. powders,
  No. 20, for emetics, solutions and fever mix-
  tures,    -       -       -      -      -
Blister Plaster, in roll,       -      -      -
Blue Pill* in mass,      -

Calomel Pills, 2 grs. each, No. 30,
Calomel and jalap Powders, 10 grs. each, No.
  10,......
Castor Oil, in bottle,     -
Camphor Spirits,     -
Caustic,    -       -      -      -      -
Cream of Tartar, in box,     -
Dover's Powder, in powders of 5 grs. each,
  No. 20,.....
Elixir of Vitriol, in bottle with glass stopper,
Flaxseed meal, in box, for poultices, -  2 lbs.
Gum Arabic,      -
Hartshorn, Spirits of, -
Iodide of Potash,  -      -      -      -
k to 1 drachm, dissolved in gruel.
4 or 5.grs. of powder, made into pill.
A teaspoonful, repeated.
Dissolve each  in  4  tablespoonsful of warm
  water.


From ten to fifteen grs., made into pill, as a ca-
  thartic.
One or two, morning and evening,  to salivate.
One powder for a cathartic.

One to three tablespoonsful, as a cathartic.
A teaspoonful.

One or two teaspoonsful in water or molasses.
One powder  in  fever and for colds, and two
  powders in rheumatism, every four hours.
8 or 10 drops, in  half a  glass  of sweetened
                                    [water.
A tablespoonful to a quart of water.
Ten drops, in water.
4 or 5 grs. in water, twice a day. 
Ipecac, in emetics of 20 grs. each, No. 5,

Laudanum,        -
Nitre (sal) Powder, in box,   -

Nitre, sweet spirits of,    -
Ointment, simple, in  tin box, -
Ointment, mercurial,  in tin box,   -
Opium, -      -      -      -      -
Paregoric, -      -       -       -
Peppermint, essence  of,
Quinine Pills, 2 grs.  each, No. 30,

Tincture Rhubarb,    -
Epsom Salts,             -
Soda, supercarbonate of,
Syrup of Squills compound,
Sugar of Lead,       -

Sulphur, flour of,  -
Oil of Turpentine,    -
White Vitriol,   -
The best emetic is  half a tartar-emetic powder
  and half an ipecac powder.
Fifteen to forty drops.
5 to 10 grs. in half a gill of water, every three
  or four hours, in fever.
A teaspoonful in a  wineglassful of water.
i to 2 grs. in pill or powder.
One or two teaspoonsful, in water.
Thirty drops.
One to two pills as a tonic.  In intermittent fe-
  ver, three to six pills, taking one every hour,
One to two tablespoonsful, as a cathartic.
One to two tablespoonsful, in water.
Haifa teaspoonful, in water.
Ten to thirty drops, in croup, colds, &c.
2 or 3 grs. in jelly, for protracted diarrhea.  1
  gr. to 1 oz. of rain water, for eye-wash.
Two or three teaspoonsful in molasses.
Four or five drops on  sugar, for cough.
10 or 15 grs. as an emetic, in poisoning ; 4 grs
  to 1 oz. of rain water, as eye-wash._______
1 Lancet.—1 12-oz. Clyster Syringe.—§ yd. Adhesive Plaster.—Scales and Weights.—Graduated Glass
Cost of Medicines..................................................................$6 50
  "     Instruments.................................................................3 50
  "     Medicine Chest..............................................................2 00
Total..............................................................................----$12 00 
NOTES  AND DIRECTIONS FOR MEDICINES,

       contained  in  the foregoing table.
1—Is chiefly useful externally to stop bleeding, and for ulcers,
    gargles, &c; internally, in diarrhea, and painter's colic.
2—5 grs. combined with calomel, in apoplexy and diseases of the
    brain ; also, for worms; 1 to 2 grs., combined with 1 or 2
    grs. of asafoetida as a dinner pill.
3—Used in hysterics and  other nervous affections j also as an
    expectorant.
4—As an emetic, take one tablespoonful every fifteen minutes,
    until it vomits ; in inflammation of the  lungs and pleurisy,
    two teaspoonsful.
5—-Useful in local pains and inflammations.   It must be spread
    very thin on kid or brown paper, and applied to the affected
    part. It is to remain on till a blister is formed,—say twelve
    hours ; the blister is then to be  cut, and dressed with a
    poultice or simple ointment.
6—Useful when the secretions of the  liver are obstructed, and
    in headaches.   When taken as  a  cathartic, it should  be fol-
    lowed by oil or salts.  3 or 4 grains as an alterative.
7—In the fevers of tropical  climates large doses are required in
    the outset—say 20 or 30 grains ; followed by smaller  doses
    of 8 or 10 grains.  When given with opium salivation is
    hastened.
8—Given when a strong purgative is  required, as in the com-
    mencement of fevers, jaundice, and dropsy.
9—An excellent cathartic to assist the  operation of other  medi-
    cines.  When a few drops of laudanum  are added, it  is ex-
    cellent in the first stages of dysentery.   Used in colds, &c.
10—Useful in typhus fever, colic, diarrhea, &c.   When mixed
    with equal parts of hartshorn and  sweet oil, it forms an ex-
    cellent liniment for sore throat, rheumatism, sprains, etc 
61
11—Used  to burn out proud flesh, make issues, &c.
12—Makes a  cooling drink with the addition of water, sugar,
    and lemon peel; is a laxative when mixed with sulphur.—
    Dose, a teaspoonful.
13—Used in fevers, colds, rheumatism, &c.   Dose, from 5 to 15
    grains.
14—Used  in consumption to stop night sweats, and strengthen ;
    also in scarlet  fever, &c.
15—Used  for poultices when boiled with water to the proper con-
    sistency ;  can be made into tea by enclosing it in a bag, and
    pouring boiling water upon it. The tea is excellent for colds,
    fevers, dysentery, and diseases of the kidneys and bladder.
16—Used  the same as flaxseed tea;
17—When mixed  with oil  it  forms a liniment;  taken in water
    as a stimulant, in doses  of ten or twelve drops.
18—Useful in  scrofulous, venereal, and mercurial diseases.
19—Mix  with a gill of water, and  take one half at a time.—
    Twenty minutes should  intervene between the doses.  Luke-
    warm water should be taken freely to promote vomiting.
20—Used to promote sleep,  and check profuse discharges.  Old
    laudanum is to be used  with  great caution, as it acquires
    strength from  the evaporation of the alcohol.
21—Good in fevers.
22—Promotes the discharge  of urine ; good in colds, fevers, &c.
23—Used to dress  blisters, sores, &c.
24—When rubbed in the groin, arm pits, &c, it promotes sali-
    vation ; when rubbed upon swellings, it favors their absorp-
    tion.   Used to kill vermin.
25—Used to allay pain, promote sleep, &c.
26—Used in coughs and colds.  Is frequently given to fretful
    children, but is a bad  practice.
27—Used for pain  in the stomach, flatulency,  &c.
28—Used in remittent and intermittent  fevers ; should be given
    when the fever is off", and is to be preceded by a cathartic.
    Dose, from 5 to 10 grains.
29—Good in chronic diarrhea, &c.
30—An excellent purgative in  inflammatory complaints.
31—Used to correct acidity of the stomach, and for headaches. 
62
32—Used for croup, colds, dropsy, &c.
33—Used in diarrhea, hemorrhages, &c; as an eye wash.  Wh*n
    dissolved in water is an excellent application to broken limbs,
    sprains, &c.
34—Used in salivation, piles, and itch.
35—Used for coughs, worms, in typhoid fever, and as a lini-
    ment.
36—Used as an emetic in cases of poisoning, &c; dose 10 or  15
    grains ; as an eye wash. 
CHAPTER  SIXTH.
RECEIPTS FOR SICK COOKERY.
              An excellent Broth.

  Boil four pounds of loin of mutton in a gallon of
water, with some chervil, till it is reduced to two
quarts; remove  the  fat, and use it as  agreeable.
Any other herbs may be used.
                Chicken Broth.

  Skin and divide your  chicken, put  it in  some
water, with a blade of mace, one sliced onion, and
a few white pepper  corns; simmer till sufficiently
good, then strain it and remove the fat.
                 Eel Broth.

  Set a pound of small eels over the fire, with six
pints of water, some parsley, onion, and a few pep-
per corns; simmer till the broth is good, then strain 
64
it off, and add salt.  The above quantity should be
reduced by simmering to three pints.
                  Veal Broth.

  Put four pounds of veal into a gallon of water,
with a large crust of bread, two blades of mace, and
some parsely; let it boil three hours, closely cover-
ed, then skim it clean.
                  Arrowroot.

  Care must be taken to procure that which is genu-
ine.    Mix  it  in the same manner as you would
starch, then  add  a  glass of sherry, with  sugar and
nutmeg to fancy, or a little brandy.  Where wine
or brandy is  objectionable,  use simply the sugar and
nutmeg.


               Arrow-root Jelly.

  Boil a pint of water with two spoonsful of good
brandy, some nutmeg, and sugar; then pour it boil-
ing hot on two spoonsful of arrow-root,  previously
mixed smooth  with cold water.
                  Eggs.

Weak  persons may take eggs in  the following 
65
manner: beat an egg very fine, add some sugar and
nutmeg, pour upon it a gill  of boiling  water, and
drink it immediately.   Or, mix up an egg with a
glass of wine, or a spoonful of brandy, and a little
sugar.   Or, eggs  very little boiled or poached are
very nourishing;  but the  yolks  alone  should be
eaten by sick persons.
                  Tapioca Jelly.

  Wash some tapioca in cold water, and soak it in
fresh water, six hours; then let it simmer in the
same water with a piece of lemon peel, till it be-
comes clear; then add lemon juice, wine, and sugar,
agreeable to taste.
                Gloucester Jelly.

   Take  two ounces each of hartshorn shavings,
eringo-root,  pearl barley,  rice, and sago ; simmer
them with three quarts of water, till reduced to one,
then strain it off; when cold it will be a jelly.  It
may then be dissolved in wine, or broth, as occasion
may require.


                    Panada.

  Set your water on the fire with a glass of sherry,
some loaf sugar, and a little grated nutmeg and lem-
on peel; have some grated crumbs of bread ready,
              VI 
66
and the moment it boils, put them in without taking
it off, and let it boil as fast as  possible ; when suffi-
ciently thick to drink, take it off.
                    Sippets.

  On a very hot plate, lay some sippets of bread,
and pour some beef, mutton, or veal gravy on them,
then sprinkle them with a little salt.
                 Rice Caudle.

  Mix some ground rice smooth  with a little cold
water, then put it into boiling  water; when it be-
comes sufficiently thick, add a bit of lemon  peel,
and some cinnamon; a glass of brandy, and sugar
to taste.


                 Mulled Wine.

  Boil a pint of wine with nutmeg, cloves, and
sugar, serve it with slices of toasted bread ;  or, beat
up with the yolks of four eggs, with a little cold wine,
and mix them carefully with the hot wine; pour it
backwards and  forwards till it looks fine, heat it
over the fire till  it is tolerably thick, pour it back-
wards and forwards, and serve with toasted bread
as above.  Or, boil some spice in  a little water till
their  flavor is  extracted, then add a pint of port
wine, with some sugar and1 nutmeg. 
67
                  Mulled Ale.

  Boil a quart of good ale with some nutmeg, beat
up six eggs, and mix them with a little cold ale;
then pour the hot ale  to  it, and return  it several
times to prevent curdling ; warm and stir it till suf-
ficiently thick, add  a piece of butter, or a glass of
brandy and serve it  with dry toast.
                    Saloqp.

  Boil some wine, water, sugar,  and lemon peel,
together; then add  the saloop powder, previously
rubbed smooth, with  a little cold water, and boil
the whole a few  minutes.
                     Sago.

  Soak your sago in cold water one hour; wash it
well, and pour off the water; then add some more,
and simmer the whole till the berries are clear; then
add lemon peel, wine, spice, and sugar, and boil the
whole together.


                  Coffee Milk.

  Boil two ounces of fresh, well ground coffee in a
quart of milk, for twenty minutes, and put in a sha-
ving or two of isinglass to clear it; let it boil a few
minutes, stand it by till fine ; then sweeten to taste. 
68
                Milk  Porridge.

  Prepare a fine gruel, strain it, and  then add a
sufficiency of milk, and serve with toast.
                  Rice Milk.

  Rub down a little ground rice, mix it with two
quarts of milk,  and boil it; add lemon  peel, cina-
mon, and nutmeg; when nearly done, sweeten it
agreeable to taste.


                 Baked  Milk.

  This is an excellent article for weak or consump-
tive persons.  Put half a gallon of milk into a jar,
tie it down  with writing paper,  and after the bread
has drawn, let stand all night in the oven ; the next
morning  it will have acquired  the consistency  of
cream, and may be drank as occasion requires.
                 Water Gruel.

  Put a large spoonful of corn or oat meal into a
pint of water, stir it well together, and let it boil
three  or four times, stirring it often.   Then strain
it through a sieve, salt it to the palate, and put in
a large piece of fresh  butter; brew it with a spoon
till all the butter  is melted, and it will be fine and
smooth. 
69
               Cranberry Gruel.

  Wash  half a pint of cranberries in some water,
and boil a large spoonful of corn or oat meal in two
quarts of water ; then put in the mashed cranberries
with some sugar, and lemon peel; boil it forty min-
utes, and strain it off; add  a glass of brandy or
sweet wine.
                 Currant Gruel.

  Make a  quart of water gruel, strain  and boil  it
with  two  tablespoonsful of currants till they are
quite  plump ; add some nutmeg, sugar, and a glass
of sweet wine.
                 Fever Drink.

  Boil three ounces of currants, two of raisins, care-
fully stoned, and an ounce and a half of tamarinds,
in three pints of water, till it is reduced to a quart;
strain it, throw in a bit of lemon peel, and let it stand
an hour.
            Draught for a Coughs.
  Beat two fresh eggs, mix them  with half a pint
of new milk warmed, two table spoonsful of capil-
laire, the same quantity  of rose water, and  a little
nutmeg.
  Observe, it must not be warmed after the eggs are
added.
                 VI* 
70
                Barley  Water.

  Boil a quarter of a pound of pearl barley in a gal-
lon of water, till it is quite soft and white; then strain
off the water,  and add to it a little currant jelly,
lemon, or milk.  Or, wash a little common barley,
and let it simmer in three or four pints of  water
with a little lemon peel.
                Apple Water.

  Peel and slice some tart apples, add some sugar,
and lemon peel, then pour some boiling water over
the whole, let it stand in a covered jug  by the fire
for an hour, or more, when it will be fit for use.
                Lemon  Water.

  Peel a lemon, cut a few slices, pour boiling water
upon them, and it will soon be fit for use.  This is
a pleasant drink during a fever.
                  Seed Water.

  Take two spoonsful of coriander seeds, and one
of caraway  seeds; bruise them well in a quart of
water, strain them, beat the yolks of two eggs, and
mix with the water; then add some sweet wine and
lump sugar. 
71
              White  Wine  Whey.

  Put a pint of new milk on the fire, and  when it
boils up, pour in as much white wine as will com-
pletely turn it; then let it boil up once, and set it
aside  till the curd subsides; pour the whey  gently
off, and add to it a pint of boiling water and some
loaf sugar.


                 Lemon Whey.

  Boil a quart of milk and water, add to it the juice
of two lemons, let it simmer five minutes, then strain
it off, and add a little  sugar.   This is  an excellent
drink to promote  perspiration.
                  Egg Wine.

  Mix a well beaten  egg with a spoonful of cold
water, then boil a little white wine, water, sugar, and
nutmeg together; when it boils, gradually stir in the
egg for about five minutes; then serve with  toast.
                  Orangeade.

  Press the juice out, then pour boiling water on a
part of the peel, and cover it close ; boil some water
and sugar to a thin syrup, and skim it well; when
all are cold, mix the juice, the infusion, and the
syrup, and strain the whole. 
72
                    Orgeat.

  Blanch and beat a quarter  of a  pound of sweet
almonds with a tablespoonful of orange flower water,
and four  bitter almonds;  then add  half a gallon of
milk and water to the paste, and sweeten with capil-
laire.
                  Wine Posset.

  Boil some slices of white bread in a pint of milk;
when soft take it off the fire, and grate in some nut-
meg and a little sugar; pour it off, and  put  half a
pint of sweet wine into it by degrees, and serve it
with toasted bread.
                  Ale Posset.

  Warm a quart of milk with a piece of white bread
in it; then warm a quart of ale  with some sugar
and nutmeg; when the milk boils, pour it upon the
ale, let it stand five minutes to clear, and it will then
be fit for use.
                 Bread Soup.

  Boil some pieces of bread crust in a quart of wa-
ter with a small piece of butter, beat it up with a
spoon, and keep it boiling till the bread and water
be well mixed ;  then add a little salt. 
73
                Stewed Prunes.

  Stew them  gently in a small quantity of water
till the stones will slip out; but observe, they must
not be boiled too much.  These are useful in  any
complaint where fruit is proper, especially in fevers.
            Corn Starch  Pudding.

  Take three  tablespoonsful  of the starch, two or
three eggs, and a cup full of white sugar ;  beat the
eggs well and dissolve the starch in milk or water;
then mix your  ingredients and stir them in while
the milk is boiling; stir it and let it boil up (wo or
three times and  it will be done.  Grate in a little
nutmeg or  lemon peel  when  you put it  to boil.
By adding a greater  quantity of starch to the milk
the pudding can be  made thick, forming a very
palatable dish  when  eaten  with  sauce made of su-
gar, cream, and sherry wine.
                 Toast  Water.

  Take a large slice of bread and toast it slowly till
thoroughly brown, and put it into a pint of cold wa-
ter, let it stand a  while and it will  be fit for use;
this is a very nourishing  and palatable drink,  and
may be taken in all cases. 
CONTENTS.
CHAPTER I.—TREATxMENT OP ACCIDENTS.
                                                  Page
Apoplexy,  -----       15
Asphyxia, or suspended animation,  -       •       •   18
         from carbonic acid gas,       -        -       18
         from sulphuretted hydrogen,      -           19
         from sulphuric acid gas,                      19
         from drowning, -       -       »       -   20
         from hanging, or strangulation,        -       20
         from cold,     -       -       -       -   20
         from lightning,                              21
         of infants still-born,      -       -       -   21
Burns and scalds,     -       -       -        .       n
Bite or sting of venomous insects,   -       -       -   12
Contused wounds,                                    10
Concussion of the brain, or stunning,        -       -   11
Compression of the brain      -       -        -       12
Convulsions, or fits in children,     -       -       -   16
Croup,      .....       17
Drowning,      -       -        -       -       -   20
Drunkenness,                                        21
Eye, substances in the,    -       -       -       -   13
Ear, substances in the,        -        .       -        14 
n
Epilepsy, ...	Page 16
Fits, or convulsions, -	16
Fainting, or syncope,	- 17
Hemorrhage,	5
from leech bites,	7
from the nose,	7
Hydrophobia, or bite of rabid animals,	13
Hysterics, -	16
Hanging, asphyxia from, -	- 20
Leech bites, hemorrhage from, -	7
Leeches escaped into the stomach,	15
Lightning,	21
Nose, hemorrhage from the,	7
Scalds and burns,	11
Stunning, or concussion of the brain,	- 11
Sting of venomous insects,	12
Sprains, ...	- 13
Syncope, or fainting, -	17
Strangulation, or hanging, -	- 20
Still-born infants,	21
Throat, substances in the, -	- 14
Wounds, -	8
incised, - - -	8
lacerated,	9
contused,	- 10
punctured,	10
 CHAPTER II.—DIRECTIONS FOR THE PERFORM-
             ANCE OF OPERATIONS.

Artificial respiration,                              25
Bleeding,      -      -      -      -          22
Issues,                   -       -      -      23 
76
Stomach pump,  -
Sutures or stitches,    -
Vaccination,     -        -         -

              CHAPTER III.—POISONS.

Acids, Prussic, or Hydrocyanic,
      Muriatic or Hydrochloric,  -
      Oxalic, or Acid of Sugar,
      Sulphuric, or Vitrolic,
      Tartaric, or acid of Tartar,
      Arsenious acid, or Arsenic,
      Phosphoric, or Phosphorus,
Arsenic,       -
Alkalies,    -      -
Ammonia, or volatile salts,
Antimony, or tartar emetic,
Alchohol,     ....
Aconite, or monk's hood,
Bismuth, or pearl white,
Bromine,  -         -        -        -
Cantharides, or Spanish fly,
Chlorine water,     ...
Chloride of lime,        -
Colchicum,        ...
Creosote,      ....
Fishes, poisonous, -
Glass, powdered,      -
Iodine,    ....
Laudanum,    -
Lead,
Lime,        .
Copper,   .... 
79
Mercury, - - -Nitrate of potash, or saltpetre, Nux-vomica, or strychnia, Opium, ...	*	Page 32 34 33 35
Oysters, poisonous, Phosphorus, -Potash, caustic,	-	33 29 29
Soda, caustic,	-	30
Saltpetre, or nitrate of potash, Tin, chloride of, (dyers' spirits,) Tobacco, ...	-	32 30 34
Vegetable poisons, -Zinc, oxyde of, Zinc, sulphate of,	-	35 31 31
  CHAPTER IV.—TREATMENT OF SOME OF THE
             MOST COMMON DISEASES.

Ague  and fever,
Abscesses,
Bloody Flux, or dysentery,
Bilious or remittent fever,
Colic,
Coup  de Soleil,or sun-stroke,
Dysentery, or bloody flux,
Debility,
Erysipelas,
Fever, intermittent,
       remittent, or bilious,
       scarlet,
Headache,  -
                   VII
38
46
36
40
47
48
36
48
42
38
40
41
49 
80
Inflammation of the lungs,         -        -         -    37
            of the tonsils,                               45
Indigestion,      -        -        -        -         -    49
Lungs, inflammation of the,                              37
Measles,        -        -        -        -         -    43
Mumps,    -----        44
Pneumonia and pleurisy,  -        -        -         -    37
Scarlet fever,        -        -        -         -        41
Ulcers, indolent,         -        -        -         -    46
       irritable,      ...         -        47

     CHAPTER V.—USEFUL MEDICAL RECIPES.
Asthma,        -         -         -        -         -    51
Colds, cure of,       -        -        -         -        50
Cough, hooping,         -        -        -         -    51
Cramp in the stomach,                                   52
Cholera,        -        -        -        -         -    52
Camphorated oil j    -        -        -         -        54
Clysters, or  injections,    -        -        -             55
Diarrhea,                                              52
Face, swelling of,         -        -        -         -    51
Flatulency of old persons,                               52
Fomentations,   -        -        -        -         -    54
Gargles,    -----        55
Hiccough,      -        -         -        -        -    52
Liniments,  -----        54
Lime water,     -        ■>•         -        -        -    55
Medicine chest, medicines for,  ...        58
Medicines, directions for use of,             -         -    60
Nipples, ointment for,         -        -        -        53
Onion syrup,    -         -         -        -        -    55 
8i
Poultices,   ---..       53
       carrot, -       -       -       -        -    53
Ringworm, ointment for       -       -        -       53
Stomach, cramp in,      -       -       -        -    52
Syrup,     -----       56
      hop,     -       -       -       -        -    56
      hoarhound,                                    56
Scald head,     -       -       -       -        -    52
Sinapisms,  -----       53
Toothache,     -       -       -       -        -    51
Tar water,  -----       55
CHAPTER VI.—RECIPES FOR SICK COOKERY.
Apple water, -	70
Arrow root, -	64
Ale posset, - - - -	72
Broth, ...	63
chicken,	63
eel, ...	63
veal, - - - -	64
Baked milk,	68
Barley water	70
Bread soup,	72
Coffee milk,	67
Cranberry gruel,	69
Currant gruel,	69
Corn starch pudding,	73
Drink for a fever,	69
Draught for a cough,	69
Eggs, -	64
Egg win©,	71
 
82
Jelly, arrow root,	Page 64
tapioca, Gloucester,	65 65
Lemon water, - - -	70
whey, Mulled wine, - - -	71 66
ale,	67
Milk porridge, -Orangeade, Orgeat, - - - -Panada, -Prunes, stewed,	68 65 72 65 73
Pudding, corn starch, Rice Caudle, -	73 66
Rice milk, -	68
Sippets, ... Saloop, - - . . Sago, ... Seed water, -	66 67 67 70
Stewed Prunes,	73
Toast water, - - . Water gruel, White wine whey, - - -Whey, lemon, Wine posset, -	73 68 71 71 72
 
	
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