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                   LECTtRES ON MIDWIFERY

                              AND THE


              FORMS OF DISEASE  PECULIAR  TO





                 DELIVERED TO  THE MEMBERS


                               OF THE

            BOTANICO-MEDICAL COLLEGE OF OHIO,


       BY  A. CURTIS,  M.  D., President of the  College,
              4* v
                                 AND


Professor of the Theory and Practice of Medicine,  Lecturer on Anat-

       omy, Physiology\ Botany and Chemistry* and Editor of

                  the Botanico-Medical  Recorder.
K
  SECOND  EDITION,  CORRECTED AND ENLARGED.




  Incvef knew a  single instance where nature had been assisted according to my praeticc,
and the patient was not able to bear her weight the same day of her delivery.—S. Thornton.
  Let Jilidwivcs know that they bo Nature's servantes.— Willoiighby.
  A meddlesome Midwifery is  bad.~-£lv.ndell.
  The  most disadvantageous position in which the head can offer, is not sufficient, either to
prevent delivery, or to endanger  the life of mother or child, so much as would be done by
the movement of the gentlest hands.—Edinburgh Practice.
  The  raBh and preposterous use of instruments has proved the bane of thousands.—lb.
  For one instance, where the retention of the placenta has been  attended with dangerous
consequences, its precipitous extraction has been fatal to hundreds.—/*.
    PRINTED  FOR  THE AUTHOR,


BY JONATHAN PIIILLlFS.
COLUMBUS, OHIO.

        1841. 
anil*
  IS4I
> .*
  Entered according to act of Congress, in the year
1836, by A. Curtis, in the Clerk's Office oLthe Dis-
.trict Court of Ohio.               Jr 

                HE COMMENDATIONS.

   Extract from the proceedings of the Zelo*Mathean Society.

   Resolved. That the members of the Botanico-Medical School and
of the  Zelo-Mathean  Society at Columbus, who  have heard Dr.
Curlis's Lectures on Midwifery &c, rejoice to see the proposition
to publish them, and cordially recommend them as  an invaluable
•directory to th« whole Botanic Fraternity and Sisterhood.
Extract from the minutes of the 5th Convention  of the Friendly
  Thomsonian Botanical Society of the United States.

                WEDNESDAY,  OCTOBEB 19, 1836*

  Agreeably  to*i resolution 'of Tuesday, Dr. Curtis delivered a
lecture on Obstetrics, after which  he proposed to publish, by sub-
scription, the'substance of his lectures to the Students of  the Bo-
tanico-Medical School at Columbus, on this subject: Whereupon
it was
  Resolved, That this Convention cordially approve  of Dr. Cur-
tis's proposal to pablish his Lectures on Midwifery and tho forma
of Disease peculiar to Women and Children.

  03r The members of the  Convention sustained the resolution
with a very liberal subscription.
       ADVERTISEMENT TO THE SECOND EDITION.

  So highly was this work prized on its first appearance, that the
whole edition of 4000 copies was sold in less than twelve months
after it escaped from the press.   Many who were  so fortunate as
to possess a few of the last copies  for retail,  sold them for five dol-
lars each.   The demnnd still increasing, I have carefully corrected
its most important errors, and considerably enlarged it, particular-
ly by the addition of a copious index and several  valuable plates.
As this edition is thus rendered much more valuable than the form-
er* the price remains the same, and the  number  of copies is  no
greater, those who want it wili do well to embrace the first oppor-
tunity to obtain it. 
FLAK  OF  THE WORK.
  1. Introduction.
  2. History of Midwifery.
  3. Dissertation—Showing the reasons why women need assist-
ance in parturition, the kind needed and how it is to be rendered.
  4. A complete System of Midwifery on the true Botanic Princi-
ples, with illustrative plates*
  5. Testimonies from the regular standard authors, proving the
vast superiority of the Botanic Theory and Practice.
  6. Testimonies from the same, showing the errors in theory and
dangers in practice of the Regular System.
  7. Examples of the different kinds of practice, showing the safety
and efficacy of the Botanic, the danger and fatality of the Regular;
and, of course, the folly of abandoning the former and resorting to
the latter in cases of supposed difficulty and hazard. 
INTRODUCTION.
  Though Dr. Samuel Thomson has exhibited, in his '; New Guide
to Health,"  his general plan on which all forms of disease are to
be treated and relief from suffering is  to be obtained, yet the
want of that experience which inspires  confidence in  any plan,
and in one's own ability and skill to apply to the best  advantage
the remedial agents recommended, has induced  multitudes of the
true friends of the Thomsonian System, to abandon its application
for the experience of mineral practitioners in cases in which, when
properly applied, its vast superiority is most signally displayed.
  Others, fully aware of the disadvantages and dangers of such a
course, have  been, for several years, making inquiries of me  for
particular instructions, especially in that branch of the  practice
called Obstetrics, the letters and oral directions in answer to which,.
would fill  an octavo volume.
  These inquiries  being multiplied  upon me in my new station
as Editor of the Recorder, I took the first convenient opportunity
to request Dr. Thomson himself to give the  fraternity a general
answer in the form of a complete treatise.
  He  replied that "his supplement contained all  the principles
involved  in the queries, and  examples sufficiently numerous and
various to give a correct idea of the proper mode of applying them
in all conceivable cases ; and that,  if the friends of  the system
wanted any thing more minute, they must prepare it themselves."
  Though 1 published in  the  Recorder the substance  of this  an-
swer,  the "inquiries for information"  have  since  accumulated
upon  me to such a degree that I have determined to publish, as an
answer to the whole, my lectures  delivered last summer to the Stu-
dents of the Botanico-Medical School at Columbus, embracing the
most  important instructions on these subjects, which the wisdom,
and ingenuity of man, either in or out of the* Thomsonian School,
have yet devised.
  In preparing this work for the press, I have made us-e of all the
means of information within my reach, (and they are not scanty,)
selecting from others, as well as from my own observations, only
those descriptions which are  essential,  and giving only those di-
rections as rules of practice, which will abide the test of  experience.
  By discarding all reasonings upon unsettled theories, and modes
and means of practice of doubtful efficacy, I trust it will be  found
that I have gathered into this small volume, every thing known on 
c
the subject of which it treats, that is worthy to be made the ground
of implicit confidence in practice.
   I have  endeavored to render this volume such that, if a Thom-
sonian should, through inexperience, fear, in  a difficult  case, to
apply  las  favorite  practice, a  reference to its  pages would show
him that the fundamental principles and most common and impor-
tant modes of application, arc advocated and sustained by many of
the most  learned and judicious authors of the old school ; while
these same gentlemen have given to the depletive, anliphlogestic,
rash,  and instrumental system, the credit of almost all  the mis-
chief--  that have ever happened in the  chamber  of parturition.
Take the  following for example :
  "Midwifery  is the art of assisting women in childbirth."—
Webster.
  " The proceedings of nature in ripening her fruits, in bursting
the husks of walnuts and almonds and opening the shells of eggs
without force, when ripe, should teach  midwives patience, and per-
suade them to  let nature alone to perform her own work, and not
to disquiet women by their strugglings; for such enforcements
rather  hinder the birtn than in any way promote it.  They often
ruin the mother and usually the child.  Let  midwives know that
they are natures servants."—Willoughby,  Ed. Pr. vol. 5. p. 5.
  Let every candid practitioner acknowledge that, for one instance
where  the retention of the placenta has been attended with  dan-
gerous consequences, its precipitate extraction  has been  fatal to
hundreds.—Ed, Pr. v. 5. p. 127
  " The rash and preposterous application of instruments [where
the head is squeezed into the pelvis in such a manner as to induce
the belief that  it cannot be extricated without them] has proved the
bane of thousands."—lb. p. 140.
  "Tho work of nature is too often spoiled by officious hands."—
lb. p.  \4%
   When I reflected on the great responsibility of giving directions
which, if wrong, might prove destructive to the lUcsof my fellow
beings, my heart shrunk from the undertaking.   But, recollecting
to have seen  saved by this practice,  many lives which had  been
pronounced hopeless by the advocates of the other, I felt it an im-
perative duty to proceed,  especially as  I  knew  that many true
Thomsonians had placed more confidence in the experience of the
old school practitioners, than in their own ability and skill to ap-
ply the practice laid down in the New Guide, who, could they see
ihc many  dangers mingled with the few advantages of this course,
which even my limited knowledge and experience might present
to them, would prefer a plan of saving thousands of lives that arc
now regularly sent from the child-bed scene,  to  the place from
which  no traveler returns • and much suffering to other thousands 
7
who escape immediate death forthe lingering torment of constitu-
tional injury, produced, as Dr. Dewees says, by  " ill judged and
rude manceuvers, under the specious pretence of relieving" the
sufferer.—Introd. Mid. p. XIV.
  In Dr. Rces's Cyclopoedia, it is stated that " not more than one
case [of childbirth] in five or six hundred requires the use of instru-
ments ;"  and Dr. Dewees states, page, 20th, that he has taken his
measures of the deformities of the pelvis, [the most common cause
which renders instruments necessary,] from the European Surgeons,
on  account of the fact that  the  most extensive practitioners  in
America, rarely witness such cas%s.
  I must therefore conclude that the many cases I have known the
regular faculty to treat, as they would have it, in a scientific man-
ner, by which cither the woman or child or both suffered death  or
little less,did not really indicate any necessity for the "rude and ill-
judged  manceuvres" of the "ignorant  pretenders" with which
they were tormented.
  I have just now heard of the death of one of my early associates
who had suffered  five or six years from the wretched effects of such
"rude  manoeuvres," and I expect soon to hear of the termination
of similar sufferings, in the similar fate of four or five more.
  As I have the most  conclusive evidence that some eighteen or
twenty others  of my particular acquaintances have been either
killed outright  or rendered miserable for life, by the " rude ma-
noeuvres  of ignorant pretenders," and as the authorities just  quoted)
assure me that there is no just cause to fear fatal results in more
than one case in five or six hundred in Europe, and few if any at
all  in America, I conclude that, if I  can persuade the  ladies to
tru«t altogether to nature, and to  remedies that act  in harmony
with her operations, to the entire exclusion of all "ignorant pre-
tenders"  and  their  "ill-judged manoeuvres," I  shall perform an
essential  service to those who have "sorrow"  crough in "bring-
ing forth children," without tne aid of "rude hands, forceps, crotch-
ets, levers" and the death dealing ergot.
  In adducing  evidence from the  regular faculty, I  have endea-
vored to  give a fair statement of their best opinions, as based on
their own practice.
  But  how much more favorable to our views those opinions
would be, were their supporters acquainted with the superiority of
our practice, let the enthusiasm with which those who abandon the
old  practice for the new, condemn the former and applaud the lat-
ter, furnish a more just intimation.
  The subject of the following pages is admitted to be very deli-
cate ; but the  conclusion often drawn from this fact,  that minute
instruction respecting it, should not be  given in books writtea ex-
pressly for the  purpose of saving the pereons concerned, the  mor- 
8
tification of indelicate exposure,  is equally unreasonable in itself,
and destructive  to  one of the principal  objects for which these
books are written.
  If we use general terms, and dark, indefinite allusions, so that
our descriptions  and directions are not understood, we confer no
benefit upon the reader.   It is only when the  case is accurately
defined, the diseased organ carefully described, and the treatment
clearly pointed out, that the patient will have confidence in her
own knowledge and skill, sufficient to keep the case to herself and
those immediately concerned.   9
  This book is intended to be a.confidential friend  to married la-
dies, on the management of those forms of disease that come more
especially under their notice and treatment.   Shall it then be si-
lent on all those subjects whose delicacy renders it unpleasant for
her to consult the experienced practitioner of the other sex in re^
gard to them ? Surely  not.
  If, instead of keeping my  book out  of the way of the common
gaze of the uninterested and the curious, to be consulted  ip her
moments of leisure  and seclusion, for th'e  plans and the means ot
relief in emergency and danger,  or for seasonable prophylactics ;
she place it on the centre table, to wound the delicacy of the mix-
ed company that assemble around that interesting  and profitable
source of amusement, I shall be no more worthy of censure, than
if she were to proclaim before a promiscuous audience, the same
instructions received from me in the private consultation, or the
confidential letter.
  Be  this as it may, it  is professedly the want of this minute and
accurate knowledge, that has dictated the numerous and pressing
calls upon me for in formation, to which the present work is intend-
ed to give a general answer.
  I have therefore carefully described  the several organs cpneern-
ed, the forms of disease  to which they are liable, the most judicious
prophylactics, and the best means and  modes of curative process.
  While my course in  this, as in all my pther labours, is sustained
by  the consciousness that I  have endeavored to do  my duty, I
shall be happy if it  meet the approbation, and more, especially the
wants of the Bblanico-Medical Fraternity and Sisterhood, to whom
it is most respectfully dedicated? 
                             3

        f HE ART OF1 AtDtNCJ WOMEN IN CHlLO-MRTH, IS CALLED
               MIDWIFERY or OBSTETRICS.

                 HISTORY OF OBSTETRICS.

  The first midwife of whom we have any account, aided Rachel
in the birth of her second child.  We have, in the Hebrew Scrip-
tures, no account of any other midwives than women.  None but
women are  mentioned under this appellation by the Greek and
Roman historians.  From the fact  that their  names  in  many dif-
ferent languages are all feminine, it is certain that, till lately, all
-civilized nations employed women  only as midwives.
  The first services performed by men in this art, were to deliver
<hose women who, it was supposed, could not be delivered without
the aid of instruments. The first employment of a man-midwife in
:general, is said to have been by Madame De la Valierc, in 1663,
-only one hundred and seventy eight years ago.  That lady sent for
Julian Clement, a Surgeon of reputation, who was conducted with
great secrecy iato the room where she wa^, her face  covered with
■a hood, and where, it is said,  the king was concealed in the cur-
tains <of the bed.  His success with her, then and on subsequent oc-
casions, rendered fashionable the employment  of men, who have
since so generally usurped by degrees, the just and natural prero-
gative of fhet)ther sex, that  it is now generally  thought a piece of
imprudence almost amounting  to  rashness, to  trust  the manage-
ment of this matter to the original and proper hands.
  But, it is abundantly evident, from a comparison of the rapid in-
crease of ancient nations and the robust constitutions and extra-
ordinary longevity of  the people, with the destruction of scores of
modern women and infants, and the miserable  condition of multi-
tudes that escape immediate death, that this change was not made
for the better.
  It is  true that the  luxury,  idleness and  congregation in cities,
manufactories &c, of modern times, have produced more deform-
ity of frame, constitutional  taint, and liability  to disease, in the
generations  of the present  age, than were found among those of
former ages, when hunting, fishing, agriculture, war, the tending
of herds, and the construction by the hand, of  articles now made
by machinery, were the constant employment  not only of a few,
but .of the general mass  of mankind,  and whose diet was simple
and coarse;; still it is  generally conceded that rash and daring ef-
forts of art to improve even  the slightest of nature's deformities,
have resulted  in more mischief than good.—Sec. Ed. Pr. vol. 5,
pa. 1*27.
  In view of the evidences afforded by dissections,  Dr. Rush ex-
claims, "What mischiejf have we not done under the influence of
false theories ?" 
10
  The Historians of the French campaign assert that, when the
battles were over, the work of death was but just begun;—that
more perished in the camp by the hands of the surgeons, than by
the sword and the cannon on the field of battle.
  The Edinburgh Practice says, "The rash and preposterous use
of instruments (in midwifery) has proved the bane of thousands."
—Vol. 5. pa. 140.
  Dr. Terry says that bleeding relieves spasms by destroying the
power of lite to produce them.  Dr. Lobstein, an eminent surgeon
and medical practitioner says, "  so far from blood letting  being
beneficial, it is productive of the most  serious and  fatal  effects,—a
cruel practice—a scourge to  humanity.—How many thousands of
our citizens are sent (by it) to an untimely grave ! How many fami-
lies are deprived of their amiable children!  how many husbands
of their lovely wives!  how many wives of their husbands!  With-
out blood there is no heat—no motion  of the system.   In the blood
is the life.   He who takes blood from the  patient, takes away not
only an organ of life, but a part of life itself."
   Dr. Hillary says, "The stimulus of  the acrid salts of canlharides
renders a fever inflammatory, and all its  symptoms worse;—that
they hasten and increase the putrefaction of the  blood ; produce
strangury &c."
   Dr. Barker says<,  he has seen  much injury done by the use of
physic where an emetic ought  to have been used, and Dr. Clary
thinks he lost several cholera patients  by it.
   Dr.  Recce  of London, says, "I  know not whether  to hail the
discovery of mercury as a blessing or  regard it as a curse, since the
diseases  it entails  are  as numerous  as those it cures." But Drs.
George, Hamilton, Hooper, Falconer, Donaldson, Swan, Coxe,
Che)iie and hundreds  of others  accuse it of destroying countless
multitudes of our race.  Cheyne and Chapman accuse it of produ-
cing jaundice.  Coxe says,  in many  cases it produced the black
vomit in the yellow fever.  Hooper says it attacks the  bones, and
sometimes causes violent purging, even of blood ; that many cour-
ses in any form, would  kill the patient, Because it proves hurtful to
the stomach and intestines.   The U. S. Dispensatory says, it some-
times  produces extensive ulceration, gangrene  and even hemor-
rhage.   Dr. Hamilton says there arc few poisons which  possess
more dangerous powers. Dr. Rush  calls it the Goliath of Medi-
cine.  Dr. Cox and others say it produces an eruption called ery-
thema mercurialc, or an excessive flow of saliva; and Dr. Bigelow
says that this mercurial disease is self-limited, that is,  that it can-
not (be arrested by medical practice.
   Dr. Ebcrlc calls the  varions forms of opium " destructive pallia-
tives," and Dr. Gailup  thinks they should be entirely banished from
Medical practice. 
11
  Professor Beck has proved Ergot to be a most destructive arti-
cle, and Dr. Smith says  " it must be wholly and forever abandon-
ed or be freely used."  It deserves the former fate.
  Similar testimony might be adduced against the use of other
popular medicines, and, indeed,  against every  poison, mineral,
animal and vegetable.   Hence, it  appears that the improvements,
as they arc called, of surgery, venesection, vesiculation, physic and
poisoning, are but sorry substitutes for the ignorance of former age?,
when physicians knew only how to sweat, to nurse and to heak
   Yet, reader,  strange to tell, these and similar, are the means
which men have introduced into the " art of aiding women in child-
birth," on account of which, they claim superiority of skill over
the proper sex,  whose highest  ambition was to watch the indica-
tions of nature, to aid her timely and promptly, but never to oppose
her prophylactic or curative  efforts.   Sad  change!  where almost
constant wretchedness  lakes place  of rare and  partial inconve-
nience.                                                   .  .
   I lay it down as a rational position, on the strength of historical
testimony, then, as well as sound logic, that women are  naturally
as able as other animals to reproduce their species without extrin-
sic aid ;  that the disabilities with  which we actually find them be-
set, are rare, very rare malformations of the system, and more com-
 monly, hereditary, cankerous taint ; but that those bv far the most
frequently observed, are the fruits of bad management in their rai-
sing, as  comprehended in their clothing, exercise, food, and racdi-
 ££t.I treatment*
   It will perhaps be inferred that, as the chief business  of the ad-
 vocates  of temperance is to preserve  the  sober from  becoming
 drunkards, so the most that can be expected of the Botanic Physi-
 cian of the present day, is to save the rising generation from the
 evils above enumerated, which  are  the principal causes of all the
 fevers,  tumors, cancers, polypes,  hydatids, dropsies, rotten bones,
 &c, whose deadly hold on  the patient may be compared to that
 ,of the bottle on the appetite  of the confirmed sol.       ^
   It is,however, encouraging to know that these constitutional and
 educational evils arc far more manageable, in the hands of a skil-
 ful physician, than the most  hopeful cases of inebriation arc, in the
 hands of the advocate of temperance. 
MIDWIFERY OR OBSTETRICS.
  Midwifery or Obstetrics, I have said, is the art of aiding Wo-
men in Child-birth.
  But why, it has been asked, does woman need assistance in the
performance of that to which her very nature is especially adapt-
ed?  Were it not almost as rational to say that she needs assist-
ance to keep the beard from growing, or to make the pelvis grow
larger in proportion to the rest of the body than it is in man, or to
complete any other peculiarity of her frame, as that she needs aid
in giving birth to her offspring?
  1 answer, the fact is admitted on all hands that she does need
it; and I  therefore proceed directly to show both why she needs it,
and how  it shall be the most promptly, judiciously and effectually
rendered.
  I apprehend that the necessity for this  aid is, with few excep-
tions, the result of a series of injurious  treatment, by which her
natural ability  to  do  the work without aid, has been  so much
abridged; and that, therefore, the kind of aid she needs is the re-
moval of those obstacles that have unfitted her for her duty, and
the restoration of those powers of whose free and full exercise, she
ought never to have been  deprived.
  Perhaps the best method of teaching this, as well  as any other
art or science, is, first, to present a comprehensive, clear and con-
nected view of the whole  subject.   Then the relative importance
of the various details, will be more clearly perceived, properly ap-
preciated and easily treasured up in the memory.
  It is especially because  the female frame includes certain organs
made for special  purposes,  that derangements of these organs or
their operations, have been called  "diseases peculiar  to women."
   To enable us, therefore, to rectify those derangements, we shall
do well, first, to learn something of the objects for which those or-
gans were formed, and the  nature and end of their operations in
a healthy state.
   As in the superfluity of seeds or eggs, produced by a single plant
or insect, fish or bird &c, which, when circumstances do not favor
their being used for reproduction, may be devoured by animals or
returned to the earth unproductive; so in every department of the
economy of the Great Author of all other contrivances and agen-
cies whose existences or  modes of existence arc subjected to the
influence of conditions or circumstances, there is a superabundant.
provision of means, both  to accomplish the great end in view, and 
13
to prevent the excess of those means, from doing any injury, if not
to turn it into other channels for good.  The organs alluded to
are termed  Uterus and Mammce and the secretions,  Menses and
Milk.
  After a formal array of the most plausible hypotheses which have
been invented to account for the existence, nature, uses and peri-
odical returns of the menses, Dr. W. P.  Dewees, Professor of Mid-
wifery in the University of Pennsylvania, concludes, (page 67,)
"From what has just been said, it appears that, hitherto, nothing
satisfactory has been advanced upon this curious subject—It yet
remains for some future  Haller or Hunter to enrich  medical sci-
ence with a rational explanation of it."
  Perhaps the  principal  reason why this explanation should be
referred to a Haller or a  Hunter, in preference  to Dr.  Dewees,
is, that Haller  and Hunter rejected the trammels of  medical au-
thority, observed, considered  and reasoned  for themselves, and
dared to  publish what they discovered; though,  as Hervey says,
"The hatred  and envy of physicians should swell against them as
a legion of devils against virtue; and the whole society should dart
their malice at them and  torture them with all the calumnies ima-
ginable,  without  sticking at any thing that should destroy them
root and branch."
  Now, though I do not pretend to possess the splendid talents or
attainments of  a Haller or a Hunter, yet I do claim the same right
to the untrammelcd use of the little share  I have; and, as all  I
conceive necessary to the task, is  a  careful observation of what
almost any one can see, and a sufficient control  of  language to
express what I  think, I shall make the bold  attempt, and leave
the decision of its correctness to others who can see and think as
well as I.   And I shall be quite as indifferent to the consequent
charges of ignorance or quackery against me,  as formerly  was
Haller or Hunter.
  The principal object in  the peculiar structure of the female
body, was its adaptation to the continuance of its species.  The
production occasionally  of the embryo of another self, a sort of
parasite that should be sustained awhile by  the strength of her
own system, required the establishment in woman, of peculiar or-
gans, and also of periodical secretions which, when not applied to
the objects to  which they are  adapted, should be discharged m
such a manner as to inflict no injury on the organs by which they
are secreted.
  For ten or a dozen, and sometimes sixteen or eighteen years,
these secretions find full employment in contributing to the growth
of the body whose maturity, on that account,  is generally accom-
plished several  years earlier in females  than in males. 
M
   After this perfection of the organs, completed in our latitude at
the age of twelve to sixteen years, there is a periodical secretion
from  the  uterus,  occurring most  naturally and  commonly, (but
often irregularly,)  once in about four weeks, until it  is arrested,
either by  disease  or, as has  been hinted, by being turned to the
nourishment of a parasite-^an embryo of a future man; or, till the
powers of life, through the worn-out capacities of the body, are so
much reduced, and all the secretions are so much diminished in
quantity,  that this (the menstrual)  is easily absorbed away, and
distributed among the  others, when its distinctive character and
■locality no longer appear.
   This usually happens somewhere between the fortieth  and fif-
tieth year, though it sometimes occurs much earlier, and at others
is  postponed much longer.  An instance is mentioned in a New
Orleans paper where  it commenced at four years;  and one in
Good's Studies of Medicine where it occurred for the first time at
70!
   From the natural cessation of this secretion, lo the  end of life,
all the secretions diminish in quantity and quality, till finally they
are insufficient to sustain the organic action, that is, to  furnish sol-
vents for  digestion, lubricating fluids, &c, the friction stops the
whole machine, and the name of this condition of things is, death
by old age.
   From this general view of the subject, it is evident that, as the
peculiarities of the female frame were formed for the express pur-
pose of bringing forth children, our efforts to aid her in the accom-
plishment of this object, must begin where nature begins lo fit her
for the office;  or, in other words,  at the very commencement of
her existence.
   In  her primeval condition, before her body was corrupted by
any constitutional taint, that is, source of disease communicated
from  the  bodies of her parents, woman was born free from  any
other defect  than what might be brought upon her by bad treat-
ment after she entered the world; but,  as civilization and moral
and physical corruption advanced, her body partook of the latter,
till it is often necessary to remove the constitutional taint or can-
ker from her frame as soon as she is born.  The  presence of  this
maternal  defect, then, so disables  her for the full and  perfect  per-
formance of all her physical duties, as to become the first reason
why woman so often needs aid in the chamber of parturition.
   But, supposing her birth to have been timely and natural, from
healthy-parents, there is a direct tendency  towards that state of
maturity in which the  size and tension of all the absorptive, circu-
lating and secreting vessels are so completely balanced, as to ad-
mit, require, produce and maintain an equilibrium of fluids through 
15
 the whole system.   Immediately after birth, then, the proper se-
 cretions  are  chiefly engaged in  contributing to the growtli and
 perfection of each  organ  or  organization, till  the  whole system
 arrives at maturity, when the waste-gales are opened and the
 overflowings appear.
    In the body, enclosing the  organs of digestion, assimilation and
 absorption, (the fountains of circulation and vivification, and source
 of the organs  of secretion.) we might expect to find the greatest
 amount of action, and, in the  extremities, the least, while the child
 Temains apparently quiet; but, the almost incessant motion which
 it gives to its limbs, is sufficient, by causing a free circulation, to
 maintain the proper equilibrium, till it is able to stand and walk;
 when the partial diminution of this action, is compensated by gra-
 vitation or the natural downward tendency of the blood, produced
 by its own weight.  These several causes combine to continue the
 vital action and consequent heat of the extremities nearly or quite
 equal to  those of the body; and thus all  the operations of life are
 carried on without obstruction; and the condition so maintained is
 termed health.
    The surface  of  the body is a network composed of the mouths
 of an infinite number of invisible'tubes, whose office is to cast off
 the excess of heat and  moisture, which, from any cause, may at
 any time accumulate in the system.  This secretion is termed per-
 spiration, sensible when the water is seen  in drops on  the skin, and
 insensible when  heat only is perceptible.
   The object of clothing is, in cold weather, tp protect the surface
 from the astringent action of the atmosphere, which it does by re-
 taining, for a while, the disengaged heat  around  the body; and,
 in  hot weather, by reflecting or warding off the excessive heat of
 the .«olar rays.  In the former case it prevents the cold air, and in
 the latter the dry heat, from contracting the network or pores of
 the surface, and obstructing the free perspiration or escape of ex-
 cessive heat and moisture.   It is evident  then, that, if the clothing
 be equal all over the  body, the pores will be equally open, per-
 spiration  will be equal  every where, and health., so'far as the
 proper action of the surface is concerned, will  continue perfect.
 Here is the moment when  we begin  to aid or hinder the female
 frame in its preparation  for the reproduction of its species.
   First, then, I will ask the mothers of our land,  whether the man-
 ner in which many of  them clothe their  daughters from this time
 forward, is consistent  with the dictates of  reason or of  common
 sense?  Do they not encumber their bodies  with numerous ban-
dages and oppressive  clothing, while  they leave the extremities
 almost destitute?  What must be the effect of this course of con-
duct, but to relax and  expand  inordinately the pores of the body, 
16
 and to contract those of the extremities, thus forcing through the
 former all the heat and moisture that ought to be secreted from
 the whole surface, and giving to the  atmosphere the  power to im-
 pede the circulation of heat and moisture through the extremities,
 which impediment or obstruction must  necessarily  reduce their
 temperature?   The arteries of the lower extremities being con-
 tracted by exposure, those of the chest and head are proportion-
 ably distended by the pressure of the blood, that is thus forced into
 them, and the sensation produced by this pressure, is  called "full-
 ness of the  head," or cerebral congestion; while the  distented
 blood-vessels necessarily press upon the nerves and disturb the
 uniformity of their action,  producing sometimes a  confusion of
 their operations, which is termed delirium.  Here also, we  have
 the origin of many cold feet and hands, flushed countenances, &c.
 Though it is true that some sprightly girls overcome, by exercise
&c, the deadly influence of this inequality of dress; yet it is equally
true that,  in the constitutions of many others, is thus laid the foun-
dation of disease that follows them to their graves.—See Lectures
on Medical  Science, pps. 73 to 81.
  If asked how I would have the extremities lo be  dressed?   I
answer, let thick flannel drawers and woollen stockings in winter,
and cotton  in  summer be  worn next  the skin; let  the body be
clothed so loosely that it  can easily move itself within the gar-
ments, which should be no warmer than those on the extremities.
  Another reason why women  need aid  in  child-birth, is, that
young girls  are allowed and sometimes  even required by  their
mothers, to wear ftiose modern instruments of lingering torture,
called corsets, stays, busks, belts &c.
  Shall it be objected that these things cannot be dispensed with,
if a person would look decent and becoming, not to say genteel?
I answer,  after  an  abortion  or a  miscarriage, a dyspepsia or a
dropsy, has racked the poor frail body for several years, in conse-
quence of this folly; they are willingly dispensed with and no com-
plaint is made of the privatiafc*  Were it not better to regard, in
health, the dictates of nature, of reason, and experience, and save
the future suffering, the wreck of constitution, health and life?
  Lest I seem too severe on these fashionable correctors of Nature's
bungling architecture, I will give, at once, some of the facts and
arguments that sustain my position.   In performing this service, I
may omit many things that might be said against it; but there is no
fear that I shall in any respect represent the evil consequences ot
its use, as  more numerous  or destructive than they really are.—
Language cannot reach  them.
  In the first place, these  misery-making machines, like the iron
prison for the Chinese  foot, prevent the growth of the body to its 
17           *
intended  and ordinary size;  and then it  renders  cartilaginous
and callous, those parts that  were designed to be,  and, if Ufcey
were permitted to grow in their own way to the size of their own
pleasure,  would  be muscular and  elastic, calculated to admit,
without pain or inconvenience, those different degrees of capacity
so essential to the safe carriage,  nourishment and delivery of a
healthy offspring.
  As the starving system of treating dyspepsia by withdrawing the
periodical internal pressure  of a  full  meal, suffers the external
pressure to act constantly on  the  coats of the stomach, till they
become so permanently contracted that any increase of the dietetic
potion produces pain; so the superficial compression of corseti, by
preventing frequent distensions and expanding  motions, perma-
nently  contracts the  chest, the diaphragm and the wall's of the
abdomen, to such a degree that the inordinate expansion neces-
sary to the growth of the foetus,  produces similar pains  in the
diaphragm, the parietes (walls or coats) of the abdomen &c. The
painfully  distended parts continually strive, by their reaction, to
expel the offending cause; and hence a  fruitful source of abortions,
miscarriages and seven months children, besides all  the  current
suffering  lo the mother, and the incurable evils that so frequently
attend those who survive such dangerous conditions, to drag out a
miserable remnant of life scarcely preferable to  death itself.
Within the range of my recollection, are more than a score of fe-
males  in this last condition, who are to charge  their present suffer-
ings, in a great measure, to early lacing, and almost altogether to
the combined influence of this  cause and  the several others pre-
viously and yet to be explained.
   Of the multitudes that have sunk under the miseries attending
the premature expulsion of the foetus, the dark and  silent regions
of the grave alone contain the  record.   I have  no  doubt  that if
all who have thus committed suicide, could array themselves  be-
fore us, the  effect would be insupportable  to  the most hardened
feelings of our nature.  This is another reason why women need
aid in childbirth.*
  * When physicians discover an abortion, a miscarriage or a premature
binh, they conclude that this accident, as they call it, is to be considered
a sort of legitimate cause of a similar catastrophe in future.  They seem
never to have dreamed that the first accident was the legitimate effect of
a cause whose tendency is to produce the same effect in every instance.
And hence, instead of directing their practice against the true cause which
produced the first effect, they wait for the  evidences that  it is about to
produce another, when their efforts themselves are worse than vain, be-
              2 
*            18
   Another reason why women need aid  in  child-birth  is, their
power to accomplish it without aid, has been early and frequently
abridged by injudicious medical treatment  on the slightest indis-
position.
   By the carelessness of the nurse, or its own incessant motions,
the infant is exposed and takes  cold.  The bowels are a little dis-
ordered, or the stomach is clogged, or a fever  rises; it matters not
what, the least irregularity creates alarm.   A few  draughts of
warm, stimulating fluid, or at most a full Botanic course,  in such
cases, would put all things right; but no! the doctor is called, and
forthwith, doses of calomel (from one grain to  three, and by some
practitioners, eight, ten and twelve)  is immediately  prescribed.
This deadly drug, (like every other poison,  they  all agree in  this
point,) "suddenly and rapidly extinguishes a great proportion of
the vitality of the system."—Eost. Med.  and Surg. Journal, vol. 9,
page 43.
   Many a time have I seen the vital energies of a poor little in-
fant, laboring under the deadly influence of a dose of calomel (a
single grain to a healthy child  is sufficient to  prostrate all its en-
ergies.—B. M.  & S. Journal, vol. 9, page 85) given to suppress
that very fever  which, if aided by a little stimulating tea and
warmth and moisture to the surface, or even if left to itself, would
soon put to flight the offending cause, and restore health and ac-
tivity to the patient. .
   But scientific wisdom adds more and more calomel, till so much
of the "vitality  of the system"  is "destroyed," that  no danger is
apprehended from "the fever."   Many a little sufferer being kindly
nourished and  nursed, now steals  a  march on  the  doctor.  Its
fever rises by steps so gradual as not to be discovered, while it
works off the most of the calomel in the same  silent manner;  and
it would appear to be as well as ever, but for its evidently increased
liability to the future  attacks of the same  and similar affections.
But alas! how  many others there are,  who sink under the influ-
ence of this deadly weight, to rise no more!  I have seen not a few
perish for no other reason, as I firmly believed, than simply that
they had taken more poison to cure disease, than the system could
bear.   Their death  was attributed to teething,  to summer com-

cause made too late and upon a wrong principle.  Being ignorant of the
true cause, they  are incapable of applying the proper remedy.
   The Botanic treatment warms  and  relaxes the  extreme vessels,  dis-
charges the cold and the morbific matter, promotes a free and general
circulation of the blood, and a regular vibration or action of the nerves,
gives tone or contractile power to the debilitated organs,  promotes di-
gestion—in short, it removes the  causes of disease, and  restores health
to the patient. 
19
plaint, to measles, to croup, in short to any thing but tho true cause;
and the wreck of constitution in others that escaped death, was
accounted for in the same irrational manner.!
   These children grow up still more  and more liable to disease,
and frequently attacked by it, till the period when, had they always
been properly clothed, fed, exercised  and doctored, the menstrual
discharges would have  taken  place.   In the United States and
under  favorable circumstances, this ordinarily  happens between
the twelfth and  fifteenth year.
   But the vitality of the patient has been so much reduced by the
inequality of clothing, the want of proper exercise, by tight lacing,
or by  poisoning the system,  instead  of curing disease, that the
growth of the organs is not yet mature; the preparation of the se-
cretion is postponed for a while, or distributed among others when
actually prepared.
   It is well if now some learned quack does not persuade the pa-
tient's mother to give emenagogues directly to iorce its  appear-
ance.  As time passes on, however, the secretion accumulates in
the proper vessels, and the system  makes an effort to discharge  it.
   "When the  growth  of the animal frame," says Dr. Good, "is
completed or nearly so, the quantity of blood and sensorial power
which have  hitherto been employed in providing for such  growth,
constitutes an excess, and must produce plethora by being diffused
generally, or congestion by being accumulated locally.  It takes
the latter course in order to perfect the organs of generation, which,
during the principal growth of the body, generally remain dormant
and inert.   It first shows itself in the ovaria, from which it soon
proceeds to the  uterus, where it  accumulates and excites  that or-
gan to a new action by which it is thrown off periodically, by lu-
nar intervals, in the form of a blood-like discharge; though  it has
hardly any  common property  with blood, except its appearance—
that of a liquid of a red colour."  "It is not always colored at first,
which may account for supposed  fcetations before menstruation."
Nor is it always discharged at lunar intervals.  "Women menstru-
ate somewhere  every  day in the year and hour in the day."—
Dewees.  "It is  not coagulable, but  a fluid thrown off from the
mass of blood, by an action of the uterus similar to that of secre-
tion."—lb.   Hence, coagula in  the fluid  is proof that  the dis-
charge is unnatural, laborious or profuse.
   Among the difficulties attending this discharge, physicians enu-

   t That I may not stand alone in this judgment, I appeal to  the testi-
mony respecting  the  injurious effects of mercury, as  described by emi-
nent physicians,  in the Thomsonian Recorder, vol. 4, pages 37, 38, 39.
See also Dr.  Robinson on medical poisons, Dr. Swan's "Inquiry into the
action  of mercury," and  Dr. Donaldson's  Practice in India. 
20
merate the retention already hinted at, indicated  by a doughy
swelling of the feet and ankles at night; of the eyes and face in
the morning, spots on the hands and forehead, a peculiar sensation
in the breasts, and a general sense of oppression, languor and dys-
pepsia.   The mind is unhinged, the appetite capricious, the extre-
mities cold, the forehead often hot, the pulse quick and low, breath-
ing difficult, sleep disturbed, face pale, urine colourless and bowels
often confined.                                     *
   The faculty have supposed  many causes  for this secretion, (see
page 13)  without pretending to know any thing very certain aHout
it, and pointed out many mode3  and means of cure, without ven-
turing lo say that any of them are specifics.  Still, they have hit
upon both, without being aware  of it.  Dr. Good says, vol.  5, p.
46, "All  the symptoms indicate that retained menstruation is a
disease of debility; there can be little doubt  that  debility is its
primary cause—a want of energy in the secernant vessels of the
uterus that prevents them from fulfilling their office till the increase
of inability, from the increase of general  weakness, at length pro-
duces a degree of stimulus [i. e.  the reaction of the system, or fe-
ver,] sufficient momentarily to supply the place of strength."
   I have therefore the testimony of the London School, that I have
given the true cause of the disease in  the "destruction of  a great
 f>ortion of the vitality of the system, by "unequal  clothing," tight
 acing, want of proper exercise, or injudicious medical treatment,
particularly the administration of poisons in former attacks of dis-
ease.
   Dr. Good says  Vol. V.  page 49, "to  cure  suppressed  at firsl,
obstructed after it has appeared, and laborious and difficult men-
struation, we must increase the tone of the general system, excite
the action of the uterine vessels where they are morbidly torpid,
or relax  them where they are pained by spasmodic constriction.
Both the last, however, are subordinate to  the first; for, if we  can
once get the system into a good state of general health, the balance
or action will soon be restored, and the affected organs will fall
into the common train of healthful order."  What a testimony in
favor of the Botanic Theory  and^Practice!  We have only  to re-
verse the order, that  is, first, relax the  strictures,  second,  excite
the system to throw out the  cold and obstructions, and third, to
tone the debilitated organs.   Our Botanic course (see Lect. 9,) is
the  very thing the good  doctor  wanted;  and my own experience
corresponds with that of thousands of practitioners in assuring the
sufferer that this practice, faithfully and energetically applied, will
do the work to admiration.
   I have quoted  from the Boston Medical and Surgical Journal,
Vol. 9, page 43,  because I  approve of it, the doctrine  that all 
ai
ft
poisons agree in the sudden and rapid extinction of a great pro-
portion of the vitality of the system.   For, I apprehend that the
vitality of the system consists in its power to circulate the blood
and heat in ample measure, to its remotest parts.   As poisons then
diminish this power, they circumscribe, in tire same proportion, the
blood and heat to  the regions of the heart, lungs, brain &c, and
invite the cold air  to take possession of the extremities, to contract
the vessel* and produce  a permanent  reduction of their calibre.
This reduction of capacity  in the extreme vessels, produees a pro-
portionate distension of the same character of vessels in those deep
seated regions of the system, as the heart, lungs and brain,  where
the action of the vital power is more  immediate, and  where the
influence of atmospheric pressure is not so easily brought to bear.
This distention of  the vessels is the dull, heavy, stupifying head-
ache of which most children who are doctored much, and all dys-
peptic patients so constantly complain.
  The pressure of the atmosphere on the body, as a reaction upon
the reduction of vitality,  whether caused by taking cold, losing in-
ternal heat or the exhibition of poisinous drugs, limits the heart
and lungs to a smaller space, which makes them act proportionately
quicker, (like the balance-wheel of a watch when its free and full
rotation is retarded by the  dirty oil about the pivot) and this more
frequent action is  called "excitement of the  pulse," "shortness of
breath" "inflamatory action, &c."  When the heart labors very
hard, its action is felt on the surface, and is called  "palpitation."
The distention of  the vessels of the brain, as  I said  before, is one
source of what is called headache.  The pressure of the distended
vessels on some of the nerves, and the stiffening by cold into a sort
of phlegm, of the lubricating mucous,  that surrounds others, cause
an unequal  action of the  nerves extending  to the  brain.  This
produces inequalities in the time in which the different branches
of the nervous system transmit to the brain the subjects of thought,
and hence arises a general confusion  similar to that produced by
the unequal vibrations of discordant strings on a musical  instru-
ment.  This condition of things is called delirium.
  To remove the pressure,  (congestion) the doctors bleed and cup
the patient.  This it is true, gives a momentary respite to the dis-
tended vessels of the heart, lungs and brain; but, by destroying the
vital energies, it also admits a still further reaction  of the  atmos-
phere on the extreme vessels; and thus renders a future repetition
of the practice still more necessary than the commencement. But,
since it is evident that, if they were to draw out all the blood, the
patient would die  immediately, they  leave enough to sustain the
breath of life, for the present; and when, after lingering in  misery
some  hours, days,  weeks, months or years, the patient dies of drop- 
82
sy or dyspepsia, the death is attributed to a chronic, "an incurable
disease."
   Not approving of it, I should not meddle with  the praclice of
the faculty, were it not, as  Dr. Bigelow says, that "the principal
business of the skilful physician, is often to prevent the officious
meddling of officious quacks."  Could  the Botanic Fraternity or
the public in general, be aware of the mischiefs that are done by
the rash, ignorant and officious members of the mineral profession,
no caution from me would  be necessary to  induce them to trust
nature in every extremity, rather than to surrender their bodies as
living subjects of reckless and dangerous experiments, founded on
the wild vagaries of the visionary theorists of the schools.
   Another reason why women need aid in parturition, is, the in-
efficiency of the system, produced by a want of proper exercise
during the period of chilhood and  youth.   The employing of ser-
vants  and assistants to dress and  undress children, to bring and
carry  for them even a school satchel; in short, to do for them every
thing  that requires the least  exertion, and the two prevalent  dis-
position to prohibit athletic exercises for amusement, as unsuitable
for ladies, are calculated to prevent the full development of the
system, and the acquisition of that organic power, which are the
well known effects of constant muscular exertion.  To have al-
ways at hand some one ready and willing to wait upon her, is one
of the greatest evils a young lady  can  suffer;  while the necessity
of waiting on herself, and of making a reasonable bodily exertion,
is a real blessing that sweetens the enjoyment of every other.
   The miserable victim of inactivity, is as feeble in frame, as pale
in appearance, and as unfit for the intentions of nature, as the vine
from a cellar in summer, is to endure the withering influence of a
meridian sun, and to perfect its fruit amidst the frosts of autumn.
   Though, by suitable attention to the above hints,  during the
period of its growth, the full energies of the female frame may be
easily developed,  yet reason unites with experience in declaring
that, when neglected, till the growth of the body is completed,
this very desirable object is not easily obtained; still the beneficial
effects of moderate and judicious exertions, even on those who
have  been inactive in early life,  are worthy of the most prompt
and persevering attention.
   The last reason  I shall mention, why women need aid in child-
birth  is, many, I fear  most mothers, from the delicacy of the sub-
ject, "leave their daughters," as they  express it,  "to find out by
their  own experience," what, if timely and correctly taught them,
might prevent much future suffering, if not save many a life.  It
is not only cruelly embarrassing to a modest young lady, to be
totally ignorant of the nature, cause  and proper treatment of a 
23
disagreeable condition of her system, till it comes upon her sud-
denly; but it has subjected many to the ruin of their health, and
some to the loss of life itself.  Girls, have been known to go, at a
critical period, into water, to wsish their clothes, and then to stand
in the  open air to dry them, that they might not be detected, and
laughed at by the members of the family.  Thus they have taken
cold and laid the foundation of disease that followed them to their
graves.  Others have been injured for life, by improper medicine
or manual treatment, or in other ways, for want of a few hours
instruction which every mother is amply qualified to give.  The
mother, however, refuses, from motives of delicacy; but, when the
dear object of her solicitude is dangerously ill through this neglect,
delicacy is set aside, and the modest girl is unscrupulously subject-
ed to the impertinent queries of some pert son of Esculapius, just
out of his teens, as  well as his nosology.  This is no harm! "It
is fashionable and  necessary for the  Dr. to know  every thing."
Often, when  reproving young ladies for exposing themselves to
cold, at the commencement or recurrence of their monthly courses, <•
have I been told that they did not know they were doing  wrong.
Within this morr.ent's recollection are several interesting young
ladies, whose  bodies were put into such a stale by imprudence at
this juncture,  that nothing short of their lives will pay the forfeit.
   Mothers, teach your  daughters, seasonably  and affectionately,
all you know, that  may save them future mortification, trouble or
sorrow.   Charge them when "unwell"  to beware of taking cold,
and to take no medicine that is calculated to impede the circula-
tion, but to wear warm clothing, to use gentle exercise, nourishing
diet, and warm, stimulating medicines, (if any at all,) till they are
entirely well.
   While I am on the subject of maternal instructions, I  may as
well add that you  ought by all means  to teach them the nature,
cause  and treatment  of the forms of disease and all the inconve-
niences they are to expect in the married relation.   Do not wait
till you are  certain they are about to enter into that state.  It
were better to teach  them  earlier than desirable, than  that your
premature and unexpected death should deprive  them of any in-
structions at all.   Young  married ladies are often subjected to
much mortification and not rarely so severe suffering, which might
have been easily  prevented by the faithful  and affectionate in-
structions of a judicious and intelligent mother.
                DESCRIPTION OF ORGANS.

  As the defects in, and injuries to, the female frame, pointed out
in the introductory lecture, have rendered necessary a special at-
•« 
24
tention to "the art of aiding women in child birth," it is proper to
commence the developments of this art, with a description of the
various organs mostly concerned in the processes which lead to that
event.  (See plates.)
  Pelvis.—See  plate 1.—The bony rim, surrounding the lower
part of the body and lying beneath the  walls of the abdomen, is
called the Pelvis.  It took its name from its supposed resemblance
to a basin; but it must be observed that it is open at the bottom as
well as the top, and that the posterior sides are  much higher than
the front.  In an adult, it consists of only three principal bones,
the back or posterior'part, called the sacrum, and the two haunch,
side, and share-bones, the back  and high  parts of which are called
ossa innominata, (nameless  bones) the sides  are called ossa illia,
(illiac bones) and their anterior  or  front ends, the ossa pubes,
(pubic bones.)   To  the lower part of the sacrum  are attached
several little  moveable  bones  which, from their supposed resem-
blance to a cuckoo's  beak, were called os coccyx or coccygis; and
from the upper and front part, is a projection called the promonto-
ry of the sacrum.  The ossa pubis are joined before, by a strong,
thin cartilage called the symphysis pubis, or joining  of  the pubis.
Directly  under this, the  public bones diverge into what is called
the  arch of  the  pubis.   The space included between the upper
projections of the ossa innominata or haunch bones, is called  the
false pelvis, and that  below the upper part of the illiac bones, the
true pelvis.   The upper part  of the illiac and pubic  bones,  the
promoaitory of the sacrum,  and the corresponding portions of  the
nameless bones constitute what is called the brim of the pelvis, and
the  lower portions of the same  bones, surround.what is called  the
outlet of the pelvis.  The  passage into  the brim of the pelvis, is
termed the superior strait, and that through the outlet, is termed
the inferior strait; the  space between these straits, is called  the
cavity of the pelvis.  If the shorter diameter of the aperture, from
the symphysis pubis to the sacrum, be from two  and a half to four
inches; and the other diameter be still longer, and the parts each
side of this be equally proportioned and of similar shape, the pelvis
is said to be well formed, and to  present no serious obstacle to a
natural  and  easy delivery.   All  other forms are  said to present
obstacles in  proportion  to the  degree of their departure from this
regularity, and are called ill formed pelves.
  Much has been said and  iwritten about the importance of mea-
suring the pelvis and the head  of the child {to  be born,) and thus
determining  beforehand whether nature has been  so  careful to
strike the due balance between the dimensions of the thing formed
and the place designed for  its  egress, as   to render the assistance
art  unnecessary; and not a few plans and instruments have been 
25
  devised to aid this research.   While Contonly recommends his
  pelvimelre, Madam Boivin her intropelvimetre, and Baudelocque
  and Dewees the calipre, the conclusions of all these authors, espe-
  cially of the latter gentleman, is, "We  have reason  to fear that
  none (of the plans) hitherto projected has attained this end.   We
  are certain that the deviations from nature in the most careful
  measurement, are often more than  equal to the exigencies of the
  case."  While, again, it is admitted that these means cannot be
  universally and accurately applied in the very  cases where they
  are most needed, Velpeau declares  that, "with the finger we may
  estimate every species of deformity  of the pelvis, of whatever na-
  ture, and wherever situated."
     But, suppose all this to be  accomplished, how shall we  know
  the size and shape of the object' to  be protruded? children  have
  been safely delivered through a pelvis whose antero-sacral diameter
  was only two inches and  a half; a diameter less than this would
  subject the woman to  almost as much danger as would a surgical
  operation!   Since we  wrote the above, we have known a case
  in which a large child passed through a still smaller aperture.
     Structures peculiar to Females—External.—The fleshy sub-
  stance lying directly on the symphisis pubis, is called, mons veneris.
  Its lower or back portion is divided  into two parts, called the labia
  pudendi, rima magna, or labia externa, which  diminish in width
  and  prominence, as  they descend  towards the  coccyx.   Their
  union is called the fourchette,  or fork.  Between the fourchette
  and the coccyx is another aperture called the anus.   Between the
  anus and the fourchette  is a septum or division called the peri-
   neum.
     On separating the labia pudendi, we observe a long cavity call-
   ed fossa magna or navicularis.   In  the upper or front part of this
  opening, is a small spongy body in some measure resembling the
   male penis, but impervious, composed of two corpora cavernosa,
   and  terminating in a  glans which  is covered  with  a membrane
   called the prepuce.   On the sides of the fossa are two spongy folds
   called nymphas apparently much contracted, but having the power
   greatly to expand, and thds enlarge the passage to  facilitate par-
   turition.   Between these, and  about the middle of the fossa mag-
   na, is the orifice of the vagina called  os externum, closed in the
  virgin state,  by folds and wrinkles called caruncalae myrtiformes.
   Some suppose that the carunculas myrtiformes  are the remains of
*  the obliterated hymen; but I have seen both present and distinct,
   in one individual at the same time.  After childbearing,  these
   frequently disappear, and the interior of the vagina is visible on
   opening the labia pudendi.   About one third of the distance from
   this to the clitoris, is the meatus urinarius or orifice of the urethra 
26
(a tube from one to two inches long, much shorter, though  some-
what larger than in men,) with a small projection at its lower edge,
for the right direction of the urine.   In infants the orifice  of the
vagina is often found partly closed by a thin membrane called the
hymen, which is open sometimes in the  middle, and sometimes at
the upper edge, so as to appear like a crescent.   Instances have
been known, in which it entirely closed the orifice of the vagina.
This should be opened immediately, with a sharp penknife or scis-
sors, to prevent the indelicacy of a future exposure,  and because
it can then be easily borne.
  Internal organs.—The Vagina.—See plates 4 and 5. G—Tho
os externum leads into a canal called vagina, of a conical form,
from three  to six or eight  inches long, about two inches broad at
the upper end  or fundus, into which is a small projection  called
the cervix uteri (or point of the uterus)  somewhat in  the manner
in which the  small pointed  bottom of  a wine bottle is projected
into the vessel.—See plate 5. D.—The  vagina is composed of two
coats, the inner is  velvet-like, interspersed  with many excretory
ducts, and contracted into plicae or small transverse folds, particu-
larly at the fore and back part.  These are lessened and generally
obliterated by child-bearing.  The outer coat is firm,  somewhat
contractile, and surrounded by cellular membrane which connects
it to the neighboring parts.  A portion  of the upper and posterior
part, is covered by the peritoneum or membrane which includes
the intestines.  The vagina is between the urethra before, and the
rectum behind, to both which it is firmly attached, by strong cellu-
lar membrane.
  Of the  Uterus.—See  plate 5. R.—Above, or beyond the va-
gina, in the cavity of the pelvis, between the urethra and the rec-
tum, with its lower point projecting into the vagina, in the manner
in which the finger might  be pressed  an inch or so, into the bot-
tom of an India rubber or a leather bottle, is a spongy receptacle
called the uterus, resembling in shape a compressed pear.   The
lower point is called the cervix; the upper or bottom, the fundus,
and the intermediate parts, the body.   The whole is about three
inches long, two broad at the fundus, and one at the cervix.   It*
walls are nearly half an inch thick at the fundus, and rather more
than half at the cervix.  Though its surface is greatly enlarged, it
is so distended with blood  that it preserves about the same  thick-
ness during the whole period of pregnancy.  But the size of the
uterus in different  women, is so various, even when not impreg-
nated, as to prevent any  very great degree of accuracy  in the
measurement.  The back is thicker and expands more during
pregnancy than the front.  The entrance into its  cervix forms a
little protuberance called os tinea.  From the manner of its inser- 
27
 tion into the vagina, the cervix of the uterus may change its posi-
 tion and direction at pleasure.  The inner  coat of the vagina, is
 reflected over the os uteri, and continued into the lining membrane
 of the uterus.  This  membrane secretes a mucus which generally
 closes the os uteri very curiously  and perfectly, immediately after
 impregnation, and continues it so during pregnancy.  Several ex-
 ceptions are on record.
   The substance of the uterus is very firm, composed of arteries,
 veins, lymphatics, nerves and muscular fibres, curiously interwoven,
 and united  by cellular membrane.
   Ligaments.—Two broad ligaments pass from  the right and left
 of the fundus uteri, to the sides of the pelvis, serving to support the
 uterus, and to convey to it nerves and blood vessels.  Two round
 ligaments rise from the sides of the fundus uteri, pass along within
 the forepart of the broad ligaments, descend through the nbdom-
 nial rings,  and  terminate in the  substance  of the mons veneris.
 Though these ligaments will allow the  unimpregnated  uterus to
 move  only  about  an inch up  and down, yet,  during pregnancy,
 they permit it to rise into the  cavity of the abdomen.  But, after
 delivery, they contract with surprising  quickness to nearly  their
 original state.
   Fallopian tubes.—From each side of the inner surface of the ute-
 rus, near the fundus, a tube passes through the uterus, and extends
 along the broad ligaments to the edge  of  the  pelvis, where it re-
 flects back and turns over behind the ligaments,  so  that about an
 inch of its extremity  hangs  loose in the  cavity  of the pelvis.   The
 extremities  of these tubes having a jagged  appearance, are called
fimbria.  The whole  tube is about as long as the uterus, very small
 in the uterus and increasing in diameter towards the fimbria1:.
   Ovaries.—Near the  fumbrius of each tube,  and about an  inch
 from the uterus, is suspended  in  the pelvis, and covered by the
 folds of the  broad  ligaments, (productions of the peritonaeum,) a
 flat oval body, about  an inch long, called the ovary, which  gene-
 rally means a little egg, but represents here rather a nest of eggs,
 or berry inclosing seminal elements.
   Each of the ovaries includes  from four to twelve vessicles attach-
 ed by threads to the inner surface  of the ovary, some deeper seat-
edJban others, filled with coagulable lymph.
  Wftysiological offices of the Ovaries.—As the life  of the female
advances, they become turgid,  and a kind of coagulum is formed in
or near the surface, until it increases to something like a quarter of
an inch in diameter.   In coition the fimbriae  of the fallopian tubes
clasp the ovary, and  press it to such a degree as to burst  the deli-
cate integument and  disengage the little  egg  which passes through
the tube into the uterus, where it is impregnated by the  male se- 
                              28

men and nourished by a secretion from the circulation to the ute-
rus, until it is ripe for parturition.  These ovula or little eggs, may
be seen in  the healthy ovaries of every young woman.   It is cer-
tain that they form the basis of every  fcetus, as none  can be found
where they do not exist, and the scars in the ovary or nest of wo-
men that have had children, correspond always with the number
of conceptions.  At least such is the most plausible theory.
  Blaoder.—Attached to the inner extremity of  the urethra, be-
hind and above the symphysis, is an elastic and muscular vessel, of
an egg shape, and capable, when distended,  of holding nearly  a
pint  of fluid.   This vessel is called the  bladder.
  Rectum.—Behind the bladder is the uterus, and, between this
and the os sacrum, is the large tube or intestine, called the rectum,
and the extremity of which  is called the anus.   Both the anus and
the urethra are surrounded by  muscular and contractile bands
called sphincters, which are powerfully contracted  except when
the pleasure or necessity of the  person requires their relaxation,
when they give way  for a momeut, but quickly recover their con-
dition.
  Uses.—One prominent use of the pelvis is to support the abdo-
minal  walls and viscera; another is to receive the effds of the
lower limbs, and furnish suitable locations and firmness for the in-
sertion of the muscles destined to move  those limbs.   In females,
the cavity of the pelvis seems also destined for the protection of the
principal organs of generation, as the vagina, the uterus,  the fallo-
pian tubes, the ovaries, and also of the  bladder and rectum.  (In
the 4th month of pregnancy, the uterus quits the cavity of the pel-
vis, and rises into the abdomen; so  does it  also  rise in  cases of
dropsy that distend it beyond the pelvic cavity.)  Some, however,
of what are called organs of  generation, as the labia, &c, are
without the cavity of the pelvis, even  in females.  Another and
very prominent use of the  pelvis, is  to protect from all outward
pressure and injury, the delicate embryo of the future man, till it
shall have  acquired that organization,  firmness and conservative
power that seem most necessary to protect  it from injuries, when
encased only within the more plastic walls composed of abdomnial
muscles.
  The labia pudendi, the nymphae, and the muscular folds of the
os externum (carunculaj myrtiformes,)  all serve to close the pas-
sage to the uterus, and protect it from cold.   Their spongy struc-
ture and elastic power enable them to  expand for the purpose of
parturition, to protect the  child  against injury from the pelvic
bones, and afterwards to contract to nearly their  original dimen-
sions.
  About the nymphae, in the vagina, uterus, &c, are glands and 
29
follicles which secrete, some  an oilyf others  a mucus substance
which serve to prevent injury by friction and close contact of the
parts.
  The vagina by its firm texture, and its attachment to surround-
ing parts, aids the  broad and the round ligaments in supporting
the uterus  in its place, and preventing injury to the cervix from
external pressure.
  The  uterus is  designed  for menstruation, and for conception,
protection, nutrition and expulsion of the foetus.  The broad and
round ligaments> aided by the vagina, sustain it in its proper place
and position.  The fallopian tubes are evidently designed  to con-
duct the ovum from its nest in the ovary, to the cavity of the uterus.
The ovaries are designed to furnish the female elements of the fu-
ture man, in regular succession during the prime  of  life of each
individual.  The ova  are  seldom less than 8 or  more than 24,
usually  10 to 14.
  By a careful inspection of the plates and references, the location
and form of these organs will be more clearly perceived, and their
uses better understood.
                DISEASES OF THE ORGANS.

  In infants, the labia pudendi, the nymphae &c, are often inflam-
ed.  This condition may be prevented or cured by washing the
parts often with  warm milk and water, and with a tea of hemlock,
bay-berry, raspberry or other medicine, or applying sweet oil or
cream  or fresh  butter to them.  Similar  appearances about the
ears, groins  and  elsewhere, may be treated in the same manned
Sometimes,  from want of attention to these matters, the labia pu-
dendi,  grow together.  When  this is observed,  they should  be
separated immediately.  The  best  method of doing this, in my
opinion, is to take hold of  the  labia and  pull them apart.   This
method is less less likely than culling to injure the minute vessels
of their surfaces, and is said to give  but little pain.  Dr. Denman
says it will  scarcely  make the child complain.   Keep the parts
asunder till  healed, by a little lint saturated with sweet oil, cream
or butter.  These are also excellent to prevent or cure chafes, <fcc,
any where.
  The vagirfa is liable to stricture, so as to render it too short and
small for the purpose for which it was designed.   This  may be ob-
viated by injections of No. 1, slippery elm and other emolient sub-
stances, and by dilatation with  sponges, tents, &c.  The course
of medicine, (see it hereafter described,)  injections  and restora-
tives, faithfully used,  will almost if not quite always save the ne- 
30
ccs>ity of mechanical distention sometimes advised by physicians.
Cohesion of the inner surfaces after ulceration, and the scars thus
formed, may be  treated as  directed for adhesion of the labia
pudendi.
   Polypus.—Attached to its  inner surface, is sometimes found a
species  of  fungus  denominated  polypus.  It is  of various sizes,
shapes and textures, and variously situated.   After some time, it
generally  becomes smaller towards the point of  adhesion, when,
with a double canula and a  loop, it may be compressed around
the neck so as to stop the circulation.  In three to six days it will
drop off, and  the place where it was attached may be dressed with
healing salve, put on the side of a large  piece of lint, or even  let
alone, and it will soon be well.   A very bad  case was lately cured
by pure Botanic courses alone.  Such tumours are also sometimes
found in the uterus.
   The. fluor ablus or  whites so called from its appearance which,
though at first generally  milky, is  sometimes changed to green,
yellow or even brown, shows itself in an irregular discharge from
the uterus and vagina.   It is often attended  by severe pain in the
back and loins, weakness, loss of appetite, dejection of spirits, pale-
ness and chillness,  and sometimes by difficult  respirations, palpita-
tions, fainlings  and swelling  of the lower extremities, wtiich are,
rarely, followed by prolapsus uteri or the "falling of the womb."
   Treatment.—This disease being caused by cold, canker and other
obstructions of the  secernants, the proper mode of cure will be to
give the patient full courses, promptly and energetically, with
generous diet, moderate exercise,  and the best articles of No. 4.
Great attention should  be paid to injections into the vagina, com-
posed of witch hazle, blood root, (or other canker tea, when this
cannot be had) with a little cayenne and nervine; these should  al-
ways be strained.  The parts should be constantly protected  by
warm clothing from the action of cold.   Let this practice be con-
tinued till the general health  is restored, and the peculiar affection
will vanish.
   Retroversion.—The uterus is liable to retroversion, by which is
meant that the  fundus is turned backwards  and downwards upon
its cervix, between the vagina and rectum, and the os uteri is turn-
ed forwards to the pelvis, and upwards, in proportion to Hie de-
scent of the fundus, so that it cannot be felt by the finger, at least
without great difficulty.  The fundus uteri may be felt between
the vagina and the rectum, pressing the former towafds the pubis.
This  generally happens about  the  third month  of  pregnancy,
though it sometimes occurs after delivery.  It causes severe pain,
costiveness and suppression  of urine.  Sometimes the bladder is
so distended and projected into  the abdomen, as  to produce the
appearance of advanced pregnancy. 
31
   Treatment—By inserting a catheter through the meatus urina-
rius, into the bladder (an operation which the patient can perform
with more ease and less inconvenience to herself than the admin-
istration of an injection) the water if necessary may be drawn off.
Then (the patient lying on one side,) by inserting the fore finger
of one hand into the vagina and that of the other into the rectum,
keeping them as near together as possible and constantly  alter-
nating gradually inward, the fundus uteri will be easily  returned
to its plttce, when the cervix will return as a matter of course.
By filling the vagina during the day, with a thick India rubber
bpttle, or other soft elastic substance lubricated with slippery elm,
after giving a course  of medicines  and  injections, to strengthen
the parts,  the derangement will soon be corrected.  A bandage
or truss of that character may be worn externally to some advant-
age, but I entirely  disapprove of all the pessaries in use.  I have
peen much mischief produced by the use of some, and no good from
that of any.
   Hydatids.—The  uterus is also subject  to hydatids, that is, little
bags containing a watery fluid supposed to surround living animal-
cuke, and  attached by a small neck to  the  surfaces.  "If," says
Hooper, "the vires nalura medicalrices are not  sufficient to effect a
cure, the«patient mostly falls  a sacrifice  to their ravages."   It is
therefore evident that the  Botanic treatment (if  it should not  al-
ways, as it certainly will generally, effect a cure,) is the  best that
can be applied; for it is calculated to aid the vis medecatrix natu-
rae, or healing power of nature, in doing what it is of itself unable
to accomplish.
   Tumors or dropsical bags that obstruct the passage of a child,
should be pushed above the pubis if moveable; if not, they should
be punctured with a  sharp instrument,  and they will discharge
their contents.
   Cancers are also  sometimes found in the uterus.  They may  be
treated according to our plan, so far as they can be reached; or
they may be treated with caustic potash, as  hereafter described.
With ulcers we, Botanies,  have no difficulty.
   The ovaria are also liable to dropsical  affections,  to inflamma-
tion &c.   Physicians guess at the existence of this form and local-
ity of disease; and attempt to cure the former by  tapping through*
the vagina, and the latter by the use of those anti-phlogistic means
which are well calculated to produce the former.  They are sub-
ject also to hylhtids and cancers.   The dropsy usually  happens
about the cessation of the menses, sometimes earlier.   It is caused
by cold or obstructions, which either contract or close up the pores
in those parts, and  prevent the fluids from escaping.  The appli-
cation of warmth and moisture on the Botanic plan, (see course of
medicine,) will relax the pores and discharge the offensive matter. 
32
  Remarks.—Though the above form? of disease need not be fear-
ed by, those who adhere strictly from the beginning, to the treat-
ment I recommend, yet I have thought proper to mention them
for the purpose of showing that, in the event they should, these of
all difficult cases are the very ones in which officiousness should be
avoided.   A friend  asks what we Botanies shall do in  difficult
cases which demand the assistance of surgeons?   I answer in the
language of the very best surgeons.
  "Such  causes of difficulty less frequently occur than many au-
thors have imagined.  The rash  and preposterous application of
instruments has in such cases proved the bane of thousands."—(Ed.
Practice, vol. 5, page 140, "and should difficulties occur, what can
we do but support the.strength of the woman  and wait  with pa-
tience."—lb. 141.   "The work of nature is too often spoiled by
officious hands.—lb. 142.  Instruments should never be employed
but when alarming symptoms occur!   The assertion perhaps is not
more bold than true, that, in general, the most disadvantageous
position in which the  head  can offer, is not  sufficient,  no other
cause concurring, to endanger the life of mother or child,  so much
as would be done by the movement of the gentlest hands."—lb.
140.
  I repeat it,  then, that difficult cases and alarming symptoms
rarely occur, and when they do, we  have the best  authority to
prove that the best  treatment, as well as the only safe one, is to
afford nature all the aid we can, but never to interrupt her opera-
tions.  I have witnessed several instances in which the patient and
the  bystanders were much  alarmed, but,  by  "supporting  the
strength of the  woman" and  "waiting with patience,*' they  were
soon convinced of the truth of our motto, that midwives ought to
"know that they arc natures  servants," not her masters.
  These evils rarely happen to women that have not borne chil-
dren, nor even to those who  have, that have been treated accord-
ing to the Botanic System.   They are almost universally  the fruits
of "scientific  skill in the chamber of parturition." This same re-
mark is equally applicable to other forms of disease peculiar to
women after childbirth.
  The Catamenia already described, commences its discharge at
very different periods of life.  In tropical climates, and persons
 t[ warm passions, it presents itself usually at 8 to 12 years; in tem-
 perate, at 13 to 16 years; in cold, at 16 to 20. There are in-
 stances in which it has commenced much earlier, fftd one is on re-
 cord where it presented itself for the first time at 70 years.
   At  whatever time  it commences,  it usually  continues about
 tvtice as long as the person has already lived.  If at  10, it departs
 at about 30; if at 15, it ceases at about 45, &c.   Tho commence- 
Oil
ment and the cessation of this discharge, al*e called the most criti-
cal periods of life to the female.   It generally commences very
moderately, and the next day increases.   It continues from two
days to 10, generally 3 or 4 to 6.  From some persons the quantity
discharged is much greater than from others, estimated at 4 to 8
ounces. .So  long, however, as the discharge gives no pain nor
weakness, nor other evidences of constitutional injury, and is not
mingled with clotted blood, the quantity is not  to  be  regarded as
injurious.
   This discharge usually occurs once in about four weeks, and is
generally  supposed to be under the influence ot the  moon.  I
know a few individuals who always have it in the increase of the
moon.  But I know many in whom it pays no regard  to the posi-
tions of that planet.  Females arc menstruating somewhere, every
day in the year and every hour in  the day.  Many have it once
in three weeks, Others once in five or six.   In very cold climates
it comes on late in life, and  returns only in summer.  It is not to
be expected (though it sometimes appears)  cither during pregnan-
cy or nursing.
   Disease  of //.—Those who discharge clotted  blood with it, or
those who do not regularly discharge it once in four weeks, (un-
less when  pregnant or nursing,) seldom bear children.   The dis-
charges are sometimes checked by grief or disappointment, and
produced by agreeable surprise.
   Treatment.—Whenever irregularity, painfulncss,  suppression,
milky or bloody  discharge, or any other unnatural effect, indicates
a want of healthy action, the patient should take full courses of
medicine  aided  by appropriate injections, and steam  should be
frequently applied to the lower extremities, till the cold phlegm,
and canker are disengaged, and then she should tone up the sys-
tem with the various articles of bitters,  so tempered or combined
as to keep the bowels open, and with stimulants and  clothing, as
to keep the whole body warm.  When  the general system is ren-
ovated, the particular affections will cease.
   Marriageable State —It is pretty certain  that  women are
incapnble of bearing children, till the calamenia commences. And
it is almost  equally" certain  that they ought not to be put to the
trial so soon by three or four years at least as this occurs.
   The consent of the parents, and of the moralist being obtained,
young ladies, in, the Southern States, are marriageable between 16
and 20, and in the northern,  between  18 and  25.   But, if any
know themselves to be so defective or deformed, as to render child-
bearing evidently impossible or dangerous to their own lives were
it possible, they ought by no means to marry.
   If asked how they are to know this, I answer, the most common
           3 
34
difficulties in parturition, arise from deformities of the pelvis by the
disease called the rickets.   Every one  knows whether she is af-
flicted with this disease.  Many material deformities of the pelvis,
may be discovered by examination of the exterior surface; small
deviations may be ascertained by the patient herself, or a confiden-
tial female friend, by examination and comparison with  my de-
scription of a well formed pelvis.   Velpeau, a famous French ob-
stetrician, says, that all deformities of the pelvis may be ascertained
with a sufficient degree of accuracy, by  the touch  of the finger.
Want of genital organs, or monstrosity of those existing, rarely
occurs.
  The want of a healthy and regular menstruation is not a reason
sufficient to deter a  young  lady from entering into the.  married
state; for such a connexion is often  found the best remedy for this
disorder.  But, whether married or not, a faithful  and energetic
Botanic treatment, added to the prophylactic means heretofore
described, will seldom fail to remove this form of disease.
  I have already remarked  that, when the hymen has never given
way,  (an exceedingly rare case)  the catamenial secretions may
remain in the vagina and uterus, and produce the appearance of
dropsy.   This is easily detected by examination, and as easily  re-
moved by severing the membrane with a pen knife or pair of sharp
scissors.  It  has been remarked that, though not removed in  in-
fancy, the hymen is almost always perforated in the centre, if not
notched from the upper or  forward edge to the centre.   Still it
has been sometimes found so strong and wide  as to  present an ef-
fectual barrier to sexual union.  Instances have been known, in
which an igndrant husband  has made application for divorce,  in-
stead  of performing the easy and  safe operation of dividing the
membrane.
  Some have supposed that  the remains of the hymen form the ca-
runculas myrtiformes, or folds which close the mouth of the vagina;
but I have seen the carunculae perfect, in a grown person, in whom
the hymen was not deeply cleft.  As the hymen, in many, is not
ruptured till the first sexual  embrace,  some have thought it a ne-
cessary proof of virginity; but its total destruction (if it ever exist-
ed) in infancy, is so common, that authors who never sav»  it have
doubted  its  existence.   Many well know, however, that "such
things there  are."
  Most authors on midwifery seem to feel bound to give a parti-
cular account of the nature  of conception, and the modus operandi
of producing it; but I think that they might safely leave these
matters to instinct, when common sense  is wanting, especially as
the more they write, the more clearly they exhibit their ignorance
of the whole subject.  My task shall be  to teach those who have 
35
by any means assumed this responsibility, to bear it with a good
grace while they can,  and to get rid of it in the  safest and the
easiest way, when they must.
  Of Utero-gestation.—By impregnation, in all ordinary cases,
one  of the ova  is detached from its place in the ovary, and
conducted, in  the course of about twenty days, through the fallo-
pian or ovario-uterine tube, into the uterus.   It is  surrounded by
two membranes, the inner, called the amnion, and the outer called
the chorion. The former incloses a fluid in which the embryo floats.
At first these membranes are separated a little by a glutinous sub-
stance, but they afterwards come nearly or quite in contact.   The
amnion is thin, smooth, and  transparent, without the appearance of
vessels.  The  chorion is nearly similar,  but of a rougher texture.
  From the moment of impregnation, commences forming on the
inside of the uterus, a membrane called, from its transient exist-
ence, the decidua, its situation being displaced by the introduction
of the ovum and its membranes into the uterus.
  Soon after the  ovum enters the utqrus, its membranes are united
with, and incorporated into, the decidua, in such a manner as to
be inseparable after the second month.  The decidua is also firmly
attached to the wall of the uterus, generally  at the fundus.  See
plates.  When this union is effected, the chorion and decidua per-
mit each other's vessels lo interlock through their whole extent, so
as to establish, between Ihem, a union,  similar  to  that which ex-
ists between the arteries and air-cells of the  lungs.   The amnion
and chorion inclose a fluid called  the waters (liquor amnii,)  in
which the foetus floats  from  the commencement to the end of the
pregnancy.  It is sometimes transparent like water, at others yel-
low, brown, green &c,  and of varions  consistences.  It differs
much in quantity, from a gill or so, to two  quarts or more.   It
gives uniform  distention  to the  uterus, protects the fcetus against
internal injury, keeps the surfaces  of the amnion and the  fcetus
constantly lubricated, and aids in expanding the  passage 40 facili-
tate parturition.
  Anomalous  Conceptions.—Instances have occurred  in which
the fcetus remained attached lo the ovary, others where it stopped
in the cavity of the pelvis, others  where it lodged in the  fallopian
tubes,  and yet others, where it  made its  bed in  the  walls of the
uterus, instead of the cavity, and in all these situations, it has come
to maturity and been  delivered, sometimes   by  dying, and then
rotting a hole  through the walls of the  abdomen and being dis-
charged by piece meal, and others, by the knife of  the surgeon.
Such cases, however, rarely occur.
   I have  known  one that carried a foetus 24 months when, by a
course of medicine, it was discharged dead  and partially wasted 
36
away.   I knew another to be retained as long, and the last time I
saw the patient she  was attending in her little shop, in tolerable
health.  How she fared afterwards, I know not.
  Umbilicus and Placenta.  See last plate.—Attached to the
umbilicus of the foetus, and of various length, about half a yard in
the full grown child, is a small  cord  composed of one vein and
two arteries, and surrounded by extensions of the chorion and am-
nion through which it passes to the decidua, where it expands into
a circular cake of various sizes,  thick in  the  middle and rather
thinner at the margin.  The  outside is attached to the inner sur-
face of the uterus, generally at the fundus, by a thin membrane so
delicate that the least bending will crack  it, and  produce a hcr-
morrhage.   The  foetal surface is coated all over  by  the  chorion
and amnion, through  which may be seen  the arteries  and veins
before mentioned, as composing the cord, divided and subdivided,
sometimes diverging towards the margins,  as rays from a point; at
others, crossing each other in  the most fantastic forms, and finally
diminishing  to invisibility.  ,
  Through the cord uniting the  placenta  to the foetus, called the
umbilical cord, the vein and arteries  sometimes  run parallel for
several  inches, then twine around each other in various ways, pre-
senting the  appearance of an irregularly twisted rope.   In this
cord are  observed one  vein to carry  blood from  the placenta to
the foetus, and two arteries to return it from the foetus to the pla-
centa.  These are imbedded in cellular  substance, containing a
ropy fluid, and covered by the membranes  called amnion and cho-
rion, as before observed.  The capacity of the vein is rather greater
than that of both the arteries.
   The placenta renovates the blood of the fcetus,  as the lungs do
that of the child or adult. For this purpose the arteries and veins
of the uterus so  completely  intercommunicate with those of the
placenta as to bring each and every one of either into such a  near-
ness to some of those of the other, as to render the contact similar
to that of the air  in the  lungs of  the mother with that of the blood.
Thus the foetus is supported and built up  by a secretion from the
blood of the mother, through the membranes that separate the re-
spective vessels;  not by  the blood of the mother circulated through
 the fcetus.
   Changes in the Uterus.—As soon as an ovum is impregnated,
 a larger proportion of blood is directed to the uterifs.  The  little
 crooked vessels  enlarge and  straighten, till the largest somelimcs
 become, at the end of pregnancy, a half inch in diameter.
   For  about seven months, the  fundus and body of the uterus arc
 mostly distended; after that,  the neck continues the development,
 till, at the full period, nothing of it can be discovered save the os
 uteri, which is generally a little open. 
37
  Labor  Pains.—The  fibres  composing tbe uterus, relax as the
size  of the foetus increases, till their elastic power is exhausted,
when they commence a contractile reaction, the foetal resistance
to which, is the disagreeable sensation called labor pain.  As the
foetus still enlarges, these become more frequent and insufferable,
till, by a succession of mighty efforts,  they discharge the offending
cause.
  False Pains.—The only difference between the premature, or,
as they are often called, false pains and the true, is, that the. former
take place at any period of pregnancy, when, from any cause, the
expansion of the uterus does not correspond with the growth of
the child.  Thus a sudden cold contracts the uterus and produces
abortion.   (See treatment  of  this form of  disease.)   True pains
may be inefficient,  on account  of their  not  extending over the
whole surface of the uterus.   Partial and inefficient pains during
parturition, are sometimes called false pains,  though more severe
than thoie in which every portion of the uterus acts, and the effect
is produced.
  Positions of the Uterus.—We have already remarked that,
if the patient  have  a sound constitution and  the catamenia be
generally  regular and healthy, pregnancy may be suspected when
the periodical secretion ceases.
  Abating variations consequent on the form and capacity of the
pelvis, the tonic or atonic  (active or  debilitated) state of the or-
gans &c, the  position of the os uteri for the first three months, will
be rather  lower in the vagina  than usual; from the fourth to the
fifth, the fundus can be felt outside above the pubis; at the  sixth,
halfway between this and  the umbillicus;  at the  seventh, about
the umbillicus; at the eighth,  halfway from this to the pit of the
stomach, which is about as high as it rises.  Then it settles and
enlarges.
  Growth of the Fasvus.—For aboat fifteen  days no solid form
is discoverable.  At six or seven weeks, it is about the size of a
small bee.  At two  months, it is about two inches long and weighs
about as many ounces, the parts are disLinct and ossification  com-
mences.   At four month?, it is  five to six inches long, and its mo-
tions are usually felt by the mothc.   The first of these motions are
called "the quickening."   The  length is seven to nine inches.
In the sixth month, the hair commences growing, the fcetus weighs
from one  to two pounds, and  its length is nine to twelve inches.
During the seventh month, parts pretty  fully developed; eighth
month, nails firmer, hair more colored, weight three to five pounds,
length fifteen inches or more; ninth month,  bones more complete,
head large, firmer, cranial bones touch each other's margins, fonta-
nelles narrower, nails extend  to the ends of the finger^  and tho
4 
38
 whole system h developed.  Its weight  (hen varies (in Europe)
 usually from five to eight pounds.  Dr. Dewees, of Philadelphia,
 says that he weighed one of fifteen pounds and a half; and thinks
 that, in this country, they are often as large, and that their average
 weight is over seven pounds.
   Sometimes the fcetus thrives in weakly women  and becomes
 proportionably very large.   Sometimes healthy women bring forth
 very small  children, that are nevertheless  perfect, and sometimes
 the children are retarded in their growth by  an  imperfection in
 the development of the parts, and sometimes imperfections or mal-
 formations  arise from maternal associations during gestation, and
 sometimes the whole force  of the mother's disease falls upon the
 child, and it is born almost in a state of putrescency.
   Duration of Pregnancy.—It is  generally believed that  the
 natural, uninterrupted period of pregnancy in a healthy woman,
 is from 39 to 40 weeks or about 9 months.  This is about fhe  du-
 ration in most cases which  occur under circumstances that leave
 no doubt as to  the exact time.   (Dewees, pages 139  and 134.)
 From various causes, however, some females carry the fcetus seven
 months, some eight, some ten and even more.  (Dewees,  pages.
 128, 142.)  As it is impossible, however, always to know when it
 commences, and, as its duration is different in different women,
 and iu the same woman at different times,  so there  is no cerlain
 rule by which either the duration or the  termination can, at all
times, be determined.  The most important matter  is,  always to
 keep the female in good health, as the first and best means to ren-
der distinct and certain, those  signs which have generally been
 relied on as indicating the  existence of utero-gestation; to be al-
 ways prepared for the  circumstances attending its approach or ter-
 mination, from the time that the reasons to suspect its existence
 are first developed, and to become so well acquainted  with  the
 signs of approaching parturition as to guard against improper con-
 duct and to render the subject all the attention which those cir-
 cumstances require.
   Signs of Utero-Gestation.—The uterus is supposed to be the
 most favorable to  conception or impregnation, directly  after the
 periodical cessations of the menses.   Sometimes women know the
 moment it takes place; sometimes they discover its effects in a few
 days or weeks; sometimes three or more months elapse before they
 discover it,  and sometimes they are in doubt even till they are in
 actual labor.  The same woman, in  some utero-gestations, is in
 doubt of her condition through  the whole  period, and  in others
 aware, not  only of its existence, but of the time of its particular
 stages.
   Regular mistakes.—Many  instances  are  known,  in which 
S9
medical men have treated pregnancy  for dropsy,  till the actual
appearance of the full grown fcetus discovered their mistake. One
instance occurred a few years ago in Maryland.  A correspondent
informed me that two M. Ds. treated the patient a long time, and
gave her up as incurable.  The father called a Thomsonian who
steamed the living dropsy info  the world!   One of my pupils in-
formed me that a similar case fell under his own observation in the
State of Tennessee, and I have lately heard of several others.
(See the  quotations under  the head of "Regular  Mistakes," or
"Scientific Quackery."  See also "Curious  Physiological Facts.").
   The principal reasons for the above  irregularities,  are, the dif-
ferent constitutional temperaments  of  different females,  and the
different degrees of health and spirits in the same female at differ-
ent  times.  When they are in .perfect health,  and their spirits
buoyant, the slightest impulse  on the  delicate structure  of their
peculiar organs, is sensibly felt.
   Interruption of the Menses.—In women whose constitution*
and general health are good,  the monthly  evacuations almost aU
ways cease immediately after  conception, and  do not reappear till
sometime after parturition, and seldom while  nursing; therefore,
if the menses do not occur for several successive periods, it may be
generally inferred that the subject is pregnant.   But this cessation
may take place in consequence of taking cold, and then bad treat-
ment may prevent its recurrence, and a consequent dropsy may
similate pregnancy so closely  as to  deceive even experienced ac-
couchers.  (See above.)
   About  the time of the final  cessation of the menses, say forty to
fifty years, there may be such  an enlargement  of the abdomen, ir-
ritation of the breasts &c., in  consequence of too early a suppres-
sion, as to induce both the patient and the physician to suspect
pregnancy.
   The regulars  who are afraid to give their Samsons in cases of
gestation, are in a bad box here;  they are obliged  to wait the
teachings of time, and let the  patient suffer, lest, by their "incom-
patibles," they do her an injury instead of giving her relief.  But
Nature's  physician gives her a full course of medicine without fear,
and thus, at once, decides  the question, and  always in favor of
health  and  comfort,  be the  condition of the patient what  it
may.  I  speak from abundant and satisfactory experience in this
 matter.
   Women, however, sometimes do menstruate during  the first months
 of pregnancy,  and, in rare cases, they have done it to the very last J
"I have myself known women," says Dr. Blundell, (page 115,) in
 whom, during the first three or four months,  the catamenia have
 continued to flow, though not in so large quantity  nor so long, as 
4fl
 if they were not pregnant; and, in rare cases, I am told, but I have
 not seen any such  case myself, that the catamenia may continue
 to  flow up to the last month.   A [medical] gentleman related to
 me the case of a lady who had had  several children, and, in three
 or  four of  her pregnancies, the catamenia  continued  till the last
 month:—in return, in kind,  and in every point except the  con-
 tinuance and quantity, the flow was of the catamenial character.
 I need scarcely add that women, when pregnant, are liable to red
 appearances, which are not of the nature of the catamenia."
   The cessation of  the menses is, therefore,  as I before remarked,
 a valuable, but not a certain indication of pregnancy;  and yet
 pregnancy may exist, where the discharge still continues, one in-
 stance of which has fallen under my own observation.   Still, these
 cases are so rare, that Dcnman and Burns, both very celebrated
 accoucheurs, declare, that "no female, continuing to menstruate,
 can, at the same time, be pregnant," they never having seen  such
 a case.
   The discharge may be prevented by local obstructions without
 pregnancy  in  a woman whose health has  been generally good, or
 by  chronic, general inability to furnish this fluid, in addition to all
 the other secretions, while, in consequence of a surplus of vitality
 in health, or of excessive weakness  of the uterine  secernants in
 chronic sickness, this secretion  may become, excessive  at tho ex-
 pense of others thus rendered deficient.  This is the only rational
 account I have ever seen of these seemingly unaccountable occur-
 rences, and I believe it true, because it explains all difficulties on
 principles in perfect harmony with established laws of vitality, as
 well as with my view of the  cause  and design  of this secretion.
 (Sec page 19.)
  Irritation of  the Bladder.—Increase in the size of the ute-
 rus, while it remains in the cavity of the  pelvis, is apt to create
 irritation about the  neck or the bladder, and sometimes an ineffec-
 tual desire to discharge the urine; this is called micturition.  Other
 circumstances being favorable, it is considered a sign of pregnancy.
  Nausea, Retching and  Vomiting.—These suddenly occurring
 in women  perfectly well  before, particularly on  rising  in the
 morning, and subsiding more or less during the  day, the patient
 spitting or throwing up, however, little else than mucus, gastric
juice, or ill-digested chyme, constitute another concurring sign of
 utero-gestation.
  Swelling  of the Lower  Extremities.—The increase of the
 uterus in the pelvis,  may cause it to  press  upon the veins and ab-
 sorbents that ascend from the lower limbs, and this check to the
 return of the fluids causes those limbs to swell.  The  same cause
 may check the action of the nerves,  and render the limbs liable to 
41
 become numb, or occasionally to "go to sleep," as it is called, and
 these tilings may happen too, in the latter months of picgnancy,
 when the weight of the foetus  presses on the brim of the pelvis.
 Connected with other  concurring circumstances,  these signs are
 of some value.
   Motion of the  Fostus.—It is generally supposed that the mo-
 tions of the fcetus are a clear and certain proof of pregnancy.  But
 nothing is more certain than that,  in multiplied instances, these
 cannot  be distinguished from spasmodic contractions, the move-
 ment of wind &c,  even in women that have had many children;
 and that this doubt may continue to the very commencement of
 delivery.   In most  cases, however, the motions of the child are
 felt  with more or less distinctness, from the end of the fourth month
 to the day of delivery.  Dr. Blundell says, "When the motions of
 the  child [rather of the abdominal viscera; if "of the child," they
 must be certain,] are somewhat obscure, but little reliance can be
 placed upon them, as a sign  of pregnancy; but where the child is
 very turbulent, the motions frequent and violent, the sign becomes
 so strongly marked  that, without looking  any  further, you  may
 infer that gestation  is undoubtedly begun."—Page 114.)   But he
 elsewhere says "the only infallible sign is  the usual expulsion of
 the  fcetus!" and gives examples  of the deception  of eminent ac-
 couchers.
   Enlargement of the  Abdomen.—Though  various causes, as
 corpulency, dropsy, wind, internal tumours &c, may produce an
 increase of size in the abdomen, where pregnancy  does not exist;
 yet it is certain that a  foetus cannot come to maturity without pro-
 ducing this effect.   Therefore, when  a sudden, gradual and con-
 siderable  enlargement  of the abdomen takes place without any
 other known  cause  than its  connexion with other signs of preg-
 nancy, it may fairly be considered  one of the  many indications,
 and  as such,  have  its value.  Some advantage may be derived
 from a careful attention to the  particular kind of swelling. Swell-
 ing from water or air, is diffused quite equally over the whole ab-
 domen, is yielding and moveable; that from  air is fluctuating, of-
 ten entirely subsiding;  that from fat, diffused over the whole sys-
 tem; that from tumours, very gradual in its growth, unconnected
 with other signs, and located in different places; while the swelling
 of pregnancy commences suddenly, about the first of the fourth
 month, just over the symphisis pubis, is constant, unyielding, and
 continually increasing;  and, therefore, all  others concurring, is a
 valuable sign.  '
  State of the Breasts.—In  first pregnancies, the breasts are
 apt to indicate the condition of the uterus,  by enlargement, irrita-
tion  and  secretion:  but, as the first  of these  may be induced by 
42
corpulency, and the second and third by the frequent exercise of
a desire that they should become so, together with repeated trials
by pressure, lo ascertain whether there be any  secretion, their in-
dications are by no means certain.  These appearances too, are
so common about the final cessation of the menses, as often, in
connection with that, to  deceive  even  the  experienced obstetri-
cian.
  Areola.—Some have placed much confidence in the enlarge-
ment, and of the changes in color to a darker hue, of the areola or
dark circle that surrounds the nipple, as a valuable  indication, es-
pecially of a first pregnancy.  Others place but very little confi-
dence in these changes.  But it is manifest that none but the lady
herself, her husband or  intimate female friend, could be  much
benefited by  this sign, were  it ever so good.  The physician is
not required  to examine each patient, sufficiently  often to profit
by those changes; nor are they very distinct or worthy of notice,
after the first pregnaucy.   The change, when manifest, is from a
narrow to a wide circle, and  from a rosy tint to a coppery red or
a mahogany brown.  Dr. Blundell thinks it, in some cases, a very
decisive concurrent sign.
  Likings and Dislikings.—Most women, during pregnancy, are
beset with certain preferences and aversions.   They will choose
those articles for food which might be supposed the most unsuita-
ble, and which yet  seldom disagree with them, while they will al)
at once become irreconcileably opposed lo others of the most  in-
offensive and nourishing  kind.  Some lose their flesh and health,
others the equilibrity of their temper, some fret and others cry, or
exhibit some other hysterical symptoms; few indeed are,in all re-
spects, in disposition and action, just what they are at other times.
   Quickening.—In the latter part of the third month or  begin-
ning of the fourth,  the uterus quits the cavity of the pelvis and as-
 cends into the abdomen.   In many females the influence of this
 change is distinctly felt,  in motions in  the abdomen; sickness of
 the stomach, agitation of mind  and tendency to fainting.  In
 others, these effects are not strongly marked.
   Cessation or diminution of the milk.—When, during nursing,
 a sudden diminution, or almost total cessation of the milk occurs,
 pregnancy may be strongly suspected, especially if there has been
 a return  and then  a  suppression of the menses.   The fact that
 lactation and menstrual secretion very seldom if ever proceed to-
 gether, and that neither of them  scarcely ever exists during preg-
 nancy, is proof that both these secretions are engaged in contrib-
 uting to the development of the  future man, till he is entirely de-
 tached from the mother, from whose secretions he has been so long
 supported, and furnishes another strong evidence  of the, truth of
 the doctrine taught page 19th and onward. 
43
   Diseases,—Such as nausea,  diarrhoea,  effusions of water, dys-
 pepsia, heartburn, depraved  taste,  costiveness,  prolapsus uteri,
 gravel, jaundice, difficult breathing and cough, convulsions, tooth
 ache, salivation, inflammation of the breasts, dropsy of the ovum
 and  of the extremities, rigidity of the abdominal muscles, false
 pains, agitations in the abdomen &c, have been  considered signs
 of pregnancy; but, as some one or more of all these may be often
 present where there is no pregnancy, and, as pregnancy may exist
 without any of them, they are of little value as signs, except when
 the concurrent testimony of those already mentioned, gives them
 value.
   Regulars profess to determine the matter by a manual examina-
 tion; but, as this mode is calculated  to do often more harm than
 good, and, in the Botanic practice is seldom useful, I can not re-
 commend its adoption.   The  signs they derive from it are, they
 say, 'in some dubious cases the only certain" signs; and yet, with
 all the precautions against error, they can take, they are obliged
 still to confess that no one of these signs  of pregnancy alone, is
 very certain, and, indeed, that they cannot determine the case in-
 fallibly by the united evidences of all the signs with which they are
 acquainted.  Dr.  BlUndell, after enumerating all the signs that
 have been found worthy of notice, comes to this  sage conclusion,
 that, "if pregnancy be doubtful, we had better wait till the end of
 ten or twelve  months, when, unless the gestation be extra uterine,
 or out of all rule, parturition must sooner or later occur!"   Thus,
 he ends the chapter  on  signs nearly  as  he began it, viz: "The
 most certain mode of knowing whether a  woman be pregnant or
 not, is by waiting till  the term of nine months is completed, when,
 unless the pregnancy be extra uterine, or unless there occur some
 of those extraordinary and rare prolongations which have some-
 times been made the subject of physiological or forensic litigation,
 if the uterus contain an ovum, it will be expelled!"
   Treatment.—Though Ihave here spoken  of  what are called
 "diseases of pregnancy,"  merely with respect to  their characters
 as signs of their existence, yet, as they are supposed, by the regular
 faculty, to require a treatment when found  in this  connextion, dif-
 ferent from  what would be proper when the patient is not preg-
 nant, it may be proper to state that all forms of disease are to be
 treated upon the same general principles and with  the same char-
 ters of remedies when the patient is pregnant, that would be adap-
ted to the case, if she were not.
  A  woman of  good constitution and in  perfect health,  will
 scarcely learn that she is pregnant from the  evidences whieh the
"diseases of preguancy" afford, while she that is feeble and sickly,
will find it as difficult to determine from what cause her continued 
44
and vexatious, hysterical symptoms proceed.  As to nausea, it may
be produced by any thing that can  irritate the stomach, as bad
food,  cold  phlegm &c, as well as by uterine  sympathy.  From
whatever cause it proceeds, however, it is to be  cured by a course
or two of medicine,  (or fifty if necessary.) with laxative bitters,
&c.   The cold phlegm above mentioned, may check the power
of digestion, and the uterine irritability may  fatigue the  stomach
before the whole of the food is reduced lo chyme.  In either case,
the pylorus relaxes and the undigested food is suffered to  pass into
the duodenum, where it continues its irritation, and, of course, the
velocity of its descent till it  is violently expelled from she system,
in connexion with the fluids which have been invited into the alvine
canal and hastened along past the mouths of the  absorbents too
fast to be taken up; the discharges thus produced,  constitute what
is termed diarrhoea.  As this form of disease loo,  has it origin in
the stomach, it is evident from reason, as well as frcm experience,
that a thorough course of medicine is the  best cure for it.
  Dr. Bkmdell says, (page 121.) "among the diseases which are
cither referred to pr;guancy, or which  require a  modified treat-
ment in consequence of their connexion with it, not the least trou-
blesome, is the irritability of the stomach and bowels, producing,
in the earlier and middle months, both  vomitings and purging*—
sometimes together—-generally alternating.  * * *. Where  there
is much irritability, the patient becomes much reduced by it, and
she may die of exhaustion  by vomitings  and purgings, or  by flood-
ing, perhaps, during premature delivery.  It is not always in our
power to put a stop to these  vomitings and purgings, but we may
do it in many instances."
  I have not found it more difficult to cure these forms of disease,
in connexion with pregnancy than in its absence,  because I have
uniformly treated  (hem wilhou^any reference to that  state.  I
would make  the same remarks in regard to all other symptoms
above enumerated.  As I shall hereafter give particular directions
in regard  to the manner in which  all the forms of disease peculiar
to women are to  be treated, I forbear to add more in this  place.
   Advantages of  Knowing the condition of the patient.  What,
I may be asked, are the advantages to be derived from certain know-
ledge of the real condition of the patient? I answer, some wicked
persons desire  to know the fruits of one sin, that, by the commission
of another, they may avoid  exposure.  To such persons, it would
not be  right for us to  communicate  the knowledge if we had it.
Regular physicians are anxious to know it, that they may not pres-
cribe for disease, a course of practice that would injure any woman
in a state of pregnancy.   Let them quit their poisonous  and des-
tructive practice, and adopt one that will cure all forms of disease 
45
without injuring any  person, under  any circumstances, and thi»
knowledge will be less impoitant to them.
  But of what use is this knowledge to the patient, or to nature's
physician?  Answer.  It is very pleasant to be relieved of doubtin
any respect;  and particularly when  it is necessary to make any
preparations  for the final result.   But, on the medical practice of
the true physician, whose duty it is, at all times,  to remove every
cause of disease, whatever be the condition of the patient, it can
have no very important bearing. Having given numerous and full
courses of medicines, in every stage of utero-gestation, I am happy
to assure all who may desire information on the subject, that I have
never had the least reason to believe that  any thing but good re-
sulted from them.  So far  from being afraid to  take full courses
of medicine during pregnancy,  every lady in that situation ought
to take them  so frequently as to keep her system free from every
cause of disease, and in the exercise of all  its proper functions, as
the very best  means of securing the full growth, hardy constitution
and safe delivery of her offspring.  By giving a full course of med-
icine  the day before delivery, I have so prepared the system for its
duty, as to render the business of parturition short in  its  duration,
and comparatively trifling in the aggregate of suffering.
  I have known a regular M. D.. to forbid a paiient the useof med-
icine, and thus prolong her complicated sufferings for many months,
under the fear that the medicine proper for one form of disease,
would be  injurious to a patient laboring under the symptoms  of
another.   Often have I entirely released, in a few hours, the mis-
erable victim  whom this species  of medical superstition had doom-
ed to  a three, four, or five months suffering of the most disagreea-
ble and even painful kind.   How ought we to prize  a system  of
practice, which may be safely, freely and effectually  applied, for
any and every form of disease, without the least fear of injuring the
patient.
  Reckoning.—Supposing the commencement, or the quickening
to be correctly established, the reckoning of nine months, or thirty
nine weeks and one  day, from  the former, or about  five months
from the latter, will complete the term of gestation, and indicate
the time  when parturition may be expected.  This is somewhat
important; for, ladies who arc properly treated during  that period,
are often very suddenly surprised "at the end of it,  and are,  of
course, liable, without attention to the  reckoning, lo be caught away
from home or at least unprepared.
  Labor.—Many causes may contribute to retard or cut  short the
hour of labor  ; therefore we should always be ready for the circum-
stances attending its arrival, and so  well acquainted with its ap-
proach, as to  guard against improper conduct, and to render the
patient all the attention which those circumstances may require. 
46
   Causes of Laeor»—Medical men have written much on the sup-
posed causes of labor, but have never very well agreed on any point
respecting them.   I think that the uterus is a muscular structure;
and, as such) is designed to relax, unless some internal cause of
reaction oppose, to an extent just sufficient to enclose a full grown
fcetus, and then, like every other muscle, to return  to its original
dimensions.  During the period of this relaxation, the deciduous
membrane,  now called  the placenta, as also the fcetus, arrives at
maturity, and, like a ripe apple is ready to quit its strong hold upon
the parent.  The whole now become an offence, as would any other
substance that did not belong there.  The regular periodical con-
tractions of the uterus, (for though a long period elapses  between
them, they  are strictly  periodical,) now commence, and are  in-
creased in frequency and power, till they expel the contents of the
uterus and reduce that organ to its original dimensions.  '1 his doc-
trine clearly explains the mystery of abortions and false pains,  sub-
jects that have puzzled  the medical world not a little, and caused
them to scribble many a ponderous folio of nonsense and absurdi-
ties on these topics.
   Abortions, &,c.—The truth is, the placenta is a hard cake, pos-
sessing, from the commencement of its growth,  very little adapta-
tion to contraction; whereas, the uterus  is capable, when power-
fully irritated, of contracting, at  any time,  in  a very few hours,
from the size to which it may be naturally distended, to nearly its
original dimensions.  The attachments between the placenta and
the walls  of the  uterus, are so delicate that the contractions of
the uterus, by  the side  of the unyielding cake, readily separate
them.   The whole contents of the uterus now  become foreign to
that organ,  and, as such, are immediately  expelled.   This is the
reason  why a severe cold or a sudden  shock, as a  fall, a  fright,
grief, &c,  all  which act spasmodically upon  the whole nervous
system, and especially upon the uterus, produces abortion.  But
among the  refined  classes of society?'no one cause  so often  pro-
duces abortion as the contracted condition  of  the  abdomen  pro-
duced by corsets.  That cavity  being thus rendered almost in-
capable of containing a full grown fcetus, it  is wonderful, not that
tight  lacers so often suffer  abortions; but that  they  ever carry a
child to maturity.  Let every  sensible  mother consider this mat-
ter in season to prevent the evil by  forbidding its  cause.  This
is also the reason why the  Botanic Practice, which consists in re-
laxing constricted organs,  removing the causes of  irritation, and
thus quieting the nerves and restoring a regular expansion of the
uterus and action of tho general system, is so effectual in prevent-
ing abortions and miscarriages.   The treatment in such cases, will
 be given in its  proper place. 
47
  Signs of  approaching Labor.—As the signs or symptoms of
pregnancy may be similatcd by those of various forms of disease,
so the signs  of approaching labor may be similated by what are
termed false pains, proceeding from colds or other local irritants*
It is therefore well whenever any symptoms present that are sus-
pected to  be those of approaching labor, to commence, at once,
that kind of medical treatment which  is calculated to remove every
vestige of disease.   If the symptoms prove to be those of disease;
they will be removed;  if those of actual labor, they will  be in-
creased in severity and frequency till no doubt will  remain  as to
to their cause.
   Giving  canker tea, especially raspberry and cayenne, applying
warmth to the feet, jugs of  boiling water, or bricks or rocks heated
red and then  cooled in water  till done hissing and wrapped in
linen cloths, (the patient being in bed or in a chair by the fire;)
and thus producing perspiration,  or  giving her  a good steaming,
arc the proper means to decide  the point.
   Sometimes, if the gestation be  complete, the patient can per-
ceive for  two or three days before parturition commences, a gra-
dual sinking of abdomen, which is produced by the sinking of the
foetus into the superior strait of the pelvis.  Micturition and tenes-
mus are frequently troublesome.  There is also, generally, a dis-
charge from the vagina, of a mixture of mucous and sanguinary
fluids, which indicates some p'rogress;  in the dilation  of the os uteri.
"The mucus," says Dr. Blundell, "is from the numerous and large
follicles which lie in the mouth  and neck of the womb, and the
blood consists of a small drain from a  few capillary vessels passing
from the cervix uteri to the membranes, and laid open by the de-
tachment of these membranes and disruption of these vessels, when
the  lower frustrum of the ovum  descends a little, and the mouth of
the  womb dilates.   Hence it is because the show of blood [as well
as mucus] is indicative of the dilation of the os uteri and the inci-
pient descent of the membranes, that this sanguineous appearance
may be looked on  as a token of commencing labor."
   Conduct when called.—If the patient have used the botanic
remedies, and should request your services, you should attend as
soon as possible, or it may be too late to be  useful.   I was called,
one morning, after sunrise, to a lady  in Columbus:  I went imme-
diately, (about a quarter  of a mile.)  She  said she wished she
knew whether her time had really come.  I told her to take some
raspberry and cayenne tea,  and  she would soon know.  She drank
some twice  or three times,  and in seventy-five minutes after I en-
tered the house, she was delivered and cleared.   It is not often,
however,  that the work is done so speedily as this; still it is proper,
as was manifest in this  case, that the practitioner should be present 
43
 as soon as possible after he is sent for.  The umbilicus may be
 round the child's neck, or cramped  between the foetal  body and
 the maternal pelvic  bones; or there may, in cases of injury,  be
 a flooding, which will  demand immediate attention.  The desire
 to relieve even the ordinary and  indispensable paiii3 of travail, as
 speedily as possible, should always be sufficient to prevent your
 unnecessary delay.
  As soon as you arrive, let the husband or some  familiar friend,
 inform the lady, and then you should remain in an  anti-chamber
 till she requests your presence.   A sudden surprise, especially if
 attended with the fear of severe treatment, will greatly retard the
 process; and. in many cases,  cause the fcetus to retract.  When
 you enter the room, let your mind be calm and collected,  and your
 feelings kindly sympathize with those of the patient.   Assure her
 that, though rather a severe duty is before her; yet she has no rea-
 son to be alarmed, for her peculiar organs arc adapted lo the pur-
 pose,  and are no more liable to be injured than any other organs,
in the proper performance of their functions.  Give an ear of at-
tention and countenance of interest, to all her exhibitions  of suffer-
ing, or her fears of it.  If others  complain of her, take  her  part
whenever truth will justify you in so doing.
  But it is! neither politic nor honest, to assure her that you can
enable her to accomplish the work speedily and with but little pain.
For, though Ibis may sometimes be the case, yet it is not generally
so;  nor was it in the days of primitive society, before either "doc-
tor or pincers or calomel or opium" was known.  Even when "the
Hebrew women were lively,"  and accomplished the task "before
the midwives  came," the most severe  suffering that  the human
body could endure, was said to have its parallel if not its  superior,
in the "pain of  a woman  in travail," especially if it be "with her
first child."   The declaration, therefore,  on every occasion,  that
the sufferings of the patient arc  to be short and trifling, will  fre-
quently prove  false  in  the result, and the practitioner and his
pracfice will suffer more from  one failure of the fulfilment of such
a declaration, than they  would from fifty  refusals to predict the
time  and  degree or amount of suffering.  Whoever has  observed
even the brutes in the act of parturition, well knows that they ex-
hibit more suffering under these circumstatnees, than  under  any
 others in which they can be  placed.  I have seen them severely
 whipped without seeming to care much about it; but, in  the pains
 of labor, I have seen them shed tears freely, and heard them make
 the most piteous moans.  Some of them too, exhibit  signs of  suf-
 fering much severer than what arc apparently endured by others.
  The proper assurances from the practitioner, are, that the Bo-
 tanic  Pratice is far more efficient, in itself, than any other, in mili- 
49
gating the sufferings of the patient, in removing the obstacles to
delivery, in securing its safety, in hastening its termination, and
in protecting both mother and child against death or serious injury.
This is all true.  And he may with safety add, that he  will do his
best to apply this practice in the most judicious manner.
  Directions in regulating the Room, Bed, &c.—Justify and aid
the lady in making almost any change in her position that she may
desire, at least till the labor is far advanced.  Neither watch symp-
toms with manifest fear  and trembling, nor with  apparent indiffer-
ence  to them.   Endeavor to inspire, in the bystanders, the same
degree of composure that you exhibit.   This is best effected  by
calmly preparing every  thing that may, in any event, be wanted.
These things may seem  trifling; but I assure you they are matters
of no little importance.  All is generally believed to be well, when
an  attentive physician seems unconcerned about danger, and  ac-
quainted with his business.  Let  them  keep up  a good tire in the
room if the weather be  cold, somewhere else if  it be warm.  Let
them also keep plenty of boiling water; let them prepare a chair, or
a low bed, or protect the one she sleeps  on, by putting several
folded sheets between the feather bed and the lower sheet.  The
best thing yet devised for this purpose, is an India rubber or gum-
elaslic spread as large as an ordinary comfortable.  This is a com-
plete  protection.   Provide means lo  bolster her up or lay  her
down, on her back  or either side, and blankets to wrap up her feet
and legs whenever they  would otherwise be exposed to cold.  Keep
constantly prepared, cayenne, canker and nervine tea, with No.  1
steeped, or 3d preparation; have a pair of sharp scissors  and  a
small cotton orlinen string in your right vest  pocket, and avoid
making any examination  till the pains become severe and  fre-
quent, and then examine as carefully as possible.
   Attention to Position or Presentation.—When the pains
 become frequent and severe, examine the abdomen, and determine
 whether the head be directly over the pelvis.   If it be, all will be
well, (unless the pelvis be known  to be greatly deformed.)   If the
 lower extremity of the fcetus be evidently resting on the front (pu-
 bic) or side (illiac)  bones, lay the patient on the back or the oppo-
 site side, raise the  pelvis a little, put one hand where the  protu-
 berance was  and press  it against the  edge of  the  bone and the
 lower part of the abdomen; and,  with the other  hand, raise her up
 in  a sitting posture in the direction of  the first  hand.  This pro-
 cess will at once give direction to the  foetus in  the pelvis; repeat-
 ed two or three times, the chest, in raising, will accomplish the
 object, even though the fcetus were to lie directly across the pelvis.
 When this is effected, it matters little whether the feet or the head
 descend first.   A careful comparison of the records of "turning,
             4
2>£??^- 
50
with those of unassisted nature, has convinced me that attempts to
turn the forehead back, where the face presents, arc more danger-
ous than useful.
  Breach Presentation.—My friend, Dr. Tibbils, of Cincinnati,
was called to "a difficult  case."   Breach presentation,   lie en-
deavored to  bring down the feet, but found it impracticable with-
out giving pain, and even the risk of doing injury.  Not consider-
ing himself authorized to thwart the manifest resolution of nature,
he°contented himself with helping her in her  own way.  He gave
her lobelia and its helpmates, and she soon rid herself of a heavy
burden, breach foremost, legs and knees on the abdomen!   Thus
we see that  Botanic Physicians  find little  difficulty  in managing
those difficult presentations that frighten others so much.
   Instruments.—The only instruments that it is advisable for him
to carry, are a catheter, a syringe, and a pair of sharp  scissors.
Even Dr. Blundcll, of Guy's  Hospital,  London, says, "The very
fact that an accoucher, on all occasions, puts the lever into his
pocket when he goes to attend a labor, proves that he is an offi-
cious, a meddlesome  and therefore to my mind, so far, a bad ac-
coucher."
   Arm or foot presentation.—Should an arm, or a foot without
the other, present, raise the pelvis of the patient higher than the
shoulders, throw the whole fcetus back into the abdomen; then, af-
ter lubricating the hand with slippery elm, enter it into the vagina,
and the fingers into the os  uteri  so far as to prevent the hand from
descending  before the head; or,if the feet  present, to bring down
both together, the heels forward  if possible.   Then restore the
patient to the sedentary or the standing posture, the hand still pre-
venting a wrong presentation.  These last directions are to be fol-
lowed  only  when such a case occurs, which is not once in a thou-
sand instances.  1 here remark, and I  wish  it never to be forgot-
ten, that no manual operations, internal or external, are ever to be
carried to such an extent, as to cause the patient to forget her other
sufferings and attend to these.
   Symptoms during Labor.—Most frequently, and especially in
first labors, there is, says Dr. Blundell, "a great deal of cutting,
sawing and grinding felt while the mouth of the uterus is gradually
 expanding and the ovum is pushed  down.  In ordinary cases these
 pains, felt in the back, front and sides of the abdomen, below and
 in the upper part of the thighs,  attack the patient at pretty regular
 intervals of from twenty to thirty minutes: occasionally, however,
 we meet with women in whom the grinding and cutting pains are
 permanent, the patient complaining, and writhing perhaps almost
 incessantly, for hours together;" and Dr. Merriman observes that
 "the irritable state  of the os uteri, during the first stage of labor 
51      '
£that is, expansion of the os uteri and the descent,] very often pro-
duces, from sympathy,  shiverings and  vomitings; and, when the
cutting pains are  very frequent and severe, despondency and low-
ness of spirits generally prevail."
  But 1 would remark here, that the number, duration and seve-
rity of these "cutting, sawing and grinding pains," depend  very
much on the kind of treatment the patient may  receive.  If due
Care be taken to have the system properly and sufficiently relaxed,
as will-be directed  in  the  Lecture on '-Ways and Means;" the
"cutting, grinding and sawing" will be reduced to comparatively
asmall matter, where, if the antiphlogistic and sedative treatment
were pursued, it might be thought necessary to "aid the too feeble
powers of nature, by the  skilful  use  of instruments!"  I need
scarcely  say that  the relaxations should be produced by steamings,
fomentations, lobelia liniments or poultices &c, with warm appli-
cations to  the parts, of  bricks, rocks,  boiled wood or  bottles of
boiling water &c.  After these pains  have  continued some min-
utes or hours, seemingly without much effect, the  woman begins
Seriously to exercise every muscle of her body, as if to force away
the offending cause.  She  seems desirous  to get  a fast hold  of
something that is  firm, as a by-stander's hand, or a handkerchief or
cord, tied to the bed post, and to fix her  feet or knees against the
same support so that she can pull smartly when the pains  are Se-
vere.  In these matters she should be indulged and assisted.
   Natural Parturition—When the  head  of the fcetus descends
first into the pelvis, and the efforts of nature are sufficient, (at most
with a little assistance  from medicine, and attention to the posi-
tion and movements of the patient,) to  expel it in a reasonable
time, (some say twenty-four hours after the discharge of the waters,
and the commencement of the labor pains,) and with no extraor-
dinary degree of pain and suffering, the parturition is said to  be
n-  rural.  In this case, the delivery is sometimes  effected immedi-
ately, as in women who have borne many children, whose pelves
are Lt ge, and in whom the parts are well  relaxed.   Instances have
been  known  in  which  the first severe pain  entirely expelled the
fcetus.   Generally, however, the process is more gradual and pro-
tracted.
    Descent of the Head into the Pelvis.—During these mus-
cular exertions, the head generally descends into the pelvis.  It
usually starts with  the face and crown towards  the illiac bones,
and the  ears forward and backward; and, after passing the upper
strait, the crown  (very rarely the face) turns forward, which direc-
 tion it continues  till it is ushered  into the world.   As  the foetus
descends into the pelvis, the waters of the amnion push that mem-
 brane before the head, in the form of a bag  which generally opens 
                              52

 the os uteri, descends into the vagina and breaks of itself, before
 it passes through the  os externum, discharging generally a thick,
 ropy, sometimes thin fluid, called the amnion waters.  When the
 Itains are severe, the membranes are tense; when off, they are re-
 axed.  It is not best to rupture them till they  protrude  entirely
 through the os externum.  The discharge from different persons is
 from a gill to a pint or more.
   Rupture of  the Membranes.—-"It is not always a rupture of
 the membranous cyst containing (he child, that takes place at this
 time, for we may have a rupture of another receptable, this [gene-
 ral]  membranous receptacle being composed  of three thinner tu-
 nics, one  lining the other, and the water may issue  from  the bag
 formed between the decidua and the chorion, that is, the two outer
 linings; a considerable discharge may  be produced in  this man-
 ner."   It were of little importance to mention the fluid, but to
 prevent alarm at its appearance.   It may be  repeated in  cases of
 plurality of children.   After  the rupture of the membranes, the
 head generally descends pretty rapidly into the pelvis, till  the face
 lodges in the hollow of the sacrum, the crown under the arch of
 the pubis, the sagittal suture on the perinasum, and the chin upon
 the chest.
   The  Perineum.—It frequently becomes  now the duty of the
 practitioner to guard the perinaeum from injury, which he may do
 by placing his forefinger upon it, with the inside of the hand next
 the child's head, and pressing gently downwards and backwards,
 during the existence of the pain, with design to get it underneath
 the head.   In this way there is little danger of rupture or injury to
 the perinasum, especially if proper care has been  taken to have the
 parts well relaxed.  The position of the hand that I recommend,
is much better than that in which the inside rests on the perineum,
 for it places the accoucher in the proper position to attend to the
 fcetus as soon as it is presented.
   Umbilicus.—After  the head is  delivered, there  is usually a
 pause for a few minutes for another pain to expel the body.  Du-
ring  this interval, endeavor to ascertain whether the umbilical cord
 is  wound  round the neck; and, if so, disengage it if you carl; if
not,  endeavor to keep the head and navel of the child as  near as
possible to  the os externum of the mother till it shall  be disen-
gaged, when you may turn the head towards the mother and easily
 extricate it.  Endeavor also to disengage  the face of the foetus
 from the membranes, and  to clear the mouth  and nose as soon as
 possible, lest it take the mucus, water or blood,  into the lungs in
 the act of inspiration, and thus strangulation take place.  When
 the child breathes and cries strongly, and the pulsation in the  um-
 bilical arteries ceases, tie a small  string or large twine round the 
53
umbilicus, about a half inch from the place where it ceases to be
of the same color as the body of the child, that is, generally about
an inch from the body, and another an inch or two from this, leav-
ing one end of this last string a foot or two long.   Let both be
tied twiccor three times round, and drawn so closely as to prevent
the circulation, but not so as to cut the umbilicus.
  Now cut, with a pair of sharp scissors, the umbilicus, between
the places where it is tied.  The reason why I tie the last knot is,
I have seen two cases in which every other part of the placenta
was detached  from the uterus before its edges  were, and conse-
quently it formed a sack filled  with blood which stopped the fur-
ther bleeding of those  arteries in the proper way.  Had the end of
the umbilical arteries  been open, there  would undoubtedly have
been a hemorrhage through them, till the placenta was disengaged.
  The Child.—It is my practice to have ready a pan or small
tub to wash the child  in.  I have also a tea-kettle or other vessel
full of boiling water and a pail full of cold.  From these two, I put
into the basin, pan or tub, a gallon or two, so combining them as
to make the whole neither warm nor cold to my own flesh at the
naked elbow.   As soon as the face appears, I endeavor to clear it
of blood, water &c, which might otherwise be taken in with the
first breath and produce strangulation.   If the child is completely
discharged and has not breathed, I dash a little sprinkle of cool
water directly along the spine.  This will contract the muscles
that connect the ribs with the lateral processes of the spine, and of
course expand the chest, which is the first step in the  mechanical
process of breathing.  (Lightly  rubbing the spine also will aid the
muscles in expanding the ribs.) A similar sprinkling may then
be dashed upon the breast and upper  parts of the chest.  These
must be done with water that is pretty cool.  If the sprinklings do
not succeed, immersion in the  water  prepared for washing, but
made warmer, say  (95 to 100 degrees) about as warm as will be
made comfortable to your naked elbow, will do much.  fLn  aid of
these means, put a little strong cayenne tea into the mouth, or into
the stomach from  your mouth, through a silver tube.   In roost
cases these processes will be found sufficient.
  Various other means have been resorted to  and recommended,
to aid the process.   It will be remembered that Dr. Thomson re-
commends the placing of the placenta on embers,  and stripping
the umbilicus towards the body; but it is evident that this cannot
be done when the placenta refuses  to come  away  immediately.
And if it could, there  is no reason to believe that the smallest ben-
efit can be derived  from this process.   In the case mentioned, the
child would  have breathed without it.   I lately attended a case
where  the child breathed and cried, eat and slept, more than twen- 
54
ty hours,  before  the placenta was removed.  Some stop up the
nostrils and blow into the mouth, either with their own mouth or
with the bellows.   Dr. Blundell says the mouth is the best, but he
recommends the use of a silver lube which he enters through the
larynx, and hence he calls it the tracheal pipe.  There is  reason
in the use of this instrument, for it  will inflate the lungs; whereas,
blowing with the  mouth or a  bellows, is as likely to inflate the
stomach as the lungs, and, of course, it does little good.   This in-
strument has the rare  recommendation that it is not likely to do
much harm if no good.  It is certainly worthy of trial, where it is
found impracticable lo accomplish the object in the ways 1 have
before recommended.  Stimulants lo  the nose, as bay berry or
hartshorn, may also be used to advantage.
  There is no harm in persevering in the use of means of this  sort,
for you can but fail; and instances have been known of success af-
ter more than an hour's apparently fruitless labor.—[See Blundell;
page 184.]
  The tracheal pipe is made just like a catheter of a large  size,
and India rubber would doubtless be preferable to silver.   "I  pass
the fore-finger of the left hand," says the Doctor, "down upon the
root of the tongue, and into the rima-glottidis, and then, with the
right hand slide the tube along the surface of the finger, till, reach-
ing the  rima, I insert it at the moment  when the finger  is with-
drawn from it, afterwards feeling on the  front of the neck whether
the instrument  is  lying in the trachea  or the aesophagus.   [It
should be the former of course.]  This  done, you  may take the
child into your hands and inflate its lungs from your own, empty-
ing them by a double pressure with your hands on the thorax and
the abdomen, the latter being necessary  to  raise the diaphragm."
This should be continued, alternately inflating the lungs  and ex-
pelling the air till 25 or 30 respirations are performed in a minute,
by the  power  of the child, when the instrument  may be with-
drawn."
   If the child cries and breathes strongly, it may be severed  from
the mother  by tying and cutting  the umbilicus  as already direct-
ed.   It may now be given to some female attendant to be washed
and dressed.  Let her wash it  in the  water above mentioned;
then put a wide strip of linen or cotton about the body loosely, but
in such a manner as  to keep the portion of the umbilicus of the
child, with a little bunch of rags upon it, in its proper place. Some]
times it is advisable to make a little hole in some  of the rags put
 on, to allow room for that portion lo rest in.  Now dress it loosely
 and warm,  not covering the  face, and lay it  in the lap or in a
 crib.
   Meconium.—You will  often be annoyed with entreaties to give 
55
 the child some kind of physic, to carry off the meconium, or first
 excrement.  But  you should reason against  the  conduct, affec-
 tionately but firmly, unless there is satisfactory evidence that the
 child is actually sick, as choaked with plegm or pained wnth wind
 or something else, when your  treatment  should be the  same in
 character thai you prescribe  to a  grown person, but milder in
 degree.
   It is reasonable to suppose that the child is much fatigued by its
 severe compression, during  its  passage into this new world;  it is
 therefore very proper, and perhaps always  advisable, after washing
 it clean (which can be done in a few minutes) to wrap it up suffi-
 ciently warm, and not  attempt  to dress it till it has had an hour
 or so for sleep and repose; and this hour, as, in  general in its other
 sleeping hours, should be spent in its cradle or  crib, or on an even
 bed; not in the uneven and uncomfortable and constantly changing
 lap of the nurse.   When it wakes, it may be  dressed carefully as
 before mentioned.
   Second Fcstus.—Generally,  each fcetus has its separate  pla-
 centa; and, in such cases, where there are twins, the placenta of the
 first sometimes comes away before the birth of the second.  Some-
 times, two placentas  are so connected that the one cannot come
 away without the  other.  In this case, direct  efforts to disengage
 the first  placenta  before the second  birth, would  be improper.
 Always satisfy yourselves, therefore, that there is not another foe-
 tus,  before you make any considerable efforts to disengage the se-
 cundines, by rubbing the abdomen directly  over the uterus with
 the  hand, not so  hard  as to  produce pain.  If there be no other
 child, that organ will immediately contract to  about the size of a
 child's head, and be felt as such just above the pubic bones. The
 abdomen being now very flaccid or loose, the hand will be able to.
 grasp the globular lump.  But, if there be another child,  the ute-
 rus will still  be large, and the  abdomen but partially reduced in
 size, or the muscles in tension.  By internal examination also, may
 be discovered, through the os  uteri, the watery  sac, formed by  the
 membranes of another child;  and the bursting forth of those waters
 insures the existence of another  foetus.  The  same means are to
 be used for the discharge of this fcetus that were used for that of
the former.  If there be no other child, the placenta or the lace-
rated membranes alone wdll be felt internally.
   Placenta.—It now becomes the duty of  the aceoucher to attend
to the delivery  of  the  placenta  and  the membranes, v. hich, with
the umbilicus, are called the secundines.  Give  the patient a little
tea of cayenne, raspberry and nervine, and^wait for the effort of
the uterus to  disengage the placenta.   If the pains do not occur in
fifteen or twenty minutes, rub gently with the left hand, the abdo- 
56
men, directly over the uterus, not so hard as to give pain, holding
the right in readiness to receive the secundines.   The gentle fric-
tion will cause the uterus to contract, or, in other words, invite the
recurrence of the pains which may be  aided by giving more cay-
enne tea.  If now the pains be severe  and ineffectual, it is either
because the placenta strongly adheres to the uterus, or because the
os uteri or the os externum is strongly closed upon or against it.
If the patient is able to be placed over the vapor bath, this will be
the best means of relaxing the parts, stimulating the uterus to ac-
tion, and disengaging the offending matter.   If not, give warming
medicines and apply steaming bricks or  cloths wrung out of hot
water to the  parts, and keep the feet warm.   Perseverance in this
course will finally effect the object.  (In case of flooding, which
will rarely if ever occur under the above treatment,  gives strong
cayenne tea, and an injection of strong witch hazle and a little
cayenne to the vagina.)   Never fear to wait for the efforts of na-
ture, aided only  by innocent means and processes, to  disengage
the placenta.  Many instances have occurred in which it has re-
mained not only for hours but for many  days, even fifteen or twen-
ty, and then  come away without either danger or inconvenience
to the patient.
   Sometimes the placenta is detached from the walls of the uterus,
but still enclosed within it; sometimes a part of it descends inlothe
vagina and the rest is enclosed firmly  in the neck of the uterus
which collapses upon it; or it descends entirely into the vagina and
is prcvedted from final disengagement by the rigidity of the exter-
nal parts.  The regulars arc very much frightened at  these things,
and forthwith often attempt to effect the delivery by manual force.
Whoever will examine the reports of  cases treated  in this way,
will be persuaded that where one  has been benefited hundreds
have been ruined by officiousness.  So many instances have oc-
curred in the practice of the Botanic brotherhood, in which nature,
a little assisted by relaxant and stimulant treatment, has done the
work with ease, after a powerful force had been long used in vain,
that it would be inexcusable in us to despair of a happy result of
judicious treatment, and unpardonable, in any  case, to allow the
direct  force of man to be used in disengaging either  the placenta
or the fcetus.  Dr. Dewees has been extremely nice in pointing
out the various ways and times  in which  the uterus contracts, in
order to expel either the fcetus or the placenta.   The whole  mat-
ter, however mysterious he has made it, is resolved into this:  The
only reason why the uterus relaxes or contracts partially is, because
there is not living action enough in the system to produce it gene-
rally.   If, therefore, in  any stage of the  labor,  or after delivery,
the parts are too rigid, make a more liberal use of lobelia, nervine, 
57
 and the vapor bath, or warm  and moist applications in bed.  If
 there be, on the other hand, no effectual effort,  or if the efforts be
 few and far between, cayenne is your agent.  Use these remedies
 with nervine, with discretion and steady perseverance, and you
 may burn all that Dr. D. has said about unequal contractions of
 the uterus, and the difficulties they oppose to parturition.
   In a case I lately attended, the placenta refused to come away
 immediately.  The child was born about 4  o'clock A. M.   I sa-
 tisfied myself, by slight trials, that efforts sufficiently violent to bring
 away the placenta, would give much pain  and  suffering.   It ap-
 peared very large, and was doubtless partly enclosed in the  neck
 of the womb; just what  Dr. Dewees would consider a very bad
 position.  Although a part of the placenta was  in the vagina, the
 origin of the umbilicus could not be  reached; and yet it appeared
 to fill the whole pelvic cavity.  The  lady was fed and suffered to
 go to sleep.   Examinations were made at three different times, to
 ascertain whether any progress had been made in the delivery. At
 9 P. M. the external parts were contracted nearly to their usual
 dimensions, and so rigid and sore that it was painful to introduce
 a finger.  Warm applications were made, and  the patient suffer-
 ed lo sleep again as she had done the most of the day.  About 2
 next morning, 22 hours after the birth of the child, the lady rose,
 and, while sitting upon a vessel, the placenta was discharged with-
 out pain.  The parts relaxed of their own accord, and then there
 was ample room.  On examination, I found  the placenta studded
 with hard pillars, and, on the uterine surface,  many little bony
 scales which preserved the remarkable size of the viscus.
   Notwithstanding my advice to keep her bed as long as her pa-
 tience would hold out, she was about her house five days afterwards.
 1 am persuaded that, had the placenta been taken by force, serious
 injury might have been done.
   In general the expulsion of the placenta is accompanied with a
 discharge of blood which  has accumulated either in or behind it
 This is no cause of alarm, but it may  be well to see that the bed is
 protected against it.
   Authors recommend a moderate but steady pull  at the umbili-
 cus, to aid in the delivery  of the placenta.  Against this conduct
 I enter  my protest.   The  cord is usually inserted in the middle of
 the back of the placenta, so that when that  portion is brought for-
 ward, it presents the greatest  surface to the external orifice, and,
 of course, meets the  greatest resistance in its passage.  I always
 allow the umbilicus to lie loose, and even to fall back, if it will,
 while, with the first and second fingers of my right hand, I get hold
of the edge of the cake or of the membrane,  and  bring it forward.
Thus the  placenta is drawn  edgewise through  the passage, and
meets little resistance. 
58
   Contractions  of  the Uterus.—Writers on Obstetrics, seem
very anxious about the contractions of the uterus, both before and
after the delivery of the placenta.   They wish these contractions
to take place partially before the delivery, because they know that
they are the best  safeguards against both hemorrhage and inver-
sion.  They do not wish them to be complete till afterwards, lest
the placenta be confined and produce mortification!  Hence their
great anxiety and often very imprudent efforts to bring away the
placenta by force, if  it should not come away of itself within half
an hour or an hour from the delivery of the child.   While, there-
fore, they enter the hand into the uterus for the purpose of disen-
gaging the placenta, they use  various means to produce uterine
contractions, as rubbing gently the abdomen, grasping the uterus
carefully with the hand, putting the child to  the breasts, adminis-
tering brandy or some other cordial &c.  If they fail to produce
the contractions,  they sometimes turn the uterus inside out,  by
bringing the fundus  down through the mouth, into the vagina, and
thus they ruin the patient;  or, if they separate the placenta from
the walls of the uterus,  before that organ contracts, there com-
mences, from the expanded mouths of the vessels, a hemorrhage
which is often rendered fatal by the injudicious use of ice  and sugar
of lead, to suppress it!
  If the strength of the patient be supported, the uterus will do all
its work  in proper time and order.  Its contractions will, at the
same time, break the  connexions between it and the placenta, close
the mouths of the  vessels thus broken, and so thicken its walls as
to render inversion impossible.   This is all that is wanted, and
nothing is better calculated lo effect it, than the administration of
cayenne  and raspberry lea, and the slight friction of the abdomen
with the hand, or, at  all events, the judicious use of the vapor bath.
Contractions thus effected,  will be uniform, general, powerful and
permanent.
  "There are four very different conditions," says  Dr.  Blundell,
"in which the womb may be  found immediately after delivery;
sometimes it is lax, and nearly as large as the adult head; some-
times small and soft,  not bigger than the head of a full grown foe-
tus; sometimes small  and rounded, and as hard as a cartilage or
the head of a foetus; lastly, it may be very hard at one moment
and very soft at another."   We must determine these conditions
by an external examination of the abdomen.   The  contracted,
round and permanently hard condition is what he likes.
  Now, as this condition is the perfectly natural condition of the
organ when not pregnant,  we might well suppose, what experience
proves universally true, that the  best way to  produce it, is to pro-
mote a general, healthy action through the system.   I  have seen 
59
a case of the protruding piles [prolapsus ani] completely reduced
by a single steaming, after it had long resisted almost every other
means for its contraction.   This is a means then, which f would
recommend to be used with much confidence, whenever the pa-
tient is tired of waiting to be  "cleared."
  As I have known much mischief to be done by the "forcible de-
livery of the placenta," as well as of the child; I must be permit-
ted to make here, a few quotations on  this head.
  Injudicious removal of the Placenta.—"When the placenta
is rudely torn away by the accoucher, the worst consequences may
be expected.   Floodings, tremendous lacerations, inversions  of
the uterus—such are  the effects of obstetric violence—ferocious
and atrocious obstetric violence; that  insatiate and gory Moloch,
before whose shrines so many  thousands have been sacrificed,  to
be succeeded in future years, by still more numerous  victim?."
  "Observing the awful consequences resulting from  the artificial
separation of the placenta, Ruysch first, and afterwards Denman
and Hunter, recommended that, in all cases the expulsion of the
placenta,  like  that of the foetus, should be left lo  the natural pow-
ers; for, they argued, 'the same natural powers which are adequate
to expel  the  child, are  surely adequate to expel the placenta
also.'"—Blundell.
  "There is no doubt that if our women, unaided by art, were left
to their natural powers altogether,  like the females of  barbarous
hordes, in a great majority of cases the placenta would come away;
but,  experience is  said to have shown that, in  some such cases,
fatal consequences occur.  Many cases  are said  to have occured
in which floodings took place.  [The  cause of the floodings is not
the presence of the placenta, but the neglect of restorative treatment
to the patient.]  Some, in which the placenta was long retained,
could not afterwards be abstracted; and, when  remaining unex-
pclled for two or three days under the procrastinated use of means
to extricate it, the greatest injury has been inflicted.   [I  have seen,
myself, great  injury inflicted by the use of these  means,  but I am
very sure that, provided  the strength of the woman be supported,
a placenta may remain and rot in the uterus, and be discharged in
the form of putrescence, without doing so much injury  to that or-
gan as is often done without  the least necessity, as  Dr. Dewees
says, "by the rude  and ill-judged manoeuvres of officious hands."]
So that the practice [of waiting for  the efforts of nature] brought
to trial in Holland under the authority of Ruysch, and in England
by the advice  of Drs.  Hunter and  Denman, has now  been  laid
aside, probably not without good reason."
   They laid aside the wrong part of the practice, the  "waiting"
instead of the leaving of the powers unassisted.   The true reason, 
60
is, that, in the cases where injury resulted, either nothing was done
to strengthen the woman in aid of the efforts of the uterus, stimu-
lants and food being forbidden; or that means were used that were
calculated directly or indirectly to destroy those efforts,  as the ex-
hibition of opium to quiet the nerves, sugar of lead and sometimes
even the use of the  lancet to prevent flooding &c.
   "It seems, therefore, to be pretty well agreed, among  those that
are competent to form an opinion, that, though we are not to be
injudiciously and rudely tearing at the  placenta, it is necessary,
nevertheless, that some artificial assistance should be given; and
the greatest and nicest, perhaps the most important of all ques-
tions in the management of natural labor, is the discrimination of
the moment at which  the assistance ought to be interposed? Shall
we interfere immediately?   Shall we wait for an hour? or even
still longer before we bring the placenta away?"
   Truly, I say  also, some artificial assistance ought to be inter-
posed, and that assistance should be, first, a little good stimulating
tea, and  then rest until the living energies are refreshed:  Then a
stronger  dose of cayenne, and, if necessary, steam and lobelia to
help it; when the work  will be sure to be quickly done and well
done.  As to the questions, Shall we interfere immediately, or
after an hour or more? that will depend altogether upon the con-
dition of the patient:  if she is sinking and needs restoratives, give
them at once; if not, let her rest till the fatigue of her recent la-
bors has subsided; then  commence your aid, not abuse, and it will
be kindly received and properly used.   Minutes  and hours have
nothing to do in the matter.
   "By different  practitioners different  rules may be prescribed;
some recommend taking the rule from time; say four hours after
the birth of the child.  Others judge by the pains without regard
to time.   Pains, they say, accompany contractions, which expel
the placenta, therefore they seat themselves at the bedside, refrain-
ing for one or two hours from manual interference if no pains oc-
cur, but, as soon as the  pains occur, following the track of nature,
our best instructress, they lay hold of the umbilical cord, and en-
deavor to bring the  placenta away. Nor is this rule lo be despised."
   The only difference I make in this practice is, that, if the pains
are postponed long, I give stimulants &c, to arouse them again,
and advise little if any pulling at the chord.   "Others are gov-
erned  solely by the  situation of the placenta.  If they feel it in the
upper part of the vagina, and especially, if they feel its union with
the umbilicus, *hey  do not hesitate to remove|it.  But, if the  um-
bilicus ascend high  into the uterus, and no part of the placenta
can be felt, they wait.   Of the three rules enumerated, I think, on
the whole, the last is to  be preferred.  In ordinary cases, you can- 
61
not err in abstracting the placenta when lying in a great measure
out of the uterus, while there is always a risk in removing it when
it lies in  the fundus of the uterus, and not only a risk, but a diffi-
culty.  There are yet others who determine the propriety of inter-
ference, by  the feel and condition of the uterus.   If it present a
permanently indurated and globose mass, they consider that a tho-
rough contraction has taken place, and that the placenta may be
safe'y removed.   Not to dwell on single indications, I would re-
commend a practice forming itself under the influence of all these
considerations, a rule of composite order.
  "Before you think of removing the placenta,  it is your duty to
ascertain  whether another  child be lodging in the uterus;  for, as
a general practice, it is improper to remove the secundines of for-
mer children, until those remaining in the uterus have been expel-
led.   Rupture of the  funis,  suffocation  of the unborn  fcetus, in
consequence of the premature abstraction of the placenta, per-
haps common to both, not to mention those floodings which we
shall hereafter contemplate, must  in some cases  ensue, where this
caution is unwisely neglected; and you ought, therefore, to inves-
tigate this point with the nicest care, before you attempt to remove
the placenta.  Again,  by all means, unless there be hemorrhage
more than ordinary, wait for half  an hour before you operate, for,
at the end of this time, you will generally find that the womb has
reposed itself,  that its fibres arc contracted, and that the placenta
may be taken away.  Examine further, with nicety, the condition
of the  uterus; if contracted,  globose  and indurated, you may ex-
tract the  secundines with more confidence;  but, no flooding forbid-
ding, you had better delay the delivery even beyond the hour,
when the womb, whether contracted or capacious,  is found to be
soft and pulpy.
  "Lastly, if you find the placenta lying so low that you may lay
hold of its body, the half hour being  expired, you may remove it
with promptitude; but perhaps you  had better delay the removal,
even though the glass be  run out, provided the plncenta be still
lying beyond the touch of the finger.
  "Here then are the four  cautionary points which  I wish  you to
remember.  Before you abstract the placenta,  ascertain always
that there is no other child in the uterus.   Satisfy  yourself that
the womb is permanently contracted.  Wait half an hour after
the birth of the fcetus, no particular symptom forbidding; and re-
member that it is always desirable that you may feel  [with your
finger] the insertion of the funis or the body of the  placenta, be-
fore this viscus is taken away."
  The above, condensed from Dr. Blundell, is, I think, on the
whole, the most judicious advice on the subject of the indications 
G2
for removing the placenta, that are to be found among the writ-
ings of the regular faculty.  To what does it  all amount, but
simply this: When the energies of the uterus have so far recovered
from the fatigue of their exertions to expel the child, as to become
sensible to tlie irritation of the still offending placenta, their first
effort is  to disengage it from the walls of the uterus,  and  their
second, to  expel it.   When it is  discharged  entirely into the va-
gina,  the  uterus contracts to a  comfortable condition,  and  its
pains cease.   Wailing now for a pain  to remove the placenta,  is
useless.  Labor pains are not felt in the vagina.   If, therefore, the
external  orifice  be contracted,  and the part rigid,  the placenta
may remain  here for a long  time, without the least effort of the
system to disengage it;  but, if the patient stand upright, or sit in
a convenient posture over the vapor bath, the parts will be warmed
and relaxed, and the  weight of the viscus alone will be sufficient
lor its expulsion.—Try it.
   Such have  been the mischiefs produced  by inversions  conse-
quent on forcible delivery,  while tlie  uterus is relaxed, its mouth
open, and the placenta attached to its fundus, that  most  women
are afraid to stand on their feet directly after child-birth, lest the
uterus  "fall through the vagina!"  They may rest assured  that,
where  no mechanical force has been used in the delivery  of the
child, and  where the powers of the system are properly sustained
by suitable food and  nature's restorative medicines,  this justly
dreaded condition of  things can never take place.   Dr. Blundell
very correctly argues that, "'when the uterus is properly contracted,
inversion is perhaps impossible."   A  proper treatment  of the pa-
tient, to the  exclusion  of all  improper treatment,  secures,  with
certainty, the proper contractions of the uterus;  and thus renders
it  perfectly safe for the patient  to stand up,  if she is  able; and
few will  be the instances in which, if she  is properly treated and
has no debilitating disease  upon her, she will not be able.   I will
now again give a few directions which may be safely and success-
fully followed in all cases  where there is not known to be a de-
formity of the pelvis  so great as to render parturition impossible.
   After the birth of the child, give the lady a little strong tea of
raspberry,  witch hazle and nervine, strained, and cayenne added
in quantity suited to her condition.  Give also a little nourshing
food if she have not eaten  within six hours.
   Now endeavor, if it can be done without force,  to remove the
placenta.  Rub the abdomen over the uterus, (not  so hard  as to
give pain,) put the child to the breast,  and,  if the parts are  rigid
and the placenta refuses to come away without a force that  gives
pain, inject  lobelia and slippery elm into  the vagina.  If the
uterus is contracted  into a tmall hard lump lying  just above the 
63
pelvis, and the insertion of the umbilicus can be felt by the finger,
push that part back, book the finger into the edge of the placenta,
or take hold of the edges of the membranes,  and bring it away.
If it refuses to come by the use of these means, then sit by her
side, and require all in the room to be perfectly still, the windows
being darkened by  shutters or blankets or some  such articles.
Cover her warm, especially her feet and lower limbs, put a steam-
ing stone or brick, or a poultice of slippery elm &c, which is bet-
ter, near the genitals, and let  her sleep if she will,  and  as long as
she will,  provided her pulse be good.   If this sink too low,  wliich
will seldom  occur,  wake her and give  her  a little cayenne.
When she wakes, if the  placenta be  in the uterus, there will be
pains resembling those of labor; if, in the vagina, there will be
none of any importance.   In cither case,  let  her  rise  and stand
or walk.  Or the means may be used before she rises, to produce
the contractions of the uterus, and, of course, the  descent of the
placenta at least into the vagina.
   If the placenta be entirely discharged,  well; if  not, apply the
vapor bath,  and your object  will soon be  accomplished.  If the
placenta be not disengaged from the uterus, there will be so much
as lo prevent sleeping; and, of course, she had better rise as  soon
as she feels sufficiently rested for that purpose, and  the means
above directed must be used.  I object  to pulling much at the
umbilicus, because, being inserted generally in the middle  of  a
thick cake, it directs the discharge in such  a way as to present the
greatest possible  resistance.   If,  instead of this, you hook  your
finger into the membranes, you will present the edge of the pla-
centa, and thus really facilitate  the  discharge.   In  several in-
stances, being satisfied that tlie placenta was entirely  in the va-
gina, I pulled  upon the cord till I felt  some of its fibres give way.
1 desisted and  watched the operations of nature.   She  gradually
turned the insertion of the umbilicus towards one side  and out of
my reach,  so  as to present one edge  of the placenta,  when the
whole was immediately  discharged  without  effort or pain.  A
word to the wise is sufficient.
   As to the  danger of leaving the placenta to be  discharged by
decomposition and piecemeal, it is all  a bugbear.   While it main-
tains its hold on  the uterus, it retains its vitality; and, of course,
will no more mortify that organ than  the  vagina or the fallopian
tubes  will.   As soon as it or any part of it loses its vitality, the
uterus contracts beside that part and casts it off. It now becomes
a foreign  body in the uterus, and as such, the neck and the os  uteri
relax  and let it pass, as they do  the menstrual fluid or the full
foetus.  All that is wanted is to maintain a  healthy action through-
out the general system,  and  to a;d it  by steam, lobelia and other 
64
relaxants,  whenever it manifests a readiness to discharge the of-
fending matter.  For proof of the truth of these doctrines, I need
only refer to the facts that many women have carried children far,
even  a year beyond the time, and those children have mortified
and come away, some of them even through the walls of the abdo-
men,  without materially injuring, much less mortifying the mother.
   They that fear inflammation and mortification, will do well to
refuse all  aid from steel,  (except in  cases of malformed  pelvis,
which will hereafter be pointed out,) and even from " the rude and
ill-judged manceuvres" of the least "officious hands."
   Floodings.—I have  given  no directions for removing the pla-
centa immediately and by force, in consequence of floodings ; for,
if the directions I have given for the management of delivery, be
strictly followed, floodings will rarely if ever take place; and, when
they do, will be arrested in a very different manner.   But as our
friends will often be called to arrest floodings that have been  com-
menced by the bad management of others, 1 will here state that the
plan to arrest them is, first, to give very hot medicine; secondly, ap-
ply warmth to the extremities and the surface generally, by steam if
convenient, if not,  by bricks &c; thirdly,if the child is delivered,
give strong injections of which hazle tea, nervine and a little cay-
enne, to the vagina. Should the fcetus not be discharged, this plan
would not be improper in severe  flooding.   If the time be come,
it will produce a separation of the placenta from the womb, and of
course parturition; if not, it will close  the mouths of the blood-ves-
sels that have been laid open, and stop the hemorrhage, leaving the
fruit to ripen still longer before it  falls.
   Remember, to restore equilibrium to the circulation, that is, to
relax  and expand the constricted  blood-vessels and close, with as-
tringents, the open mouths of otheis, is  to check hemorrhage wher-
ever it takes place.
   I have said that  the patient might rise and  stand or walk, for the
purpose of disengaging the placenta when you are sure that it has
descended into  the vagina.  Some may be frightened at this direc-
tion, but I  can  assure them this  is the way ladies have generally
done it in such cases, under my management. " When the uterus
has been  properly contracted," says  Dr. Blundell, " prolapsus is
scarcely possible." If,  however,  from  previous disease, much fa-
tigue  at the time, a still relaxed state of the uterus, or any other
cause, she should not wish to rise, she may be lifted into a chair,
or raised up in the bed, or relieved by warm  injections of slippery
elm and  lobelia, where she lies, care  being taken as before men-
tioned to protect the bed.   Any disposition to  flooding must be
checked  by taking hot medicines and  steaming by witch hazle in-
jections to the  vagina: and by slight  friction over the region, of 
65
the uterus, which will cause it to contract and close the hioiiths of
its vessels so as to prevent hemorrhage.  But I insist upon it that
no artificial force be used, nor officious handling be allowed to dis-
engage the placenta, that will give pain or distress to the patient
  Dr. Blundell,  speaking, page 172, of the appearance of a pla-
centa which had been taken away by force, says, " Do not need-
lessly pass the hand into the uterus, the vagina, or  even  the ge-
nital fissure; is the voice of this preparation;—he that hath ears to
hear let him hear it.  Ah! that violence of an  ignorant and sav-
age hand! After examining these  preparations, tell me,  is it loo
much to assert that, in obstetrics, a thrust of the hand is more dread-
ful than a thrust of the bayonet? Could the field of Waterloo ex-
hibit injuries more dreadful than these?"
  Let  it alone till  it comes away of itself.   A case is reported irt
the Edinburg Practice where one remained fifteen days, another
in the  Boston Medical and Surgical  Journal where the placenta
remained twenty-four days.  They both came away without the
least pain to the patient.  I saw one remain  six hours, another
twenty-one or twenty-two, and then both came away themselves;
but they generally come away in a half hour or so*
  Putting to bed.—Soon after the placenta &c, are discharged^
she should be put to bed as it is called, that is, washed where ne-
cessary, with warm water, by means of a sponge or cloth, her wet
clothes removed  and warm and dry ones put on her; a broad band-
age may be put  round her, and she be put either into another bed
or a dry and  comfortable part of the same.  She should also be
provided with a  soft, spongy linen  or cotton cloth of many thick-1
nesses  to absorb  whatever may be discharged, and  this should be
removed as often  as necessary.   The external  parts should be
mollified with sweet oil, and a steaming brick or stone placed near
them  to  prevent  swelling, inflammation  and  soreness*  This
warmth should be kept up for several hours, say six to eighteen, Or
till the soreness  is  entirely gone.  The cloths will of course be
continued as long as there is occasion for them.
  She  should now be fed again, and permitted to rest and deep
as long as she appears comfortable.  The food should be light and
nourishing and given in reasonable quantity.  A  bowl Of bread
or mush and milk, of chicken soup &c, almost any thing she wants
may,make her meal.  If puerperal fever should arise, it comes as
a friend to tell you of a cause which you must at once remove*, by
a course of medicine.
  Lactation*—If the application of the child produces the secre-
tion of milk, well: if not, a lobelia and slippery elm, or bass-wood*
Linn, (Tilia) poultice, sprinkled on its surface with camphor, will
keep the breasts  from hardening and inflaming, and relax the ori"
            5 
66
fices and let the milk escape.  It will  be sure  fo prevent  sore
breasts—mark that.
  After pains.—Keeping the patient warm, especially the feet
and the pelvic region, will secure  her against after pains, puerpe-
ral fever &c, in all ordinary cases.  When these means do not
accomplish this object, remember the course of medicine.   Altcnd
to her for six to ten days,  removing at once every difficulty, and
she will, in all ordinary cases, be about her business.
  Cleaning the child.—On page 53  I  have given directions
concerning the treatment of the child.  I here add that you should
be careful to get off the greasy and yet  wax-like substance  that
adheres to its whole body.  Strong soap suds will do it;  but, Dr.
Dewees says, that the process is rendered easier by first rubbing,
for some time, hog's lard upon it,  then using the  soap and water,
by means of a piece  of flannel or other cloth.  This should be
done in a  warm room by  the lire.  No  spirits of any kind should
be used.  They evaporate quickly, and of course leave the surface
cold.   But for their stimulating properties, instead of preventing
a person from  taking cold, as is generally supposed, few things are
so well  calculated to make one take  cold.   Vinegar is equally
stimulating, without  either the poison,  or the  evaporating  and
cooling property of alcohol; but neither is wanted  in this case,
unless it be to revive the apparently sinking child, when vinegar
and cayenne should be used, and  a little volatile salts or camphor  |
put to the nose.
  Dressing the child.—In dressing  the child, Dr. Dewees says,
"Pass the  remaining portion  of  the  chord [left on  the  child]
through a hole in the centre of a piece of linen rag, seven or eight
inches in length and about two and a half broad, envelope it in a
bandage about ten inches  long," and wide enough to cover it all;
"(urn it up towards the breast, and over it  the lower end of the
first mentioned piece of rag, and secure  the whole with the band-
age."   Then dress as before mentioned, page 53.  Examine of-  (
ten, and take care that the dead matter  be removed  as soon as it
is disengaged.   If the child is well washed in the groins, under "
the arms, behind the ears &c, and a little  sweet oil, or fresh but-
ter melted and boiled till the water is all out, be  rubbed on those
places, it will prevent all chafes and soreness.   Lei it be repeated
often, first washing with soap suds, then greasing.
   Meconium.—The  first discharge from the bowels of infants, is
called meconium.  It is a too general impression that physic ought
to be immediately given to effect it, and not a few  children are
much injured, and many  are actually destroyed by treatment in
accordance with this impression.   If the mother afford the infant
milk within a few, say two or three hours after its birth, that milk 
67
is best adapted to the accomplishment of the object.  But, whe-
ther she does or does not, it is not necessary nor proper to give
medicine to remove it, till the child gives some evidence of suffer-
ing for the want of such motions.   When the mother does not af-
ford milk immediately, other food is provided for the child, as milk
sweetened with molasses, the quantity of which should be increased
till it produces the desired effect.   A tea of white elder blossoms
sweetened is excellent for this purpose.   Some use salt and water,
some rhubarb and some aloes.   1 object entirely to  this practice.
If the discharges do not take place after a reasonable time, they
may be effected by an injection of slippery elm tea, or sweet oil,
with  a very little cayenne.  True, Dr. Dewees says  that "the
practice of purging off the meconium should never be neglected."
Yet in the same paragraph  (596)  he refers to two cases, one ob-
served by himself, in which the meconium was freely passed for
many days, though there was  no passage from the  mouth to the
stomach!—Wonder how the meconium got away without physic!
The Doctor, however, "protests against the use of any  acrid pur-
gative for this purpose."  The worst that he  recommends is a tea-
spoonful of castor oil.  But he adds, (sec. 600,) "Oftentimes much
mischief arises from  over-purging  newly-born infants," &c, and
here  I am happy to agree with  him.
   Urine.—It is also necessary to attend to the discharge of urine.
If this be suppressed or too scanty, the bladder will swell, and the
child will suffer.   A little strong tea of clivers, sweetened with
molasses, and  keeping the parts  warm, prevents costiveness and
the suppression of urine.  If the  urine be much accumulated be-
fore it is discovered, a lobelia poultice and a steaming brick to the
genitals, will relax the strictures and allow it to pass; and keeping
the parts warm and moist will prevent a recurrence.
   Food.—Doubtless the best food for the child, when the mother
does not supply it, is milk, warm from the cow, when it can be
had so, and a little warmed when not; and here again, as it is a
little more astringent and  not so sweet as that from the human
bfeast, it is proper to add a very little molasses or brown sugar, to
prevent it from producing costiveness.  Give  a very small portion
at a time, three to five or six tea-spoonsful at first, and repeat it in
an hour or two,  but not so often or abundantly as to make it "run
over."  Nurses are apt to feed them a great deal too much, and to
give them bread, crackers, or other articles besides the milk, which
are very improper.   But the child should be  put to the breast of-
ten, and, when the milk flows freely, no other food should be given.
Let the child be put into a cradle or crib, and if it cries do not take
it up  and stuff it with food and shake it about, but examine care-
fully whether some of its pins or bandages are not giving  it pain, 
m
and if not, and you are sure that it cannot be hungry, (it should
never be surfeited,) let it be.   A piece of gauze should be spread
over the top of the cradle or crib, not its face, to keep the flies from
annoying it.
   Principles.—I am here compelled to refer again to the princi-
ples (see Introduction) by which we are guided in the management
of women and children, before I  can  so well point out the proper
ways and  means of applying those principles to every given case.
We base all our medical practice,
   1st.  On the self-evident proposition that, as the female frame is
wisely adapted to the performance of all the  duties which  will
ever be incumbent on it in the course of nature, so, in all our me-
dications &c, we are to aid when present, and imitate when want-
ing, these several operations, and to depart from  these principles
only so often  and in such cases as we find  that, from some casual
obstruction of the proper growth, there was a manifest departure
from the course of these general  laws in the original structure of
that frame; and then  our operations  must be precisely those that
are calculated, as far as possible, to remedy the defects of such a
structure.  For example,  In  all cases of well  formed pelves, we
believe that a female may be, and  ought to be safely delivered of
her offspring, without any other aid than  that of keeping her sys-
tem free from obstructions and strengthening her for  the perform-
ance of her duty; that artificial intermeddling here, farther than to
change her position so as to give a proper direction to the fcetus,
is in all cases reprehensible; but that, when the pelvis is so dwarf-
ish or distorted as to present insuperable obstacles to delivery, then
embryotomy or the Cesarean operation may be justifiable.
   2. That all vital action is friendly to health, and not to be op-
posed; but, that any irregularities in this action, are indications of
the presence of obstructions or causes of disease (in different de-
grees) which must be removed.
   3.d.  That all disease is caused  by obstructions of some kind to
the full, free  and universal operations of the living principle, and
is itself, in essence, the  incapacity or inability of some organ or
organs to  perform its or their duty.
   4th. That these causes of disease must be removed by supplying
the living machine with those substances or medicaments,  and  aid-
ing it by those processes which it is pleased to make use of it in the
accomplishment of its object.
 _ 5th. That  the intention of the system in every effort to remove
disease, is to remove the obstructions, generally, first,  by  relaxing
itself, and, secondly, by stimulating the vessels to  an unusual de-
gree of action, and, thirdly, by restoring the organs to their origi-
nal tone, texture and equality of action, or by renewing their con-
nexions where they have been separated. 
69
     6th. The obstructions lo vitality are, substances arrested in the
   capillaries, filling them up; contractions of those vessels by irrita-
   tion;  substances relaxing them  by  opposing  the  action  of the
   proper nerves; mechanical or  chemical lesions of  the organs; as
   wounds, bruises, ulcers, corrosions &c.
     Ways and Means.—In the 1st, 2d and 3d cases, which may
   be exemplified by the condition of the skin in fever, after  taking
   a sudden cold, or the state of  the stomach  when cramped, or of
   the bowels in constipation, or when the capillaries are filled through
   the whole system, as is often the case in jaundice and bilious fever,
   the means of removing them evidently are,
     First, Relax the parts obstructed.  It is well known that
   a comfortable degree of warmth and moisture are the most natural,
   direct and convenient means of relaxing all animal bodies.  Hence,
   when the stomach, bowels, skin,  or anv other part of the sys-
   tem,  is unduly contracted, cramped or collapsed, the application
   of mere warm water will afford some relief.   If that water  be in a
   state of vapor, it will do  still better;  hence the  vapor bath and
   steaming stones or bricks are better than baths of warm water, &c.
   If materials that possess the power to relax the system, by merely
   quieting the irritation of the organs, without in the least injuring their
   power to re-act, (such as lobelia, nervine, boneset,  &c. &c.,)  be
   added to the warmth and moisture, the effect is still greater.
■yf    Lobelia.—The true therapeutic action of lobelia, I think is not
1  generally  understood.   Most  persons  are under the  impression
   that it is the principal agent in producing the action which we call
   vomiting.   But this must  certainly be incorrect.   All practition-
   ers, regular and irregular, who habitually use it, agree that its  ef-
   fect is anti-spasmodic, as it instantly relieves spasms, fits, lock-jaw^—
   cramp &c, and relaxes contracted sinews.   But it is also agreed
   that vomiting is produced by muscular contraction either  of the
   chest, abdomen or stomach, or all combined.   If this were  the  ef-
   fect of the irritation produced  by  lobelia, that article would not
   be, as it certainly is, a  sovereign remedy for spasm.  But one will
   say, "How do you know that lobelia does not, like cayenne, pro-
   duce alternate  relaxation and contraction,  perhaps by different
   properties contained in it, that act at different  points of time?"
   I answer,  I know it by the fact that the more  vitality in the sys-
   tem, the less the relaxation and the more speedy and effectual the
   vomiting after taking  lobelia;  and that, on  the  other hand, the
   less vitality in the system, the greater is the  relaxation and the
   feebler the reaction; and further, when there is little vitality, as
   when the patient is dying, there is no reaction at all.
     Alarming symptoms.—In what are called "the alarming symp-
   toms," there is so little vitality, that the relaxing power of lobelia 
70
completely overcomes  the  reacting powers, and  the only reason
why death does not take place, is, because lobelia does not injure
the organs, by destroying  the sensibility or stopping the circula-
tion; but only overcomes, in a greater  or less degree, during the
period of its own influence, the disposition to reaction. The nearer
the reacting power of the system, is to an  equality with the re-
laxing power of the lobelia, the greater will be the struggle and
alarm.   As the effort of the system is now to recover its tone, giv-
ing cayenne and astringents will aid it in producing the reaction
that constitutes the vomiting, which, if free,  always relieves the
patient.  Giving more lobelia throws the scale the other way, and
makes him quiet a while longer.   Letting him entirely alone, the
lobelia, after some time, loses its power to act, and then the re-
active energy of the system meets with no resistance, and recovers
the condition of its organs as a matter  of course.  When there is
no disease, that is, debility of the organs, the lobelia has not power
to relax the system much, and hence there is  no room for any re-
markable degree  of reaction, and of course there  is little or no
vomiting.  "But," says one, "are you sure that lobelia possesses no
other control over the living body than simply to  relax its several
organs?"   I  anwer, not  quite sure; but am  perfectly  convinced
that, if it have fifty other influences,  this one of relaxation so far
predominates over them  all, as  to throw them entirely  into the
shade.   "But,  is not lobelia a sudorific?"  Yes; but its mode  of
producing  this effect is by relaxing through  nervous  action, the
contracted mouths of the emunctories or pores of the skin, and let-
ting off the portion of the  blood  called perspiration.  It also pro-
motes the secretion of bile and urine, by relaxing the vessels whose
unnatural constriction  is the cause of the retention of these fluids.
   The object in giving here these facts, arguments and illustra-
tions of the modus operandi of lobelia, which are more extensively
considered in my "Lectures on Materia Medica,"  is  to establish
the  point that lobelia is to be considered, at all times, and un-
der ALL CIRCUMSTANCES, AND WHEREVER APPLIED, NOT ONLY A PURE
RELAXANT, BUT THE MOST POWERFUL AND INNOCENT YET KNOWN.   I
wish this point to  be well settled, for,  if it be proved  true, it  at
once puts to flight, from obstetrics, the use of instruments, and even
 manual force, in every case except perhaps  the very few patients
 whose pelves are known to be remarkably  deformed, by  rickets
 or some other unfortunate circumstance.
   Their treatment.—I must not leave this article without repeating
 the remark that, though giving more lobelia during  the alarm pro-
 duced by a course, will check the struggle of the system for a while,
 yet it rather prolongs  the duration of the condition.  Sweet milk
 or sweet oil will, by combining with it, check the  action of what 
71
 is already taken, and a dose of cayene and  strong bay berry or
 other astringent, will aid the vital energies in producing the re-
 action or vomit which puts a period to the whole transaction.  I
 must also remark that, when lobelia cannot be had, other articles
 that are known to act like it, must be used in its stead.  Thorough-
 wort is an excellent  article, but it is  not,  like lobelia, a pure re-
 laxant.   The therapeutic principle of a  true emetic,  must be,
 speed in relaxation, great volatility, and incapacity to injure the
 vitality of the organs on which it operates.  Such is  that of Lo-
 belia.  It is like the power that pulls a bow-string: it strains the
 bow quickly, and as suddenly lets it go; thus allow,ingit to recover
 its condition without injury to its elasticity.  Did it act slowly, the
 tone of the system would gradually give way to it, and suffer the
 encroachment to proceed without an effort at reaction.  Did  it
 not cease to act suddenly, the re-action of the system also would
 be gradual,  and  would  produce no  vomit.   Did it continue its
 power over the organs a great length  of time,  they, like the long
 bent bow, would lose their elasticity altogether.  Such are poison-
 ous relaxants.   They either break the bow at once by over-strain-
 ing, or they relax it so gradually as to  excite little or no resistance,
 (as tyrants fasten their chains on their subjects,) or else they retain
 their possession till all the reacting power is destroyed.
   The emetic effect of copper and zinc, is the resistance the sys-
 tem makes to their introduction into it, as its greatest enemies to
 healthy action.   They threaten "suddenly and rapidly to extin-
 guish the vitality of the system." in exact proportion to the quan-
 tity given.   (See Boston Medical and Surgical Journal, vol. ix,
 page 43.)
   The administration of lobelia &c, in warm teas, either inter-
 nally or externally, (in  the  last case  it may  be combined  with
 poultices, slippery elm, oils, &c,) is  the best means yet known to
 relax constricted or obstructed vital organs, and the more directly
 we can apply these means to the parts  affected, the more speedily
 and effectually shall we  accomplish our object.   It will depend
 upon the circumstances of the case, how Jong we wish to continue
 this relaxation.   The means must of course be used as  long as we
 wish the effect to continue; as, in fever, moderate steam and bland
 drinks should be continued till perspiration  is free,  so, in cases of
 parturition, a lobelia  liniment should  be  used, and fomentations
 or other applications of warmth and moisture, should be kept about
 the parts to be relaxed, till the end is  accomplished.  In cases of
 local inflammation, tumors, ulcers, &c, these relaxant properties
 should be combined in poultices, which should be  continued till
 the end is accomplished.  By the administration of articles which
soothe the action of the nerves, the constricted vessels are enlarged 
72
and the fluids combine with, and attenuate and dissolve the mor-
bific materials that obstruct the passages, and now
   The next step is to stimulate these  vessels to a healthy
action.—For this purpose the acrid principle of cayenne, in com-
bination with a  suitable portion of heat, is  the best means yet
known.  Any other stimulant that is  permanent and innocuous,
that is, that will excite the organs to action without exhausting
their power too suddenly, or depriving those  organs of the power
to react as well as before, may be combined with the cayenne, or
used instead of it when it cannot be had.   The specific action of
cayenne is evidently in perfect harmony with the operations of the
living  power, that is, when the action is too low, cayenne will raise
it; when congested, it will extend its influence through the nerves
of the circulation, till that action is equalized.  Therefore,  whe-
ther cayenne find the system or any organ of it, too much relaxed
or contracted, its power  to  excite the living principle, and, of
course, organic action, is adapted to bring the living organ from
either extreme to a healthy state.  The stimulus of cayenne then,
in a morbid condition of the body  or any part of it, aided by the
mechanical structure of valves, is calculated to push-all the circu-
lating materials forward through their destined course.  If applied
to a relaxed stomach that is full of fluids, it produces vomiting; if
to the bowels, in the  same condition, dejections; if to  the  skin,
when the systemris full of fluids, perspiration; and, lastly, (which
comes  more particularly under our present consideration) if given
to the  stomach, (between which and the uterus there is an intimate
nervous connexion,) at the  time when  that organ is disposed, but
unable, through  weakness, to expel its burden, and also, if rubbed
lightly on the abdomen, it will wonderfully aid in facilitating par-
turition.  There is, on this  very  account,  no one article in the
materia medica> so universally applicable in  all cases of disease,
as cayenne,   I can conceive of but two states of the living body,
in which its internal use is injudicious;  one  is when the skin alone
is obstructed and a consequent fever pervades the  whole internal
nian (rather a rare  case,  and, when it occurs, to be cured by a
plenty of bland  fluids  and steam,) and the other is, when  the pa-
tient is, in all respects, in perfect health, when its use would make
him wear out his system too fast.  Cayenne is  not directly injurious
like brandy and other poison stimulants, because, first,  it does not
suddenly raise the action to an excessive degree, an/} then let it as
 suddenly sink under consequent exhaustion.   It continues the ir-
 ritation for a great length of time, which so recruits the debilitated
 organs as to enable them to retain their power and sensibility after
 the cause which arouses them to action,  is  discharged from the
 system.   2nd. It never destroys, as do opium, nitre, digitalis, mer. 
73
cury, &c, the power, capability or fitness of the organs for vital
action, but rather renders them more  susceptible to that action.
It is uniformly, universally  true, that the more opium, nitre, or
mercury you  give a  patient,  the less vitality there will be in his
physical organs; till paralysis,  apoplexy or anasarca &c, close the
scene: and it is equally true, that the  longer you  give a patient
cayenne, the better effect it has upon him,  and the less he needs,
till he gets entirely well and needs it no  longer.
   If cayenne be introduced rapidly into the system, it will produce
momentary pain, by relaxing the stomach before other parts relax;
but, if gradually introduced and the outlets of the system be kept
free, little inconvenience can be produced by giving it even in very
large quantities.   But for its extremely pungent and, to some, es-
pecially infants, very  disagreeable taste,  and also the impossibility
of always getting enough of it in  its purity, we might safely rest
satisfied' with it in all cases where a natural stimulant is required.
Various other articles, however, as ginger, xanthoxvlum,  snake-
root &.c, may be used as substitutes when pure cayenne cannot be
had or when its taste is peculiarly disagreeable.
   Cayenne, then, should enter into the composition of all those ar-
ticles which are intended to excite the system  or any  organ  of it,
to a natural action.  "Why then," says an objector, "if cayenne
always stimulates the system in the same way,  do you  prescribe it
 both to prevent abortion and  to promote parturition?"  I answer
again, cayenne  always stimulates the  living organs to act in har-
mony with the living intention.  Now it happens that abortion is
threatened by accidental contractions of the uterus  (by cold, fright
 &c, or by a partial disengagement of the  placenta occasioned by
excessive labor, walking, fatigue &c.,) during a period when the
 natural disposition of that organ is to expand to accommodate the
 growing foetus; whereas, in  parturition, that expansion, having  been
 carried to the utmost extent of the natural law, the disposition of
 th§^rgan now is to contract  and  expel  the full grown fcetus.  If
 trafn, cayenne aids the intentions  of nature, it must of necessity,
 both prevent abortion, by removing the cold or obstructing fluids
 and allaying  the irritation caused by fright &c, and promote par-
 turition by enabling the uterus to  detach itself from the placenta,
 and expel from its cavity,  that which,  like  ripe fruit, has no longer
 any need of nourishment from the parent stock.  Can we place too
 high a value  on a medicine which almost supersedes the necessity
 of the administrator's knowing much more of the condition of the
 patient than simply that she is sick?
    Some suppose that lobelia  is the  most important article in the
 materia medica.  In this opinion I cannot  agree; for, though  I ad-
 mit that there are some cases that cannot be cured with cayenne 
74
 without lobelia, yet I am sure there are more that cannot be cured
 with lobelia without cayenne,  or  something that  will serve as a
 substitute.
   Indeed it may be said, that,  while cayenne is  proper in every
 form of disease (except  the one just named,)  it may as  truly be
 said that lobelia is proper in only one form of disease, and that is,
 where relaxation is  necessary.   (See remarks on  lobelia,  page
 107.)   We would not give lobelia to contract a muscle after we
 had relaxed it to set a bone, to restore the tension of the viscera
 after we had reduced a hernia or a  prolapse; nor would we give it
 to a patient to restore the strength after a course of medicine had re-
 moved the cause of his weakness.   But cayenne is not only inval-
 uable in all these cases; it is even so in  aiding  lobelia  in all its*
 own appropriate spheres, as in removing a fit and reducing a lock-
jaw', &c. &c.
          "For all its various virtues to relate,
          Would tire ev'n Fabius with eternal prate."
 . "How then," says the objector, "does lobelia always harmonize
 with the living intention, if its sole power is exerted  in relaxation?
 Surely we do not always wish to be relaxed!"   I answer: Lobelia
 is  a medicine.  We do  not recommend it as food.  As a medi-
 cine it always acts according to a certain  intention, viz. to relax.
 When a patient is sick, there is  always some morbific material (as
 canker) or contracting influence (want of heat) in the system which
 it is the intention of the living power, the vital energy, (vis vitae,)
 to remove.  But this morbific matter or the cold fluids cannot be
 removed  till the vessels in  which they  are  lodged be  relaxed.
 Therefore lobelia acts in harmony with the intentions of the living
 power, aiding  her in the first step to remove disease.   Were lo-
 belia able to entirely overcome  the living power as opium does, or
 to destroy the capacity of the organs for  action by continuing its
 deadly grasp upon them as mercury does, it would be a poi|pn,  ,
 like them; but it only relaxes the organs, that is, takes off fflllir
 tension till they rest awhile, to recommence their operations in a
 short time, with redoubled energies.  Glorious medicine!  It acts
 in perfect harmony with the living intentions.  But he must be a
 sad blunderer  in therapeutics, who gives it for any purpose except
 to relax the vital organ or organs to which he applies it.
   Canker Medicines.—In  addition to cayenne we have several
 articles that are calculated "to scour the stomach and bowels, and
 to remove the  thrush" or canker from the system.   From what I
 have said  of the relaxing power of Lobelia, the stimulating princi-
 ple of cayenne, and what I shall presently say of the tonic power
 of bitters &c, the reader will  perceive that all the intentions of 
75
the living principle in the restoration of health, are fulfilled by the
articles above named, and, perhaps, be at a loss to know what pe-
culiar office I  shall assign to the articles that are said to be "good
for canker."   In elucidation of this subject, I remark,
   It is well known that the effect of introducing canker medicines
into the system, is "to stimulate the glands, to cause the saliva to
flow freely," to detach the thrush from the mouth, and to promote
secretions wherever their influence extends.  Now it is  very cer-
tain that neither saliva nor any other secretion can flow freely, til!
the vessels from which it is secreted, are first relaxed to permit
the discharge, and then stimulated to reaction to aid the valves in
pushing along the fluids to  the places of their destination.   It is
this alternate relaxation and reaction, aided by the fluids thus put
in motion, that disengages the canker or thrush from the parts on
which or the pores in which, while inactive, it settles, and to which
it adheres.  It is therefore  demonstrated  that  the  canker medi-
cines possess a compound character, combining the relaxing pro-
perties of lobelia with  the  irritant properties of cayenne.  The
astringency of some, as witch hazle,  sumach and raspberry; and
the bitterness of others, as  hoarhound, wormwood, tansy, camo-
mile, bittersweet, &c, prove that they might also, with much pro-
priety, be placed among the class of tonics  or restoratives.  It is
important to remember these facts, as they show why it is that the
canker medicines generally, are so efficient in removing disease
and restoring a healthy condition of the organs, without the aid of
either  lobelia or  cayenne.   They carry on gradually, at the  same
time, all the operations of a full course of medicine.  These facts
also prove, what all  experience confirms, that cayenne itself,  is the
simplest and  most efficient of all the canker medicines.   It has
been supposed that  roughness is essential to a canker medicine,
but this cannot be correct, as some of the roughest articles, when
chewed, "leave the mouth dry and parched."
   jjphiay be asked  then, "If cayenne, is the purest and most effi-
cient canker  medicine known, why not depend  on it  altogether
and seek no other?"  I answer; the chief value of canker medi-
cines depends on the acrid properties they possess, which are cal-
culated to excite the living action.   These properties are various,
stimulating the organs in different ways; the effects of some being
very disagreeable, as those of cayenne, xanthoxylum, gum myrrh
&c, those of others very  agreeable, as the juice of a delicious ap-
ple, of an orange and of various other fruits.  Other pungent arti-
cles may produce all other imaginable sensations, between the
most delightful and the most disagreeable.  It is  our duty as well
as our pleasure and our interest, to select, out of this vast multitude
of irritants, those which will produce the best effects with the least 
76
unpleasantness in the administration.   These will be different for
different persons, and in different states of the same  body.  Of
course, if a patient has a peculiar dislike to the taste or mode of
operation, resulting from the administration of one kind of canker
or stimulating medicine, we should try another  which may be less
objectionable and equally useful.
   On this principle, we administer, to infants and weak patients,
ginger instead of cayenne; raspberry or witch hazle, or tea of dried
apples, instead of  bayberry; poplar bark tea sweetened with mo-
lasses, instead of common  bitters.
   Many substances very agreeable to the taste, as dried apple tea,
molasses and vinegar, &c, will cause  the saliva to flow as freely as
cayenne.  These should, therefore, be chosen instead of that arti-
cle, when the object is merely to keep the mouth moist and to slake
thirst.   The fact that an article produces a most powerful and dis-
agreeable sensation, is not proof that it is the most effectual in the
cure of disease.  Witch hazle tea produces a pleasant effect on the
organs to which it  is applied, yet no article excels it in closing the
relaxed  mouths of vessels.   So,  sage,  pennyroyal, catnep, and
balm, all pleasant  to the taste, are as good sudorifics, in ordinary
cases, as cayenne;  and clivers is as good a diuretic as tanzy.  More-
over, judicious combinations of the most pleasant with the  more
acrid articles, will  so modify the latter as to render the whole un-
objectionable to the taste, while the combinations themselves will
be far more efficient in the removal  of disease in general, than
even the most efficient simples when used alone.
   Another important  property of the  canker medicines is the
astringent and antiseptic influence of the tannin they  contain.
This principle coagulates  the  phlegm, renders it thick and ropy,
and thus greatly facilitates its entire removal; while, by its stimu-
lant power it keeps up such an action in the system, as to remove
all morbific agents from the body  before they produce inflamation
and gangrene.  .                                         flL
   Restoratives.—It  now remains to consider the last class of rem-
edies which I here call restoratives.  Many of them are bitter, but
they are not all necessarily so. It is important in the restorative
process, not only to furnish the bitter principle, but to keep up the
reaction in cases of relaxation, as after diarrhoea; and the relaxa-
tion in cases of too much tension, as after costiveness.   Hence, we
need some restoratives to furnish,the bitter principle, as balmony;
others to contract  relaxed organs,  as the astringent articles, rasp-
berry, witch hazle, birch, cherry, oak  &c, and yet others to relax
constricted organs, as  butternut bitterroot, and the  like; and we
often want the combination of them all with the stimulant proper-
ty of cayenne.  This demand for  general lemedies, in almost  all 
                              77

 cases of sickness, has stamped such a permanent value on the
 "composition powder" which combines almost all the properties
 wanted in the healing process.
   I may close this article as I did the last, with the remark that
 restoratives the most disagreeable to the taste and in their effects,
 are not necessarily the most efficient in the  cure, and that a judi-
 cious combination of the several articles demanded by the given
 case, will be both more pleasant and more salutary, than the most
 irritating simple, unmodified by the more mild.  1 account for the
 fact that they are more salutary, by supposing that their different
 properties may  stimulate different  organs, or the same organ in
 different ways, and that they may also supply some of the mate-
 rials whose deficiency in quantity or inaptitude for vitality may be
 the secondary or proximate cause of the disease.
   The 4th Condition of the body, organic lesion, comes rather
 under  the head  of restorative treatment, than the removal of dis-
 ease, inasmuch as the business of the practitioner is rather to aid
 the living power and protect and supply the organs with whatever
 materials they want for the performance of their own duty, than to
 remove by art, any obstacle to their operations.   If, however, the
 lesion be a fresh  cut,  we  can often so unite the parts as to give ef-
 ficiency to the tendency of the organs  separated, to re-unite, and
 the permanent restoration of the connexions  is almost immediate.
 In case of bruises, ulcers &c, we must aid the vis vita, by keeping
 the whole  system clear of  obstructions, protecting the parts from
 atmospheric action or other injury, and sustaining the action of the
 organs at the  healthy standard.
   Having exhibited the intentions of nature in her attempts to re-
 move disease, and described the character of several articles which
 are calculated most effectually to aid her in the accomplishment of
 those intentions, I now proceed to show how these agencies of art
 may be brought to bear the most speedily  and effectually in the
 removal of the most various, complicated, powerful or inveterate
 causes of disease.  In other words, I shall give what I  conceive to
 be a good example of the mode and means of administering what
 is commonly called
   A course of medicine.—As soon as you  determine  on giving
a course of medicine, in  a cold, languid debilitated and chronic
 case, give a tenth of a tea-spoonful of cayenne in a little milk, honey
or molasses to commence raising the action of the system.   I al-
 ways  carry in my pocket, a vial of cayenne  and molasses or some
kind of hot syrup.  It is an  excellent article for this purpose, and
to cure pains in the viscera, relaxes and  slight colds, and to convert
the enemies of the practice.
   Put into the fire a dozen half bricks, or  as many rocks about 
78
their size.   Into a two quart pitcher, put an ounce or a very large
table-spoonful (heaped  as high as you can) of canker powders or
of composition, a tea-spoonful of nerve powder and an ounce of
brown sugar.  Mix them well with a spoon, pour on a quart or three
pints of boiling water, and stir it  up  till the  powder is well wet.
After it settles a little, pour out a tea-cup half full, dilute it a little
with cold water, and, if composition, give it; if canker tea,  add
cayenne enough to make it as hot as composition would be, and then
give it.  Pour out another  cup full, and set it  upon the table or
window to  cool.   Pour out half a cup, and put into it cold water
till it will not burn your mouth, add five tea-spoonsfull of lobelia
(powdered herb)  or three of the seed, and let it stand where it will
keep warm.  Pour off another tea-cupful of the tea, put in  a tea-
spoonful of cayenne, another of lobelia seed, and another of nerv-
ine, and let it stand  by  the fire to keep warm.  Give the second
cup of tea about  five to ten minutes from the first, and get your
steam apparatus in readiness.  Pour out another cup, put into it a
quarter of a tea-spoonful of cayenne, and give it about ten minutes
after the second cup.  Prepare also a quart or more of pennyroyal,
sage, catnep  or peppermint, or some  other pleasant tea to drink
during steaming, and also during the operation of the emetic, when
the canker  tea is particularly disagreeable.  By  this  time  the
steam should be ready.
 If the bowels be either constipated, or much relaxed, obstructed or
cold, or there be pressure to the head or lungs, an injection of the
canker tea with cayenne, slippery elm  and a little lobelia, should
be administered before getting over the steam.   This  plan is al-
ways good,  as it tends greatly to equalize the heat of the body, and
prevent the unpleasant sensation of fullness in the head and  chest,
often experienced  during steaming.  It is also an  excellent plan
to wash the feet in water, scrape off the dead skin, throw away the
dirty water and fill up the vessel with clean as hot as it can be
borne to keep the feet in while steaming.
  Steaming.—Put two strips of board about two inches wide across
the top of the largest wash tub about the house, in such a manner
that you can set an open, flag, or split-bottomed chair upon them,
with the back feet directly over the edge of the tub.   Put into the
tub a common wash bason or other small vessel, and  then  place the
patient upon the chair, covered only with a blanket, pinned  round
the chair and tub, so as to exclude all the air except from the face.
As  soon as she is seated, open  the  blanket a little at the bottom,
and pour into the bason from a tea-kettle (which must always be
ready) about two  or three quarts of boiling water.  Now give her
a little more hot tea, and take, with the tongs, a brick or rock from
the fire, put it partly  into the water, but still hold it fast (resting 
79
the tongs on the edge of the tub) till it is so much cooled by grad-
ual depression into the water, that it will not make too much steam
when you  may let  it  entirely down into the bason and leave it
there till it ceases to make steam enough, when you should take it
out of the bason and leave it in the tub, on the side where the pa-
tient feels the coldest.   Give a little tea'of some sort, with cayenne
if necessary, every time you change a brick.  Take another brick
and use it as you  did the first.  If sickness at the stomach occur,
the patient's face being red, her muscles strong, and body restless;
give a little tea with cayenne, dash a little water suddenly in the
face and on the breast, and she will soon vomit and  be relieved.
If faintness, weakness  and paleness occur, lower the steam by re-
moving the stone and opening the blanket about the neck, and
dash the face, and, if necessary, the breast with cold water, and, if
this is not sufficient, take hold of the back of the chair and pull it
back, (seating yourself in another,) till the head is at least as low as
the pelvis, and retain her in  that position, giving warm teas, and
occasionally sprinkling the face suddenly with cold water, till she
recovers her strength, when she should be raised up again and the
steam applied  till  she gets warm.   I have sometimes held a patient
 in my lap and arms in this  way two hours, letting pass under the
 blanket from a pipe just steam enough to keep the air warm about
 him.  He would  be as cold as clay  the whole time, and  unable,
 through weakness and chilliness, to lift a hand to his head, or many
 times, oven to speak, till the cold  fluids were all expelled and the
 heat pervaded the system, when the strength would return and he
 would sit up and  receive a  fine steam, during which he would be
 very amusing in conversation.
    1 never measure my steaming by minutes or hours.   The object
 of steaming is, in  cases of cold and  consequent fever, to open the
 pores and let out  the cold and dense fluids.  In patients filled with
 cankery fluids, it  is to carry out the virus that may be afloat in the
 system at the  time, and to excite the skin to action  by the stimu-
 lus of heat.   The  first will  be  accomplished when the patient
 sweats freely all  over, and  her flesh is  hot  particularly on the
 knees and the tops  of the feet, just back of the toes.   The second
 should be continued as long as, by giving freely of the pleasant tea
 before mentioned, with occasionally a little cayenne, she can  com-
 fortably endure it.  During the latter part of the steaming, let an
 attendant wash clean  with warm soap suds and a cloth,  every part
 of the body, to get away all the dead skin, the dirt that is loosened,
 and the morbific  matter that was disengaged, that it may not be ab-
 sorbed again.  This is very important.   After the washing, close
 the blanket, put  in a hot rock, give a little hot tea to raise the ac-
 tion pretty high, and then dash with cool water, rub dry and put 
80
 on the under clothes, and help, if necessary, the patient inlo bed,
 and put a steaming stone or jug of boiling water to the feet.  Give
 another cup of tea, and soon after, a cup of the emetic first pre-
 pared.  After ten minutes at most, whether the patient pukes or
 not, give more  tea, and soon afterward, as much more of the emetic
 as you can pour off clear from the powder.
   Now follow up with teas every five minutes or so, (putting into
 the pitchers more boiling water when necessary,) till she has puked
 at least once freely.   Fill up the cup of lobelia with tea again, and,
 after it has stood awhile, strain  and press it.  Continue the teas,
 using the tea of lobelia  if necessary, till  the stomach is  settled,
 making them as  stimulating  as  the case requires,  and adding a
 little pearlash, sal asratus or carbonate of soda, (the size of a large
pea of the first is  the best,) whenever there is acidity on  the sto-
mach, and rubbing the surface dry often if the perspiration is con-
tinued and profuse.
  It must not be forgotten to keep  something warm at the feet; a
gallon jar or other bottle of boiling water  is an excellent article,
much better than steaming stones, except in  cases of burning fever.
It is.more equal, will last ten times as  long,  and is every where
convenient.  If the patient is very sick, full of tea  and  cannot
vomit, give her a table-spoonful  of  the liquid out of the cup con-
taining lobelia, cayenne  and  nervine, and  this  will do the work.
If her stomach is cramped, give  a cup of weak lobelia tea.  If it
burns, give a little sweet milk or milk porridge.   Continue the pro-
cess, especially  the canker tea and cayenne, till the stomach ap-
pears  free from  morbific matter and settled, in all weak, chronic
cases using porridge freely after the first thorough vomiting.
  It will often seem  as though the  stomach were sick, when,  in
fact, the disagreeable feeling is caused by mere emptiness, and will
be removed by  a  tea-cupful  or porridge.-  If the stomach refuses
to settle, give an injection, and  the patient will either get better
or puke.   If she sickens and does not puke, give tea and cayenne
and rub the gastric region.  If one course does not appear to give
essential  relief, give  another after an hour or two.  Keep up the
action and advantage gained, by stimulants  and tonics; and, while
the patient improves fast, courses are not  necessary;  but if she
sinks, repeat the courses.  Wherever it can be had, a steam-pipe
and stop-cock connected with a boiler,  is much better than rocks
and bricks, as it is far easier to use or to regulate.
  A convenient apparatus for steaming, may  consist of eight or ten
pieces of tin or copper pipe, from a half to three quarters of an
inch in diameter, so constructed that the small end of any one piece
will just fit into the large end of any  other.  Two of the pieces
should be knees extending about an Lack each side of the joint, 
81
two inches long in the whole, and making an angle of 135 degrees
or a right angle and  a  half.  Take a common  brass stop-cock,,
drive out the stopper and saw it with a keyhole saw, from one side
of the  hole down to the lower end; saw  off the other side at the
top of the hole, smooth the remainder and put it back again, but
do not fasten it.  Let the coppersmith or tinner solder a tube an
inch or an inch and a half long, to the little circular projection di-
rectly below the stopper, the lower end of the tube being rather
smaller than the upper.   Let now a thick copper plate be made
in circular form, large enough to cover the top of a large tea-ket-
tle; bore a hole through the centre one-fourth of an inch in diame-
ter, and make a screw three inches long with a high flat head and
a flat smooth shoulder lo  cover the hole.   Mako a flat  iron bar,
half or three quarters of an inch wide, one-fourth of an inch thick,
and just as long as the diameter of the copper plate, and cut a hole
in the  centre to fit the screw.  Now make a hole in the copper
plate an inch fiom the central one, to fit the tube that is soldered
on the under side  of the  stop-cock.  Put the screw  through the
plate,  and just insert it into  the bar below; then put the bar into a
tea-kettle, lift it till it touches both sides, and turn the screw till it
brings down the copper  plate close  to the top of the  kettle.   To
make a good fit, the plate should be bound round the edge with a.
strip of cloth an inch and a half wide, with fine twines so run along
its edges as to tie above and below the plate, and draw them lik»
the lining of a hat; or it may be made of two circular pieces sewed
at the circumference and the centre cut out.  Put  the tube of the
stop-cock through  the hole of the plate, and fit the first piece of
pipe on it.  This plate has another hole at right angles with the
centre and the last mentioned, for the purpose of inserting a small
funnel and pouring in  more hot water  when necessary.   This is
stopped (except when filling the kettle) with a cork  or piece of
 wood.   The joints enable  the  practitioner  to direct the steam
cither into the tub, to the floor or into the  bed.  This cap will fit
on any tea kettle and constitutes a complete steam apparatus.  By
turning the stopper you may regulate the steam  at pleasure.
   The tub protects  the carpets or floors from being wet by the
perspiration and the water that may be dashed on the patient, and
elevates her to a proper height above the steam, and prevents the
cold air from coming up  under the blanket; but,  if it cannot be
had, the chair must be  put upon the floor and the process conduct-
 ed as I have already  directed.
   A narrow and  low cot frame covered with very  open cloth,
 should be provided in houses where there  is a very weak patient
 that will need many steamings.
   I have steam boxes that come up to the  waist, containing an
             6 
82
open seat within, and requiring a blanket only round the neck,
shoulders and chest.  They hold water at the bottom, near which,
at one' end, is a hole to admit the steam pipe.  I like these boxes,
because they admit of the utmost convenience in handling the pa-
tient, and keeping the lower extremities warm.  They also allow
the tying of a towel  or handkerchief around the waist,  so as to
confine the steam below it, a practice of great importance  in re-
moving obstructions in the pelvic regions.
   It may be well to remark here, that  steam confined below the
waist in this manner, may often be applied so long  and so efficient-
ly as to remove obstructions from those  parts, when, if it were per-
mitted to come up to the chest and neck, it would so fatigue and
exhaust the patient that you would be obliged to remove her before
her feet were scarcely warm.
   When steaming is necessary.—High heat  is a tonic.  When the
skin is cold, lax and clammy, it has lost its tone or tension.  Steam
will stimulate it to a natural action, and enable it to hold the heat
of the body in  quantity sufficient to keep the whole warm.   If the
skin be very hot and parched,  its tension is too great.  Sponging
with lukewarm water and giving bland fluids in this case till the
perspiration is free, is better than steaming, as there is so much
heat directly under the  skin  that none is needed outside of it.
After giving emetics and injections,  which let down the inward
action, and  take off the tension of the skin, the steam may be ap-
plied to advantage, and it will aid in removing the morbific matter
from the capillaries, the deep-seated glands &c.  If the skin be
dirty or scurfy, though it be neither parched nor clammy, steam-
ing is necessary to cleanse it.   If it be clean, of natural color and
temperature, and so active that a cup or two of weak cayenne tea
will excite a perspiration, but not be succeeded by chills, and the
extremities  be not cold nor inactive, steaming is not necessary.
   Food in the  Course.—Weak  patients and those that  have not
lately eaten, should  have milk porridge, or chicken broth, or beef
tea, or rice water, or toast water, or some such nutrient, after the
first free vomiting.   After the course is completed, a little pleasant
 bitter, as peach syrup, or some similar compound should be given,
 and then the  patient may have a little dry toast, a cup of milk
 and water or chocolate, a little broiled or fried bacon, or mush and
 milk or indeed any thing she craves, and at this time she will sel-
 dom, though sometimes, be inclined to eat too much.   The de-
 mands of the  appetite at this time, though often very singular, are,
 in my opinion, our best guides  to what is proper for food.
    A little spice bitters or cayenne and  golden seal, or chewing
 some ginger, or a tea-spoonful of the cayenne and molasses mixture,
 taken soon after, will prevent it from hurting her.  When the pa- 
83
 tient craves something solid and salt or acid, give her a piece of
 broiled fish, bacon or dried and  broiled beef, with  vinegar and
 cayenne, which I have never known to hurl any one that craved
 it.  Though, for a well person, and, in general, I prefer Vegetable
 food to flesh; yet, when the stomack is very weak, it wants some-
 thing that will digest quickly, lest it should sour and fill the bowels
 as well as the stomach with carbonic acid gas, producing distressing
 colic in the bowels, and pain at the pit of the stomach.
   But she frequently desires to  go to  sleep,  and then she should
 be permitted to  do so, and be fed when she wakes.  If she  has
 perspired freely during sleep, she should be rubbed dry, or be
 steamed again, then rubbed dry, and be dressed with dry clothes*
   Food after the  Course.—Before I leave this subject, I may as well
 give what I consider the best directions respecting diet for alt per-
 sons at all times, old or young, male or female, sick or well*  The
 fundamental propositions are,
   1. The feebler the digestive organs, the more urgent the neces-
 sity for selecting that food which requires the least exertions of those
 Organs to derive from it the greatest proportion  of nourishment,
 that is, the more nourishing and the more easily digestible should
 be the food in proportion to the quantity that is taken.  This will
 not be doubted by any one who reflects upon it.
   2. The only means by which  a patient can certainly know what
 articles of food are, to him, the most easily digestible and will afford
 him the most nourishment, is actual experience, not the experience
 of others on others, nor his own on others, but of himself dn him-
 self.
   Lest this proposition be so controverted as  to injure the force of
 the  conclusions  I shall draw from it,  I think proper,  at once to
 establish it beyond a doubt.
   Food in Cholera.—When  the  news arrived in America, several
years  ago, that his Sovereign Majesty the  Cholera proposed to
 make us a visit,  and to abstract from amongst us  all who were in
 any way predisposed to give him a welcome reception, the whole
 medical faculty throughout  the length  and breadth of the land,
 made up, in their separate conclaves, their opinions relative to what
 wras  the most and what the least digestible and nutritious of all  the
 aVticles of food  ever devoured or  thought of for consumption, by
that omnivorous and ever-changing animal called  man.  Between
these extremes, they arranged with the nicest care and gradation,
according lo  the  wisdom of  "four thousand years  of experience,"
all the several articles known in the catalogue of eatables, from the
delicate frog soup of the French or Italian Madame, through the
train oil of Greeland, the codfish of Maine, to the bacon and greens
of Virginia.   The vegetable world, too, was no  less strictly ex- 
84
amined, and-its various elements nicely approved or condemned;
and forthwith, clouds of sage manifestoes were sent forth  among
us, teaching us what we should eat and  what we must sternly re-
fuse-^-but lo! when all these directions were assembled in mass,
such was the praise bestowed by one set of medical philosophers
on an article, and such the condemnation of the same by another,
that it was found utterly impossible for  the  ordinary sagacity of
man, to discover whether any  given article could  be eaten  with
safety or not.  To this collection of records of medical discrimina-
tion, the universe contained but one like—I mean a library of all
the nosologies, from the monographs in  the  Delphian temple, lo
the volumes of Good and the pamphlet of Hosack!
  With this mighty accumulation of wisdom before them,  the
people began to select as best they could, the prophylactics of the
cholera, but, lamentable to tell,  experience soon taught them the
lesson that they who  supposed that they had done the most to
ward  off the stroke, had in  reality done the most to invite an
attak.
  Instructions of Authors.—In the course  of my reading, I observed
great  discrepancies in the recommendations of eminent medical au-
thors in relation to different articles of diet.  Observation of the in-
structions of practitioners, also proved that they had learned no rule9
on the subject that could be depended on; for they not only differed
from each other,"but each individaal was constantly changing his
prescriptions in this respect.   I have known a doctor advise, in the
course of a few weeks, many changes of diet, to the  same patient,
when there was no apparent change in  the symptoms of the dis-
ease;  the only  foundation  for his changes being simply that the
former article did not suit the condition  of the patient, which the
doctor himself had learned only  by trial.  I observed,  too,  that
almost any change in diet for a sick  person, especially if it  was
what  the appetite craved, generally proved  beneficial for a while,
and then the article not only lost its power, but even became dis-
agreeable.
   Deductions.—Reflecting on the above  facts, as well as upon the
results of  my own  practice, and  comparing them with the omni-
vorous habits of man, I concluded that the  reason why a person
craves a particular article of food, is the same as that why he some-
times craves food at all, and at other times prefers drink, viz.  that
the system is, at that time, in actual need of at least some of the in-
gredients  contained in that article, and that, but for the presence of
other ingredients also contained in it,  which may not be suited to
the condition of the patient, the gratification, in reasonable quan-
tity, of this craving of nature, would never prove injurious.  This
discovery also explained the reason why  an article of food or medi- 
85
cine soon lost its power to produce ^generally beneficial effect.  It
does, indeed, continue to produce its specific effect, whether good
or bad.  But, while we are directing our attention to one specific
effect and giving a simple article of food or medicine to produce
it, we are neglecting the use of the means to produce other effects
equally important, for want of which the general system soon be-
gins to languish even under influences which at first seemed to pro-
mise all that was desirable.   Indeed,  it seemed to me  perfectly
reasonable that the body which is composed of different simple and
compound substances, that are in a constant course of wasting and
renewal, could not be sustained for any length of lime, by the use
of any one simple article, however good in itself, or however much
needed at the time it is first applied, and that the most effectual
way to keep up these charges in due proportion, is to eat a mode-
rate quantity of several different articles of food that are known lo
be good for the sustenance of the body; and so also, the most ef-
fectual  means to remove disease and  restore health, is  to use to-
gether where  proper, and where not, in rapid succession, all the
means within my reach that are calculated  to  effect the object I
have in view.  These  principles, constantly demonstrated by my
experience to be true, led me in practice; to adopt the two general
rules I have so often urged in  the Recorder, viz.
   1st.  Whether sick or well, never deny yourselves variety in
food, but reject only that which your own experience tells you is
not good, and, in all cases, confine yourself to what is generally
considered a small quantity.   Don't eat too much, sick or well.
   In explanation of this rule, and to guard it against abuse, 1 must
remark, that we must not mistake a good effect  that is temporarily
disagreeable,  for one that is in its nature bad; for the best articles
of food, as milk, sweet butter,  and many vegetables, will often 50
excite  the living organs to an effort to  throw out  the canker,
phlegm, morbid secretions &c. from the system, as to make us feel
very disagreeable, and induce us to suppose that these articles of
food "hurt us," when, in  fact, they are acting, not  only as food
to nourish us, but as salutary medicines to rid us of disease. When,
therefore, any article of food that is generally good for us, actually
makes us sick, we may conclude with certainty that  we were sick
before we eat it, and kindly warned by the disturbance it produces,
of the propriety, if not the necessity of taking at once a full course
of medicines, to remove the real occasion for  that disturbance.  It
is proper here to remark that,  when a great number and variety of
articles are eaten at once, there is more danger of eating too much,
than when the whole meal  is made from a single article; because,
in the first case, after some  of the cravings, as for meat, bread &c.
are so satisfied, that  no more  would be eaten if confined to them, 
8G
there may yet ucmain some cravings or tastes which  will carry
down without disgust an  additional quantity of pies,  puddings,
sweetmeats &c.   This is the  reason why high living is supposed
to produce gout &c, not that spices and sweets are in themselves,
in reasonable quantities, more injurious than meat or bread &c;
for experience proves that the aromatic spices, as cayenne, cinna-
mon, ginger, nutmegs &c, which were formerly supposed to have
produced the gout, are, in  reality, the best possible means for cu-.
ring it.  Hence, when I find  a patient that will  not confine him-
self to a reasonable quantity of compound food at a meal, I recom-
mend to him to make each meal from a single dish, and change
every meal, if he pleases,
  2nd.  When you wish to remove obstructions or restore  health,
use'together a good number of the best articles and processes that
are calculated to effect the object  you have directly in  view; and
follow them immediately with a similar combination of means and
processes that are adapted to  the fulfilment of the next intention;
being careful  always  that the various means  used shall produce
effects in due proportion with each  other.
  For example, cayenne in pills is calculated  to excite the system,
generate heat, remove obstructions, pain &c;  but, all these opera-
tions are greatly aided by putting the article  into hot  water, and
the patient into the steam  bath.   So, lobelia alone will relax the
nerves and  muscles in  such  a manner that  the reaction of  the
whole will, in general, produce a vomit;  but  these processes  are
much facilitated by the addition of boneset, pennyroyal, steam and
cayenne.   So, the bitter herb is  a xery good  tonic; but, in cases
of great debility, the addition of some ajtringent will help the cause,
and, if the bowels are constipated, something laxative, as well as
bitter and astringent,  is indispensably necessary.   Sprinkling cay-
enne into the stockings, or rubbing the lower extremities with the
strong vinegar extract, will slijl  further  aid  the process of cure.
These hints will be sufficient,
   Other means of warming and relaxing the  surface.   Inasmuch
as the modes and means of steaming I have recommended, are not
convenient in all places, nor at all  times to the same person, I here
mention others which can be used as substitutes.  When the skin
is moist and cold,  and  the patient cannot be conveniently steamed
and rubbed dry,  the  best applications in bed, are gallon jugs of
boiling water wrapped in a thick  cloth and put at the  feet  and
sides.   Common  flat-irons will answer a gopd purpose in this case.
But, where the skin is dry and contracted, whether cold or hot, (it
will generally be the latter.) wrap the bottles or irons in  wet
cloths, if good porous rocks or  bricks cannot be had.   Or wrap
in  cloths a dozen or  so of large boiled potatoes, or ears of corn 
87
 or pieces of very porous green wood, as ash &c, just out of the
 boiling water, and apply them, renewing  as  they  cool.  I saw
 boiled potatoes, and peppermint, catnep or  sage tea, cure many a
 "bad cold" and "obstinate rheumatism," before I ever heard of the
 New Guide.
    When the skin is very hot and  dry,  and the healing applica-
 tions are oppressive, sponge it with water neither so warm nor so
 cold as to be disagreeable, till it becomes cool and comfortable,
 giving diluted sudorific (but not heating) drinks, as sage, penny-
 royal, catnep, balm &c, till perspiration is  free and the pulse be-
 gins to diminish in frequency and  increase in  volume, when you
 may give cayenne according to the necessity of the case.
    When the skin is cold, lax and inactive, use freely some good
 stimulating liniment, all over the system; and, in the bottom of the
 stockings, to keep up the action of the skin  and prevent the feet
 from becoming cold.
   Intermediate Course.—It is now all-important  to maintain the ac-
 tion and advantage gained.
    The first step in this process, is to give, regularly, just cayenne
 enough to maintain constantly a standard action in the system.  If
 more than is necessary of this article be  given,  it will produce fe-
 ver, high excitement and uneasiness, or  else profuse perspiration,
 especially at night.   So long as  the quantity regularly given  pro-
 duces neither of these effects, it is not too great.   If fever and irri-
 tability, or profuse perspiration occur, lessen the quantity of cay-
 enne.
    The next step  is to furnish  the system with bitter articles, which
 experience proves are calculated to  correct and increase the bilia-
 ry secretion and promote digestion, and of course restore the natu-
 ral action of the various organs.   A compound of poplar, balmony
 and golden seal, equal parts, may be styled a neutral bitter, it be-
 ing neither laxative nor astringent.  This and  composition given
 alternately morning and evening, and cayenne on the food at din-
 ner, are  suitable restoratives  for a patient whose bowels are neither
 too loose nor too constipated.
   If the  bowels are too constipated, give  the same articles, adding
 enough of butternut, bitterroot,  or some other mild and innocent
 relaxant, to produce from one motion  of the bowels to  three in
 twenty-four hours.
   If the voluntary dejections be bilious, that is,  light yellow, acrid or
 cutting, or very offensive, five or six a day, will be of service, pro-
 vided cayenne be given freely and the  patient steamed daily to
 keep up the action of the general system  and the tendency to  the
 surface, and a stimulating injection or two, a day, be added.  After
several days, these free passages of acrid bile &c, will either cease 
88
of themselves or begin to weaken the patient.  If the latter effect
take place, use many warm and astringent injections, and give a
thorough course of medicines, steaming after the emetic, and con-
fining the steam below Jhe  waist, as already directed, till the lower
parts be as warm  as they can bear; then letting the steam all over
the system till the whole body is very warm before you dash  with
cool water.   Indeed, this is the best mode of steaming patients in
every case; for, while the lower parts are generally the coldest, and
need the most  heat, the  tendency of that agent is to rise as  high
as it can; of course, when the blanket is loose round the body, it
surrounds the head,  neck and shoulders,  and expands and stimu-
lates the- vessels there, more than those of the lower extremities,
which perhaps are the only parts that much need its influence.  In
proof of these assertions,  every attentive practitioner has observed
that, in steaming in the  ordinary way, the head, neck and breast
often become uncomfortably warm, while the knees and feet still
remain  cold; and, if he try my plan  of confining the steam below
the waist in similar cases, he  will find that the upper parts will  be
sufficiently heated, through sympathy with the lower, even though
the steam should not be permitted to surround them.
   Use of the Courses.—It should be remembered that the  courses
are intended to break down the morbid tension of the system, and
to disengage, at once, those accumulated  morbific materials which
the unaided efforts of the vital power are unable speedily to  re-
move.  Therefore, if the attack has been  acute, and the course has
been sufficient  to remove the cause, the restoration will be speedy;
but, if the case be chronic, and the organs much debilitated or in-
jured., some time  will be required to restore the tone of the organs,
even after the morbific  materials  are removed.   If, in this  case,
the  appetite and digestion be good,  and  the patient feel that she
is relieved from this burthen,  and gradually improve under a good
tonic treatment, the courses need not be repeated until she begins
to sink, or ceases to  improve, and even then, perhaps a more  ener-
getic use of the tonics and stimulants will supersede the necessity of
a course.  It is a fact well established by  the history of the Botanic
Practice, that those  who work rapidly till  they  remove  the  ob-
structions, and then keep up a thorough tonic treatment, are  more
 successful  with less courses, than  those who give a course once a
 week, and depend upon that chiefly  for  the cure.   Indeed, what
 is the use of removing half of the obstructions and leaving the or-
 gans too feeble to prevent the reaccumulation?  I have entirely
 cured,  in a very short time, many very obstinate cases,  by giving a
 full course of medicine every six hours for twelve  or twenty-four
 hours,  and I recommend this plan in all obstinate cases.   Why
 should  we fear such rapid  treatment?  Igive a course of medicine 
89
and feed the patient and let her rest an hour.  Finding her better
but not well, I reason thus: If one course has made her better by
removing part of the morbific  matter,  another course  will make
her still better by removing more of it.   I give it, and the reason-
ing is demonstrated.   I go on till the  morbific matter is removed,
and then find my tonic course to tell fast in the restoration of the
organs to a healthy  state.  To  know when I have given courses
enough, I commence the tonic treatment directly after each course,
and, when I find this treatment able to  sustain the action and ad-
vantage gained, know, of course, that I  have removed the primary
cause of the disease. After this, I give  them only when I find that
the progress of the cure is retarded by  a fresh cold,  or by the pa-
tient's neglect to keep up the action, or  by new accumulations of
obstructions through inability of the organs to prevent them.
   Let it be remembered, however, that multitudes, by  errors or
excess  in  diet, directly after  a course, prevent that  speedy re-
 action  of  the system which would  otherwise take place, and thus
 render necessary many an additional  course which prudence in
 eatin^and  exercise would  have enabled them to avoid,  lhe
 stomach has had a severe task during a course, and  should not be
 heavily loaded with food directly afterwards.
    Poultices.—la cases where there is  much soreness, inflamma-
 tion or ulceration, and the ordinary  courses  are not sufficient to
 remove the morbific matter with ease, poultices should  be applied
 to the parts affected.   The  intentions to be answered by poultices
 are two, relaxation and stimulation.   The ingredients necessary
 to  fulfil them are three, warmth, lubrication and irritation.  It is
 further necessary that means be used to keep these agencies con-
 stantly at work.  The warmth desired, may be secured either by
 aDDlvine  some non-conducting substance to prevent the escape ot
  the natural heat of the body, or by rubbing on  some irritating ar-
  ticle,  as cayenne,  &c, and the lubrication or moisture  suited to
  the case is found in a tea of? slippery elm or any  other mucilagi-
  nous article.                           ,         ...   ,
     It is also necessary, in cases of ulcers, that the poultice be a po-
  rous body, in order  to absorb and remove from the system  the
  morbific matter which it is calculated to aid the efforts of the vital
  power in throwing  to the surface.  As I have said in regard to food
  and medicines, the most effectual means of securing al  these ends,
  is a judicious combination, in one application, of all the agents
   hat Ire  calculated to secure any one  of them.   A  tea of slippery
  elm lime tree or other similar article, will furnish  the lubricating
  fluTd; lobelia and other antispasmodics will aid these in relaxing
  the pores; cayenne, ginger and the like, wil stimulate the nervous
  toe? so as to put  thl vascular system  in motion, a body of cracker, 
90
 wheat flour and other bulky and somewhat porous article will ab-
 sorb the morbific virus and preserve around the part the heat of the
 body generated by its own action. The thick slimy tea of slippery
 elm that remains in the poultice, dries on the outer surface in such
 a manner as to form a sort of skin or crust which prevents a very
 speedy evaporation of moisture from the remainder; that part of it
 which may be taken up by the absorbents, so lubricates the inner
 surfaces as to enable them to force along, without pain, the mor-
 bific materials contained in them, and here we have an explana-
 tion of the mystery that the same poultice should sometimes "scat-
 ter" a threatening ulcer, and  at others, "draw it to a head."
  Inflammatory tumors  are ordinarily produced by tho increased
 action of the  capillaries in  their efforts to move  forward certain
 morbific materials, which, either  from their own crude oc non-
 assimilated state, or from a collapse of the capillaries upon them,
 are obstructed in their progress.   Of course  these materials will
 accumulate, till, in some  way or other, the obstructions to their
 passage are removed.   The influences of a poultice containing the
 ingredients above enumerated, explained and illustrated, will re-
 lax the pores both where  the morbific materials are  lodged, and
 between them and the surface, dissolve and thin them and render
 smooth their passage, and stimulate the absorbents and secernants
 to move them along, some to  the excretory dutts within the body,
 and others to the surface from which  they will be removed by ab-
 sorption into the poultice.  If the quantity of morbific material
 deposited, be not too great or too corrosive to be discharged  by all
these means, without injury to the vessels containing it, it does not
 accumulate in any place, and therefore  it is said that it has been
 scattered; but, if the quantity be too corrosive to remain in, or pass
through the vessels without injuring them, the tendency of the vital
 action to force it to the surface, and the aid given  by the poultice
in relaxing the external secernants more than the internal, combine
 to produce what is called  a suppuration  or ulcer; and, with  few
 exceptions, the more corrosive or poisonous the morbific material,
the  more speedy will be the  progress to  the surface,  and the  less
extensive the swelling.
  From the  above explanations and facts, it is evidently unphilo-
sophical  to talk about  one poultice as a "drawing poultice" and
another as a  "scattering poultice," because all kinds of poultices
that are  worthy of the name, act upon the same principles.   A
poultice that would contract the surface and stop its action,  would
have the same effect on the  vessels deeper sealed, and, of course,
 produce an ulcer like the other, only under more aggravated and
painful circumstances.   It is also evident that it matters little what
are the particular, materials of which  you make the poultice, pro- 
91
vided they are known to contain the principles of relaxation, lu-
brication and stimulation, and will protect the part from atmos-
pheric influence and absorb the virus that the action of the system
has forced into contact with it.  These considerations are very im-
portant, as they do away all the necessity for searching after spe-
cific articles for a poultice, prevent the culpable neglect to apply
One  when needed, for the want of those articles, and enable the
practitioner to select, from nature's botanic garden, with speed and
judgment, such articles as he wants, whenever he cannot readily
obtain those with which he is familiar.  Thus, for example, when
I could not obtain lobelia to relax, 1 would take any other article
(not poison) that I knew to be nauseous or sickening to the taste.
For slippery elm, I would use basswood bark,  (Tilia) or the herb
saponaria, or any other  vegetable  of the  caryophyllous  tribe, or
any other plant that has very succulent or slimy leaves or roots,
as lilies &c.  For cayenne or ginger,  I  would take  snakeroot,
prickly ash  or any other article  (not poisonous) that would pro-
duce a permanent stimulating and heating effect, when rubbed in
my hands &c.   These directions are not given to induce persons
to be continually experimenting with new articles,  but to enable
them to  accomplish the humane and benevolent object of healing
the sick, at all times and under all circumstances, even though they
may not have at hand, the best means of doing it.  When a part
becomes debilitated, and there is danger that  morbific accumula-
tions may be directed and deposited there, as in the incipient for-
mation of wens, polypuses, and the like, an astringent is applied to
advantage.   By collapsing the capillaries it  checks the determi-
nation to the part, when the venous radicles remove what is there,
and this has been termed scattering the swelling.
   Remedies—Simple.—From what I have said on  the subject of
vital action, on the simplicity of its  intentions, (notwithstanding
the great variety of its modes or symptoms which the fruitful and
erring fancy of man has transformed into so many evidences of a
great number and variety of invading  and active enemies to life
and health,) and on the three classes of remedies that are calcu-
lated  the most effectually lo remove all obstructions, it is evident
that the best means of knowing and applying our remedies, are to
keep these  classes, as far as it can well  be done, in their most sim-
ple state.   For example, if we keep lobelia in the seed, and cay-
enne, bayberry and bitter root, by themselves, either crude or pow-
dered by our own hand or under our own inspection, we are better
 able, in the first place, to judge of their genuineness, purity, quali-
 ty and power, and the character and  degree of their effects on the
 system, than if they are combined with other articles; and, in the
 second, to unite them in a moment in such a manner as to suit the 
92
condition of each and every patient.  It is therefore evidently bet-
ter to keep all our remedies in a separate state, except where their
specific action can be  rendered more  speedy and powerful, by
combination with something else.   For articles in their simplest
form, classed  according to their powers  and intentions, as  anti-
spasmodics, stimulants, laxatives, astringents, bitters, demulcents,
diaphoretics, &c, to which arrangement I shall hereafter aid you,
will always provide you  with the best  means of bringing  all the
powers of your science  and your art to bear in the most effectual
manner upon any given case. Thus, to unite all the simply relaxant
or simply stimulant,  or simply astringent, or simply diaphoretic
modes and means in the same process, is to produce a much greater
specific effect, than to  use any of these means  and processes in
connexion with others.
   But I have already proved that most vegetables  contain various
active properties, and, of course, that the effects they produce on
the system, are not the specific effects of any one property, but the
predominant effect of some over others,  or the resulting effect of
the combination.   In this sense, many single vegetable prepara-
tions, as an astringent bitter, like birch; a bitter cathartic, as bit-
ter root; or an  astringent stimulant, as bayberry; are actually
compound medicines.  If we  could separate one of these prin-
ciples from the other,  the medical effect of each would be differ-
ent from that of the  combinations and  more powerful in its own
way.   To do this, as far as we can,  is certainly desirable.  I
would therefore recommend the procuring of essential oils by dis-
tillation, of extracts by boiling down the decoctions, compressing
the juices &c, by  preserving them in spirits or oils.
   There are, however, many articles that cannot  be made lo act
speedily and  powerfully in their simple state, and these we are
obliged to  combine  with others that are calculated  to prepare
their  properties  for  absorption into the system.   For  example,
gum myrrh is not so suited to the immediate wants of the system,
till either digested or dissolved in alcohol.  The* relaxing property
of lobelia seed, is more available  in sudden emergencies,  in the
concentrated  tincture  of the 3d preparation, than in the form of
powder, and,  of course, when combined on scientific principles,
the more condensed and better suited  to assimulation, the more
speedily will its benefits be felt.
   Compounds.—I consider the  compounds made by Dr. Thomson
as among the most  judicious that can be made.   They are so, be-
cause they were framed by experience, and are calculated,  of
course, to be generally  useful.  Their usefulness can be increased
by variations to suit particular cases, and by the condensation of
their powers,  so far as that can be effected  without altering their 
93
nature; but, it is equally true that any condensations are objec-
tionable which, on account of the trouble or expense  of effecting
them, open the door for designing, avaricious and unprincipled
men, to injure, destroy and corrupt or adulterate them, and thus,
by monopolizing the sale at a high price of what cost them little
or nothing, to make  themselves rich at the  expense of the cre-
dulity, the health and ultimately the life of the people.   I would
therefore recommend to all practitioners and to every  family,
  1st.   To collect or purchase, in their crude state, all the valuable
remedies within their reach, and to prepare,  of each, at  least as
much as they may  probably want for their own use,  in the most
condensed and efficient form that their  knowledge will suggest,
and  their means will enable them to effect.  Some will be able to
do much more of this work than others; but I solemnly  warn
every man that  the moment he commences to trust to the know-
ledge, skill, means and faithfulness of another, to do what he can-
not effect himself, that moment he takes  the first step which may
end  in risking his life in  the hands  of an unprincipled villain.
The wisdom and  benevolence manifested by Dr. Thomson, in ex-
hibiting the ingredients and proportions of his compounds, and in
recommending,  teaching and  permitting  every  man to  prepare
them for himself, cannot be too highly commended.   Though no
man who understands the real value of the blessing thus conferred,
will  think  it overbalanced by paying the paltry  sum of twenty
dollars for the little  "Guide to Health,"  or will, for any trifling
reasons, abandon it for other means of doubtful character and
value, still, on the other hand,  no one who is  able to  give greater
efficiency to Dr.  T's means, or to aid them by others of similar
character, or of superior efficacy, if such be found, will hesitate to
do it, for fear that he should be branded with degrading  epithets
for attempting "improvements on  perfection!"  If  any man  is
able to make real improvements even on what is by many counted
"perfection," I say let him do it.   All  I want is,  to be sure  that it is
an improvement.   But improvements  that  are available only to a
few choice spirits, even though good  in themselves,  can scarcely
be considered, on the whole,  desirable.  They compel  the few
that devise them, often to use inferior articles, to satisfy the increas-
ing demand,  if not to  endeavor, for  the sake of fame and filthy
lucre,  to destroy the confidence of the many  in the value of that
which is not only as good, but within the reach of all.
  I would not be understood to say that, in no case are we to trust
to the honesty and fidelity of other.?,  for what we cannot  piepare
for ourselves;  we are under the indispensable necessity of  doing it
in many cases.   The principle I  advocate is, that we  should do it
as little as possible, and least  of all  in preparing food and medi- 
94
cine, in which our health and life are concerned.  The reason H
this.   In proportion as the manufacture is confined to a few,  in
just that proportion will the demand on the few increase:  As the
demand is increased, so will  increase the difficulty of obtaining
genuine and efficacious simples for the manufacture.   Indifferent
articles will be considered better than none.  The security which
compounds afford against  detection  of fraud, even when the in-
gredients and proportions are professedly made known, the greater
profit made on the mass composed of cheap ingredients,  and the
lasting influence of a fame acquired, perhaps at first justly, by the
manufacture and sale  of  a good article—all combine to deter-
iorate a compound food or medicine, whether secret or not, and
consequently  to  jeopardize the. health and life of him who  buys
and uses it.
   To illustrate.—I go to the fields and gather the seeds of lobelia,
I raise  my peppers in my garden, and gather my myrtle  or  bay-
berry from the sea shore, my balmony from the water courses, and
my bitter root from the uplands or sandy intervales.  I now know
what I have,  and can estimate their power and  depend on their
effect.   If I buy these articles of my neighbor, I am not sure that
he may not have gathered, through  mistake, if not design, some
of the  seeds of  campanula or of the poison  cardinal flower for
lobelia inflata.   The cayenne brought by the merchant, may be
much adulterated by the  introduction of other fruits of similar
shape and color,  especially if ground.  My bayberry may be the
bark of the branches instead of the root, if not even much alloyed
with that of some other bush; my balmony  and bitter root may
suffer as much, if it be in no other way than by being gathered in
the wrong season.—Indeed,  what attentive practitioner has not
observed that the most of the  simple articles of the Botanic Ma-
teria Medica  have actually diminished in power, as the  demand
for them has increased?  Take another step into the liabilities to
deterioration and abuse, and who has  not observed that it is now
far more difficult to get good composition, spice bitters &c,  than
it was five years ago?  Is it not then, evident, that the more com-
plicated and difficult  to be made, the compound, whether for want
of the  whole ingredients in their purest state, or of the ability or
honesty of the maker to be faithful, the less likely is the medicine
to be genuine and good?   And do we  not actually find it so?  Is
it not sometimes the case that a skilful practitioner fails by the
use of  medicines which he purchased, and of which, for that rea-
son,  he did not know the genuineness  and the power; when, had
he gathered and prepared  the articles with his own hand, he might
have succeeded?
   If such things happen where  the whole matter is open to in- 
95
spection, and that loo without charging any purchaser, manufac-
turer, vender or practitioner with deliberate design to do wrong,
what are we  to expect from rushing with our eyes wilfully blind-
folded into the arms of those who manufacture nostrums, in such a
manner as to elude the detection of fraud, without the possibility
of any other motive than the mere monopoly to themselves of all
the money that can be made by it? every motive of philanthropy
urging them, if they have really made any valuable discovery, to
make a fair disclosure to the world!
  I would then conclude this article by repeating the recommen-
dation to every one to gather all the simples that he can, and make
as many as he can of all the compounds that he wants.  When he
must purchase of others, let it be in as crude a state as will answer
his purpose, and always use first in practice those simples or com-
pounds with the nature and powers of which he is the best acquain-
ted.   A strict adherence to  this advice will  soon enable him to
arrive at almost entire independence of others, and freedom from
hazard, in the supply of his own medical  wants and  those of his
household, and confer on him and his, the greatest blessing limited
to earth, a sound and healthy body, through which the  immortal
spirit can have free and perfect exercise, in the accomplishment of
all her vast  philosophic, and benevolent aims.
   Instructions for  making  compounds.—In accordance  with the
principles just laid down, I proceed to give some specimens of my
practice for the consideration and profit of all who prefer knowing
what they do and why they do it, to becoming the mercenary tools
of others who, by withholding  these important matters, literally
say that men are not worthy to be trusted with the knowledge of
the means of preserving life and health.
   For the eighteen  months previous to 1814, I had been affected
with a pain at night in my arm.   Being informed by an old gen-
tleman too  familiar with  the complaint, that it was  rheumatism
and proceeded from cold, I determined to burn it out. I obtained
a number of red pepper pods, put them into a pint of vinegar and     m
 boiled them till there was but a small quantity of the fluid, with
 which I bathed my arm for half an hour, heating it in by hiding
 a hot shovel near it.  I then took out the dregs, put them  on a
 large piece of flannel, bound them round my arm and went to bed;
 but, such was the intolerable irritation that I felt no  disposition to
 sleep till about daylight, when  I drowsed a little. So much of the
 article was absorbed that it produced a burning heat and redness
 which spread over my whole side, neck, face and head, and did not
 entirely cease  its action for more than a week. | But I felt not
 another vestige of the disease for three years, whlen it returned
 again in the same place.  I repeated the experiment, with the 
96
 tame success.  I felt no more of the disease till, in 1832, I com-
 menced the Thomsonian Practice, when the frequent and sudden
 changes from a hot room and a free prespiration, to a  driving on
 horseback through a keen northwester, or a cold, d.imp and drea-
 ry northeaster, gave me colds and produced rheumatic pains, not
 only in  the arm but in other parts of my body.   I now bathed
 with Dr. Thomson's Rheumatic Liniment, and took No. 6 accord-
 ing to his directions, but it did not touch the disease.   I  doubled
 the portion of cayenne, but  still failed.   I again  resorted to my
 old plan of bathing with vinegar as strong of cayenne  as I could
 make it, and was soon cured, and still remain so.
   Stimulating Liniment.—Cayenne has ever since been  my stimu-
 lator; its strength  being obtained either by boiling  it in vinegar
 or in neatsfoot or goose oil or fresh butter, and pressing it out hard.
 The oils enable it  to retain its power longer, and they aid, by lu-
 brication, the action of the capillaries. This liniment may be con-
 cealed  by aromatics, injured by gums, and counterbalanced by
 poisons;  but it will not be much improved  by  them.  I object to
 gum myrrh in  a mere stimulating liniment, to be used where there
 is only inaction and no danger of putrefaction,  for it tends to close
 up the pores.   There are, indeed, other stimulating  articles that
 would aid the  cayenne, if combined with it; but, as  they are not
 indispensable  nor  always convenient,  I omit lo mention them.
 Spirits are too cooling  for  any case but a hot skin, and it  is much
 better to dispense with them, even  in this, than to keep  them in
 the house.  The soft animal oils are preferred, because they do not
 prevent the perspiration;  and volatile oils evaporate and  cool the
 surface too quick except in cases of fever.   The vegetable oils, as
 oil of sassafras, juniper, origanum &c, are good; but, as  they must
 be bought from the merchant who, in his turn, obtained them of the
 distiller or presser, how can we be sure  that they are good? Some
 may think there is little danger  of their being impure; but I can
 assure  them, that it is  no easy matter to obtain them in their pu-
 rity, and the more valuable they are, the more likely they are to
 be adulterated.
   AJady fell upon a chair and bruised  her eye very much.  It
 turned quite Mack.  After suffering it to extend for several days,
 she applied for relief.   I bathed it frequently with No.  6 which
 relieved it some.   I then put a tea-spoonful of cayenne into a half
ounce phial full, and directed her to put it on often enough to keep
the part constantly smarting.  In twenty-four hours it was entire-
ly natural. From these and a multitude of similar fact3,1 can as-
sure you  that Jcayenne, although  when strong it is very unpleasant
 to bear, will,}n no form in which you can apply it, produce a blis-
ter or mortification, but that, on the contrary, it is not excelled by 
97
any known article in ils power to prevent both.  This should be
used in all bruises  and places where the blood settles and turns
purple, and put into old sores, especially if they contain proud
flesh.
  Antispasmodic Liniment.—If it could be obtained in sufficient
quantities, the oil of lobelia would probably be the best article for
this purpose; but that is not yet certain; for, as other parts*of the
plant than the oil are certainly relaxant, their properties may be
advantageously  employed in  the composition of the  liniment.
1st.  Bruise the young plant, add as much vinegar, press  out the
juice with it, and cork it up.  2d. Take the bruised seeds  of lobe-
lia and powdered nervine, and make a saturated  tincture in vine-
gar.   This is an excellent article to open the skin in cases of swell-
ing, fever or inflammation.  3d. Put the powdered seeds of lobelia
into twice .as much neatsfoot or goose oil, sweet oil or fresh butter,
and keep them  warm  but not scalding hot, for five  or  six hours,
then press with  a  very heavy weight, through a  strong cloth and
preserve it for use.  To cure sores  on the surface, or counteract
the effects of corrosive poisons, the above cayenne and lobelia pre-
parations or others of similar character, should be united.
   Tonic Liniment.—It is very evident that, for the contraction of
relaxed parts, some kind of astringent is  necessary; but, as is ij;
also certain that vital action is indispensable to  the restoration of
a healthy condition of the debilitated organ, astringents alone will
not answer  all the indications for the use  of this species  of  lini-
ment.   We must therefore not only prepare some of the most as-
tringent articles either  in  liquids  or oils, but  we  must add to
them  the stimulant properties  of cayenne or some of its various
equivalents.   A strong  decoction of  witch hazle, red oak bark,
common galls, birch  bark, or  any similar article, with cayenne,
will effect this object.   Every  body in the country is acquainted
with some powerfully astringent,  yet innocent article, to which he
may resort for such a purpose.   If he can add to it others  that are
valuable, let him do so, but let him not hesitate to use  one good
article, because he has not at hand all the others that may bp re-
commended  to  accompany it.   It  is  painful to receive, almost
daily,  from Thomsonians  in different parts of the country, from
Maine to Texas, and  from Florida to Wisconsin, the lamentation,
that the people  must call in an M. D., because they cannot get all
the articles  necessary to make the  several compounds, so much
praised by some of the fraternity, nor  even the  few very simple,
but very useful ones recommended  by  Dr. Thomson, w hen I am
fully convinced  that, were one who thoroughly  understands  the
principles I  have here presented, and the science of Botany, caught
in any of those four quarters,  or any  spot of ground within  the
             7 
98
 compass of a line that should surround them all, and deprived of
 every accredited article in the Botanic Materia Medica, he would
 soon muster, from the fields of frhat region, reniedies sufficient to
 cure nine-tenths of all the forms of disease  to  which the inhabit-
 ants of  the place are liable.  I  therefore impress again on your
 minds,  the importance of becoming  well acquainted  with the
 true principles of medical science, with the science of Bolany and
 the art of applying the remedies effectually in  the prevention and
 cure of disease.
   Unless this is done, avaricious and  unprincipled men will im-
 pose on the public, by preparing worthless compounds and vend-
 ing them at enormous prices; practitioners will fail in their attempts
 to cure with these preparations;  confidence in the whole system
 will be lost or greatly shaken; the regulars will cry,  "I told you
 so," and the whole world will again fall into the cruel tender mer-
 cies of calomel,  opium and the lancet.
   But, I may be asked if the  obviously good effect of a medicine
 is not  an all-sufficient reason  for us to believe it good in itself,
 whether we know its  constituent principles or not?  I answer no,
 by no means.   This is the rock on which all learned quacks have
 split—the very foundation slone of the boasted four thousand years
 experience.
   The Doctors say, "Bleeding removes spasms;" it is true.   They
 continue, "Calomel opens the bowels"—true again.  "Opium eases
 restlessness and pain"—even so.  "Sugar  of lead stops bleeding
 and diarrhoea"—still  correct.  "Ice  cools  a fever"—can't dis-
 pute it.
   But I  am not  quite ready for the conclusion, that, therefore,
 bleeding should be prescribed  for spasms, calomel for costiveness,
 sugar of lead for cholera and dysentery, ice for fever, and opium
 for delirium  and pain.   Surely not.  Of what  use then  to the
 practitioner, is the criterion so boastfully set forth by a certain
 celebrated nostrum maker, that no remedies purporting to be his, art
genuine, unless they immediately relieve pain?   We know that pain
 may be removed in two ways—by removing the  cause of it, and by
 destroying the power  of the nervous system to be  sensible  of it.
 Opium and strammonium, and many other articles, will surely re-
 lieve pain, but, is it a matter of no importance in which of these
 ways they do it?  Suppose the action of the living principle should
 recover, in some, yes,  in  many cases, the healthy tone of the or-
 gans, in spite of the bleeding, calomel,  opium, lead, ice, strammo-
 nium &c, is it right to attribute to all articles called medicines, the
good results that may  have been produced by the sanative  efforts
of nature in opposition to the specific tendency of those articles?
It is weH  known too, that a majority of good articles in a compound, 
99
will often entirely overrule the evils which the minority of bad are
Calculated to produce.  This was the case in the cholera medicine
of the celebrated Dr. S. Cartwright of Natchez, Mississippi, who
was rewarded with the honor of a service of plate, for mixing so
much cayenne with  his calomel, that the medicine cured a great
many patients, in spite of both the disease and the poison!  Who
docs not see that the only way in which we can rierhly estimate the
value of any compound, is to become thoroughly acquainted with
each  and every ingredient in its separate state?
   Lastly, when a practitioner is ignorant of the true therapeutic
principles, and uses secret nostrums or even compounds professedly
made after a well known recipe, if he  should fail in a given case,
how shall he know whether the failure is to be attributed to the
science,  the skill, the general remedy or some ingredient in it, or to
the only proper and  legitimate cause,  the total loss of vitality in
the essential organs?  and, if he knows not where the fault lies, how,
I ask, can he apply the proper remedy?
   Classification  of remedies.—It is not the object of this little
book to exhibit the entire materia medica, nor to teach the whole
theory and practice of medicine.   It is presumed that all who pur-
chase it, will possess some other  work in  which these subjects are
more  minutely set forth.   I shall merely insert the catalogue of
articles prepared by  my friend Dr. A. C.  Logan, and published in
the 2d volume of  the Thomsonian Recorder, page 351, with the
addition of their several  predominant powers or properties, so far
as I am able to determine them.
   Those that relax the  nervous and muscular fibre,  I shall call
antispasmodic and relaxant; those that  contain tannin and con-
tract it, I shall call astringent; those that contain acrid principles
which so irritate the  nerves as to produce both relaxation and con-
traction, I shall call  stimulant;  those that furnish the bitter prin-
ciple, I shall call bitter; those that have a very slimy or  mucous
parenchyma,  I  shall term  emollient; those that  strengthen the
system, or restore  the power of the organs, I shall call tonic:  and
1 shall, in general, endeavor to arrange these in the order of their
predominating properties.  The  difficulty  of  this  last task may
subject me to some errors, but I am happy to say that these errors
are of little importance.
  I would remark, in general,
   1st. That, as  all relaxants open the  pores of the system, they
must necessarily be measurably secernant and deobstruent; that is,
they must indirectly promote salivation, gastric and biliary dis-
charges, the internal secretions and perspiration. On this principle
we find  that lobelia increases the saliva, the  perspiration, and
sometimes even the urinary and alvine discharges. 
100
  2nd.  That all stimulants, because they recover the action of the
system, must necessarily be more or less deobitrueut and tonic, or
restorative; these effects, with proper nourishment, being all that
is necessary to bring the system to a healthy state.  Hence we find
cayenne to be so valuable in the removal of canker, and in the
restorative treatment.
  3d. That the only reason why canker medicines are so useful in
the removal of obstructions, is, because they contain such varied
combinations of irritating properties as to promote both relaxation
and contraction, or action and reaction, which are but other terms
for  stimulation.   The  acrid effect of bayberry on the glands of
the mouth, is  a striking illustration of this position.
  4th. That it is improper to use pure  astringents while there is
much canker in the system to be removed—The fact that the regu-
lars could never cure the dyspepsia with bitters, nor the diarrhoea,
dysentery nor cholera with opium, may  serve to illustrate this re-
mark.
  5th. That it is equally improper to use antispasmodics and re-
laxants, when it is our sole object to tone up the system, and,
  6th. That  when we are  in  perfect health, stimulants are not
wanted and of course are improper.
                  MATERIA MEDICA.
            CLASSIFICATION OF PRINCIPLES.
                   Division  1st.—Simples.
                     Class 1—Relaxants.
  This class includes those that merely reduce the tension of the
organs.
  The purest and most powerful known to us, that is also perfect-
ly harmless, is Lobelia Inflata.
  It may be aided by all the articles that move the bowels, pro-
mote perspiration or any other secretion, and make the person feel
weak and free from excitement.
                    Class 2—Stimulants.
  This class includes those  that stimulate the system to a uniform
action and reaction, and leave it in neither a relaxed nor contract-
ed state.
  The purest is Cayenne, to which we may  add Ginger, Red and
Black Pepper &c.
                     Class 3—Bitterrs.
  That which comes the nearest to a simple or pure bitter, is Bal-
mony.  Golden Seal, Aspen bark, Barberry and Peach and Cherry
barks, leaves and kernels, are approximations towards it. 
101
              Division 2—Natural Compounds.
                   Class 4—Astringents.
  Tannin is the principle  of vegetable astringency, but it is not
found pure in any one article.   It predominates in Witch Hazle,
Sumach, Marsh  Rosemary, the leaves of Birch, Alder and forest
Poplar, Hemlock bark, and any other article which, when chewed,
will dry  up the saliva, and permanently contract the muscular
fibre of the tongue, cheeks &c.
                           Class  5.
  Articles containing many properties, the principal of which are
mentioned in connexion with each.
  The following are prominently Antispasmodic, partaking also of
the otlier properties named.
  1. Lobelia Inflala.  Muscular relaxant, antiasthmatic, sialagogue,
and general secernant, through relaxation.  Its effects are follow-
ed by reaction of the stomach and chest, or emesis.
  51—52. Verbena Hastata, Verbena Urticifolia.   Blue and White
Vervain.  Nearly similar, but stimulant, (not used.)
   19.  Cypripedium  Pubescens, vel Parviflorum,  vel Luteum et Hu-
mile, vel Acaulc.  Umbil or Valerian.  Nervine and bitter stimu-
lant.
  68.  Panax  Quinquefolia.  Ginseng.   Nervine, stimulant and
secernant.
  4. Kymphaa  Odorata.  Pond  Lily.  Antiasthmatic, stimulant
and secernant.
  41. Arum Tryphillum.  Wake Robin.   Stimulant and secern-
ant.
  44. Gallium Verum et Aparine. Cleavers*  Stimulant and secern-
ant.
  The following are variously and prominently stimulant.
  2. Capsicum Annuum.   Cayenne.  A pure stimulant, of course,
secernant, deobstruent and tonic.
  21. Zingiber Ammomum.   Ginger.  Stimulant, secernant,  de-
obstruent and tonic.
  22.   Piper  Nigrum.  Black  Pepper.   Like, biit  inferior to
Ginger.
  24. Oleum Terebinthina.  Spirits of Turpentine.  Balsamic and
and tonic.
  3. Mybica cERrFERA.   Bayberry. Astringent.
  11.  Erigeron Purpureum.  Squaw Weed.   Deobstruent and
tonic.   We have never been satisfied that this article is really  the
Squaw Weed of Dr. Thomson.
  23.  Lauras Camphora.   Camphor.  Astringent.
  25. Mentha Piperita.   Peppermint. Secernant and deobstruent.
  26. Mentha Viridis.   Spearmint.   Antispasmodic and nervine. 
102
   557. Saturcia Hortensis, vel Satureja Hortensis. Summer Savory.
 Secernant and tonic.
   28. Hedeoma Pulegeoides.  Pennyroyal.  Secernant and tonic.
   37,  Matricaria  Vulgaris,  vel   Chrysanthemum   Parthenicum.
 Featherfew.  Secernant and tonic.
   43. Geum Virginianum.  Evan Root.  Deobstruent and tonic.
 The Geranium-maculatum is also sometimes called Evan root.
   45. Abies, vel Pinus Balsamea.   Balsam Fir.   Balsamic and
 tonic—healing.
   48. Sinapis Alba, et Nigra.  Mustard.   Secernant and tonic.
   47. Aristolochia Serpentaria.   Snakeroot.    Do.   do.
   53. Solidago Odora.  Golden Rod.  Balsamic and tonic.
   49. C«chlearia Armoracia.  Horse Radish. Secernant and tonic.
   54. Pyrola Umbellata.  Pipsissiway (green,)       Do.  do.
   55. Pyrola Maculata.    Do.     (white)         Do.  do.
   56. Cnicus  Officinalis.   Bitter Thistle.   Bitter, secernant and
 tonic.
   57. Rumex Crispus.   Yellow Dock.  Acrid and cathartic.
   58. Carduus Benedictus, vel Centaurea Benedicta. Blessed Thisle.
 Bitter, secernant and tonic.
   59.  Zanthoxylum Fraxineum.   Prilkly Ash.   Secernant  and
 tonic.
   60. Pyrola Rotundifolia.   Wild Lettuce.     Do.   do.
   62. Hclonias Dioica.  Colic Root.    Do.  do.
   65. Lycopus Vulgaris, vel Europeus.  Archangel,  (light green.)
 Do.   do.
   69.  Myrica Gale.  Meadow Fern.  Balsamic and tonic.
   70. Trifolium Pratense.  Red Clover.  Mild escharotic.
     The following  are prominently bitter:
   12. Chelone Glabra.  Balmony.   Secernant and tonic.
   34. Anthemis JYobilis.  Chamomile.  Secernant, stimulant and
 tonic.
   31. Anthemis Colula.  Mayweed.    Do.   do.
   29. Marrubium  Vulgare.   Hoarhound.   Antispasmodic  and
 tonic.
   30. Inula Heltnium.  Elecampane.  Demulcent and tonic.
   13.  Berberis Vulgaris.  Barberry.  Stimulant, deobstruent and
 astringent.
   14. Amygdalus Persica.  Peach.   Stimulant, deobstruent and
 tonic.
   15. Apocynum Androsamifolium.  Bitter root.  Laxative, stimu-
 lant and tonic.
   16.  Hydrastis Canadensis.  Laxative and tonic.
   17.  Frasera  Verticillata.  Mild cathartic and emetic.
   18.  Prunus  Virginiana.  Cherry.   Stimulant, astringent and
tonic. 
103
    20.  Amyris Kataf, vel Myrrlta.  Stimulant, antiseptic and tonic.
    32. Artemisia Absynthium.  Wormwood.  Stimulant, deobstru-
 ent tonic.
    33.  Tanacetum  Vuigare.   Tansey.  Stimulant, secernant and
 tonic.
    38. Betula Lenta.   Black Birch.   Astringent and stimulant.
    39. Celastrus Scandens. Bittersweet.  Stimulant, secernant and
 tonic.
    42.  Eupatorium Perfoliatum.  Boneset.   Relaxant, stimulant,
 emetic and tonic.
    50. Juglans Cinerea.   Butternut.   Stimulant and Cathartic.
    61.  Aletris Farinosa.   Unicorn.  Acrid, Stimulant, secernant
 and tonic.
    63.  Coptis Trifolia.   Gold Thread.  Stimulant, secernant and
 tonic.
    61. Lycopus Virginicus.—Var: Ruber.  Archangel, (dark.)  Bit-
 ter stimulant and tonic.
    10. Populus Trepida, vel Tremuloides.  Poplar (yellow.)  Stimu-
 lant and secernant.
    Ptelea Trifolia.—Stimulant, deobstruent and tonic.
    Jeffersonia  Diphylla et Lobata.—Stimulant,  deobstruent  and
 tonic.
     The following are prominently  astringent:
   8.  Hamamelis Virginica.   Witch Hazle.   Stimulant and, when
 green, demulcent and tonic.
   9.  Rubus Strigosus.  Red Raspberry (wild.)  Stimulant and,
 when green, demulcent and tonic.
   6.   Statice  Carolinian®.   Marsh  Rosemary.  Stimulant  and
 tonic.
   7.  Rhus Glabrum.  Sumach.  Stimulant, secernant and tonic.
   5. Abies, vel Pinus Canadensis.   Hemlock.  Stimulant, secern-
 ant and tonic.
     The following are prominently emollient:
   46.  Ulmus Fidva, or Slippery Elm.  Basswood, Comfrey, Sapo-
 naria, Adder Tongue, Field Sorrel, Hollyhock, Mallows, &c.  All
 excellent in poultices.
   Though, by reference  to the principles, page 68 and onward,
 and a practice accordant with them,  all the forms of disease pecu-
 liar to women and children, if taken in time, may be removed; yet
I shall now present the common  forms to which they are liable,
making further remarks on some that have been mentioned, and
prescribe  what I deem a judicious  and  effectual  mode of treat-
ment in all.
  Disease, Peculiar to Females.—Adhesion of the Labia Pudendi.
Inflammation of the external parts.   See page 25, and onward. 
104
   Constant cleanliness  of  these parts,  merely washing them in
warm water two or three times a day, and  then  greasing them
with sweet oil, or butter melted before it has-been salted, will pre-
serve them from irritation and inflammation}and, of course, adhe-
sion.  A general purification of the system  by the canker teas,
cayenne and frequent steamings, or washings with warm water,
will prevent the supply of the canker which produces sores in these,
as well  as in all other parts.   The inflammations, suppurations,
swellings,  tumors, warts, polypes, &c,  found in these parts and
in the vagina, are made up of  the  cankery humors and morbid
secretions  that lurk here for want of attention to the free action of
the system, and to cleanliness  of the parts.
   Sores.—If cleansing and  greasing and a free use of canker teas
and the course, should not be  sufficient to cure any  sores that may
break out about the external parts, or to reduce any swelling, poul-
tices of slippery elm, ginger, cracker and lobelia, (adding a little  4
cayenne if necessary,) should be applied till the disease is removed.
The  form of disease called  pruritus, which so much troubles with
apprehensions, the mineral faculty and baffles their skill, will readi-
ly yield  to this course  of treatment.  When disease is  in the va-
gina, it must be met by injections suited  to its character.
   Except  the  above, and  others  before mentioned, the forms of
disease with which females  are  attacked, present little that is pe-
culiar to them till about the age of  puberty, especially if care be
taken, according to our directions, to keep them equally comfort-
able all  over as to their clothing.  If this latter point be neglected,
then the female  may  expect, as a certain consequence, sooner or
later, an ample reward for her folly, in a postponed and suppress-
ed, or a painful and irregular menstruation.
   Daring the period from infancy to puberty, care should betaken
to keep the lower extremities  warm,  by  wearing thick cotton
drawers in warm weather, and flannel and thick shoes and  stock-
ings  in cold; and, if girls should be so unforunate as to take a lit-
tle cold, instead of giving  them calomel, that (I had almost said)
greatest enemy to the female frame that  ever bore the name of
medicine,  let them take hot, ginger,  cayenne,  composition  or
other stimulating and sudorific teas, keeping the  feet  warm till
a free perspiration throws  it  off, or, if  necessary, let them take a
full course of medicine.
   Swellings.—Swellings of all  kinds, wherever they occur, arise
from obstructions of some sort, to the action of the organ or organs
affected.   Thus the dropsy in the flesh, is occasioned by a collapse
in the skin that prevents the serum  of the blood from escaping in
 the  form of perspiration.   Inflamed tumors  may arise  from this
 collapse, but more commonly from the lodgment of morbific mate- 
105
rials in the parts.  They may also succeeed organic lesion. I say,
these things and others may be the cause of various forms of dis-
ease; but, let it ever be remembered, that the true cause of all ac-
tion in the system, (except mortification—chemical action.) is the
presence of the vital power; and, that the action of the organs will
always be proper or improper, in proportion to the capacity or con-
dition of those organs to be acted upon.
  All poisons, in any  quantity, diminish, and, in larger quantities,
destroy entirely, the capacity of the organs to be acted upon.  This
is proved by the fact that the more they are taken, even  in small
quantities, the less striking is the apparent result, that is, the less
able is the living power to bring the organs to operate upon them.
This is the reason why it is so much more difficult to restore a pa-
tient to sound health  after he has been treated a long time with
calomel, opium &c, even though he should not appear very  sick,
than  to cure one that has  just been attacked, though ever so vio-
lently, by disease in almost any form.
   To cure swellings,  then, of every description, relax the  parts,
generally if the swelling be general, and  locally if it be local, and
then stimulate the organs  lo a healthy action to remove the mor-
bific matter.  (See "Ways and means," page 69 and onward.  The
swelling of the lower  limbs in females, is sometimes caused by the
weak and relaxed state of the veins and absorbents, which, instead
of forcing the fluids up into the body, enlarge and allow too great
a quantity to remain in them at a time.   The frequent  and faith-
ful  application of the  stimulating and astringent liniments, (pages
96, 97,) after the system has been  thoroughly cleansed by courses,
will correct  these evils.  Sometimes,  particularly  during preg-
nancy, the lower limbs swell because the fcetus presses on the veins
and lymphatics in the pelvis; this  may be removed any  time  by
lying down awhile, with the pelvis  and lower limbs higher than the
shoulders.   Ladies thus affected, should not allow themselves to be
constantly walking.   Let them frequently assume, for a short time,
the position above mentioned.
  Menstruation, as a form of Disease.—I have already remarked
that the early or tardy appearance, the small quantity, or the pro-
fuse discharge of the  menses, is no proof of disease, without some
other concurrent symptom, as general debility, congestion in the
head, palpitation of the heart, cold feet and hands, clots of blood
in the discharge, top frequent occurrence &c. &c.   It is obvious,
therefore, that a mere retention of this fluid beyond the usual time,
is not lo be considered disease, much less to be treated on any other
than general principles, and  with those universal remedies that are
calculated to promote the general health and remove all the causes
of disease without regard to name. 
106
   When the retention is connected with serious derangements of
 vital action, as evinced by cold extremities,  flushed countenance,
 palpitation of the heart &c, great pains should  be taken to heat
 thoroughly the cold extremities, by confining the blanket round
 the waist in steaming, wearing flannel drawers &c, and by using
 stimulating liniment.  (See page 96.)   Direct efforts should also
 be used to  relax the parts constricted, by warm  fomentations, in-
jections of lobelia &c.  If the uterus swells so as to indicate an
 accumulation of the secretion in its cavity, and the general treat-
 ment does not succeed  in a reasonable time, introduce a catheter
 and discharge it.   If a membrane cover the os uteri, (a very rare
 occurrence,) it must be pierced by  a sharp pointed instrument.
   Regular physicians recommend and practise in the above eases,
 bleeding, purging., low diet &c, and warn their students and pa-
 tients against taking stimulating remedies and generous food; but,
 after all, nothing  is more common  in medical practice, than for
patients who have exhausted all  their still to  no good purpose,  to-
go to the Thomsonians and be  steamed, puked, stimulated with
cayenne, and fed  with nourishing diet, and thus, in a few weeks  or
months at most, to recover sound health.  Dr. Dewees finds the pa-
tient "laboring under  severe  headache, pulse  full and a little
quickened; tongue slightly  furred,  appetite impaired and bowels
costive;" suppression caused by "standing on a damp brick-paved
cellar in a hot day, at the warm employment of preserving."   Her
mother  "put  her  feet in warm water and gave pennyroyal tea
which removed the chills, but did not restore the discharge."
   For three.months, she took  "remedies" (doctors' emenagogues,
I suppose,) and then called  him, who found her  as above stated.
Had he been a friend of vapor, cayenne and  lobelia, three hours
would, in all probability, have been sufficient to relax the parts and
restore the discharge; but he "directed  her to lose  12 ounces of
blood, to be freely purged by senna and  to confine herself to ren-
net whey, barley water, or thin  topioca for nourishment."   The
next day he repeated the order  for purging, directed a continuance
of the diet, and added the aloetic pill every night.  After several
days her menses appeared.
   The Doctor  supposes that his treatment was the cause of the
cure in this case, though he must have seen hundreds in which it
would have failed.  Indeed he admits just before, that the same
treatment might, in  another case, have not onjy been unavailing,
but injurious.  Because his guess-work here, did not hinder nature-
lrom performing her work, he concludes that he must have guessed
right. But what is the  reason that similar guess-work did not cure
or did actually cause the suppressions in the dozens which we, and
the hundreds which  our friends have been obliged, after the doc- 
107
 tors had exhausted all their skill, to cure with steam, lobelia and
 good food?
   Excessive  Menstruation.—This is the reverse of retention.
 Instead of being closed so as to prevent the discharge, the uterine
 vessels are  too  much relaxed, and, in case of bloody discharges,
 some of them are even ruptured.  This easy egress invites the fluids
 to this organ at the expense of the healthy performance of some
 other  function.   The vessels from which the fluids are abstracted
 and diverted, are of course collapsed, and hence there is a continued
 pressure to the uterus.  Though the principle of cure, viz. lo relax
 the  constricted  vessels and  restore an equilibrium to the circula-
 tion and proper tone to each organ, is the same as in retention; yet
 the  locality of the operation will be  reversed.  Astringents must
 be directed to the vagina, and the general system must be warmed
 and expanded so as to direct the fluids from the uterus and restore
 the full action of the other secretions, particularly the perspiration.
 This will regulate every thing  as nature requires.  The doctors
 use  all possible  efforts to make the people  tremble at the thought
 of using hot medicine in this case and in floodings; but, never mind
 their learned folly; experience, the best of all teachers, uniformly
 proves that this is the  true way to do the work.
  Difficult or Painful Menstruation, is to be treated, in all respects
 as I  have directed for  retention of the  menses.—Page 50.
  Decline  of the Menses.—Were the general health always at-
 tended to, the final cessation of the menses would  be so gradual as
 seldom even to disturb the animal economy;  but, by a sudden cold
 or bad medical  treatment of cold or some other  form of disease,
 this  secretion is  often suppressed before it should be, and  then the
 system suffers.   Being entirely ignorant of the whole philosophy
 of this discharge, (Dewees, page  67,) the regulars have adopted a
 mode of treatment calculated to increase rather than  correct the
 difficulty; and this has induced  females to suppose it among the
 most dangerous  forms of disease.   By the practice I have recom-
 mended for the retention of the  discharge,  I  have not only soon
 relieved patients in ordinary cases, but, eventually restored some
 to health, who had been tormented several years  by  the lancet,
 calomel, opium,  assafoedita, musk, belladonna, colchicum &c. &c,
 which  so generally prove curses instead of blessings to the female
system!  one patient had  been  thus afflicted for several  years,
when the doctor told her he  had  "tried every  thing he could think
of" for her case, till he knew of nothing that would benefit her in
one respect  that would noHnjure her in another!  We might well
suppose that, when a learned doctor had given all the poisons he
 could think  of, she must have been in a deplorable  state; and truly
she was little better than a  raving maniac.   But, unwearied dili- 
108
 gence in the use of the Botanic remedies, eventually restored her
 to comfortable health.
   Bloody Menstruation.—This arises  from the same causes as
 hemorrhage  from any  of  the capillaries,  viz. collapse or obstruc-
 tions of other vessels  and pressure  towards these; and must be
 treated as we treat excessive  or  too frequent menstruation, only
 more vigorously, collapsing  by astringents the expanded  or rup-
 tured capillaries, relaxing constricted parts and equalizing the cir-
 culation.
   Hemorrhages.—These, wherever found, arise either from a re-
 laxed state of the capillaries, or a lesion of the larger  vessels from
 which the blood flows.   The relaxation is  caused by actual  de-
 bility of the parts; but the lesion is either from direct  violence, or
 from the pressure of the fluids forced from other collapsed parts to
 the region whence the hemorrhage proceeds.
   The regulars bleed to take off the pressure, and use sugar of lead
 and  other mineral, and, occasionally, vegetable astringents, and
 often aid them with ice or cold water to the parts.   I  have known
 them put, at once, a half bushel of ice round a female  pelvis, to
 stop  a severe hemorrhage!  It is  no  wonder  that death so often
 follows.  It  is certainly better—much better to do nothing at all
 for the patient, than to treat her with this savage cruelty.   Very
 few if any would continue to bleed till they died, if left entirely to
 themselves:  and, suppose they  did, is it not better to die of disease
than to perish at the point of the lancet?  But,
  Once let  the equilibrium be restored by warming  the  patient
with hot teas and steam, and the blood, no longer forced by col-
lapse of the vessels in one part, to congest in those of another, will
 remain in  the system in hydrostatic balance (as water in a sponge,)
 without anyr disposition to discharge itself.  Now,  by  astringents,
 collapse the  parts affected, and keep the system in this condition
 for a time, till the injured vessels regain  their integrity, or the
weakened their tone, and you have effected your object. Cayenne,
tonics and food will do the rest.  This plan is to be pursued in all
 cases of flooding, without regard to circumstances.  If it take place
in or before  the commencement of childbirth, no fears need be ap-
 prehended of the consequences of this treatment.   Give cayenne
 and  bayberry, or witch hazle, and the uterus will contract as it
 should, expelling the foetus,  disengaging the placenta, closing the
 vessels and stopping the discharge.   Do it and fear not.  Among
 the best astringents within the compass of my experience, are a
 strong tea of witch hazle leaves or bark, red oak bark,  running
 blackberry,  grape vine root, &c.  Alum water is  sure to stop the
 hemorrhage; and I have never known it to do any injury.   Blood
 root  is said by our friends to be excellent.   I have never tried it. 
109
  Nausea, Vomiting Salivation &c.—On these subjects I have
treated in general terms, (page 40.)   I add only here, that thor-
ough courses, being careful to keep up  the determination to  the
surface during the intervals, until the stomach is evidently cleansed,
have, in the Botanic practice, proved not only all-sufficient to sub-
due these disagreeable symptoms, and secure a comfortable de-
gree of health;  but also to enable the female to nourish  and,  af-
terwards, safely to bring forth, an offspring free from canker and
hereditary taint.
  Heartburn is caused by tlie fermentation and souring of the food
and the corruption of the gastric juice  before digestion can take
place.  Dr. Dewees says, "It is generally very distressing and very
difficult to subdue."   He has tried so  many "remedies" for it with
so little effect, that he "thinks it better, in  bad cases, to  abandon
the attempt to neutralize the acid."   (Females, page 212.)  How
scientific!   Can't cure nor even palliate the heartburn which pro-
ceeds from a foul or inactive stomach!
   Salivation in this case, is caused by the nervous sympathy of the
stomach and the salivary glands with the irritated and expanding
uterus.  I have observed that, where the  stomach had been kept
thoroughly  cleansed,  the  salivary discharge, though  a little in-
creased in quantity, was not very troublesome  nor disagreeable.
The length of its duration will depend much on  the treatment it
receives.   If the regulars treat it, we may expect it to be "self-
limited" and "run its course," which is sometimes the whole period
of  pregnancy.   I once broke it up in a week, in a lady who had
generally suffered from it during a large portion of her utero-ges-
tation.
   Pain in the right side, during pregnancy.  Dr. Dewees informs
us  that, "after, seldom before the fifth month, the woman is some-
times attacked with a deep seated, rather obscure pain  in the right
side," especially  troublesome at night.   He says that, having
treated  it with  "blood-letting, leeching,  cupping and blistering
without," as far as he has observed,  the  slightest advantage, he
"has now ceased to  prescribe for  it!"   This  pain is  doubtless
caused, as he says, by the pressure of  the ascending and expanding
uterus on the liver, and we can assure him that a fine steaming and
 a little lobelia now and then, will so relax the walls of the abdo-
 men as to give room for the uterus to enlarge and ascend without
 encroaching on the liver and  producing pain.  Will  he dare to
 try it?                                      .         ..    .,
   Restlessness  at night.—It is really amusing to  notice  the
 various  '-regular"  opinions  of the cause  of this affection during
 pregnancy.  Some attribute it to fullness of blood, others to a de-
 ficiency; and each treats it  according to  his  notion of its cause. 
110
All of them consent to bleeding, purging, low diet, cooling &c,
and object to all heating stimulants.   Some prescribe opium in
large doses, others in very small ones, and in a peculiar form. This
restlessness,  watchfulness,  and generally  febrile state of the sys-
tem,  no doubt arises from  the new irritability of the nervous sys-
tern, and the pressure on  certain nerves and vessels, by the expan-
sion of the uterus  and its  dependents; but,  instead of bleeding
&c, to cure it, the true plan is to relax the general system so that
its capacity may increase in proportion to the augmented quantity
of the material secreted  for, and embodied in the constantly en-
larging fcetus.  This may at any time be effected  by  a judicious
course of medicine, if nothing else ail the patient.
  Costiveness.—This arises during the early periods of pregnancy,
from the pressure of the enlarging uterus on the rectum in the pel-
vis; and also  from  the circumstance that the irritable state of the
stomach prevents  much  eating, and throws up some of the little
that is eaten.  These combined causes render it so long before the
fceces collect in the rectum in quantity sufficient to form a passage,
that they become so  hardened and dry  as  to be still  longer im-
peded in their progress.  The rectum is less  irritated, chiefly be-
cause a smaller portion  of irritating matter is permitted to descend
into it.  Let a lady not pregnant, in ever so  good health,  eat as
small a quantity of food for days or weeks, as  many a female does
when laboring under this irritation of the  stomach,  and she will
generally become costive.
  To cure this costiveness,  first, relieve  it,   for the present, by
emollient and stimulant injections; secondly,  cleanse the stomach
and restore the appetite, so  that a reasonable quantity of food can
be eaten and digested; thirdly, eat such food as will keep the bowels
open, (experience and observation will tell you  what,) and take
cayenne enough to aid the operation when necessary.  A constant
use of unbolted wheat bread, with proper exercise, seems to be suf-
ficient,  in almost all cases, to prevent  costiveness.  Always re-
lieve the bowels by  injections  whenever they have been motion-
less for more  than  24  hours.  An  excellent  substitute for injec-
tions, where it may be inconvenient to administer them, is a small
piece of Castile soap first rolled in a little powder of cayenne and
introduced into the rectum.   It will soon produce a passage.
  In a very obstinate case  of costiveness that came under my ob-
servation, the lady took  a fancy to eating chocolate in  the cake.
She eat it freely.  It corrected the acidity of the stomach, nourish-
ed  the system abundantly and kept the bowels free, after all the
other means  tried had but partially accomplished these  desired
ends. 
Ill
   Costiveness also occurs in the latter months from the  pressure
t>f the more grown foetus on the rectum where it passes the brim
of the pelvi3. Let it be relieved as often as it occurs, and be care-
ful that no other cause unite with this to produce it.
   Hemorrhoios or Piles.—Costiveness is the principal  cause of
this very painful complaint; of course, strict attention to  the fore-
going directions will generally prevent it, as well as be very ser-
viceable in curing it whenever it occurs.   It presents itself first in
the descent of the inner coal of the intestine.
   If immediately poulticed with slippery elm  &c, it will soon re-
turn, and seldom descend  again until forced  down  by hardened
fceces.   If this is neglected, and the organ remains protruded, it
soon  swells, inflames, becomes very sore and turns purple.   Some
of the regulars now recommend making  a longitudinal  slit in it;
others, tying  a string round it and letting it mortify and fall off;
others, leeching or puncturing it &c; but I have cured  very  bad
cases, by perseverance with the poultice, and keeping the bowels
free.   This is certainly the best plan.    Emollient injections, as
slippery elm, should be used immediately before every passage in
this case, and after the passage, a strong decoction of some astrin-
gent, as  witch hazle, red oak bark, galls, or  any other innocent,
powerful and permanent vegetable astringent, to contract the or-
gan  to its proper dimensions.  Steaming and full courses of med-
icine, I  have found the best means of reducing it.   A  little soft
grease, as neats-foot or sweet oil, frequently applied, is an excellent
preventive of piles.
   As causes of piles, Dr. Dewees  enumerates costiveness, pressure
 of the uterus on the pelvic vessels, sedentary habits, soft cushions
 for seats, and long standing on the feet.  (Diseases of Women, page
 223.)   I think these are all probable causes.  Many hypotheses
 are then adduced from  different authors, and strictures  are made
 upon them, after which  comes the treatment, viz. emollient poul-
 tices, purging, puncturing,  leeching, hoi, and cold applications,
 (even ice) opiates, injections of sugar  of lead, and finally " the
 knife."  If. however, the inflammation should be subdued and the
 organ reduced by the bread and milk poultice, castor oil injections,
 light food and mild physic;  then the doctor thinks "the vegetable
 astringents" will do much to effect a cure. Of these, nut-galls, the
 dust  of puff-balls and opium are considered among the best.^  It is
 not a little strange that, while the piles are considered the.effect
 of costiveness, and costiveness the effect of diminished vitality, the
 cure should be expected from the  use of opium and sugar of lead,
 some of those deadly "poisons which all agree in suddenly and
 rapidly  extinguishing  a  great proportion  of the vitality of the sys-
 tem'" But nothing is too absurd  to be believed or recommended 
112
 by a regular doctor.   No caution is deemed necessary by Dr. D,,
 in the use of these; but, stimulating vegetable astringents must be
 administered with a discriminating judgment,  lest they should res-
 tore the vitality of that  sluggish organ the rectum, which  would
 preventcostivencss and of course piles, that proceed from it!  When
 will doctors learn that, to keep the system clear of canker, the di-
 gestive powers in order, and to take a reasonable quantity of good
 food and moderate exercise, are the sure means of preventing dis?
 case or curing it?
   Dr. Cullcn learned, of " an empyrical  practitioner," the great
 value of balsam copaiva.  Dr. Good did not believe in it,  for he
 had "tried it often and varied the dose."  "When the tubercles
 are not very sore," he says, "they will often  yield to a  layer of
 gypsum, or, what is better, fuller's earth rubbed into a soft paste."
 but these things, he intimates, will not  answrer in a bad case.
   Now what can be the reason why the learned doctors differ so
 much in their opinions respecting the value of different remedies
 in this or any other form of disease? It is simply because the dif-
 ferent conditions of the body render it in some cases more, in  oth-
 ers less susceptible to the action of all remedies; and, of course a
 remedy will be effectual in the cases of some patients, or in some
 attacks of disease on the same patient, and not in others. The doc-
 tors who see the good effects, praise the remedy; those who seethe
 failures condemn it, while the true nature and  effect of that reme-
 dy must forever remain the same in all cases.   If a medicine ever
 has a tendency to remove disease, it always has  that tendency, and
 is proper to be administered whenever the state of the system de-
 demands its peculiar action.  If it is ever adapted te destroy life or
 injure the system, it always has that fitness; and, when its  evil ten-
 dencies (as is sometimes the case) are overruled for good, the credit
is due, not to the poison nor the skill of the administrator,  but to
 the power of the system to defend itself against all encroachments
 upon its sanative operations.
  The business of  the physician then,  is to learn the true nature
 and effects of all the remedies he uses,  to study the condition  and
 demands of the system, and then to apply the best remedy for that
 condition, in quantity and  frequency  adequate to the demand.
With these rules for his guide, he  will  never reduce directly, by
blood letting, the arterial action, in order to aid the vital power in
 removing obstructions; nor will he administer, to restore the action
 of a sluggish organ, any of those scientific remedies of the  doctors,
which, however different  their action in other respects, "all agree
 in suddenly  and rapidly  extinguishing  a great proportion of the
vitality of the system."  (Boston  Medical  and Surgical Journal,
vol. ix., page 43.) 
113
  The people of the United States have much reason to be grate-
ful for the improvements which the fame of the Botanic practice
has effected, even in the regular practice where its humble self can
find no admission.  The  doctors are now often most sadly hamp-
ered,  as they ask for a bowl and a towel or a piece of paper, by
the solemn charge, "Doctor, you must not bleed me; Doctor, don't
give me your calomel; I  won't take  mercury nor opium."   Un-
less, now, he can persuade the patient that cupping or leeching is
not bleeding, that blue pills are not mercury, and morphine is not
opium, as he sometimes does, he is reduced to the extremity  of
sayin"-, "If you know better than I  do what should be done, you
must  take care of yourself."
   Palpitation of the Heart.— Whatever much  disturbs  the
nervous action, or obstructs the  free and  universal circulation of
the fluids,  will produce that labored motion of the heart, called
palpitation.  I have  before shown that the more free the system
from  cakcr, and  the more relaxed, warm, active and supple the
parietes or walls  of the chest and  the abdomen, and  the nervous
vessels of the pelvis,  the  less disturbance can take place in the
action of the vascular and  nervous systems.   Of course reason
unites with experience in dictating the propriety of full courses of
medicine, with special attention to those parts of  the system, as
the pelvis and lower limbs, that seem most obstructed.  Equalize
the action of the system, and you stop palpitation.   The extremi-
ties must be heated, stimulated, kept clean and clothed warm, and
the chest clothed more lightly and loosely.
   Displacement of the LIterus.—Of retroversion I have spoken,
on page 30.  The uterus  is sometimes invet ted, that is, the fundus
descends through the os tinc.ee into the vagina.  To cure it, give a
course of medicines, with thorough application  of strong lobelia
and slippery elm tea  (nothing else) to the vagina, keep the patient
in  bed, with the  pelvis high, and  it will  soon return.  Now use
injections of strong witch hazle, or nut-galls, raspberry, blackberry
briar or sumach, or any innocent strong astringent, and tone up
the general system.
   Sometimes the uterus  sinks too  low in the vagina and even
through the external  orifice,  without turning inside out.   Give in-
jections of bayberry or other canker teas and cayenne, and follow
them with the astringents as  above.   This  course will contract the
upper parts of the  vagina and the round and broad ligaments, the
 weak, relaxed state of which is the principal cause of the affection.
 Whether the fundus of the uterus falls forward or backward or side-
 ways, the plan of restoring it is the same, viz. raise the pelvis and
 administer an injection of lobelia and slippery elm to the vagina.
 If the bladder is distended by urine, it should first be emptied by a
                 8 
Ill
catheter.   The rectum should be emptied by an injection before,
if it can, if not, after the reduction.
  I am aware that, if regulars read my book, they will condemn
me as "ignorant," because I have not carefully distinguished be-
tween inversion of the uterus and polypus, and given the precise
treatment.   My first  reason  is, if ladies reject their destructive
practice, and  apply  the  true life-preserving,  anti-poison  system,
they will never be troubled with either.   My second is, that, with
all the researches the regulars have made, they have arrived only
at the sage conclusion, that, "though inverted uterus and polypus
may readily be confounded, and the mistake either way may give
rise to very different  results, yet the diagnostics of  the inverted
uterus, and a polypus of this organ, as laid down by writers, are
both vague and discrepant.   This has createdno small embarrass-
ment and uncertainty to the surgeon who is about  to undertake
the removal of the tumor occupying the vagina, since he  cannot
satisfy himself of the  real nature of  the disease  he has to contend
with.  Mr. Newnham appears to have felt all  this uncertainty in
its fullest force when he was about to  apply the ligature upon the
uterus.  To aid his  judgment  in this interesting and perplexing
case, he laboriously consulted almost all the authorities extant; and,
after carefully collating their opinions, he reduces them to the fol-
lowing summary."  (Dewees on Females, page 251.)
  "It is generally remarked, that inversio uteri may be distinguish-
ed from polypus of that organ  by the os uteri not encircling the
former tumor in cases of complete inversion, and by the impossi-
bility of passing the finger around the neck of the tumor, between
it and the os uteri, where the inversion has been only  partial; by
the form of the tumor, the polypus being broad at its base, and at-
tached by a narrow peduncle, while the inverted uterus is broader
above  than below; by the insensibility of the tumor in  the one
case, and by its extreme sensibility in the other; by  the compara-
tive  fixity of the one tumor, and the extensive sphere of motion of
the other; by the rough and  fungous surface of inversion, contrast-
ed with the smooth and polished surface of polypus; and by the
previous history  of the patient's disease."  "But  it  is clear, that
these diagnostics are liable to a great degree of uncertainty," as he
proves by most ample quotations.
   Dr. Dewees says,  "We arc a little surprised at this distinction;
for certain it is, we have never witnessed an instance "of the invert-
ed uterus," being "broader above than below;"  nor can we  imagine
how it can exist.   We are every way sure, that the  same  relative
proportions exist between the fundus and the body, and that of the
neck, in both the natural and inverted  condition of this organ;
consequently, the mark mentioned by Mr. N. cannot be present, but 
115
by some unusual arrangement; and, of course, must not be consi-
dered a diagnostic."
   "Mr. Newnham has collected, as we have remarked, with great
industry, nearly all that ha3 been said upon the diagnostics of these
two complaints; and, from all that can be learned from these va-
rious sources, a conclusion must be drawn that there are none
which are absolutely certain.   Mr. N. says, "On reviewing the
foregoing testimonies, we  shall  be induced to conclude that it is
always difficult, and sometimes impossible, with our present know-
ledge, to distinguish partial and  chronic  inversion  of the uterus
from polypus:  since, in  both  diseases, the os  uteri  will be found
encircling the summit of the tumor, and, in either case, the finger
may be readily passed around it.  And if, in order to remove this un-
certainty, the whole hand  be introduced into the vagina, so as to
allow the fingers to pass by the side of the tumor, to the extremity
of the space  remaining between it and  the os uteri;  and if we find
that the finger soon arrives at this point, it will be impossible to as-
certain whether il rests against a portion of the uterus, which has
been inverted in the usual way, or by the long-continued dragging
of polypus upon its fundus.  And if, under these embarrassing cir-
cumstances, we call to our assistance our ideas concerning the form
of polypus, its enlarged  base  and narrow peduncle, we must also
recollect the abundant evidence to prove  that the neck of such a
tumor is often as large, and sometimes  larger,  than its inferior ex-
tremity;  and we  shall still be left in  inexplicable difficulty."—
Page 82.
   Now, suppose we, Botanies, admit that we are not sufficiently
learned or skillful to discover the difference between polypus uteri
and prolapsus uteri, how far should we be, in this respect, behind
our "scientific" brethren, even according to their own snowing?
But the fact is, we have vastly the advantage of them; for, by fol-
lowing the plan I have recommended, all  cases of real prolapsus
will be easily and speedily reduced; while the polypes will  either
be absorbed away, or increase in size till there  is  no doubt of their
real character, when they will often ripen and dropoff, or may  be
safely removed either by suppuration produced by the vegetable
cautic, or by  ligature, as described, page 30.
   Facts and Cases.—After trying various means to cure a case of
inversio uteri, Dr. Dewees and his "consultation" resolved to apply
the ligature,  "but  the patient died before  the operation could  be
performed!"   One case only ever came under my knowledge; that
was made by  a "learned" doctor in pulling away  the placenta; it
was treated by the same and others "in consultation"  for fouryeara
or  more, and finally  the patient died under the  influence of this
learned quackery, in the full persuasion that "the mill of the Lord"
alone was accomplished! 
11G
  On the other hand, I do not know of any instance (and many
have been reported to me, besides several that have come under
my own treatment,) where derangement and exerescences of the
uterus have not been  entirely cured by our treatment.  One of the
cases I treated, had been under the management of the most emi-
nent regulars for more than six years, and had become truly de-
plorable; the nervous system was nearly ruined.  But how can the
M. Ds be expected to  cure by their quackery, what they have first
made by quackery? Where upon  the earth were such forms of dis-
ease ever serious, till the patient had been treated a while for these
or some other affections, by the sons of iEsculapius?   Again, I say,
let  the ladies  abandon  all medical  poisons and "obstetric vio-
lence,—ferocious and atrocious obstetric violence," and adopt the
cayenne, vapor and lobelia system, and they may dismiss their fears
of polypus and prolapsus uteri.   These, with the lancet, calomel,
opium, and other poisons, as remedies for disease, are destined soon
to be numbered among "the things that  were."
  Disease of the Uterus and its dependencies.—Of these, Dr. Dewees
says, (Females, page 254,) "The  whole of the  internal  organs of
generation are liable to disease, the most of which may be consider-
ed incurable.  To describe minutely  the  whole that  are known,
would of itself require a volume;  and, if this were done,  we might
be disposed, in many instances,  to enquire,  cui bono? [whom would
it profit,] as regards the success of medical treatment."
  This testimony is fully sustained by Dr. Mackintosh, (page 667.)
  "Ovarian Disease.—In the exercise of  our profession, nothing
is more disagreeable  and even  humiliating, than to be obliged to
witness, from day to day, for a  period of months or years, the suf-
ferings of patients, under a disease like this, without being able to
do more than palliate symptoms by means of narcotics.  Sometimes
we  have the additional mortification to  find that temporary tran-
quillity is produced at the  expense of increased after suffering;"
so that there really is something  to tempt an individual with an
enterprising spirit, to the performance even of the horrible opera-
tion of opening  the  abdomen  from the ensiform cartilage to the
pubis, in the hope of being able  to effect a radical cure!  This
operation has now been  performed several times by Mr. Lizars of
Edinburgh, and I have no doubt, from his anatomical knowledge
and experience in operating, it was done in all the cases with the
greatest dexterity, and that no  means were neglected which could
insure success.   But mark the  results:
  "The first woman died in 48 hours, and nothing was discovered
bat flatus in the intestines.  The second was laid  open, the uterus
and ovaria were sound and healthy, but it was discovered that the
woman was very fat. She escaped with her life at that time, al- 
117
though stated often to be severely tortured with pain.  The third
had also ascites; a large tumor was taken from the left side, but
one on the opposite side was left untouched, from the extent of the
adhesions  to surrounding parts.  She survived the operation, but
died three years after.   The fourth case,  Mr. Lizars took away a
tumor, and separated adhesions between it and the viscera; but she
died from  mortification.  The fifth case,  the tumor was so com-
pletely attached to  the surrounding viscera, with  so many large
blood vessels in the way, he was forced  to abandon it and stich up.
She survived the operation.  The sixth  case, a tumor was cut away
projecting from the fundus of the uterus, which was thought to be
an ovarium; she died in a few days from inflammation.  The  ova-
ria were found quite snug and sound in their proper situation.
  "The following are  the reasons why I consider this operation
unadvisable:
  1st.  It is difficult to tell whether there  is a tumor or not in the
abdomen—See two cases out of six in which no disease was found
to account for the tumefaction of the abdomen.
  2ndly.  If there is a tumor, it is  impossible to determine if it is
in the uterus, ovaria, or some  other part.  Another case, examined
per vaginam, by many  M. Ds, was pronounced by all, ovarian dis-
ease.   She died six months after and was dissected.   The ovaries
were found quite healthy, but the liver was enormously enlarged,
which was the cause of the tumefaction of the abdomen.  Another
case was most unhesitatingly pronounced to arise from ovarian dis-
ease.   She died some time after, and,  on opening  the  body, the
uterus and ovaries were perfectly sound, but extensive disease ex-
isted in the stomach, colon, liver and kidneys.
  3dly. It is impossible to tell if the diseased ovarium is attached
to surrounding parts,  which is always  an  insurmountable objec-
tion; for, should there be extensive  adhesions, which require to be
separated  during the operation, such separation, whether effected
by the knife  or by the fingers, must seal the fate of ninety-nine out
of a hundred.   Even in a dead body, half an hour has been taken
in separating an ovarian tumor, from its adhesions, which was not
effected without wounding many large  blood vessels.
  4thly. It  ought to be considered whether the  dangers arising
from the operation are  not greater than from allowing the disease
to remain  undisturbed.   First, we have to consider the chance of
the patient dying immediately from the shock, or from hemorrhage,
or afterwards from inflammation, after she had undergone the  hor-
rid torture occasioned by an incision from the sternum to the pubis,
independently of that produced by exposing and handling the vis-
cera and cutting away the tumor, not to speak of the difficulty of
restraining the protrusion of the intestines,  both during the per- 
118
formance of, and after the operation.   To give my opinion in the
shortest manner possible, 1 simply state that I regard a recovery,
after such an operation, as almost miraculous, and to be consider-
ed more in the light of an escape, than a recovery to be expected."
  The instruction then derived from the above extracts from the
most celebrated Pathologists of the age, of the schools of Philadel-
phia and Edinburgh,  amounts to  simply  this, that the regular fa-
culty know not the causes nor the seats of the most common forim
of disease; that they have no certain remedies  for their cure; that
they often perform the most dangerous surgical operations which
destroy many lives, on the strength of a mere guess that these ope-
rations arc needed to  save life; and, last but not least, that it is
much safer to trust to nature in all cases of disease, than to employ
the most distinguished among them, unless  he has abandoned the
rules and instructions of authors and professors, and limited his
practice to simple and innocent means?
  With all due respect for the benevolence of physicians as a class
of men, and  admission of the usefulness of many of this latter classy
so fully are we convinced of the pernicious tendency of "the sci-
ence of medicine," as they understand it, we solemnly declare that
no  morbid condition of our  body could induce us to prefer the
practice of "the regular physician," to the unaided efforts of na-
ture.   Let us die  at once by  the violence of disease, rather than
be poisoned to death, or ruined for life by the desperate remedies
of the popular medical and surgical practice.
  Do our female friends suppose that we  are about to leave  them
in this dilemma, this "glorious uncertainty, or rather inglorious cer-
tainty?"   No; we can assure them that the  Botanic Practice is so
sure and safe in all "diseases of the generative organs," that, under
its judicious  and  persevering application according to our direc-
tions, the chances for death from any of them, are  so  few and  far
between, as to coase to be legitimate objects of dread.   The most
conclusive proofs of the truth  of this declaration, may  be found in
almost every number of the Botanico-Medical Recorder issued  for
the last nine years.
  While I lived in Richmond, Va., a lady in the country wrote me
a letter in which she described her case.  According to the opi-
nions of her numerous physicians,  several  of whom were among
the very heads of "the profession," she had  been at different times
afflicted with almost every form of disease  to which the peculiar
structure of the female frame is liable.  I put away the letter with
intent  to use it in this place, so safely that I cannot  now lay my
hand upon it.   So thrilling was the description of her "miserable'1
and truly deplorable condition, that I could scarcely read it, even
a second or third time, without shedding tears of sympathy for a 
119
suffering fellow being.   Truly, thought I, (confident that her af-
flictions were chiefly the results of the fashionable poisoning and
depletive medical practice,)
          "Man's inhumanity to man,
          Makes countless thousands mourn."
  The last affection she mentioned, if memory serves me, was ova-
rian disease.  It being impracticable for her to come to my Infirm-
ary for some weeks, she  entreated me to prescribe something that
would relieve her immediate sufferings, from which death would
have been, as Dr. Good  says, "a friendly stroke" to relieve her.
  Her letter indicating that she was a very intelligent and judicious
lady, I wrote her a long  answer prescribing the proper course, and
advising her to commence it at once, and have it applied by some
member of her  family,  and by herself, so far as she was able.
Some months afterwards, I  saw a gentleman from the same neigh-
borhood, who said that  she had followed the prescription to the
letter, and was at that time perfectly well; that she had preserved
my letter, and was in the habit of showing it to heE intimate friends
as her "medical diploma," which she  valued beyond all price.
The directions given were substantially the same that are given in
various parts of this work.   Much stress was  laid on the very fre-
quent use of canker enemas to the vagina, and keeping the pelvic
region and all below it warm.
  I have attended in person many other ladies whose female or-
gans had been so much deranged by  "learned quackery" that "the
most gifted sons" of this hypocritical science,  could not determine
what particular organ was affected; such were the number, variety
and contrariety  of  the  symptoms in the case.  Yet I never lost
one of them when I was the sole  physician.   The proper indica-
tions  of cure  have been developed  in the "principles," and the
modes of operation will be  found  in the chapter on "Ways and
Means."
  To the account of the above reported cure  by my prescription,
I might add multitudes from the Recorder;, but, suppose a patient
had no confidence in our remedies or our judgment  of the real
nature of these  cases, and  should go to the regulars for advice.
Some might say that we Revolutionists were "ignorant quacks, more
likely to kill than to cure—that they have all  the science, and can
cure if the disease be curable."   But what do the wisest of them
say, on this subject, lo their  brethren  and pupils? Let Dr. Dewees
answer this question.
  Of the ovaries, he says, (see Females, page  256,) "They seem to
be so far removed from  the general sympathies of the system, so
insulated in position, so  independent in function, that the common 
120
agents for the removal or control of disease, seem to waste them-
selves in unavailing attempts to influence their actions or to modify
their affections.  Who flatters  himself that he has  removed  a
dropsy, resolved a scirrhus, or interrupted suppuration of these
bodies?  We believe, if he be candid, none will declare he has,"
[i'/eknow, whether they confess it or not, that the regular practice
has made many such affections.]  "Little more then, is ascertain-
ed, than that these pcrU are very liable to disease [about as much
fo as the patient is lo fall into the regular practice,] and but very
little susceptible of cure."  [while she despises and rejects the Bo-
tanic]  He mentions five different affections, as discovered by dis-
section, and adds, "unfortunately, they have much more frequently
furnished subjects for the anatomist's  knife, than triumphs to the
physician's skill,"
   Of the Fallopian or utcro-ovarian tubes, he says, (page 257,) we
have every thing yet to learn as regards the diagnostics of the dis-
eased tubes; for, to this moment, we  are altogether unacquainted
with the port ons of the body with  which they sympathize."
   How, we ask, can  ladies  expect  to gain important information
from  persons  who confess that they  "have every thing yet to
learn?"  We assure  them  that we, steamers, have learned at least
one thing about these affections; that is, how to cure  them.   But,
one will ask how I know that we have cured them? it may be we
do not understand pathology sufficiently well to detecf*the pecu-
liar characters of internal diseases?  I answer, The regulars have
declared that many patients had these diseases, and  were conse-
quently incurable.   We neither affirmed nor denied the testimony,
but cured  the patients.  Now it follows of course, either the doc-
tors cannot detect these diseases, or  they are the witnesses that the
Botanies can cure them.  They may choose cither horn of the di-
lemma.
   Of the particular diseases  of the uterus, says Dr. Dewees, as
carcinoma, cauliflower escrescence, corroding ulcer &c, "a short
account will be sufficient, as we are unfortunately acquainted with
little more than their ravages."—Pages 258—9.
   Carcinoma uteri is a tumor on, or thickening of the cervix uteri,
which  is disposed to ulcerate.  Several have been cured  by the
steamers.   "It  seems doubtful," says the Doctor, "to those best
acquainted with this  complaint, whether a  cure or  mere suspen-
sion of this disease has ever been effected ;v but, he thinks the best
treatment is "local bleeding, severe diet and  absolute rest. Leech-
ing immediately from the uterus is incomparably better than more
remote leeching, and notwithstanding the  great  aversion of our
American ladies to this mode of depletion,  we are happy to say
lhat we have, in a number of instancesy been able to overcome this 
121
 aversion P'  So it seems that, "in a number of instances, our Ame-
 rican ladies" have  allowed a learned doctor to cram the vagina
 full of leeches, that they might get hold of the cervix uteri.   For
 conscience sake, let us hear no more about the vulgarity of the
 Thomsonian practice.  Proper diet,  constant cleanliness  and
 suitable and frequent rest, I can cordially approve.  I am, how-
 ever, fully persuaded that the antiphlogistic plan of treatment re-
 commended by Dr. Dewees, in these cases, is better calculated to
 render existing cases fatal and to produce others, than to prevent
 or cure any.
    Hydatids.—After having  proved that their origin and nature are
 involved in total obscurity,  Dr. D. says, "No remedy has hitherto
 been discovered  for the relief of hydatids," but fortunately it is a
 form of disease rarely to be found.   Madame Boivin uses stimu-
 lating injections; Dr. Clarke uses cold applications and astringents;
 Dr. Dewees, his hand, and the poison  and destructive ergot or
 spurred rye!—So they go.  They agree only  in  one thing, they
 all cause the patient much pain  and suffering, while the benefits
 they confer  are few and far between.   While Dr. D. advises the
 inseriion of the hand into the uterus, he says, "violence must never
 be employed in this or any other instance, in passing the hand into
 the uterus!"  Wonder what the Doctor means by the term "vio-
 lence!" can it be any thing short of breaking the patient's neck?
   Treatment of Uterine Affections.—Let it be remembered that
 the affections of the  uterus and its dependents, to which I have just
 alluded, are  very rarely found, seldom more than two or three in-
 stances of  each, and often  not one, in  the whole practice of the
 most experienced accoucheurs; that they are generally the  most
 common in the fashionale and idle circles of life, and, lastly, that
 they  are the most dreadful  and fatal under the treatment of the
 regular faculty.
   Among the Botanic fraternity, (except those who may have re-
 tained them  as memorials of their former allegiance to the lancet,
 bleeding, poison and starvation,) they are seldom found.   Where
 they are permitted to arise through neglect to attend to the general
 and particular internal and  external cleansing of the system, they
 may be soon cured by a judicious medical treatment.   But, if this
 be true, I may be asked why are they professedly incurable in the
 hands of the  regulars?  I answer, simply  because the course they
 pursue, is calculated lo make disease, not to cure it.   Let me prove
 this.  To prevent ulceration, their plan is to destroy the "local in-
 flammation which,"  they say, "is essential to the disease; to di-
 minish the  circulation of the blood, and to abate arterial  action."
 Here, they start upon a fatal  blunder, in taking an effect of the
disturbed vital action, for the cause which produced the disturb- 
122
 ance.   I need not say that all conclusions drawn from false pre-
 mises, are erroneous; let me present  the  facts, as they are often
 more  conclusive than argument,  however sound.  Dr.  Dewees
 says, (Fem., page 263,) "These ends will be found best answered,
 by blood-letting, general and local;  by  purging, by  abstemious
 diet, by cleanliness, by rest."  True, "these means," especially the
 first three, are effectual to accomplish  "these ends."  But are these
 truly the ends to be accomplished?—That is  the question.   All
 admit that the vital action  is the only conservative  power of the
 organized  body against putrefaction.  Therefore,  1  argue, the
 greater the diminution of this vital power, the more danger of its
 total extinction, by the encroachments of mortification.   Example'.
 Bind a ligature round any organ and stop the circulation in il, and
 it immediately mortifies or dies:  yet Dr. Dewees  advises us to di-
 minish the circulation in  an  organ  "to prevent ulceration" or  mor-
 tification!  The bleeding and purging check vital action, and pre*
 vent it from pervading the affected organ; of course it  checks the
 warfare for the time, between the conservative power of life, and
 the chemical  power of  decomposition.   If, then, decomposition
 does not soon take place, in every instance, it must be because the
 conservative power is not, as in the case of the ligature,  entirely
 destroyed, but is continually rallying its forces and trying to repel
 the encroachments of chemical decomposition, or, in other words,
 of mortification.
  To either prevent or cure  these affections, it is evident, from rea-
 son as well as the  facts  that the regular  plan renders them  "in-
 curable," while the Botanic Practice either prevents or cures them;
 that the "ends" above, are the true causes of death instead of life
 to the part, and, therefore, are not the true ends to be accomplished.
  What then, are  the true ends to be accomplished?  Evidently
 to relax the strictures, and remove the obstructions which disturb
 or repel vital  action.  This will equalize  the circulation of the
 blood, when it will be found that there will be no  necessity for
 "diminishing its quantity."   The arterial  action"  is always suffi-
 ciently "abated," when the circulation of the blood is free and uni-
 versal, and the absorbents, secernants  and execrnants are in good
order.  Therefore, we, Botanies, reverse all the Doctor's prescrip-
tions.  Instead of withdrawing vital action from the part which we
fear will "ulcerate," we stimulate it directly to the performance of
its duty; instead  of diminishing the quantity" of the vital fluid, we
promote its equal and universal diffusion; instead of removing the
organ to get rid of the obstructions that hinder the due performance
of its functions, we remove the obstructions to save the organ.
 For the plan  and  process  proper in the  case, see  "Ways  and
Means." 
123
   Irritability of the Uterus.—Doct. Dewees classes this property
among diseases.   I  should be glad to be told the use of a uterus
that is not "irritable."  It surely could never perform any  of its
proper functions.  But Dr.  Gooch calls it  "a painful and tender
state of the uterus,"  something rather more intelligible.  Dr. D.
says, 4,The general symptoms are, an increased  frequency  and a
preternatural firmness of the pulse;" that  it "is always more fre-
quent and corded than usual."   But Dr. G. says, "The pulse is
soft and not much quicker than natural"—a direct contradiction,
but that is a small affair among doctors.   Dr. D. adds, "headache,
pale and  white  tongue,  dry skin, irritable stomach,  scanty and
high colored or pale and abundant urine."
   Now, we ask,  if the above symptoms are peculiar to the uterus,
why are they as  common to  males as to females?   If not peculiar,
of what use are they, but to perplex the practitioner  and lead to
an erroneous course of practice?   The Doctor then gives the local
symptomatic  descriptions; after which  he  quotes those of Drs.
Gooch and Addison, and says, "to be convinced that these gentle-
men have added many symptoms that do not belong lo this affec-
tion, it will only be necessary to compare their descriptions" with
his!  Very modest,  indeed!  He goes on  through twelve octavo
pages, reporting  the  opinions of various authors, coming, as  usual,
at last to no conclusion for himself, though fully establishing,  in the
mind of every reflecting reader, the declaration of his worthy col-
league,  Dr. Chapman, (Therapeutics, vol.  1, page 23.) "To har-
monize  the contrarieties of medical doctrines is, indeed,  a task as
impracticable as to  arrange the fleeting vapors  around us, or to
reconcile  the fixed and repulsive antipathies of nature."
   Having fully established the certainty of "the  highest degree of
uncertainty" in  the knowledge  of "the faculty" in regard  to the
nature and symptoms of this form of disease,  Dr. Dewees com-
mences  an exposition of the  regular treatment; ("The  remote and
predisposing  causes are involved in  great obscurity;") and then,
(notwithstanding the regular hue and cry against the Steam fra-
ternity for treating all forms of disease on the same plan and with
the same general remedies,) we have the same old tune of "bleed-
ing,  purging, blistering and rubefacients, narcotics, injections of
nitrate of silver, opium, sugar of lead &c, starving and rest.  But
mark, it is by no means  certain that this course of treatment will
do any another good than make a long doctor's bill: for  he say*,
(page 326,) "From the length of time required to overcome the
disease, and the privations to which the  woman must submit who
looks forward to its  cure, patience becomes exhausted, and  confi-
dence in the efficacy of remedies is too quickly destroyed; for relief
is not only almost always tardy, but is too often uncertain; *  * for, 
•       124
 however judiciously remedies may be advised, or however faithful-
 ly they may be applied, they arc far from being speedy and uni-
 form in their effects.  This  is the declaration of the  several au-
 thorities before us, and  but  too  certainly confirmed by our own
 experience; months, nay years are sometimes required to accom-
 plish a cure; and, if it be effected even after a very long trial of
 means, the woman may felicitate herself that she has been able to
 procure health  even at so great a  price."
  The Doctor gives us three  cases which he treated; the first was
 so far relieved as  to enjoy a very comfortable state of health," the
 second  "was entirely restored in seven months," the third "was re-
 lieved in  about five months;'1 she, however, did  not  "persevere
 three or four months longer" under the "reasonable expectation
 that it [the plan] would have proved still more beneficial."   But,
 "notwithstanding the success  that attended the cases just related,
 [only one was cured, and that after having suffered seven months,]
 as well as many more that  we could mention, it is but fair to ac-
 knowledge that there have been others in  which no such benefit
 was  received, though remedies, generally speaking, were faithfully
 used, and every reasonable  precaution taken to ensure success."—
 Page 336.
  I have copied thus extensively from Dr. Dewees, for three rea-
 sons; 1st,  because he says,  (page  327,) he  has  "detailed  all that
 experience has  hitherto suggested  for its relief;" 2nd, because, be-
 ing "Professor of Midwifery  in the University of Pennsylvania,"
 he is a standard authority in the United States;  and 3d,  because,
 by so doing, I fully redeem my pledge given in the first number,
 to prove that if, in the use of the Botanic Practice, there should be,
 in any case, the fear of a failure of success, a resort to the regular,
 would almost certainly ensure wreck and misery to the constitu-
 tion, and loss of health and happiness, if not even life itself to the
 patient.
  But, must I leave this subject of "irritable uterus," as I find it in
the hand of Dr. Dewees?   I hope not.   I enquire then,  What is
''irritable uterus?"  Answer,  such a complication of local or gen-
 eral  affections, that "the faculty,"  as we have seen, can neither tell
what it is, what is its cause, nor how it should be treated.   What
 are its symptoms?  Answer,  "Inflammation," to be sure, and "great
 tenderness in the  first stages," with "danger of  suppuration  &c."
 Now, what is the  cause of inflammation?   Answer,  it is the accu-
 mulation of vital action.  But vital action cannot be accumulated,
 where there are no obstructions to the free operations of vitality.
 Therefore, obstructions are the cause of this disease as well as every
 other.                                                      J
  What then is the proper treatment?  I answer, relax the parti 
                             125

constricted, remove obstructions from the vessels that are clogged,
and restore a healthy action to the organs.
   But how shall we know, any better than the M. Ds, amidst the
multitude of conflicting symptoms,  what  particular organs  are
diseased?
   Answer.  Here it is that we have the advantage of them.  We
commence with general remedies, means that  are  calculated to
remove obstructions wherever found, and which cannot, like their
specifics, do mischief where we do not intend they shall operate.
A repetition or continuance of this course, by removing, one after
another, the different causes of the various symptoms, soon reduces
them to so few in number, and confines them to such narrow limits,
as to leave no doubt what is the  organ  primarily diseased, what is
the nature of its affection, or the proper local treatment.   As fast
as we thus determine the seat and character of  the affection, just
so fast we apply the proper modes and means of removing the ob-
structions to a healthy action of the organ, and  thus our patient is
soon restored, in all  cases where the vitality of the  organ is not
extinct.   For the  proper mode  of doing this, see  "Ways   and
Means."  I add only in this place, that the practitioner is to re-
member, in all cases of disease within the pelvis, that the vapor bath,
confined below the waist, and  injections of the required character
to the part affected, are powerful means of removing obstructions
and promoting  healthy action; that nothing is equal  to a poultice
of lobelia  and  slippery elm, for relaxing "inflamed surfaces" and
removing the causes  of their "tenderness;" and that few things are
easier in practice than to  fill the vagina, and of course, surround
the cervix uteri, with such a poultice.  It cannot do the least harm,
may be confined at pleasure with "a cloth," and easily washed out
with a syringe as often as it is proper to renew it, which should
always be as often at most as every  twelve hours.   After all the
"inflammation  and tenderness" are removed, the injections should
contain the astringency of witch hazle, and the stimulus of cay-
enne or ginger, enough to be felt.
   The above is a course which, in its essential features, I have ac-
tually pursued  with complete success, without being  compelled to
acknowledge, with the learned Dr. D., the intervention of a multi-
tude of failures.  Similar  advice also, sent in private letters to indi-
viduals, has been attended with similar results.  In fine,  I remark
that a judicious and faithful practice will not require "some months"
to exhibit evidences of its utility, or to afford "reasonable expec-
tation" of final  success.
   Hemorrhage of the Uterus.—I have already given a sufficient
account of the  causes and nature of this form of disease, with di-
rections for its treatment,  which, if followed fearlessly and faith- 
126
fully, will be found amply sufficient for its management.   But the
evil consequences of the great terror which it generally carries to
the heart of the patient and her friends,  have induced me to add,
here, a few remarks which prove that nearly all the causes of alarm
are to be found in the bad  management of the regulars, from
which, if she abstain, she shall do well.
   Of the connexion of the ovum with the fcetus, Dr. Dewees says,
"Soon after the ovum is deposited in the  uterus, its external cover-
ing, or chorion, shoots out innumerable vascular fibres, and, on the
internal face of the womb, is produced a soft, spongy, vascular sub-
stance, called decidua;  these, when  connected, serve as the bond
of union  between the ovum and the uterus.  These minute vessels
interlock with each other, after a certain period, so firmly that
they cannot be well separated  without rupture.  Therefore, should
a portion of the ovum be detached, in the earlier months, the quan-
tity of blood that will issue, will be commensurate with the surface,
especially if it be from the fundus, and proportioned to the advance-
ment  of  pregnancy."   (Condensed from pages  336—7.  Dr. D.
must pardon this liberty here and elsewhere.  I have not patience
to copy his unmeaning verbiage, nor any dispositipn for mere book-
making.)
  It is agreed by all, that the  separation of some  part of this con-
nexion is the principal, if not the sole cause of hemorrhage during
pregnancy.   Whatever can produce this separation, as mechanical
violence, unequal circulation  and disease  in any form, should be
carefully avoided.
  Doctors enumerate plethora  among the causes of the separation,
and hence  they direct bleeding as the remedy.   But their error
lies in mistaking inequality of circulation and local congestion, for
excess of fluids.   On this  mistake they build the practice of draw-
ing entirely out of the body, that blood which thfy ought  rather to
invite to places where it is deficient, as the true mode of relieving
the system from danger.  Dr. Dewees thinks that abortion is gen-
erally produced  directly by the contractions of  the uterus, what-
ever be the remote causes of those contractions.  I think so too.
Dr. Burns  thinks it impossible to prevent them after they com-
mence, and of no use  to try.  Dr. D.  doubts this  position, and
thinks he ought to try in  every case, though he should succeed in
only one  in twenty!  In only  one case does he "never interfere,"
that is, where the breasts have become tumid, and then pretty sud-
denly subside"—"The only symptoms that mark  the death of the
ovum, with a certainty that has stood the test of  experience ever
since  the days of Hippocrates."  The Doctor says he "must con-
fess that  he has known the ovum  to  be  expelled  where this sign
of death  was wanting,"  yet he believes the expulsion was owing 
127
to "the indomitable nature of the contractions of the uterus."  He
thinks also that the contractions may be prevented after they com-
mence; for he brings cases of the expulsion of one foetus premature-
ly while the other of  the  same gestation  remained to maturity.
Therefore, he concludes that the contractions may be prevented and
the hemorrhage stopped,  though it be but in one case in twenty.
The ways and means by which he attempts to  prevent these con-
tractions, will sufficiently  explain the reason why he is so unsuc-
cessful.
   Among the first steps in his curative process, is the use of "ice
water &c."  "No stimulating substance of any  kind should be per-
mitted.  All changing of  clothes,  "putting the bed to rights, or
-altering her position should be strictly forbidden."  This done, if
plethora present, "blood should be taken from the arm, in a quan-
tity proportionate to the arterial system;  remembering that we do
little or no good by the operation, if we do not decidedly diminish
the force  of its action."—Page 347.  Take  an  example of the
manner in which the Doctor treats these cases.
   "In 1796, Mrs. B. was much exhausted with uterine hemorrhage,
in the 4th month of gestation.  Early on the 16th of January, the
usual means  were employed; and, for the time, the discharge was
arrested.   At 5 P. M. it returned  and was soon flowing very ra-
pidly.  There being a high arterial action, she was instantly bled
from the arm until there was a reduction of the force and frequency
of the pulse:  the abdomen was covered with ice and snow.  There
was an abatement in  the  discharge, followed  by slight alternate
pains in the back, shooting  towards the pubis.  Forty-five drops
of laudanum  were now given, and strict injunctions left,  that the
patient should be kept as quiet  as possible.   On the morning of
the 19th the  patient was free from fever, and almost free from dis-
charge.  About 5 P. M. the whole scene, as described before, was
renewed; she was again bled,  ice  was applied  and laudanum  re-
peated.  On the 18th  at 8 A. M. she had a return of fever with
hemorrhage; she was again bled  &c. In  this manner did matters
proceed for several days; when it was observed that the arterial ex-
acerbations observed  no regular periods;  but  that  the  floodings
were  uniformly continued during  the excitement.  To interrupt
this recurrence, I placed a young gentleman at the patient's bed-
side, with orders to bleed her the moment he perceived an increase
of pulse; this  was done; and, from each bleeding decided advantage
was discovered.   The loss of five or six ounces of blood, was sure
to stop the uterine discharge in a  few minutes; and sometimes even
to prevent  its appearance.  Proceeding in this manner, till the
23d, entirely relieved the  patient from this distressing complaint
5he was bled seventeen limes, and lost, by computation, one hundred
and ten ounces of blood in the course of seven days."  Page 348. 
128
   Had I not known some cases that were treated in the same man-
 ner, I could scarcely believe that any man could be so cruel; and
 ^id I not know the strong tendency of the living power to main-
 tain the possession  of its  citadel, I could not readily believe  the
 Doctor's additional remark that the patient "gradually gathered
 strength, and was safely delivered at the proper time."   Having
 known so many to  be delivered by this kind of treatment, of their
 own lives, instead  of living children, I  must regard this, as Dr.
 Mackintosh says, as rather a miraculous escape from a destructive
 medical practice, than a cure of hemorrhage.
   But the Doctor  is not  yet  done with the  course—-hear him
 through:—
   "The acetate of lead should now be given,  [that is, after the re-
 duction of the pulse by  bleeding,] in doses and frequency propor-
 tionate to the extent of the discharge.   From two to three grains,
 qualified with opium, must be given every half hour, or less fre-
 quently, as circumstances may direct;  per  anum, in case the
 stomach be irritable.   Twenty or thirty grains may be dissolved
 in a gill of water; to this must be added a drachm of laudanum and
 this be repeated, pro renala, (in case of emergency,) &c.  If pain
 attend, opium should be given until a decided impression be  made
 upon  the uterine contractions; or till it  appears to  be totally un-
 availing.  Should the discharge be  profuse, a large  bladder two-
 thirds filled with ice and water, should be applied to the pubes, and
 a tampon [sponge] should be introduced without delay"—page
348.
   But, fair reader, severe as this practice appears, we are told, "the
 discharge from  the uterus, when very profuse,  will not always yield
 to these remedies."   What a story!  Has the doctor so little sense
 as to suppose that blood can still flow from the  uterus after it has
 been all drawn out of the body through the veins?
   This is "scientific practice" with a vengeance.  A person  takes
 cold, the vitality of certain organs is diminished, the circulation is
 deranged, congestion takes place, a fever rises,  delicate and dis-
 tended  vessels are ruptured and hemorrhage  occurs.  To cure it,
 the cold is increased, and of course the congestion; the vitality of
 the organs is still further diminished by the poisons, sugar of lead
 and opium; the blood already flowing with dangerous rapidity, is
 made to flow still faster, by opening other vessels, till there is not
 enough in the system to flow at all!   If now, one patient in twenty
 survive this murderous practice, it is considered  sufficient to  sanc-
tion it on nineteen others whom it kills.—See Fern., page 340.
   Suppose the hemorrhage were left undisturbed, could it continue
 after all the fluid was exhausted?  But, says the regular practice,
"taking it from another quarter  diverts it from the uterus, and the 
129
application of cold to that organ contracts the ruptured vessels, and
then they have time to heal."  If this be the case  only  once in
twenty, under that practice, il can be easily proved that death by
flooding, where this practice is not used, does not occur in one case
in twenty!  The chance is therefore four hundred to one in favor
of having no interference at all, rather than the regular practice.
   Let me not be understood to attribute to Dr. Dewees any bad
motive for prescribing such a course*  I believe that he is a humane
man, as  ready, perhaps, as  myself, to relieve the sufferings of the
distressed.  My warfare is  against  the errors of his head,  not his
heart.  Still it is, to me, passing strange that the regular faculty,
with all their  advantages of numbers,  wealth, respectability, sci-
ence &c. have learned, in 4000 years, only how to murder people
instead of curing them.
   Will the reader now believe that I have taken such a case as
Dr. D. describes, given a strong dose of cayenne &c, put her di-
rectly over the vapor while  flooding, continued the stimulants,
raised the heat of the bath to a hundred and twenty degrees, (by
which I stopped the  hemorrhage in fifteen minutes,) washed off,
rubbed  dry,  given an emetic, wich hazle injections, with cayenne,
and followed  with  restoratives,  and the next  day  repeated the
course, and thus cured a patient in whose caae the most of Dr.
D's prescriptions had been followed for several weeks before, with
no other effect than to aggravate  the fever and the hemorrhage?
Never since I commenced  practice have  I failed completely to
subdue a uterine hemorrhage  in less than one hour, whatever were
the cause of the discharge or the condition  of the patient.  Those
who wish ocular demonstration of the sovereign power of this plan,
have only faithfully to try  it in similar cases.   True the  regulars
cry, "not a particle of stimulus should  be used," but what should
this weigh against our own  positive experience?
   But, does  the propriety of our practice rest solely on the mere
fact that some have been so treated and escaped death?  By no
means;—'this fact is the principal if not the only evidence on which
rests  the practice I have just condemned in Dr. D.   The regular
course is justly condemned because all the  means used are calcu-
lated to  destroy the life of  the most healthy.  In the  first place,
the patient is bled profusely to prevent her from bleeding to death;
then  she is treated with snow and ice to cure her cold; now it is
expected that opium and sugar of lead- which all admit are calcu-
lated to "suddenly and rapidly extinguish a great proportion of the
vitality  of the system,"  will give to the minute vessels lacerated,
the vital power to contract their walls and join Ihcir edges?  Can
more direct paradoxes be found in language, or more consummate
folly be pronounced philosophy?
             9 
130
  But what Is the philosophy of our plan ?   Answer.   The patient
caught cold,  which caused collapse of the extreme and external
vessels, and  congestion in the larger and deeper seated.  The
Bterus, participating in the general spasm, contracts and thus se-
parates itself, in part at least, from the placenta, if one exist; or,if
none exist, the minute  vessels aro ruptured by the pressure.  Our
practice  reverses all these unnatural  conditions.   We warm and
relax the surface and let out the cold  fluids; the extreme and the
superficial vessels being thus expanded, their enlarged  capacity
invites back the blood from the places of congestion, on  the prin«
ciple  of  hydrostatic balance.   Then the stimulants and astrin-
gents  increase instead of "diminishing"  the vitality of the injured
parts, and  enable them to contract and soon to  knit again;  and
this is done without the smallest injury to the uterus or the ovum,
  The generality of mankind seem not to be aware that the blood,
in all  parts of the body, has immediate access by pores, to some
internal or external surface; that the healthy tone or contraction
of these pores is more than equal to the  pressure of the blood in
its efforts to escape through them and to seek its gravitating level;
that all hemorrhages by rupture, must of course arise from exces-
sive contractions in some parts and congestions in others, and must
therefore be cured by  restoring the equilibrium.   Let the public
meditate a short  time  on this manifest truth, and they wijl  not
much  longer suffer a fever to be discharged or a hemorrhage sup-
pressed, by reducing the quantity of the blood, and destroying the
vitality of the organs, instead of equalizing the circulation and aid-
ing the curative process.
  I must be excused for  a seeming wantonness  in  opposing  the
practice of Dr.  Dewees, against whose character as a well meaning
philanthropist,  I bring  not the slightest accusation.   It is because,
as I have said,  being Professor of Midwifery  in  the  University of
Pennsylvania, his work is at the head  of authorities for all the re-
gular physicians in the  United States.   "If, therefore, the light he
gives  be darkness, how  great is that darkness!" and how important
that it should be dispersed by the light of true medical science?
  It is proper,  however, to admit that there maybe, though it very
rarely happens, a case of flooding which is not so easily  subdued.
It is that iu which the  placenta is attached directly over the neck
of the uterus.  In this case, it would seem that hemorrhage must
take place during the latter months of pregnancy, when the neck
of the uterus  commences its expansions, but this  conclusion is
not inevitable, for the placenta  may expand in its centre to ac«
commodate itself to the emergency, or the rupture may be of such
a nature as not to expose many large vessels.   But, suppose the
worst, the management I have directed will, in all probability, save
the mother, even though the fcetus be  prematurely expelled. 
131
  Nothing can be more diverse than the opinions of different Profes-
sors of Midwifery, on the propriety  of meddling or not meddling
mechanically in flooding cases.  Some advise measures for the im-
mediate expulsion of the ovum, and yet dread the hemorrhage that
will probably ensue from the relaxed state of the vessels of the ute-
rus; while others object to the abortion on account of the difficulty
of removing the young and adhesive placenta.
  I remark  first, that, if we  treat the patient aright, that is, ac-
cording to nature, with means and processes in harmony with her
operations, either the placenta will be disengaged by uterine con-
tractions, and it and the fcetus will come away together, or else it
will strongly adhere to the uterus; in which case, as the tone of the
uterus is restored, the hemorrhage must cease.  "Hands off,'^ then,
in all those  cases where the foetus may not be  arrested in full
growth, by wrong position) ought to  be the inviolable motto.   If
authority were  of any use to us who have absolved ourselves from
all allegiance to what is generally  called authority, Dr. Dewees
and many of his brethren would fully sustain us here.  "That the
most mischievous consequences have followed the practice of those
who forced  the  hand into the uterus and immediately effected de-
livery, we have the authority of Pasta who deprecates the practice
as both cruel and dangerous; of Kok who says he has  seen it fol-
lowed by inflammation of the womb;  of Leroux who declares it to
be dangerous to both the mother and child; of  Baudelocque who
insists that nothing can justify the accoucher who persists to deliver
while the neck of the uterus retains its natural thickness and firm-
ness, and I may add my own experience, as I once witnessed death
as the consequence of this proceeding."—On Females, pages 356
—7.                                                 ,  ,
   After this testimony against violence, Dr. D. recommends plug-
ging the vagina closely with sponge, which  could do no  harm; (but
would  be unnecessary in our treatment,)  and  lastly, delivers by
force, {art* non  vi, says Blundell,) though with little expectation of
saving the patient's life.  To this last, I say no—let the  patient
die, if need be, but not by my violence.   Let me not do to save
life, what is of itself sufficient generally to destroy it.
   Some suppose opium to  be good to stop hemorrhage.  Dr. D.
says, he "has not recommended it,  simply because  it has never
merited the smallest  commendation in his hands, nor does he be-
lieve that it deserves the encomiums  which have been  so lavishly
bestowed upon it by others."   So  agree  Denman  and Barlow.
 He also condemns the cold, (except merely enough to abate local
inflammation  and act  as a uterine astringent,) and  says, "it ha?
acquired so much popularity among the vulgar [who  but the Doc-
tors gave it that popularity?] as to render it unsafe for the practi- 
I'M
tioner who has omitted it in his treatment of this complaint.  [Do
they still retain their popularity?]  "The injecting of cold water,
cold alum water, the solution of acetate of lead, the introduction of
ice into the vagina, and even into the uterus, have been practised;
and, it is said, with advantage.   The merits of such applications
must rest on the authority of those who recommend them.  I have
no experience in either of them."—Page 360.
  I have devoted a large  space to the subject of hemorrhage or
flooding, because no affection of the female system excites so much
alarm, and because it  is generally aggravated if not most frequent-
ly induced by what is called "scientific practice."
  I finish the whole with this direction—Equalize the circulation,
use astringent but  not cold injections to the vagina, remove mor-
bific matter  from the stomach &c, keep the action of the system
up, and the extremities warm.  For the plan of doing it, see "Ways
and Means."
  Inflammation of the Uterus.—This is another of the forms
of disease which, produced as it generally is, by violent artificial
means lo hasten or facilitate delivery,  and aggravated as it is by
mal-trcatment, often becomes a terror if not destruction to the suf-
ferer, and a  disgrace to the practitioner and his science.  - In re-
ality, however, it is an affection little to be dreaded when the pro-
per means of prevention and cure are seasonably and  faithfully
applied.
   1. When no "instruments nor rude hands"  are used in delivery,
inflammation of the parts will seldom occur.  2. Where care has
been taken to keep the pelvic region warm and relaxed, by clothes,
fomentations, the direct  application and the taking of lobelia &c,
it will occur still less  frequently—and 3.  Wherever it occurs; and
from whatever cause,  a thorough course or two, added to the above
local applications, will soon remove it.  Constantly warm, moist,
and slightly stimulating applications, are sure to reduce inflamma-
tion and remove soreness, wherever seated.   The divisions of the
symptoms, by authors, rest upon no foundation that requires any
variation in our plan  or remedies, nor in fact do they much affect
the "regular treatment" which is  uniformly "bleeding, purging,
blisters, opium, &c; with now and then an incidental prescription
of fomentations, sudorifics and the  like.  In proof of the above I
need only state that, among the causes, Dr. Deweeji mentions four
grand divisions,  the principal of which  are, 2nd. "Violences com-
mitted in the use of instrument's of any kind, injuries sustained in
the act of turning, or  ill-directed manceuvres executed on the neck
of the uterus, in attempting its dilatation, or too frequent handling."
3d.  "Lesions of the internal face of this organ from a sudden, rude
and unnecessary interference in the separation  of  the placenta," 
133
&c.—Fem., page 260.  Hence, if ladies are anxious for an attack
of this formidable affection,  which carries multitudes of them to
the grave, they have  only to call a regular doctor, who, to show
his superior skill, will first bleed them:  this will so  reduce their
power to deliver themselves, that "the action of the forceps"  will
be "indicated."   Then, according to  the  above statement,  the
"injuries sustained" will secure  inflammation of the uterus.  Now,
for "the hair of the dog that bit you," viz. "bleeding," to cure this
affection of which it was, itself, the remote cause!
  As to the other causes, ''the rigidity of the soft parts, caused by
colds, the violent action of the uterus &c, we know that these may
be easily obviated by fomentations, vapor, lobelia and cayenne.
The more local and definite the symptoms, of course the more at-
tention must be paid to local warmth,  moisture, fomentations and
injections.   The locality of the pains and soreness, will distinguish
inflammation from the general  fever, commonly called puerperal,
and indicate all the necessary difference in  the treatment.  This
affection, like most others, if allowed to progress, will soon involve
the whole  constitution in the suffering,  and give rise to  a great
number and variety of symptoms which it is unnecessary to detail;
first, because they arc not, in any two cases, in all respects exactly
similar, and secondly, because a judicious general treatment is the
only cure for them.
  Puerperal Fever.—"This  species of fever,"  says the Edin-
burgh Practice, "is usually the most  fatal  of all the disorders to
which the sex is liable.  But, notwithstanding its prevalence in all
ages, its real nature  has remained to the present time a subject of
dispute and uncertainty.  Some writers have considered it as pro-  *
ceeding entirely from inflammation of the  uterus, others from an
obstruction to the secretion of the milk, and still more from a sup-
pression of the lochia. Perhaps it is not the necessary consequence
of any of the causes above mentioned!"—Page  54:2.
   "It  generally  occurs within forty-eight  hours after delivery,
though it may occur many days later."—lb.
   A minute description is unnecessary here, for we, Botanies, con-
sider it (as we do all other fevers) an indication of the presence of
obstructions, which  must be removed.  The only reason why I
need give particular directions  about it is, that ladies are so gener-
ally deterred from a proper course of treatment, by the fear of the
awful  consequences, popularly supposed to be  necessary to  any
considerable disturbance of bodily repose, so soon after parturition.
Nothing, however, is so good for it, as a thorough course of medi-
cine, (see page 77.)  giving a good vapor bath before and after the
emetic, and an enema or more before the first bath.  Keep up the
action of the system and the warmth of the cxtnmilics, (sec page 
                             134

87,) and repeat the course if necessary.   This fever frequently in-
dicates  not  only  an obstructed perspiration, but the presence of
much morbific matter, both in the stomach and the bowels, and is
attended with an irritability which is calculated, unless it be speedi-
ly arrested, to carry off the dejections so fast as to overcome the
tendency to the surface and draw  the determining powers inward,
as in cholera morbus.   Hence, it  is important to give the course
promptly,  lo keep up the action of the system steadily  with cay-
enne, and to. soothe the stomach and bowels with  mucilaginous sub-
stances as soon as the cold, tough  phlegm and the bilious or pu-
trescent matter are discharged.
   Among the immediate causes enumerated by authors, "are the
stoppage of perspiration, neglect  to procure stools after delivery,
and too hasty separation of the placenta."—(Ed. Practice, p. 545.)
As the cure is often "gradually effected by spontaneous vomiting,
or by a long continued discharge by stool, of that porraceous mat-
ter, the existence of which in the stomach is usually evinced at the
first attack of the disease, the most unfavorable prognostic  arises
from such a weakness of the patient as renders her unable to sup-
port so tedious an evacuation as that by which the disease is over-
come."—Page 544.
   Hence, it is evident that an emetic in the onset will clear the
stomach, and check the formation or supply of "porraceous mat-
ter," while the cayenne will maintain  the  determination to the
surface, and prevent all  the danger  of  sinking; and the regular
action of  the bowels, procured by injections, will prevent the ac-
cumulation there.   So much for the cure of this puerperal fever,
caused by obstructed perspiration, "the action  of the forceps, or
injudicious handling, either in removing the child or the placenta;"
or by "porraceous matter" accumulated in  the  stomach and bow-
els.   In no case of labor that I have  attended, has this fever pre-
sented any alarming symptoms, nor have I ever heard  of a death
from it under the administration of the  true Botanic practice.  I
lately relieved a case in three hours; (a lady who had been treated
with the lancet and opium till her death  was expected every hour)
and, in a few days cured her.   She was relieved of all disease in
twelve  hours.  The balance of the time was required  to restore
the loss by the lancet and morphine.
   After an elaborate essay on Puerperal Fever, its causes &c, Dr.
Dewees remarks, (page 387.) "From all this, it would appear that
the subject is still open  for enquiry; and we would earnestly re-
commend it to those whose practice will furnish them with oppor-
tunities, to enquire into the fact, and endeavor to discover the cause
why a tedious and protracted labor should be any way instrumen-
 tal in diminishing the liability to puerperal fever.  For we may 
135
well ask how it is that long suffering, and, very certainly, lesion of
some kind, and to various extents, should diminish  the predisposi-
tion to this disease, or abate the force of exciting causes!"
  We answer the Doctor, that even our little observation on fevers
in general, (we have seen only slight symptoms of this in particu-
lar) affords us an answer to his queries,  as clear as the noon-day,
and as easily and certainly  demonstrable, as any conclusion drawn
from the principles of other physical sciences.  Will he give it a
candid consideration?  All the reason why  medical men have not
ascertained the reason of this medical fact long ago, is, they  have
made all their observations and conducted all their arguments un-
der THE GUIDANCE OF THE FALSE PRINCIPLE THAT REVER 19 DISEASE!
Let them just abandon this error, and all their difficulties will at
once vanish.   Let them receive the truth that fever is an extra ef-
fort of the system to remove all obstructions to ordinary and pro-
per action; and it will follow  of course that the more vigor in the
system, the more likely it will be to  show irritation from obstruc-
tions; and  that the lower the  power of the system is reduced by "a
tedious and protracted labor," the less able it will be to make any
sudden and powerful effort against obstructions.  The system, un-
der these circumstances, must rise by slow and almost impercepti-
ble degrees, and such also must be the removal of the obstructions
if they are ever removed at all!  More:  The reason why bleeding
ever reduces this or any other fever, is not  because it diminishes,
in the smallest degree, either the disease or the cause of the disease j
but because it acts like a tedious labor, in checking if not destroy-
ing the power of the system to war against disease.  On the  truth
of these propositions, we are  willing to stake our medical reputa-
tion—disprove them by demonstration,  and we will never write
another line against the regular theories of fever, or the modes of
treating it, nor will we, for any consideration, give a grain  of cay-
enne to any  sick patient who is so  fortunate as to be loo low to
"have  a fever."
  But, dear sir, we have so much faith  in your benevolence  that,
could you visit with us,  a patient suffering under the influence of
the form of disease which, from your experience in treating it, you
have so much reason to dread, and see us remove all the alarming
symptoms in  an hour or two, without doing  the slightest injury to
the patient, we  are confident that you  would be the first man to
commit to  the flames, all your recommendations of the lancet and
of leeches in  the case.  Yes,  sooner would  you cut off your  right
hand than allow your book to continue a  standing authority for
shedding rivers of the vital fluid from the frail, fair  and  will-be
happy  daughters of our country, when physicians shall have learn-
ed to relieve  their  special sufferings.  I am  aware that you  have 
136
quoted Drf Armstrong to prove that "the stimulant treatment Is at
once the most delusive and dangerpus that can be adopted," and
have stated that Dr. Denman, though  once an advocate of "the
stimulating treatment," finally "renounced it  with much magna-
nimity, and a candor which all must admire, though few may imi-
tate it;" page 425; and I am as ready as you to admit, page 426,
that "it is a great error to suppose that, when a case will not bear
depletion  with profit, it then absolutely requires the opposite treat-
ment"   Thpugh I believe that no disease  is ever removed or or-
gan cured without stimuli, either natural or artificial; yet I am far
from supposing that the system always needs  the latter.  It was
this supposition and a correspondent  practice, that  discouraged
Dr. Denman, and made him abandon the whole plan; whereas, if
he had been satisfied with the natural action of the system when
sufficiently strong, and  directed his attention, with proper means,
to the aid of that action  in disengaging  the  morbific materials
which disturbed or displaced it, he would have had the pleasure of
seeing his patients  recover rapidly  and almost universally.   The
failures of the stimulating treatment were not  then  nor are they
nowr, attributable to error in principle, but to  injudicious  means
and modes; while the "escapes" from the depleting system are to
be ascribed, not to any virtues  of that system,  (for its whole ten-
dency is to the destruction of life,) but to the power of life, the vis
vitee, often to overcome the attacks of bo^h disease and a destruc-
tive treatment:  for no man will dipute that depletion, carried out,
will universally destroy life; while all sound medical men agree
that nature alone cures,  either by  her own power (stimulus)  or
sometimes by the aid of artificial irritants.  The question then is,
not whether the stimulating treatment  is the correct  one; that is
immovably settled; but by what means and in what  way, and to
what extent it shall  be  applied?  And the  answer to this question
is simple, viz. When the living action is  altogether too low, raise
it; when disturbed or displaced, remove the cause  of the derange-
ment; and when confined, remove the obstructions  to its diffusion;
and do all these by means and modes that experience has proved
will do them, without injury to any  of the  organs.  Such are the
means and modes prescribed by the  Botanic System,  and success
will almost universally  be the reward of their timely and judicious
application.
  But  you cite cases to condemn  the stimulating practice and
commend the depleting.   These cases are among the  "false facts"
of which  Dr.  Cullen said there were more than of false theories in
medicine.  Let us examine them.
  In order that you may understand my explanations  of the cases,
I must entreat you to adopt,  as a key, while you  read  them, the 
137
sound principle that excessive or disturbed action or fever is vital,
not morbific action, and always friendly to life and health, inas-
much as its object is to remove obstructions to healthy action.  I
know that this will be difficult for you, and perhaps you will tell
me that Cullen and others believed it long ago, but their practice
did not prove it true.  I answer, their practice  did not prove it
false; for,  while they believed that  the vis medicatrix ought to be
aided in removing disease, they attempted to render the aid by
means and processes directly hostile to its action—they still gave
poisons and depleted.   Had they known the character and use of
the Botanic remedies of the present day,  Dr. Dewees would not
have been an advocate of depletion.  While, then, they were more
correct in theory, they were  less consistent in practice accordant
with their theory; hence,  physicians of the  present day  suppose
that the science of medicine, as they teach it, has improved since
the days  of Cullen; whereas,  in fact,  the most  important truth
which was then believed, is now abandoned, while a deadly prac-
tice is retained.  Consider then, fever as a friend, and the whole
of the following explanations will be clear as the sun, and conclu-
sive as mathematical demonstration.
   Stimulation.—You  say  of the first case, that the stimulus of the
10th  day  "reduced the pulse" from  120, and made her belter.
Now you  well  know that no stimulus reduces the pulse, unless it
promotes some confined  secretion.  In this case, though you do
not say what, it was probably  perspiration; for the previous invo-
luntary discharge of urine is proof of suppressed perspiration, and
the present correction of this discharge, is proof that the fluids
found their way through the surface, as you mention no diarrhoea.
Or else, as we suspect, the poison destroyed the energies of the sys-
tem, and thus checked the pulse and the urine without any secre-
tion.  On the 11th day, although the pulse was still 106, the phy-
sicians gave more stimuli,  which raised the pulse to 120, increased
the "heat," and so overcame the living energies by excessive ac-
tion, that "the patient became gradually weaker, her pulse was
accelerated more and  more, and her urine was again discharged
involuntarily.  She lived two days  in  great anxiety and restless-
ness, and  died"  the 5th  day of their practice.   This death you
attribute to the stimulating practice, although you admit, page 426,
that the first stimulus given  was "exactly suited to the system!"
and '-happily achieved an improvement."
   This case being one of "derangement" and "excitement" of some
organs, proves that some  other organs were deficient  in  the per-
formance of their duty, and that the latter needed suitable stimuli
to enable them to perform that duty, so that the  former need not
perform excessive duties;  for we know that a free,  universal and 
138
 equal performance of all the functions, constitutes a state of health.
 In this case, the skin was closed and inactive, perhaps other secre-
 tions were obstructed, and hence, that of the urine sustaining all
 the pressure of vitality, was incontrolable.  The skin therefore
 demanded moisture to relax it; the stimulus of heat it already pos-
 sessed.  A cool, pleasant bath would have given vent to the accu-
 mulating heat, and a free use of warm drinks, as soon as they were
 demanded, would have washed out  the morbific obstructions that
 checked the perspiration; the fluids being diverted to  the surface,
 would no longer rush to the bladder, and now, a  cleansing of the
 stomach with an  emetic, and of the bowels by injections, and the
 administration of a few laxative bitters, and a little stimulus to ex-
 cite the wearied organs, would have completed the cure.   But no;
 the stimulators did not understand their business.   They failed to
 give the succor needed.
   True  they  relieved, by injection,  the bowels of morbific mat-
 ter, which was right, as is proved by the fact that the system, thus
 relieved, directed a still stronger power to the contracted surface.
 This they erroneously considered making her worse, notwithstand-
 ing the increased effort of  the system to relax the surface, raised
 the pulse to 132, and  forced  again an involuntary discharge of
 urine!  Frightened at  these effects, so contrary to  their notions of
"better," the practitioners, instead of relaxing the surface and aid-
ing the pulse to reduce itself, administered a deadly poison  (sul-
phuric ether) which, you all agree, "suddenly and rapidly dimin-
ished a great portion of the vitality of the system," (Boston Medi-
cal and Surgical Journal, vol. ix., page 43,  and Hooper,  on  poi-
sons,) without removing a particle of the obstructions which ex-
cited that vitality.  This reduces the pulse to 106, (I  repeat, not
by relieving it, but by destroying its power to act,) and this condi-
tion of the patient you all  pronounce "better," though, in fact, it
 was worse; for, while the obstacles to be overcome remained the
same, the power to surmount them was diminished.   Still it was
 not too late to save the patient, had they relieved the surface.  But,
 they raised the action of the  system, already, as you  agree with
 me, high enough, and kept it up, not only till the organs' became
 fatigued with excessive action, but till the morbific materials in the
system  which ought at first to have  been removed, had accumu-
 lated a chemical power superior to the over fatigued  and  conse-
 quently debilitated vitality, and commenced the process of decom-
 position which of course soon terminated in death.
  Now, Doctor, I assure you, I have treated (on the stimulating
 plan) many such cases, and should think myself much to be cen-
 sured if, my prescriptions being strictly followed, I  should lose one
 in a hundred of them. As you will  doubtless agree with me that 
139
no plan ought to be condemned for its maladministration, so yoa
will agree (indeed you have virtually agreed) with me that the stim-
ulating plan in this case was, " doing well," "achieving happily,"
so long as il was judiciously administered.
   The reasons why the patient died,  are, the stimulating was done
internally instead of externally, and, at first, with a deadly poison,
(see Toxicology, Art. Nitre,) instead  of an innocent sudorific; and
the stomach and bowels were left full  of morbific matter,  instead
of being cleansed by lobelia, cayenne &c.
   Let us examine the second case, where you suppose that the de-
pleting system was triumphantly sustained.
   Depletion.—"On the  10th  day, .the patient appeared very low,
and her pulse was frequent and feeble.   Her tongue was dry and
brown, and her teeth were encrusted with sordes.  Her head was
yet affected with pain, but she made but little complaint of her bo-
dy.   It was, however, enlarged, and, though not very tender, was
sensible to pressure.  The symptoms of active inflammation having
given place to those of a typhoid character, the purgatives had
been  omitted, and the evacuations had consequently  decreased.
" I recommended," says Mr. Hey,  "such a repetition of the purga-
tive as might procure an evacuation about once in four hours, and
a  continuation of the saline  mixture in a state of effervescence.
The strength of the patient was supported by a light but nutritious
diet, such as broths, jellies, chocolate and milk.   This plan wa3
regularly pursued for four days, when the patient was convales-
cent."
   You seem to triumph in the success of the case, as though it had
been  treated  on your depletive plan; but, in fact, it was  treated
on the stimulating plan, less  injudiciously than the other, but not
half so judiciously as it might and ought to have been.  The bow-
els were full of morbific matter which was removed by dejections
every four hours; (in the other case they were left undisturbed,)
being careful to support the  system, by the stimulus of nutricious diet,
such as broths, jellies, chocolate and milk, which are well  calculated
to promote also  a tendency to the surface.  The "saline mixture,"
being about as stimulating as it was  cooling, was of little  impor-
tance any  way, except  to furnish fluid for the use of the system.
This  case had three important advantages over the other, which
are, first, no  deadly poison (nitre) was given  in the commence-
ment; 2nd, the morbific matter was removed from the alvine canal;
3d, the  system was supported by food instead of barks  and wine.
To these we  may probably add a fourth, perspiration was doubt-
less produced by the draughts, broths &c.,as nothingis said about
the "pulse being 132," or the "heat increasing" or the  "urine be-
ing discharged involuntarily." That, had she been more judicious-
*) 
140
 ly treated, she might have  been cured sooner, I believe; or that,
 had she been treated as the other was, she might have died also,
 I am disposed to admit; but  how it can  be shown that she was
 treated on the depleting  plan, and that her recovery justifies you
 and Dr. Clarke in abandoning stimulants and operating freely with
 the lancet and direct antiphlogistics, I  cannot comprehend.   The
 fact that many escape the dangers of extensive and deep-seated
 injuries, or of violent attacks of disease, by the mere recuperative
 efforts of nature, is pioof enough of her power to resist injuries;
 but no reason why still greater injuries should be heaped with de-
 sign to remove the former, on those who have been so unfortunate
 as to suffer some by accident.
  But you will ask, shall I not try a plan that has saved more than
 this stimulating one, even though I know it to be sometimes inju-
 rious?  I answer no, positively no.  This principle of doing positive
 evil  in the hope that good  may come, has been the greatest hin-
 drance that medical science ever had to encounter.  What then
 shall I do, say you? I answer again, reject both practices, and, in
the  guidance of principles known to be correct,  experiment with
 means and in modes known to  be innocent, till you hit a better
plan..  You well know that,  to bleed  as you direct, till no more
 bjood will run, even when invited by  warm water, and to physic
till the bowels, overcome by the chemical agency  of poisonous
drugs, cease their action, and to destroy the sensibiiity of the nerves
to pain, with  opium, as others recommend, will greatly endanger,
if not certainly destroy, the life of a  well person, whatever il may
do with the sick.  Away  then, with that  practice in  any form of
disease, which loses every ninth patient, as did that you detail pre-
sently; or, if it loses every fiftieth, search diligently for and prompt-
ly reject the  deleterious article  or process that causes the failure.
  On pages 430 and 432, you give comparisons of cases treated,
some with and some without depletion, in which  you show that the
 larger proportion of recoveries was of the former.   Hence, you
 draw the  conclusion  that judicious depiction is always a proper
course of treatment for the disease; whereas it only proves that it
 was, on the whole, less destructive in  those cases than the other.
  The truth is, that bleeding, being in  its nature calculated to des-
 troy life, can never be the proper means of restoring health, how-
 ever much more destructive some other course may be. The deaths
 of the patients treated without depletion, may  have been, and
 doubtless  were effected by  giving poisons as stimulants, a  plan
 more certainly destructive than the rash and daring use of the lan-
 cet, can be.  In some cases, failure might also follow an injudi-
 cious use of the proper stimulants.   Does the fact that what you
 call depletion, which signifies a  pretty severe evacuation of blood 
141
from  the  veins, and an  excessive discharge of eXcretory matte?
from the bowels, was less destructive than the stimulation with poi-
sons in the cases quoted, prove that the depletive plan is, in itself,
either right, or preferable to the stimulating plan with proper means,
properly applied?
   Had the stimulating plan been used with  proper means and in a
proper time and manner, it would probably have saved all those
patients.   At least, the Botanic practice of the present day, when-
ever jndiciously administered,  fully sustains us in this belief.   Il
is always wise  to avoid that which is calculated, in itself, to des-
troy life, (as bleeding and poisoning,) and, if we must make expe-
riments, to make  them with means and in ways that can do  no
harm if no good.
   In  the cases you report of those that had  been  depleted, out of
eleven, three died; of thirty-three, three died; of forty-three, five
died; and of fifty, five died.  Here are 137 cases of puerperal  fe-
ver, treated with depletion, of which sixteen  died, one out of every
eight and a half! And this is called skillful treatment, and justifi-
 able in every case where the symptoms are  urgent!
   Suppose the Botanic Doctors of the U. States  should lose every
ninth patient that happened to have a fever after child birth, what
a hue and cry should we hear about "quackery " and  "murder
by steam and lobelia!" and with what a good grace  would it ori-
ginate, as it always does, directly or indirectly, with regular phy-
sicians!  When a  certain  Botanic accoucheur had attended the
200th case, he had not lost the first mother or  child.  Dr. S. Thom-
son lately stated that he never lost either, in  his  practice of more
than  forty years!
   Lochia.—After the delivery of the secundines, the extremities
 of the uterine  vessels  being open, there will  be  a discharge from
 them which will continue during the sloughing of pieces of the pla-
centa, or the membranes that  may  be left  behind, and  until the
 uterus is entirely  clear, and the lacerated capillaries are healed.
 This discharge is  called the Lochia.   If it flows constantly, and
 continues to change from a bloody to a light color and to diminish
 in quantity, keep up  the action of the system, see page 87, cleanse
 the parts at least  once a day with injections of cajiker tea, and af-
 terwards slipery elm, and  all will be  well.    If it become bloody
 and profuse, treatit as directed for hemorrhage, page 108.  If it
 be suppressed, and pain and inflammation follow, treat it as  di-
 rected, page 10G, for  suppressed menstruation.
   Milk  Leg—{Phlegmasia Dolens.)—"Its  pathology,"  says" Dr.
 Dewees,  "is still unsettled."  "We have five  different hypotheses,-
 [respecting the cause,]  of either of which  it  would be difficult to
 make choice."  He   '-believes neither to be the true  proximate 
142
cause."  The symptoms are heat, pain and swelling, commencing
in the hip,  groin or back, and proceeding down only one leg at a
time.  Swelling elastic, white and exquisitely sensible;  total ina-
bility to  move the limb, and  great suffering when moved.  After
some time the sensibility diminishes and the swelling becomes
cedemafibus, (watery, leaving a pit  after pressure,)  and then the
same symptoms and effects are felt in the other leg and side of the
pelvis.  The milk  usually diminishes and sometimes disappears."
   I consider that the  causes  of this affection are,  either  a cold
taken, or the cooling  and sedative  treatment  of the  fashionable
practice.   It has never supervened in a single case that 1 have
attended.  To prevent or cure it, steam the lower extremities as
directed, ("Ways and Means,") give a full course, and repeal it if
necessary;  maintain the power gained, and it^vill soon "run its
course."   When the limb is  already swelled and tender,  a poul-
tice of lobelia, slippery elm and cracker, will aid in the cure.
   Phlebitis.—This  is an inflammation of the coats of the veins or a
filling up of their cavities, so as to obstruct the return of the blood
to the heart.  Instead of being loose and general in the whole struc-
ture, the  cold humors or cankery materials are here lodged in defi-
nite localities.  The veins first become tender and corded or hard,
and then the flesh  swells because the blood is arrested in its return.
This form of disease, being  more difficult  to cure than the other,
will require a more rigorous and persevering treatment, but of the
same character.   The morbific matter must  be loosened from the
veins by relaxants and stimulants.  The surface should  be fre-
quently rubbed with equal parts  of the  antispasmodic and stimu-
lating liniments.   I need not remark that the  regular practice in
this, as in every other inflammatory affection, is depletion;  "blood
letting, leeching, cupping, purging,  blisters, opium" &c.   Noth-
ing is so good, intimates Dr.  Dewees, as to promote a perspiration
of the whole limb by "steaming it with  hot bricks,  cooled  by
plunging them in vinegar, folded with cloths and put at the side of
the leg and the foot," the limb being covered with the bed clothes
raised from it by a rick of half hoops fastened at right angles to
longitudinal strips. But, unfortunately this cannot  be effected
till, by bleeding, leeching, purging &c, the arterial action  [of the
veins!] is "reduced to the sweating point.'"  Fortunately this affec-
tion is of rare occurrence in  the regular practice,  and seldom if
ever found in the true Botanic.
   Sore Breasts.—Under the head of poultices and inflammatory
tumors, pages 89-90,  I have given an  account  of the principles
on which this disease should be treated, and the means  of reduc-
ing the tumor.  On a review, I perceive that I omitted  to state
that, when there  is heat and soreness already in the tumor, the 
143
stimulating article is not wanted in  the poultice.  Stimulation  is
necessary only when the flesh is cold and clammy, as in oedema,
anasarca, and the like.  A  simple lobelia and slippery elm  or
basswood (Tilia or lime bark)  poultice, is all that is wanted for
sore breasts or any other tumor that is hot and painful.   If the
heat and pain are very great,  the poultices should  be kept cool
and moist, by frequent applications of cold water, till the temper-
ature of the tumor be reduced lo nearly or quite the healthy stan-
dard; when the organs will be relaxed,  and then the morbific hu-
mors will be either excreted by perspiration or absorbed away, and
the milk will be softened and thinned, and discharged.   The prac-
titioner on fever and inflammation, should always bear it in mind
that too much action in a part may dry and contract the skin, and
cause the accumulation of too much heat (the extreme of which is
a burn) as well as that too little action in a part may leave it to be-
come cold, inactive and obstructed; and that his duty is to equal-
ize the action.—"Hold there,"  says the  regular, "you are coming
over to our side!   We teach that the action and the heat must be
equalized!"   Soyoudo; and, were  you to practise what you teach,
all would be  well.  We  never left those "sides" in  which you
teach truth.   It  is  only  your  errors that we abandon.  We  all
teach that the tone of the organs must be regulated, and their  ac-
tion and the heat equalized:  but  you do it by destroying their
power to act  at all, and we, by removing  the cause of the distur-
bance.  You "kill the fever" by bleeding and poisoning; we remove
the obstructions that disturb vitality, by relaxing the strictures,
 with  means that inflict no organic injury.
   I have never had a case of suppuration of the breasts; I have
 always prevented it by  removing the cause in season.   Should one
 occur in my practice, I should treat it exactly as I do every  other
inflamed tumor, with moist, cool and relaxing poultices, courses if
 necessary;  and, lastly, if much swelled, painful and evidently  full
 of matter, I should lance  it and discharge the pus, and poultice
 again.  Ladies who will  keep out cold and canker from their sys-
 tems, and nurse their  children, or, if they lose them, draw  the
 breasts often, need have no apprehensions of this painful affection.
   Hysterics.—When, in the course of "medical manceuvenng,
 most  commonly—very rarely of neglect to attend  to herself in
 cases of slight cold, &c, (or  by  the indulgence of a fretful or
 crooked  disposition, of which 1 do not mean  to say that  one of
 them ever is actually guilty; but only to  hint what would happen
 if  they should be,)  a lady's  whole nervous system becomes so  de-
 ranged that the doctor cannot determine what plan  of treatment
 to pursue, where to begin it, or what remedies to use; it is fashion-
 able to style the whole, hysterics, and place it among the opprobria 
144
 medicorum (reproaches of the faculty,) diseases, the cause df which
 they do not know and for which they have no remedy; and to hold
 forth as a reason for refusing to Ireatit, not their ignorance and in-
 ability, but the declaration that il is a disease of the imagination,
 not of the body.   The true definition of the name  is,  disease in,
 or inseparably connected with, the uterus; and, of course, wholly
 confined to females.  But, even the sapient nomenclators some-
 times forget its origin, and apply it to similar symptoms in our sex,
 which  circumstance, while it is not a little ridiculous in them, is a
 positive proof toothers, that they are ignorant of its nature.
  Of all the diseases both  of males and  females, that I have ever
 treated, this general derangement of the system, indicated by irre-
 gular, fitful and anomalous, nervous action, has been  the most com-
 mon.   As either this or death is generally the end of the "bold and
 energetic" regular treatment of all acute forms of disease, so  it  is
 the form with which our Botanic brotherhood throughout the coun-
 try, are most frequently  called to grapple;  I shall, therefore, be
 pardoned for devoting a number of pages to the consideration of it.
  The first difficulty you  meet in the treatment of  this universal
 chronic, is the popular doubt thrown over your ability to cure it, by
your manifest inability to give it an appropriate and specific name.
 To obviate this, you should make extensive and  minute inquiries
 respecting the symptoms, and then name it, as you find it in fact,
 a complication of affections, a universal derangement of tlie  sys-
tem.  This will not only be admitted, but felt to be true; and will
inspire confidence in your  prescription of a general  and thorough
 treatment, as the proper means of checking the sympathetic affec-
 tions, and enabling you  to discover and eradicate the orginal
 causes.
  Another difficulty is the discouragement, arising from the 6low
 progress of cure, even after the remote causes are removed; the re-
 covery being  protracted by the inability of  the organs to regain
 their tone  and  activity.  Because  the  patient is  not in constant
 agony from acute pain, she thinks she is not very sick; and, because
 she does  not rapidly recover, she doubts the propriety of the prac-
 tice, and begins to lose confidence.   To  prevent this difficulty, as-
 sure her before you commence, of what 1 am supposing to be true,
 that, though she is not in any apparent danger of immediate death,
yet she must, in reality, be  very sick, or the means  already used
 by others or herself, would have cured her; that she is sinking, and
will continue to sink unless  more energetic  means be used to save
her.   If she doubts this, while you know it to be a fact, you had
better do nothing for her till she is convinced of it; otherwise you
 may labor in vain as  to the cure, and  be afterwards  abused  for
 your lenience.  If, however, she sees her condition  clearly, and, 
145
after some  weeks or months of resolute practice, finds even that
she only is no worse, she will still be encouraged, as she might have
been dead without it.  If, now, a given general treatment prevents
her from growing worse on  the whole, it  will be found, by strict
examination, that she is,  in sundry important respects,  materially
better^ that, in other respects, chronic symptoms are exchanged
for acute, which, though not more agreeable to bear, are certain
indications of return to the healthy state from which she has so far
departed; and, of course, that a prompt increase in the energy and
frequency of the prescriptions, will soon turn the scale in favor of
the patient.  This looks reasonable enough to induce a trial; and,
fortunately for the practitioner and the patient, the practice cor-
roborates the reasoning.   In time, patient and  energetic perseve-
rance are rewarded  with success.  Such at least has been my ex-
perience.  In several instances, two  or three years have accom-
plished  what one year's faithful effort hardly seemed to begin.  To
a vigorous and unremitted general treatment, I  kept  constantly
adding  direct applications to local derangements, till the  vitality
or circulation and action of the whole system was equalized, and
the organs enabled to maintain, by their natural operations, what
they had been enabled to regain only by the aid of our  art.
   In the treatment of this affection, or this compound of almost all
affections, care must be taken to  obviate  every local difficulty as
fast as it arises; as, to remove costiveness, a slight cold or a sick
stomach, &c; and so to vary the articles  of general and constant
prescriptions as to prevent  the patient from getting tired of any
one thing.  The reason of this, 1 have not room here to explain; I
only state the fact that, when a good medicine answers well the de-
sign for which it was given, but does not accomplish all  that i«
wanted, we should endeavor to supply the  deficiency with another,
but we  should not abandon entirely the use of the former, lest we
lose what we had gained.  All the remedies should be rendered as
agreeable as possible to the taste.  The compound called  restora-
tive bitters, which I shall presently  mention, is agreeable, aud a
person  will cheerfully eat enough of it to keep up the action of the
system.                                                 .    f
   In this chronic affection, as in almost  all  others, the action ot
the system is partial, and the progress of remedial  influence is
slow; therefore it is important to apply the means at as many points
as possible.   While  general cleansers and restoratives are regular-
ly given, the surface should be stimulated to action by an occa-
sional vapor bath followed by a free use  of the stimulating lini-
ment, pa. 96; and a small but pretty active enema should be ad-
ministered occasionally when the bowels arc empty, to  rouse them
from their torpidity.  If it  irritates  them more than is intended,
                 10 
146
give another of slippery elm.   The feet should be kept constantly
stimulated till they cease to be cold and clammy.  If the urine is
vitiated, give the diuretics,^as cleavers &c, freely; if these do not
soon correct the difficulty, inject with a small  syringe, through a
catheter, a little of the tea of these and of bayberry and cayenne
into the bladder. Make up a compound of equal parts of as many
of the different approved  bitters as you can  get; add of slippery
elm, of bayberry, nervine and cayenne, same quantity as of each
of the others; half as much cinnamon and cloves, if you have them,
and sugar enough to make the whole agreeable to the taste.  Mix
well in dry, fine powder, and take a tea-spoonful three to six times
a day, dry, if the bowels  are too loose; in  cold or hot water, if too
costive.  Watch the effects.   If the whole compound is too astrin-
gent, mix in more bitter root, or butternut  extract; if  too laxative,
put in a strong astriugent, as woods poplar, &c, till you temper it
to suit the case.  No man is fit to be a general  practitioner, who is
not well enough acquainted with the several conditions of the body
in sickness, the principles that should govern his practice, and the
qualities and powers of his remedies, to enable him to proportion
and apply them  so as to suit the case before him.  To depend  al-
ways on compounds made to our hand, and on giving them accord-
ing to a written prescription, is to fail in many a case where the ex-
ercise of our own judgment might have given us the victory.
   It is freely admitted that many of these hysterical cases are very
difficult to cure.   The  organs have been so long and  so much de-
bilitated by  the presence of obstructions, either naturally or artifi-
cially introduced, that  the prospect of restoring  their energies is
gloomy indeed, and  would be totally abandoned, but for the cer-
tainty that death is the only alternative to  perseverance.  I have,
therefore, in many instances persevered in the expectation of only
keeping the patient comfortable while she lived; and, in not a few,
have seen success awarded  to perseverance,  rather  than to any
change to an apparently more energetic or judicious course of prac-
tice.  Hence it is, that I have so often advised persons not to  let
any unfavorable circumstances discourage  them.   If the case does
not improve under a judicious and energetic practice, it is certain-
ly hopeless under none.  And diligence and faithfulness  may be
crowned with success.  Be sure then, when you have a bad case,
that you are doing  that which is  best calculated to aid nature in
the recovery, and persevere, till death arrest your efforts, or health
reward your toils.
   Injuries suffered by parturition.—I have  stated that, when
the patient is properly treated, both during pregnancy and at the
close of it, material  injury is seldom inflicted on any of the organs
concerned in' any part of the process.   But it is not every one who

                                                   § 
147
rs thus treated.  For want of proper attention in relaxing the sys-
tem, the parts concerned are sometimes lacerated in parturition,
communications have, been made between the vagina and the rec-
tum or the bladder, the uterus has been torn by the fingers, the
perineum has  been sometimes entirely divided, and sad work has
been made by the forceps on the pelvic muscles and ligaments.
  When these are not so injured as to cut off their connexions and
destroy Nature's means of applying the healing process, constant,
moist and soothing applications to the parts, and a general sustain*
ing treatment of the whole system, will,  in  time, effect recovery.
In lacerations of the recto-vaginal partition,  if we see them while
fresh,  we must fasten  in contact the  adjoining  edges, either by
stitches with lead wire or white silk, or, what is better, if they can
be made to stay, by strips of adhesive plaster, at short  distances
from each other, on the vaginal side.   If their lacerated edges are
healed, we must flay them afresh and  then join them.   The sys-
tem must be  prepared for this operation, by  thoroughly emptying
the stomach with emetics, and the bowels with injections, and then
continued in a quiet and unopprcssed,  irritlcss state, by giving the
patient only food enough to sustain her, and that in a liquid state,
until  the adhesions are complete and firm.  This plan  has been
adopted and has succeeded.—See  cases by Dr. J. P. Mettauer, in
the Boston Medical and Surgical Journal.
   My advice was lately asked in a case where the accoucher, in an
attempt at embryotomy, or  cutting away the fcetus by piecemeal,
made the small mistakes of cutting out a piece of the neck of the
bladder on one side, and of opening a passage to the rectum on the
other!  The latter difficulty comes under the above treatment; but,
for the former, a remedy is scarcely possible; the preventive of such
disasters is to keep off men  who  "aid delivery"  with knives and
forceps.  Even  in this case, however, I should endeavor lo pass a
catheter through the external part of the urethra, across the sepa-
ration, and through the remaining part into the bladder.   If, now,
the cut ends of the urethra could be reached through the  vagina,
scraped till they were  raw, brought together and confined till they
should firmly  adhere, well; if not, possibly a silver tube might be
constantly worn there to some advantage.   But .the urine would
be continually flowing, unless  the healing could be effected and   «
the tube removed.
   The debility of the  organs, even where there is r.o lesion. pro->
duced by the  use of fingers, forcer-s, crotchets and blunt hooks, is
often the cause  of diarrhoea, incontinence of urine, prolapsus uteri
&c; to correct  which, the parts should be kept well cleansed, and
properly lubricated and toned.  By compression of the nerves, or
actual lesion ef them,  these means often produce spasmodic or pa-
( 
14S
ralytic affections which are more easily prevented than cured.  In
cases where the supports of the uterus have been so weakened as
to permit its vertex to descend to the perineum, I have been able,
by a long and thorough course of restorative practice on the gene-
ral system, and of cleansing and astringent applications to the  va-
gina, to effect a cure.  But the regular practice has sometimes ta-
ken away parts of the vagina, and at others, ruptured  its body, or
turned it wrong side outwards, and then cut it off.   I  know of no
cure for those forms of disease!  We must learn to prevent them.
  Sometimes, from the swelling that follows injury to the pelvic
organs, the urethra is closed, and the urine accumulates.  Efforts
are frequently made to draw it off through a catheter, but the in-
sertion of the instrument, in this condition  of the organ, is painful.
The same means should be used as for a dysuria or retention of the
urine, at other times; viz., emollient and relaxing injections to the
vagina, poultices of powdered and  sifted slippery elm made in
strong lobelia tea, inserted into the  vagina, sustained by a cloth
and bandage, and washed out clean every twelve hours, with warm
water, injected from the common syringe.   Keep up the action of
the system, and place a half gallon  bottle or  jug  full of boiling
water, wrapped in a large towel, with its  side  in contact with the
externafparts during the night.  This practice will soon relax the
pores and remove the swelling, or a stricture from any cause, and
will let the water escape.
  On the other hand, the sphincter of the  urethra may become re-
laxed, and the urine will flow involuntarily.   In this case, use as-
tringent injections, as wilch hazle, oak bark &c, after having first
cleansed with bayberry and a little cayenne.
  If hectic fevers occur, it is proof either that the action  of the
system is  low and unsteady, or that  there are obstructions which
should be removed.  Equalize the action and retain it, and remove
the obstructions if any.   If the fever be intermittent, alternated
with chill, and succeeded by perspiration, the  surface is too open;
it must be kept closed by frequently rubbing dry, and the strength
must  be supported.   Syncope  or fainting, or  a frequent sense of
sinking  is  proof of either much internal obstruction  or  much
debility  of the deep-seated organs, or a very  lax  surface.   The
indications are to cleanse the general system, and close the surface
by friction.
   If the lacerated parts show a strong tendency to putrescence, or
if the system  exhibit much eruption, it is  proof of  the presence of
 corroding canker, which must be removed  by our ordinary method,
 remembering that, after a  general cleansing of the system, a con-
 stant and steady aid must  be afforded te maintain the action ai
 nearly at the healthy standard as we can.  The  morbific matter
I 
149
that is distributed throughout the system, must be removed by the
regular course of absorption, and secernance or excretion; and this
process requiring some time, the  organs should not be so over-
exercised as to become fatigued before the labor is accomplished.
   Palpitation, sinking, panting for breath, vertigo fyc—These are a
series of symptoms that, generally  if not universally,  have their
causes in the mal-practice of depletion.   By abstracting an undue
portion of the fluids of the system, the hydrostatic pressure is every
where diminished; the power of the cool atmosphere, in some cases,
and the  obstructed condition of the organs in others, force the
fluids to  those parts that are less influenced by these causes: hence,
there is a pressure of the blood to the large veins and  heart, and
an opposition to  its repropulsion through  the arteries.  Conse-
quently  it accumulates in the heart, lungs &c, producing conges-
tion and causing  the heart to labor fruitlessly "in  back water.
The  symptoms thus produced are  called palpitation.  It takes
place at the commencement, during the progress, or at the termi-
nation of exercise, because il is then  that this inequality of distribu-
 tion of the fluid is most powerfully resisted.   The  power of the
 system to overcome it, will be exerted to fatigue and sometimes to
 absolute prostration, which will be indicated by the  sinking ot
 strength, panting for breath, &c.
    The  vertigo or swimming of the head, arises from  the  same
 cause, pressure of the  fluids, but upon different organs, viz. the
 nervous system, instead of the vascular.  Some of the nerves are
 harder  pressed, and, of course, more impeded in their action than
 others.   This makes a difference in the time in which the different
 external objects and parts of objects are impressed upon the mind;
 hence these  objects themselves appear to be  in motion, now to-
 wards,  and now from us.  We imagine ourselves falling towards
 those that appear to approach,  and we make efforts to balance
 ourselves accordingly.   These efforts, together with our real weak-
 ness, make us really stagger, and sometimes throw us entirely
 down.                               ,      ,   .A  ...   .
    Poisons of every description, tend to destroy the vitality of every
 organ on which they are permitted to produce their natural effects.
 This needs no proof.   It is universally conceded  that it  is only
 when the system is able to throw off both them and the cause of
 the disease for which they are given, their administration is justifi-
 able; and that, when they remain long in the system, they do it a
 real  injury.   See the disease called "mercurial,' in any of the
 popular works on The practice of medicine.   In proportion, then,
  as mercury or any other poison, fastens upon any ganglion, plexus,
  ramification or fibre of the nervous system, it checks the vitality of
  tbatpart; what is the  necessary consequence  but confusion  in the 
150
  combined action of the whole?   Thus  calomel is frequently the
  cause of this derangement, yet how often do we see, instead of an
  attempt to remove the calomel, another poison; as opium &c, ad-
  ministered, to check the action of the remainder, and thus equalize
  the nervous excitement?
    Such treatment reminds me of the conduct of some wicked boys
  who found the head, fore-legs and  body of a toad making powerful
  and uncommon efforts, because its bind-feet were deep in the throat
  of a serpent that was about to swallow the whole.  To  quiet this
  unusual action, they very scientifically  cut off the head of the toad,
  instead of that of the serpent.   I need  not say that their skill was
  crowned with a success quite equal to  that of the administration
  of poisons to cure delirium and congestion!   It sometimes hap-
  pens, however, that the blow at the head, however destructive its
  nature, or mistaken its  intensions, does  not entirely answer the
  aim;  and, after a few more struggless, the poor animal escapes the
  two-fold danger, with only a scar on the  head, and the loss of the
  use of only  his lower limbs.  But who  will contend that the blow
  itself, or the intention in giving it, is the means of saving the poor
  reptile's life?
    I would not  be understood to say that nothing but poisons in the
  system  can  be  the occasion of delirium.  Any substance that can
  produce unequal pressure upon the different nerves of sensation and
  motion, will produce the same irregular action for a  time; but
  there is this difference, that the irregularity produced by the latter,
  as it suspends or impedes only the action, not the capacity to act,
  is easily removed;  while that produced  by  the former  is  lessor
  more permanent, according to the partial or total destruction of
  organic capacity.   Of  course,  the delirium  that  proceeds from
  mere obstructions to nervous  action, will be  cured by  simply re-
  moving those obstructions.  That  which proceeds from  partial or
  total  destruction of nervous capacity,  will be but partially cured,
  if cured at all.  I know this will sound harsh to many  "believers
  in calomel, opium, nitric acid, digatalis, cicuta," &c. &c.; but I feel
  it my duty, as their friend, to  warn them that these deadly poisons
  are what  first make nine out  of ten of  the chronic diseases in our
  country, and then render  them "incurable;" to sav nothing of the
  "countless hosts" that are sent to the grave from infancy, childhood,
• youth and manhood, by the same destructive instruments, admin-
  istered  so rapidly or under such circumstances  as to destroy the
  whole,  instead  of a part of the vitality of  the system, and thus pro-
  duce  a  more speedy  death.   But even this is certainly preferable
  to a lingering existence, unprofitable to  the world and a burthen
  to one's self, from which, as Dr, Mason Good says, "Death, with a
  friendly stroke, finally  puts a period  to one's sufferings."  And 
151
then, what renders this course the more reprehensible, is, the blame
is laid to the will of that kind Providence who, instead of ever tell-
ing us to use poisons to  cure disease, actually told us that poisons
are themselves the consequence of wickedness; that  we are to eat
only of what is "good for food," and cure our diseases only with
healing balms;  and more than all this, who has  scattered  these
healing balms,  in rich  profusion, wherever man  is found with a
malady, to be cured.
  The description of the causes and pathology of these affections,
will suggest the plan of cure.  The  particulars are given in the
Lectures on "Ways and Means."   The steaming should be con-
fined longer to the lower than the upper extremities, the obstruc-
tions removed and the circulation equalized, not by destroying the
little action that remains, but by stimulating the sluggish organs to
come up to the performance  of their duty.  All  the  difficulty in
these cases, is, like the preservation of civil liberties, they require
(almost) "eternal vigilance" in the practice.  Long perseverance
is often rewarded with success, after the most vigorous treatment
for a time, seemed to do no other good than merely to postpone  the
dissolution.
   Disease of Children.—I have already shown,  page 14, that
many forms of disease  of children,  such as scrofula,  erysipelas,
consumption, syphilis, &c, may have their  origin in the parent.
It is therefore evident that the first medical treatment of children
should be exercised on their parents, whose blood  and  flesh should
be kept constantly free  from all impurities.   It is a mistaken  no-
tion that "iL is dangerous to doctor women during pregnancy."  If
"the science of medicine  teaches the art of preventing and curing
disease," where can be  the harm of exercising it  in  any case?   If
experience has proved that what is commonly practised as this  art,
actually makes disease instead of preventing it, then  it may be and
ought to be abandoned, not only when  persons are  very liable to
be seriously injured by  it, but when they are the  least susceptible
of injury.  But, does this prove that means calculated to effect the
end  in  a proper way, should not, at all limes, be  used?  Surely
not.  Let the parents then be kept ::i  good health, and their off-
spring will be  blessed with  a sound constitution,  as surely as a
flourishing, healthy plant will produce a perfect oced.
   I have  already spoken extensively and carefully on the treat-
ment of the new-born infant,  pages  52, 66, and  elsewhere.   To
wash off the sticky matter from the £vtus, Dr. Ebcrle says that the
yolk of an egg is hotter than the soap and k<rd of Dr. Dewees; that
the water should be  at  least lukewarn,  in all  cases, and warmer
where the infant is feeble.  Dr. Gunn says this meally covering is
designed by nature to protect the child from the two violent action 
152
of the atmosphere, and should by no means be removed by us. In
a few days it will come off itself, and leave the skin soft, natural
and free of all disease.  Care should be taken not to fatigue the
child too much.   Infants should be washed at  least once a day,
over every part of the body and  always rubbed dry with a soft
cloth: then a little sweet oil, or oil made by melting unsalted butter,
rubbed into the groins, armpits, and wherever else chafes are likely
to occur, will prevent them.  The lower part of the body should be
washed  clean twice a day, and at other times as circumstances re-
quire.   Dr. Eberle thinks  that the  bandage should  be worn "four
or five months," and longer if "the parts about the navel appear to
be weak and readily to yield to the pressure of the viscera."  These
parts should be examined often, and kept dry and clean.  It can-
not be too strongly urged on those who have the care of infants,
to "keep the  feet warm, the head cool," the clothing loose,  and
the body free and easy; to  change the clothes to suit the variations
of  the  weather, and not  to let them sleep in cotlon or flannel
worn during the day.
  Disease is often produced in  infants, by unsuitable food, or by a
too frequent or a too liberal use of that which is good.   The new-
born infant is not in  so great a hurry lo "eat or take physic" as
most persons imagine.  It may, if vigorous, pass five or six  hours
after birth, without either food  or injury; and, when food is given,
if the mother does not supply it, new milk, sweetened  with a little
molasses, is doubtless the best.   No remarks would  be added here
to what have  been made heretofore, but to correct an error which
Dr. Eberle seems to  have  committed in supposing that, because
the mother frequently  supplies no milk for some time, we are to
conclude that the child  does not need  nourishment till she does
supply it.   But I would not do him injustice.  He "does not mean
to inculcate that nourishment is always  to  be withheld un+il the
milk is secreted; but that,  "with healthy infants, several hours at
least should be suffered to pass after the birth, before any aliment-
ary substances are  introduced  into the stomach;"  and then he
"would  most  strenuously insist  on  the  importance of giving but
small portions at a time, and at such intervals as will obviate all
risk of overloading the stomach.   A few tea-spoonsful of some very
bland and weak fluid, could not be  detrimental, though given  im-
mediately afterbirth; but the usual practice of filling the stomach
to overflowing, and keeping it in this state of fullness  and  disten-
sion, is most ruinous lo  the health  and comfort of  the child."  I
perfectly agree with the Doctor, in all but the supposition that "the
supply" will  generally be  furnished as soon as the want is felt.
This ability of nature to do her original duty, in spite of the im-
pediments thrown in her way  by the refinements of  the age, as 
153 (
luxury, idfeness, corsets,  silk stockings;  blecUng and physicking
out the plethora, and checking, wi/h poisons, Hie tendency of the
system to produce it in the idle an! luxurious, has >een examined
in the first Lecture, where it is reniered at least questionable.  As
but a small quantity of food, however, is requisite t« support the
Bystem, and as  the digestive apparatus is unaccustoned to its in-
tended exercise, much caution is necessary  as to the mture, quan-
tity and frequency of the food that seems requisite befo-e the child
is furnished by  the mother.  When it is  necessary to  hed the in-
fant, Dr. Eberle says  "two parts  of fresh  cow's milk and one of
warm water is the best."   And this, he thinks, should be"the only
food for  the infant during the first three or four months," when it
cannot be supplied by the mother or a wet nurse.
   Nursing.—When, from any cause, the child cannot be entirely
supported from the  breast of the mother or the nurse, small quan-
tities at a time  of the milk or milk and water, should be  given it.
It should be drawn  from a vial or little bottle, through an artificial
nipple; or, when this cannot be had, a piece of clean linen  rag an
inch wide and  long enough, when rolled  up closely, to  fill the
mouth of the vial, may be used.   This will prevent the child from
eating too fast, and give the  stomach time to become satisfied be-
fore it has received too much.  The cloth  must be unwound and
washed in scalding water once or twice  a day.
   After six months, even when the mother nurses the child, it may
be well to commence giving milk,  in small  quantities, two, three or
four times a day, to gradually accustom the child to derive its food
from other sources than the breast.  Light bread may be, by de-
grees, finely  crumbled and mingled with  the milk; and thus the
lightest food may succeed from time to time, till the child will not
only become  accustomed  and able to subsist  without the mother,
but be very willing to do it.  There are many things that may  be
given to  it in infancy, with impunity, provided they be not given
in too  great quantity.  Barley water, rice water, milk porridge,
fine corn  mush and milk, &c.  But milk is  the best,  and this
should be given by the judgment  of the  parent, not to stop the
cries of the child.   The common practice of nursing or feeding a
child to  stop it from crying, or to  put it to sleep, is not only very
injurious to the infant, but unwise in the  person who does it; as the
cry is notunfrequently an indication of pain produced by previous
over-feeding; and, of course,  more stuffing  only makes the matter
worse.  When a child cries, that is known to have eaten enough
for the abundant support of nature,it would be much better to en-
deavor to ascertain whether the cause may not be the irritation of
a pin in the clothes, or some uncomfortable position, tight bandage,
or the like. 
   Nurses.—Thoagtf it is  generally supposed that it  is about a*  ,
 well to obtain a wtt nurse for the child, as for the lady to nurse jt
 herself, yet I ma inclined to tiink that, in general, the disadvab-  *
 tages of "bringing a child up by the bottle," (I don't mean the rum
 bottle) are fir less than those  of entrusting it to nurses.  In the
 first place, tleir milk is not so suitable, especially if they have not
 just then be*un to afford it.  The first  milk,  says Dr. Dewees, is
 the most a/propriate "natural physic to the child."   Secondly,
 they may |ave some disease in the blood, as  syphilis,  tetter, itch,
 &c, whicl they may communicate to the child.   Thirdly, they
 draw awa/its attention and attachment from the mother.  Fourth-
 ly, they /o not so well attend  to  the  child as the mother would.
 either as it regards its food, clothing, comfort or cleanliness. They
 are impatieit  of  the necessity of incessant  watchfulness, feed it
 too much atone time and too little at another, leave it  too long in
 the same position, and handle it too roughly when they condescend
 to move it at all.  They not unfrequently, too, give it some vicious
 anodyne to keep it quiet and  make it sleep.
   But, bad as  these  evils are, they can  scarcely be considered the
 worst.  Ncrscs communicate to the child the influence of all their
 evil tempers and  examples, and teach them false and vicious no-
 tions of right and wrong; for it must not be forgotten that infants be-
 gin to observe  and to receive deep and lasting impressions from the
 moment they open their eyes.  If there were no other objection to
 employing a nurse, than simply the disadvantage to the mind and
manners, I should strenuously oppose it in all cases except those
in which the nurse were a better woman than the mother! cases
that do sometimes occur.  In other cases, even where a nurse is
 employed, it will be profitable  that the mother should take charge
 of the child at all times except when at the breast.  A nurse of vi-
 cious passions  even  vitiates her milk as well as  her example, and
 renders it not only totally unsuitable to the infant, but  positively
 injurious:  Such,  therefore, should always be avoided.   In some
 cases, however, of very weakly or premature children, all efforts to
 raise them by  feeding, prove fruitless.   Then the best nurse that
 can be had should be obtained, and dismissed as soon as she can
 be spared.
   After the  teeth begin lo appear, it  is  proper enough to com-
 mence giving  the child  a little mutton  or chicken soup, and small
 portions of boiled beef or mutton, or chicken may be chewed; but
 greasy food, as pork, and what is hard to digest, as veal, should be
 avoided.   A few articles that are plain and nourishing, are the best
 food for children.  They  may eat four or five times a day if they
 do not cat too much.   Milk and water when  young, and water
 alone afterwards, should be their only  drink.  The pulp of ripe 
155
peaches and apples, is good for food; but an infant should never be
permitted to eat the seeds, the core, or  the skins  of these, or any
other fruits.   Currants, cherries, whortleberries, grapes, raisins
&c,  are  particularly   objectionable on that  account.   Tough,
smooth skins should never be eaten.  Being indigestible, they ir-
ritate the stomach and bowels, and  create serious derangements.
The little seeds of raspberries and strawberries are indigestible; of
course they will irritate the internal canal and become sources of
disease; but the juice expressed from them or other similar fruits,
is good.   In  short, nothing should be given to infants or young
children that is known to be difficult to  digest; for, whatever is not
well digested, is pretty sure to produce diarrhoea.  Nothing, however,
is better for this affection, than the  raspberry or blackberry juice,
or a tea made of the roots or leaves, sweetened with loaf sugar and
a little milk in it.   This last may also be given  by injection.  The
principal reasons why any of  the ordinary fruits  are injurious, is,
either they are given unripe, or in a hard, solid state; or the  skins,
cores or seeds that cannot  be digested  at  all, are not removed.
Clear these from the rest, reduce the remainder to a pulp  or jelly-
like substance, free from shreds or fibrine  as well as hard  coria-
ceous or bony substances, and the remainder of any fruits that are
good to eat by any persons, under any circumstances, may be eaten
by infants with impunity.  It is  the want of proper mastication
that renders many vegetables, as potatoes, turnips, parsnips, car-
rots, peas, beans &c, often injurious.  I have repeatedly been told
by a sick person, that he or she had an almost insatiable desire for
certain vegetable  food, as potatoes or turnips, but that they were
sure to produce  diarrhoea, that  is,  "to  come away as they were
eaten."   In  hard lumps? said I.   "Yes, mingled  with watery
fluid."  It appeared to  me that the fault was  altogether in their
not being masticated so that the gastric juice could act upon them.
Passing in ragged, angular forms through the intestines, they pro-
duced an irritation which forced them along rapidly; and the fluids,
which generally pass so slowly as to give time for absorption, were
carried  along with  them.  1 directed  these very  articles  to be
thoroughly boiled, then bruised till  all the lumps  disappeared and
forced through a fine seive, to get out all  but the  parenchymatous
substance.   Of this I  permitted the  patient to eat freely,  and I
never knew an instance of injury from it.  Children  may cat the
expressed juice or the fibreless pulp of any fruits that are good for
the parent.   There is, therefore, no painful necessity of denying
them any  fruits or vegetables which they see their  parents eat.
Peas, beans, snaps, cherries, and all such things are innocent, de-
lightful and nourishing, when thus treated.  Pears are supposed to
be more indigestible than apples; and all dried fruits  than  fresh. 
156
The only reason  is, they contain more hard or stringy substance
in proportion to  the  parenchyma, than others do.   Bruise and
strain the pears, or dried fruits, and they are quite as good as the
fresh apples; far  better, unless they too are thus prepared.  You
may cure in children, with the expressed and clear juice of rasp
berries and blackberries, the very  diarrhoea which was produced
by the irritation of the seeds  of those  same fruits,  when eaten
whole.   Hence, it is not only necessary that children and the sick
adult, should have good food, but that this food should be properly
prepared.  I give a sick person a little of any thing he craves; but
I take care that it is properly prepared for  his reception.  I have
seen a patient eat with impunity the expressed juice of a raw tur-
nip,  when there was neither appetite to eat nor ability to digest
the fibrous pulp of a boiled one.               ?
  Even particles  of matter that is not very  fibrous, as boiled pota-
toes, artichokes, &c,  may be  so firmly united by cohesion that
they will not all,  except when well masticated, be submitted to
the process of digestion; of course they become  irritants to the al-
vine canal.   The reason why a roasted potato is more wholesome
than a boiled one, is simply that the dry heat disengages the water
from them, separates their particles and gives free admission to the
gastric juice among them.  Hence they are reduced to solution,
and rendered subservient to the  nourishment of the system, while
their power to irritate mechanically, is destroyed.   I have never
known good Irish potatoes do harm when they were ripe and well
roasted,  and skinned and thoroughly bruised  before they were
eaten; and I have frequently prescribed them in this way for very
weak stomachs.
  Medicine—For Children.—In  the commencement  of this work,
I mentioned some of the evil effects on children,  of improper medi-
cine, and wrong modes of practice.   As they  have, generally, a
more healthy constitution than  grown persons, it will  require a
far smaller portion of medicines  to cure them, or of poison to kill
them.   The organs being more readily roused into action, a larger
portion of the medicine is used at the same time, and, of course
the effects are more alarming.   In giving medicine,  therefore, to
children, great care should be  taken that nothing poisonous or in
any  respect hurtful, should be used, and (hat no  excessive quantity
should be given,  even of that which is innocent and good.   None
but the attentive  practitioner can determine just how much should
be given in any particular case,  the action of  the pulse and the
state of the stomach, bowels, extremities and surface, when well
understood, will give a clue to the proper quantity of medicine, and
the time and mode of adminislration.  The true way is to begin
with a little, and increase or vary the dose, as  the circumstances 
157
and effects require.  In general,  I have found ginger sufficiently
stimulating for infants, and they are much less displeased with this
than cayenne.  Raspberry leaves too, are excellent for them, and
bayberry, if good, is often sufficiently stimulating without cayenne.
It may be remembered that, while there is a high fever and a burn-
ing surface,  there is more need of external relaxants than of inter-
nal stimulants, till the pulse begins to sink, when stimulating fluids
may be given more freely.  There are cases, however, which will
require the energy of a half tea-spoonful of cayenne at a time and
even several times repeated.  If necessary  to sustain the system,
let it be given, and as long as required.
   As it is very difficult to make children take medicine of suitable
kind and in sufficient quantity, particular attention should be paid
to giving it by the bowels, and applying it to the surface, whenever
there is a prospect of its  acting with equal  comfort and benefit
that way.   Nauseous medicine should never be given to open the
bowels.  It is much  better as well as quicker done by an injec-
tion, only slightly stimulating, and repeated if necessary.  The
necessary articles may also be much disguised by putting milk, su-
gar, and some pleasant aromatic in the tea.   Milk may  procrasti-
nate the time, and moderate the violence of their effects; but will
not materially  diminish their value.  But  I insist that children
should never be cheated as to the sensible qualities or the intend-
ed effects of what is  given them.   They should be  told candidly
the danger  of their  condition, the taste of the medicines and the
effects which it is intended they shall produce.   Then they should
be persuaded to take them,  if they can be; forced to take them  if
they must.   To cheat them is the way to make them troublesome.
   Exercise.—However feeble the  first motions of the infant, no-
thing should be permitted to impede them.  Its  dress  should be
free, and no heavier than is necessary to keep it warm.  When
asleep, it may of codrse be covered with more clothes than might
be convenient when in active exercise; but, when inclined  to be
restless, it should be  laid upon a mattress or hard wide pillow, and
suffered to use its feet and hands as freely and as long as it pleases.
In cool weather its arms and  legs should be covered with cotton,
and, in cold, with flannel, and thick woollen socks.   It should also
be carried about in  the arms, but not required for  two or  three
months, to support itself upright, without assistance to keep its back
and head straight.  Its position should be changed frequently, as
from one  arm to the other, that it may neither grow crooked nor
become tired.  lis spine is too weak to support its body erect for
the first three or four months, nor is its neck strong enough to hold
the head up long at  a time  even  then, without fatigue and  pain.
Therefore, when carried in the arms, all parts should be supported 
158
1
as much as possible.   Those that handle the little infant, should
remember that it is not accustomed to rough treatment, to being so
suddenly raised and depressed several times its length, as almost to
deprive it of breath; and, especially, they should remember that
its arms are not so  strong as to  justify the frequent lifting of its
whole weight by them.   All  sudden jelling or jarring of infants,
as dandling them severely on the knee and letting the heel strike
the floor, or striking them with the hand on  the back, or  rocking
them violently in a  cradle, in short, all operations  by which the
whole or parts of their bodies are suddenly and severely  shaken,
are injurious, and should be discountenanced.
   The custom of giving infants air and  exercise in  little wagons,
is good.  But I have thought that the air so near the ground may
not be so refreshing,  as it is well known, at some  times,  and in
some countries, to be very injurious to health, when that which is
inhaled at the height of a man, is good.   Perhaps the best mode of
carrying an infant about, is  to place it on a pillow in an  oblong
basket, hung upon the arm, or string it  by a belt under one arm
and over the opposite  shoulder.  The basket may be pushed for-
ward under the nearest  breast.  The holding  by the  arm to the
neck of the nurse, as it is commonly carried, is calculated to de-
form the shoulder, especially unless it be frequently changed from
one arm to the other.  Whatever be the mode of artificial exercise
for infants, it should be frequent, moderate in character and short
in duration, and under such circumstances that all its limbs may
be free for whatever motion they may be  inclined to make.  All
uncomfortable motions should be carefully avoided.   It is often the
case that an infant is sadly shaken about,  jolted or rocked to pre-
vent it from crying, when the fatigue and suffering it has  already
endured in consequence  of former shaking, may be the cause of its
crying.
   "Creep before you  walk,"  says the proverb.   Cribs are prefer-
able to cradles, if they arc not made too  high and too liable fo
turn over.  . The upright posts are fine things for the infant to try
the strength of its hands and arms upon.   It will often seize them,
(they should be small, round and  plain) and pull  just as  much or
as little as it should, and let go when it is  tired.   In this way, the
development of the  muscular power of the hands and arms, will
commence much sooner, and be more gradual and more effectual,
than when confined in a smooth-sided cradle  which it cannot seize
with its fingers.  It should never  be taken up nor even supported
when up, by one hand or arm, nor should it ever be  lifted by its
arms at all till  it has been observed to raise  itself upon its feet by
their use, and even  then  it should not be held long by them.  To
develop the strength of  its feet and legs, the  foot of the crib should 
159
be a solid board, and the bed should be mad\ so near it, that the
feet  may push against it when the legs are Sraight.  The head
can  be filled up with pillows.  It will be sooi\ observed that the
child takes great pleasure, at a very early period, in pulling at the
pillars and kicking the foot board of the cradle,and much time will
be spent in this way, which would  be passed in crying in an ordi-
nary cradle with the bed made close to the head.  When  the child
becomes so strong as to hold its head firm and erect, and to balance
its body in the cradle without holding to the pillars or rails, it may
be placed upon the carpet, and watched, relieved and stayed ofteflj
till it has learned to sit  firmly, when various play-things should  be
putihto its lap.  It will presently begin to  lose, and reach and
move itself after them, and, in a few days, will creep all over the
floor.   The articles may then be put into a Utile chair to induce it
to climb after them, and it should be watched and prevented from
falling in its first attempts, till it  has acquired  so much pleasure
and skill in the exploit, as to encourage its frequency and and se-
cure its safety.  Let the  articles now  be placed upon a common
 chair, and it will raise itself upon  its feet, where it should not, at
 first, be permitted to remain long at a time.   By degrees it will
 learn to let itself down  again, when it  becomes tired, and now it
 may be permitted to rise, stand,  or  sit at pleasure.  It will now
 commence walking  round the chair, and, when it is strong enough
 to steady itself by one harjd, it will attempt to pass from one chair
 to another that may be  within its reach.  It may then be held by
 both hands and induced to step  after  a person; and, after this is
 done  with ease, two persons may teach  it to walk by  itself from
 one to the other, near  together at first; afterwards at greater dis-
 tances.  These exercises  must not  be continued long  at a time,
 but may be  frequent.   But 1 repeat it that children should not be
 pulled and whirled about by their arms,  nor  tossed high  and  sud-
 denly into the air; nor should their bodies be subjected to any ex-
 ercise much more violent than themselves are capable of making.
 They are often materially injured in their form and future growth
 by these  means.  When they have learned to walk, they should be
 permitted to do it as much as they choose, out of doors, whenever
 the ground is dry.  For this purpose  every nursery should have
 a small piece of grass  near  it, which should  be free from stones,
 sticks  &c, and not permitted to  grow high, and ere it should be
 permitted to rise, walk and fall too, as much as it pleases.     #
    I have said that children ought never to be pulled about by their
 arm or arms.  Dislocations, sprains,  and deformities are the fre-
 quent results of such conduct.    I have  seen nurses, in leading a
 child by one arm, pull so hard as to cause it to fall forward, Hot
 being able to set its feet firmly on the ground, and  then of course
t 
160
  its whole weight w«*ild be suspended upon one arm.   Not unfre-
  quently, too, does tie nurse lift it in this way over a drain, a log,
  or up or down a st'P»  Those who handle children in  this way do
  not seem to reflec/ that it would not be very comfortable for them-
  selves to be thus pulled about by the arm with a power and velo-
  city adequate to the task.   Yet what reason have they to believe
  that children can bear it better than adults?  They may rely upon
  it that the cause of much of the fretfulness and crying of children'
  and of many a deformed shoulder,  may be  found in this violent
  dealing with infants, perhaps for  the purpose of preventing their
  crying.  Not only are infants thus treated by a careless unfeeling
  nurse, when unobserved by the parents, but I have often seen it in
  the mother herself.  She cannot be supposed to " forget her child,"
  but it were much better that she should at times neglect it, than to
  treat it so rashly as she frequently does.
   "After children have acquired the entire use of their legs," says
 Dr. Eberle, very justly, "walking is decidedly the best exercise they
 can take.   When the weather is fine, they should be taken out
 daily, and freely indulged  in  running and walking out under the
 superintendence of a careful nurse. These little excursions, if pru-
 dently conducted, have a highly salutary influence  on the infan-
 tile system.  Children that are raised in the  country, are, in gen-
 eral, much more robust, healthy and active than those that are
 brought up in cities:  and this difference is mainly to be  ascribed to
 the greater freedom which the former usually enjoy, of walking, run-
 ning and tumbling about the grass-plats; enjoyments often in a great
 measure denied to the latter.  In taking this kind of exercise, chil-
 dren should not be accustomed to rely too much on the assistance
 of others.  If the ground is soft, or covered with grass, and free from
 stones, timber &c,  they should be permitted to have  their way.
 A few falls will do them no injury;  but, on  the contrary, make
 them less timid, and teach them better than any other instruction
 how to avoid a similar accident in future.  Children that are nev-
 er suffered to surmount, by their own efforts, the little difficulties
 which may occur in their sports,and are continually warned against
 trifling accidents, seldom fail to become unduly timid, helpless and
 irresolute in their actions.   Parents  ought not to intimidate their
 children by inspiring them  with a constant dread of falling and
 hurting themselves.   The custom of exaggerating the dangers in-
 cident to their usual sports, and of plying them  continually with
 admonitory injunctions against accidents, when they are engaged
 in their amusements, is calculated to favor the occurrence of the
 very accidents which  they are meant to  obviate, by the timidity
 which  these perpetual lessons of caution and fear almost inevitably
inspire. When the ground is soft, it,is much better to let the child 
161
take the chance of two or three falls, and give a full scope for the
exercise of its limbs, by running and gamboling about till it is sa-
tisfied.  Nothing can be more invigorating to the whole organisa-
tion than this kind of unrestrained exercise, in suitable situations,
and under the superintendence of a  prudent nurse.  When they
happen to fall or hurt themselves, they should not be soothed by
expressions of extreme pity and sorrow, which tend very effectually
to render them  effeminate  and timid.   Children thus commis-
erated, seldom fail to acknowledge the tender sympathy in strain-
ing their little lungs to the utmost by crying, on the reception of
every slight injury.
  After they have passed through  the primary  period of detitia
tion they should be encouraged in the pursuit of active amusement
out of doors, as an essential and regular part of physical discipline.
Nothing contributes more effectually to enfeeble the body, and to
lay the foundation of permanent constitutional infirmity, than con-
finement within doors and want of active exercise at this tender
period of life.   The development of the moral and physical ener-
gies of children, can in no way be more effectually promoted, than
by  permitting them to engage freely in the usual sports of child-
hood, in tbe fresh and open air.  The practice of obliging them to
remain within doors, and to  con over their lessons between school
hours, is by  no  means commendable.   These intervals should be
devoted to innocent amusement and bodily exercise.
  Clothing, Air, Exercise, &c-—In  the Preliminary Lecture, I
spoke especially of the evils  that follow a want of proper clolhuig,
pure air and abundant exercise.  I must insist here, that children
that are constantly deprived of either of the above named com-
forts, are seldom healthy, and  never have a good constitution.
Nothing is more important, whether we desire the development of
the physical power or the mental energies, than that the system be
protected from the  excessive action of tlie atmosphere, the sun or
the shower,  by suitable clothing, comfortably adapted to the figure
and motions of the body, and then permitted to enjoy the pure air,
from which  it may derive oxygen for the perfecting of the blood,
and be subjected to steady and varied exercise during the whole
period of its growth.   Children that have been bred in the house
in idleness, or in factories where the air  was impure, or in the
depths of that poverty which deprived them of comfortable appa-
rel, are seldom able to bear, with impunity, the labors and priva-
tions of those reverses of fortune to which all are exceedingly lia-
ble, while those that have been accustomed to labor on a farm (on
the whole the best exercise in  the world) more or less every day,
during the whole period of  their growth, are  seldom afterwards
broken down by any severity o£ either bodily or mental exercise.
             11
                           ♦ 
162
The clothing should not only be warm or cool, according to the
season,  but it should be properly distributed and comfortably at-
tached.   The feet,  legs and arms should be clothed as warm as
the body.  No  bandage should be drawn so tight round any part
of the system, as to leave a mark after removal.   The shoes should
be always loose and comfortable; in infants very soft, and the feet
should always be kept  as  dry as possible.   All children should
wear drawers under their clothes, adapted to their necessities; cotton
in summer, and flannel in winter.  'Ihus appareled and comfort-
ably fed, there need be little fear of their taking cold on exposure
to any ordinary temperature of the atmosphere, while they should
be frequently employed in the greatest convenient variety of useful
exercises, in which il may be supposed that they will ever be ne-
cessarily or profitably employed.   When the  weather is damp and
chilly, they should have an opportunity to play  in a large room.
They may be  permitted to walk or run through  passages and
draughts of air, but never to lie, sit or stand long in  them. They
■hould not be tied a long time in  a little armed chair, but allowed
to run about  and tumble over the floor, any thing against which
they might injure themselves  being removed.  For  several years,
girls should have the liberty to play out of doors with the boys.
Nor do I see any good reason why they should not, till tbey are ten
or a dozen years old.   But, if any think that they should  be sepa-
rated before  this lime, I  earnestly insist that the girls be not de-
prived of exercise by themselves  in the open  air.  The keeping of
them in the  house Or  always covered with a  long  close bonnet
when out, may  give them a whiter and more delicate skin, but it
deprives them of that robust and  hardy constitution which is of far
greater value.  Neither girls nor boys, however, should be permit-
ted to stand, sit or lie, long at a time on the damp ground.  There
is little danger of taking cold while exercising; but,  when the ex-
ercise is over, care must be taken that they do not cool too sudden-
ly.  They should be required to walk about till the perspiration
has ceased, and by no means permitted to drink more than a swal-
low of water at a time.   If they are very warm, a cup of warm
water and milk is far better.  Washing the hands and face in cool
water directly after severe exercise in hot weather, is not only a
sure remedy against taking cold, but will allay the thirst in a very
great measure.   The clothing that may have been thrown off be-
fore exercise, should always be immediately  put  on afterwards,
that the heat which is then escaping too fast, may be  retained
round the body till the pores close gradually, and exclude the chilly
air.
   The  Nursery.—Where children are kept in the  room  with the
other members of the house,  as ie most commonly the case, espe- 
163
cially in this country, the rooms are so often opened as to keep fhe
air pure and wholesome, unless, indeed, the house is so small as to
require many to huddle in one room, and sometimes even to cook
there.  But most families who have the conveniences appropriate
to the children and their attendants, have a certain room they call
a nursery.  Into this they are frequently pretty well crowded, to-
gether with their dirty clothing and every thing that pertains to
them.  This room is frequently made nearly air light, lest they take
cold; many are suffered to crowd into it and  corrupt the atmos-
phere by absorbing  the oxygen, and what is worse than all, the
children's clothes arc changed and, if only wet, are suffered to dry
in the room; if dirty as well as wet, they are frequently suffered to
remain in the room till they have rendered the air totally unfit for
respiration.  Instead of all this, the room should never be thronged
with those  who do not belong in it, (the larger children being com-
pelled to take their exercise in more  open places, and to  "play
with the baby" when brought to them, or to be but few at a time in
the nursery.) should be so constructed  as to be easily and  freely
ventilated  at any time; should often be deserted while a current of
air is permitted to pass through it, by door and window for half an
hour or  so; should be  very  frequently washed, always kept free
from any  and every thing offensive, even a wet diaper, and con-
stantly ventilated by lowering the upper window-sash a little, if no
more.   However unwholesome may be the air without, that within
will soon  be  more  so, unless  it be often changed.  The room
should never be  entirely close, either  at night, or in the coldest
weather  in winter.  It is well to keep a thermometer in the room,
and never  to raise the  heat  above  65 to 70  degrees.   But there
should, if possible, be two rooms for this purpose.  It were much
better that a nursery be divided into  two  apartments, even though
they should be small.  Then the  children may sleep in one and
play in the other, and be changed  from one to  the other while
washing, sweeping or ventilating.   Still it is desirable that both
should be large, airy and well lighted and ventilated.  An upper
room is preferable.  It may be warmed either by a fire place or a
stove, provided  the latter be  not heated too hot, and  a basin of
water be kept.upon it, so that the evaporation shall prevent the
air in the  room from becoming too  dry.  Let the stoves be pro-
perly proportioned in size to  the rooms, and there  will not be much
danger that there will be too much heat.  But this heat is, in my
opinion, far preferable to that of a fire in the chimney, as it is
much more equal all over the room.  A high fender should sur-
round the  stove or fire plaee, so that the children cannot get at it
to burn  themselves on it.  the room in which  they  spend the
day, should have little furniture in it except a good, thick, woollen 
164
carpet to prevent the children from injuring themselves by falls.
Now fill it with useful play-things, such as balls, and various geo-
metrical figures made of cork and painted, and with any thing ehe
that is calculated both to amuse and instruct them.   Their little
eyes may as well become accustomed to seeing, at once, something
that is useful  as something that is worthless.  If attended by an
intelligent person, they may learn,  even in  early infancy, the
nature, operations and names of all  the geometrical figures, and
a  thousand  elements  of useful science,  merely  as matters of
amusement.  But, of all the requisites in  the  nursery,  none is
so really important  as that  which is frequently  least  thought
of, viz. a person  to direct  the  amusements and  attend  to the
wants  of children, who is  well  acquainted  with human nature,
and qualified by  experience and self-government to mould the
infant mind  in  the  way  it  should  be  formed.  I  have not a
doubt  that a large majority of infants commence,  before  they
are eighteen months  old, that course of subjection either of the
judgment to the passions or the passions to  the judgment, which
is  rarely changed in  character during the whole course  of  after
life.  And yet, how  often do we see them taught, during this pe-
riod of their pupilage, to indulge the most revengeful spirit, allow-
ed to "whip" or command the nurse to whip those persons or things
that are supposed to  have annoyed them; to  get almost any thing
or license they  want, provided they will cry long, loud and pitiful-
ly enough to weary the patience of the attendant; and to get rid
of the performance of any duty by merely making a firm and per-
severing resistance.  What  can be expected of the child that has
commenced its mental discipline in this manner?  Yet such it will
be, unless the nurse be both able and disposed to teach it better*
   Cleanliness.—Nothing is  more important in the preservalioBi
of health and the prevention of disease, than cleanliness.  By this
remark, I do not wish to be understood that a child should be pre-
vented from going where it would be likely to get dirty.  It will
become as dirty from the drying of  its own  perspiration on the
surface, as from any  other cause or exposure.  The surface should
be cleansed often, and that too, not merely by wiping with a damp
cloth.  Children should be taken into a warm room, every night,
before going to bed,  the doors of the room being closed to prevent
currents of cold air from striking them, and should be stripped and
thoroughly washed in a tub  of warm water, and with a little soap;
then  rubbed dry, dressed in clean night clothes, and put to bed, at
least till they are weaned; and it should be continued often, by the
nurse, till they can do it themselves, when they should be requiredto
 do it till they do it willingly, for the pleasure and comfort it affords.
 Some are afraid that this will give their children a cold, but I am 
165
sure sickness has occurred ten times for the want of this frequent
ablution  where  it  ever did  in consequence.  Children  that are
permitted to get ever so dirty during the day and are thoroughly
washed every night,  do not, in reality,  get half as  dirty as  those
that are supposed to be kept so constantly clean as to need no gen-
eral washing at all.  The custom of wiping instead of  washing,
and thus  leaving the  acrid fluids or the  still more solid and  offen-
sive materials about  the groins and hips of children, is  the princi-
pal cause of chafes and eruptions in those parts.
   A dirty, waxed up, or contracted skin, too, is sure to check the
perspiration and produce derangement of the stomach and bowels.
It predisposes to internal and eruptive form3 of disease, by check-
ing the vital opposition to them, and maks them much more dan-
gerous by retaining longer in the system, the morbific matter that
induces them.   The water in which the child is washed should be
as warm as is comfortable;  and, after  three or  four months, the
washing  may be finished by a dash of water a little cooler,  in the
manner of our cold dash after steaming, proportioning the heat so
as only to make the child startle a little at the change of tempera-
ture.   It should then be wiped dry immediately and dressed warm,
and, if it be thought  at any time that there is any danger of taking
cold, it should have a little warm tea and be induced to commence
some active exercise, to raise a perspiration  before the skin  be-
comes cold and  contracted.   Warm baths and cold dashes should
be given to children  frequently, till—even their  second childhood
is ended!  Physicians recommend washing with cool  water after
the child becomes  older; this may be well, but the warm bath with
the cold dash is doubtless far preferable at any time.  If the cool
bath is used, it should not be while  the body is perspiring unless
done very quickly.  They think the warm bath the most desirable
to benefit the constitution, and the cold, the best calculated to se-
cure against taking cold.  Our plan unites both these advantages.
I have no objection to a sudden plunge into cold water,  when the
tendency to the surface is strong; but I am persuaded that it is in-
jurious to let the body remain long in a bath much cooler than its
own temperature.   To wash the body in warm or tepid water and
!ea*'C the skin relaxed, would tend to debilitate it; but the sudden
cold dash or a thorough rubbing restores the tone, retains the heal,
and greatly strengthens the  system.
   Wevning.—"The obvious correspondence," says  Dr. Eberle,
"which exists between the successive appearance of the teeth and
the development of the digestive powers, affords us a safe guide in
relation to this subject."   The artificial nourishment may be com-
menced with the appearance of the first teeth, and gradually in-
creased in quantity and quality,  till  the incisor teeth have made 
166
their appearance, (seldom sooner than the eighth or later than the
twelfth  month,)  when, the child being pretty healthy,  it may be
taken from the breast altogether; and its digestive organs will have
acquired sufficient activily  and power to enable them to digest
what the system  demands, viz. a more substantial nourishment
than that of the  breast.   But the change should be very gradual,
fuse to a very simple fluid, then to more dense, and then to solids.
"When  the period of weaning is approaching, small portions  of
milk, thickened  with bread, rice or flour of rice,  chicken, mutton
or beef tea &c,  should be allowed the child two or three times a
day, whilst, at the same time, the intervals of sucking should be
more and  more  prolonged."   The same kind of food  should be
continued some time after the child is taken from the breast.  The
first meat that is generally allowed is chicken, mutton or beef.   I
remark  that these ought to  be boiled, and the fluid only given, for
some time.  When meat is boiled till it falls off the bones, the nu-
tritious parts are chiefly in the fluids, very little is left in the fibrine,
which is now indigestible and ought not to be eaten.   Care should
be taken not to give too much  at a time.
  In case of the death of the mother,  or her inability to furnish
milk, the child must of course be either entrusted to a nurse or fed
from the phial; but the materials must be such as have been alrea-
dy recommended.  Sometimes, however, the mother gives abun-
dance of milk, but its quality is vitiated  by disease; as scrofula and
other morbi^c tumors.   It is  apt  to  be bad  when  menstruation
occurs, as it sometimes does during lactation.   So it happens too,
occasionally, when little but debility  appears to affect the mother.
In all these cases, the health of the child will generally  be serious-
ly affected.  It must be withdrawn from her breast and nourished
from some other  source.  When its constant drains from  her breast,
seem greatly to  exhaust the mother, it  must be withheld from her
for her  own sake.  Many females, especially young and delicate,
are alle to supply only a part  of the  nutriment  that  is wanted.
They should be  permitted to  supply  what  they can comfortably,
and the deficiency should be made up by feeding: But  the period
of lactation should seldom be prolonged beyond  twelve months,
on any  account.  When children show very  great unwillingness
to quit the breasts, they may be induced to  do it  by putting some
bitter substance  on the nipple, as butternut extract, gum  myrrh &.C.
   Tongue-tie.—Sometimes there is a thin,  wide membrane ex-
tending under the tongue of infants  almost  lo the tip, so as to hold
the tongue from  projecting beyond the tops of the under  teeth.
This membrane  should be carefully  cut with a pair of blunt point-
ed scissors.  Examine carefully and  not cut so far as to take what
ought to be left, in which there are  arteries and veins to sever 
167
which might produce dangerous hemorrhage, besides the mischiefs
that would be done to the motions of the tongue, by cutting off the
OCrmuscle that attaches il to the arch of the lower jaw bone.
  Thus far, I have treated on the prevention of disease in chil-
dren, which I consider a matter of the first importance.  Unless
these hints be regarded, it will be very difficult either to cure sick
children, or to keep them well after they are cured-  But, if they are
carefully obeyed, I am persuaded that there will be but very little
sickness to cure.   I have treated also, in the preceding pages, of
several forms of disease peculiar to children.  1 shall now mention
the symptoms and treatment of most others of any importance, and
give directions  which will answer for all, of however minor eone-
quence.
  Eruptions.—Eruptions  of various  names sometimes come out
upon children, and sadly frighten doctors, if not old women.  They
are called, jaundice, erysipelas, measles, scarlet fever, chicken pox,
and other "exanthematic affections,"  &c.   These are said to  be
more or less "acute," according to the degree of fever that attends
them.   Our plan is  to treat them all upon the same principle and
with different degrees of energy according to the urgency  of the
case.  The best plan is to give an emetic, and empty the bowels
at  once in our peculiar way, accompanying both administration*
with just stimulus enough to keep up  a moderate tendency  to the
surface.   If the internal canal is very foul, we repeat this, until it
is pretty clear; then continue the determination  gently to the sur-
face, which must be kept clean by occasional steamiugs, or washings
in  warm  water when  steaming cannot  be practised; and (he pa-
 tient will soon be well.   The  only error  1 have seen committed
 by our friends, in their treatment of these  forms of disease, is such
 an effort to drive the obstructions out so soon, that, in some eases,
 the skin was opened too freely and the patient rendered too liable
 to  take cold; and in others, the fever was. raised u-nnecessarily
 high, before the  surface was opened  at all.  One or two  gentle
 emetics in  the beginning, and a few injections, followed, not pre-
 ceded, by a  judicious steaming, will, in all ordinary cases, break
 the power of these  forms of disease: and  then  a steady course of
 stimulation just  energetic enough t©  keep up a  healthy action, is
 the best course.  In measles,  expectorants should be given  to
 loosen the phlegm;  and, if there be much  irritation, emollients, as
 slippery elm or flaxseed tea, should be drunk.  In this and in scar-
 let fever, generally, some mild sudorific, as sage, boneset, penny-
 royal, catnep, peppermint, &c. is  sufficiently stimulating.   In  the
 putrid sore throat, a gargle made of tincture of cayenne and gum
 myrrh, not so strong as Dr. Thompson's No. 6, should be frequent-
 ly used.  The bowels should be kept free by enemas, and the  ex- 
168
tremities warm.  I have had patients of all these forms of disease,
and treated them as above, without the loss of one.  The symp-
toms do not decide so that a  regular  physician would  be sure
which  it is, till a Botanic, following the above plan, would have
any of them half cured.   The eruptions are all preceded by more
or less fever, some by chills &c„ but these do not determine which
it is to be, soon enough to be of use to the practitioner who knows
how to cure them all in the best way.  "He sees nature struggling
against [obstructions, the cause of] disease," which are threatening
to produce disease, and "he raises his club and strikes,"  but not
Wat random,"   He  has a club as sure  as a Kentucky rifle, that is
terf|ble and dangerous only to the enemy of health and life.  He
tajfis certain aim, and disease  alone  is  slain,   The scarlet fever
and the measles, require three or four to six or eight days to get
entirely out of the system; the jaundice, erysipelas and small pox,
some longer:  but none of these  forms of disease are much to be
dreaded if properly treated.  The Botanies do not lose one in fifty
of them.
   Regular physicians often make a great noise about our con>
mencing practice on every one of these forms of disease, before we
are certain which it will prove to be;  but nothing is more  certain
than that we  can break  the  power of any one of them  before
they can decide the same, to us, little important question.  Our
practice  for one, is not, like theirs, injurious to any other.  But,
as for  those  who  teach  that "scarlet fever is best subdued  by
the most powerful bleedings in the onset," and  that some of
the others "are of a typhoid character," in which "even moderate
depletion would be  death," we  admit  that they are right in wait-
ing till they are sure that bleeding will not be  death, even though
the disease should become, by such delay, far more difficult to cure.
   The Urine.—Cold  or  obstructions may contract the  urethra,
and check or  entirely stop the discharge of urine. After these
causes have been in operation for some time, the sphincter urethra;
may relax and allow the urine to pass involuntarily. In all these
cases the parts must be relaxed a little  and stimulated to such a
degree as to disengage and eject the obstructions.  This is best
done by applying warmth and (if necessary) moisture to the parts,
and then giving freely diuretics, as cleavers, bayherry, ginger, su-
much, cayenne, asparagus, or water mellon-seed tea, or the aroma-
tics, as the mints &c, and in a short time  these difficulties will all
vanish.  To prevent them, children should be induced to discharge
the urine late at night and early in the  morning and to sleep on
the side.  These forms of disease, are supposed to be very difficult
to cure, but I  think that it depends altogether  on their treatment,
I have had but little difficulty with them. 
169
  The Bowels.—Costiveness, Relax, Piles, Colic $/c.—No physic
should ever be given merely to open the bowels.  Injections are
not only the most speedy and  effectual remedies in the  case, but
they are the most easily administered.  They will always open the
passage, and, if they are made of  cayenne and bayberry, lobelia
and slippery elm, they will correct the morbid state of those visce-
ra so as to prevent disease.  When the  bowels are too lax and the
stools watery, containing undigested food, the stomach is in fault,
and the child  should have  an  emetic and then  injections.  The
state of the skin should be  examined, cleansed and kept open.  If
the stools  arc  slimy or bloody, and seldom contain natural  fcecal
matter, the bowels are in fault,  and must be cleansed with injec-
tions of canker teas, and then a small  injection of slippery elm,
If they are painful, slippery elm will relieve them; if they descend
in the form of piles, use astringent injections after the cleansing
ones, and  then the  slippery elm.  If they are  sore, grease them
with sweet oil, goose grease or fresh butter.  Injections with a little
cayenne are the best  means  of relieving wind in the  bowels  or
cholic, with which children are very apt to be afflicted, when the
abdomen  sometimes swells  quite large and is very  elastic.
   Dentition.—The teeth,  as  they appear in infancy, are four in-
cisors or cutting teeth, two  bicuspid or eye teeth, and four grinders
or double  teeth in each jaw, in all *J0.  The two front teeth gen-
erally appear  about the fifth or six month; sometimes the second
or eighth!  Some children have been born  with their front teeth
protruded, others have lived nearly two years without them!  Three
or four weeks afterwards, those above them.  Then follow, gen-
erally, the other incisors, the first eye teeth, and, lastly, the second
grinders—the lower of each pair preceding  the upper.
   The chief symptoms are  the widening and flattening, reddening
and swelling of the  top of the gums, the disposition to bite the fin-
ger, a fretful temper, starting  in sleep, salivation, sometimes fever
and diarrhoea &c.  Dr. Eberle  thinks that this disease, "although
a process of physical development, and, therefore, strictly in ac-
cordance  with the regular  process  of nature," gives the body "an
increased  susceptibility to the  injurious  influence  of  irritating
causes, and hence all diseases, whatever be  their cause or origin,
are apt to assume a more violent character during dentition than  at
other periods.  From this circumstance, as well as from the  direct
tendency of dentition to originate violent affections, the period during
which this process is going  on, is justly regarded as one of the most
perilous stages of life.  It has been computed that one-tenth,  at
least, of all the deaths that occur during childhood, may be fairly
ascribed to dentition, and it does not appear to me that the esti-
mate is exaggerated."
/ 
170
  Now it seems rather strange to me that "a process strictly in
accordance with the arrangement of nature," should naturally kill
one-tenth of all nature's children.  There must be some other rea-
son for their death!  Let us see what it is.   1st. This disease has
been so formidable in the fashionable circles, in the mouths of doc-
tors, and college text books, and  "Domestic  Medicines,"  lhat a
doctor is generally sent for to cure it.  He begins by saying that
the "febrile symptoms," the slight irritation in the system and de-
rangement in the circulation, caused by the pressure and pain in
the part of the gum pressing on the top of the tooth, this sensitive-
ness of nature to expel from the system any thing and every thing
that opposes her uniform and universal action, is "the disease" that
ia to be cured!   So, to work he goes,  (certainly very consistently
with this theory,) "to diminish the irritability (the vital action) by
bleeding, purging, poisoning &c, and he follows up this practice
as far as he dares without the danger  of immediate destruction to
the patient.   Nay, he frequently gives, within a short space, what
he knows to be enough poison to kill two or  three well children
when given at once.  True the child often dies, but it is so far more
scientific to attribute the death to "a process strictly in accordance
with a development of physical nature," than lo poisons, the legi-
timate enemies of vitality, that the doctor, instead of being called
by his right name, a man-slayer, gets  great praise for his  science
and skill!  I accuse no man of evil intention in this matter, but I
do accuse, of the most consummate stupidity, every man that gives
a poison  to cure "a process of nature."
   But I am asked, Why the diarrhoea just at that time?  I answer,
the diarrhoea takes place, because the system, being irritated gen-
erally, by the tenderness of the gums,  is more  sensible  to the pre-
sence of trifling obstructions which, when  less  active, it would dis-
regard.  Why are other diseases so much worse?   They are not.
Greater excitement in the system is proof of greater sensibility to
the irritation of obstructions, but by no means to the greater dan-
 ger of the case.  Is a smart fever from violent cold,  more danger-
 ous or difficult to cure, than the consumption,  the dyspepsia or the
 hysterics?  Regulars "guess" so;  but we know better.  But, say
 they, the diarrhoea relieves  the febrile symptoms, and checks the
 violence of arterial action by diminishing the quantity of the blood,
 and thus proves that depletion is good.  No, I answer.  The di-
 arrhoea removes the morbific matter that was deposited in the vas-
 cular system, for want of that action, which the febrile stimulus of
 dentition excites, and hence the real cause of disease, not the im-
 aginary one, is removed,  while the  symptoms of dentition only,
 remain.
    "When the gums become inflamed, swollen  and painful, the 
171
secretion of saliva scanty, with torpor of the bowels; the whole or-
ganization  generally sympathizes strongly with the local affection,
the nervous system, especially, is liable  to great and  dangerous
irritation.  Indeed, when, from the influence of previous morbific
causes, the sy stem has become feeble, and unnaturally irritable,
the most alarming consequences sometimes result from the irrita-
tion of the  advancing teeth, before any signs of irritation  and in-
flammation are discoverable in the gums."
  These "consequences" of dental irritation are "alarming" only
to those who have adopted the principle that fever and irritation
are disease, and that depletion and poison  are the proper cures.
The numerous  deaths, under  this faith and practice, are indeed
alarming, but I am not disposed to ascribe them to "a physical
development strictly accordant with the designs of nature."  It
seems to me a very blundering design that contemplates and ren-
ders unavoidable the destruction of one-tenth of all the ends it was
made to subserve.   It is surely not  the work of Him who is wise
in counsel and infinite in power.
  But it is said that one cause of these alarms is,  that the fretful-
ness of the child induces the nurse to feed the stomach too fre-
quently and with indigestible  materials, which  derange the func-
tions of that organ and induce  dyspepsia.  Very true, but then
the fault is in the nurse, not in dentition.  Still, Dr. Eberle insists
that "the risk of [even these] consequences from dentition is al-
ways very  considerable."   Surely no one will dispute the sound-
ness of such scientific logic!  It is added, that stimulants increase
the danger of this disease,  by increasing the irritation.  I answer,
no: they increase the danger of the patient by inciting the doctor
to an effort to destroy the vitality of the organs instead of removing
the causes  which disturb their action.  But  "the practice of cov-
ering the head with caps and keeping the child confined in impure
air, make the consequences of teething more alarming."   They
have no consequences of their own  it seems!   If  these things are
attended with  bad consequences,  (and they certainly are,) con-
demn them as severely as you please; but lay not all their sins to
detention;  for,  as this  cannot  be prevented, there is no hope of
cure.
  "The morbid sympathetic effects of difficult  dentition are very
various."   Why?  Because all the effects, whatever their  origin,
that happen about that time, are ascribed to this as a cause.  But
it is here that excessive local  irritation is calculated to check the
action of some of the important functions, and render excessive
that of others, as that of anxiety grief &c, checks digestion and
excretion, and increases cerebral action; and, therefore, disagreea-
ble consequences ensue, for which something  ought to be done. 
172
And what is it?  Answer 1.   Clear out all morbific matter from
the system,  and leave nothing to obstruct the action exerted by
the dental irritation;  then give none but suitable food in reasona-
ble quantity.   For the manner of doing it, see "Course of Medi-
cine," page 77 and onward.   This being done, and the  patient
being secured against the danger of taking poisons or losing blood,
the system will be left solely to the effects  of "a process of nature
designed for the development  of the system," which cannot well
produce death, without going out  of its appointed course,   If the
child  be permitted to have, among  its  playthings, something of
proper shape, a piece of smooth wood  or polished and  rounded
bone, fastened to a ring or cross piece, like the handle of a gimb-
Jet  or an ivory ring  to prevent  it from getting too far into the
mouth,  and to bite it as soon and as often as it pleases,  the teeth
will be cut  through in due season, without much  "disturbance to
the general system."  The child will show a disposition to relieve
itself, by biting the nipple or the finger, when it should be taught to
bite the wood or ivory which it will soon much prefer.   The teeth
will thus make way for themselves as fast as they  grow,  and little
disturbance  will be produced in the circulation.   If, however, the
gum should swell and be painful,  and yield  very unwillingly to
the pressure of the tooth,  it  should be lanced directly on the top,
which may be known both by the feeling, and by  a little white
mark produced by the compression of the capillaries over the end
of the tooth.  The incision must be made entirely to the tooth, and
as long as the tooth is wide.    When convulsions attend dentition,
they should  be treated as those are that proceed from any other
cause.  A course of medicine  is the relief, and a  regular restora-
tive treatment the cure,  Attend strictly to the above instructions,
and few will be the victims of the tithing  disease  called dentition.
  Dr. Eberle say?, "Nothing tends more strongly lo favor the oc-
currence of convulsions during dentition, than gastric or intestinal
irritation from the use of improper articles of nourishment, or from
overloading the stomach.  I am inclined to think that the majority
of instances of convulsions usually ascribed to the  sole irritation of
dentition, arc, in fact, excited  by the improper or  immoderate use
of alimentary ingesta.  When the diarrhoea, which frequently ac-
companies dentition, is suddenly arrested by astringents, opiates
&c,  the  liability to convulsions is always much increased; more
especially in robust and plethoric infants.   The same thing oc-
curs when, from cold or any other cause, the salivary secretion is
suddenly checked or suspended, and the bowels remain costive."
   "Various eruptions on  the  skin are among the most common
morbid consequences of difficult dentition,"   This is because the
''general  irritation" moves  forward  more rapidly to the surface, 
173
the various morbid humors and morbific substances that are lodged
in the system then, than at other  times.  "Fever is perhaps the
most common  sympathetic affection of difficult dentition.   It sel-
dom,  however, assumes a  vehement character, unless  there are
other sources  of febrile irritation  present.  It is generally slow,
irregular, changeable, intermitting or remitting, presenting the
usual  phenomena of chronic,  irritable fever from slight local af-
fections."  This shows that, in fact, dentition alone is not capable
of creating any great disturbance in the system.  "The majority
of instances of fever that occur during dentition, arc excited or at
least  greatly promoted by other causes."  Then pray, why  lay
them all to the charge of dentition?
   Dr. E.'s plan of prevention is air,  exercise, cool head,  warm
feet,  free  bowels  &c.  Very  good—"avoiding all stimulantsj"
For the cure—strong purges  do "much harm."  "When  habit-
ual costiveness," says the  Doctor, "is attended  by a deficient
secretion of bile,  from one to two grains of calomel  should  be
given  every  third or  fourth  evening,  and a moderate dose of
castor oil or magnesia on the following morning;" bu% "great care
should  be  taken that it be not carried to the extent of inflaming
the gums and  producing  a general mercurial action on  the  sys-
tem.   [Yes he adds,]—1 have witnessed several highly distressing
instances of extensive ulceration and sloughing of the gums  and
cheeks, in consequence of employing calomel" &c.   I suppose that
the Doctor intends that we shall "take care" lo stand  and watch
the operation, and forbid it from producing such an effect! "Slough-
ing of the gums and cheeks,"  however, can be borne with from
 calomel, more patiently than  a few moments smarting from cay-
 enne!   The Doctor prescribed the calomel with ipecac and chalk*
 in one case in which "nothing of a dangerous character occurred
 except a diarrhoea which, in a short time,  became extremely vio-
 lent and prostrating."  Thus "moderating the complaint to a suf-
 ficient extent, he advised  a  decoction  of the root of geranium
 maculatum, in milk.  The bowel  complaint was soon entirely ar-
 rested.  In about ten hours after the complaint was thus  stopped?
 a violent paroxysm of convulsions occurred which terminated  in as
 torpid  or  comatose condition; and, although an active purgative
 and repeated enemata were administered, a second fit of convul-
 sions terminated the life of the little  sufferer."   (Drying up sores
 produces similar effects.)
    This child  doubtless died  because not only  the effort  of  the
 diarrhoea to throw off irritating substances was arrested, but poi-
 son (calomel) was given to destroy vitality, by this scientific doctorf
 A very littla  calomel, given  when the system was exhausted by
 over  excitement, was sufficient,  it seems, to destroy  life*  The 
174
spasms or convulsions were nothing more nor less than fruitless ef-
forts of the system to recover its wonted action.   The Doctor
recommends blisters behind the ears, in some cases, to prevent in-
flammation in  the brain.   But, to prevent sanguineous congestion,
and convulsive action in the brain,  03r"thc simultaneous ap plica.
lion of a cloth dipped in cold water, to the head, and a warm bath
to the feet  and legs, is, in general, more prompt  and certain in
giving relief than any other remedy we possess."
  Here then is the  declaration of a Professor, supported by cases
of his own  reporting, that, while his  poisoning, purging and con-
strictions produce death,  the  Botanic remedies, the cool bath to
the head and the warm bath to the lower regions, badly as they
apply them, equalize the circulation, and are the most prompt and
certain remedies they possess.  Alas for the four thousand  years1
experience, and the war against steam and lobelia!   Choose your
practice, friends!   Good and evil, life and death are set before you.
  Erysipelas.—This form of disease is  common to infants  and
adults.  It is supposed, by physicians, to have some peculiar con-
nexion with or affinity for the first four or five weeks of infancy.
It is characterized by the presence of small blisters on  the sur-
face, occupying different places at different times, and sometimes
separating and producing mortification; in short, it is an itinerant
whose  visits are rather unwelcome in any place.  From all  that
has been written on the subject, no decided points can be learned
respecting its origin, nature  or cure.  It is extremely doubtful to
physicians,  whether the fever that attends it, is really  "active" or
"typhoid;"  and, of course, whether they should deplete or  stimu-
late.  They decide  this point according to the general strength of
the patient.
  Dr. Eberle, to whose work on children I refer for the truth of
what I have just said, on the  disease, or may yet say on the regu-
lar treatment, thinks that four leeches may  draw blood enough
from an infant in any case.   He thinks it generally  of a typhoid
character, not  admitting active depletion. The remedies mention-
ed by  him are calomel,  castor oil,  ipecac, bicarbonate of soda,
Jame's Powders, quinine, hyoscyamus, chalk,laudanum, ammonia,
spirits of turpentine, &c. The "calomel," he says, "can seldom be
omitted with propriety," in "the early stage," "though it is  apt,at
this lender age, to give rise to dangerous irritation  of the stomach
and intestinal canal," page 156. In the typhoid stage, quinine and
ammonia are  his best remedies.  Of the value and use of external
applications, " the weight of good testimony is decidedly in favor,"
though writers "of respectability " say "they are generally unne-
cessary if not prejudicial." However, as the poisons and leeching
before mentioned,  frequently fail, (no! they do their  work very 
175
surely,) the affected surface must be treated with "blisters, [to cure
blisters! like bleeding to cure hemorrhage!] Lead-water mercurial
ointment, corrosive sublimate and nitrate of silver f_the last two
must be put on with  a brush, feather or pencil, lest it eat off the
fingers that apply  it!] must  be successively tried.   Last, but not
least "scientific," "the practice of making free  incisions, through
the inflamed  skin  and subjacent cellular and adipose [fleshy]
structures, has recently been greatly extolled as a means of arrest-
ing the progress of phlegmonous [inflamed] erysipelas!" This an-
swers  " when the  case is a proper one  for the  practice! and the
state of the patient admits of its being fairly tried!" Some recom-
mend "one long incision through the whole inflamed part;" others,
"several short ones, an inch or an inch  and a half long," &c.
When, by these means, they make large sores and bring on morti-
fication, then, "a poultice of charcoal, oak bark and yeast forms
a valuable  application," though there is little hope of cure in
these cases! Is not all this very learned? I assure the reader it is
the only legitimate child of the celebrated parent of 4,000 years!
   I have never treated this form of disease in infants; but, as the
Doctor says it is the same in adults, I will close this subject by giv-
ing a case.   Mrs. Purkinson, of Richmond, Va., had been afflict-
ed with this disease, every summer, for three years.   It was more
aggravated and continued longer at each successive season, that at
the preceding, the attack of  1833, continuing under "regular"
treatment nearly all summer.  In the spring of 1831 she applied
to me.  Her face was so swollen that she could scarcely see, and
blisters an inch long, more  or  less, were raised all over it.  I di-
 rected an emetic and a sweat, relief to the bowels, and a poultice
 of bayberry, slippery elm &c, to the face. The next day she was
 about, and, in less than a week, entirely well. No traces of the dis-
 ease had been seen when I left Richmond, the latter part of the
 next summer.  I  advise, then, first, a course of medicine; second-
 ly, poultices  of bayberry, lobelia, slippery elm and cracker to the
 6ores, and repeat till they all  disappear; then  the "intermediate
 course;" and I advise it with full confidence of success.
   Skin Binding.—A form of disease in which the skin commences
 drying and hardening about the pubes and the thighs, and spread-
 ing on the body, till it finally so confines the action as to stop res-
 piration.  It is very uncommon, seldom occurring in this country.
 I notice it only because Dr. Eberle says it is nearly  allied  to ery-
 sipelas, and  that "the aqueous vapor bath is decidedly  the most val-
 uable remedy that has hitherto been recommended for the cure of
 this affection.
   Aphthje,  Thrush or Sore Mouth.—This is a very common as
 well as a very troublesome affection of infants, and not unfrequent- 
                              17(3

 ly Of their mothers tocu  Sometimes it appears at first, in small
 white spots on the  tongue or  inside of the mouth, as the cheeks,
 fauces &c, the spots increasing in number and size &c«, ripening,
 detaching and falling off; at other times turning brown^ becoming
 harder and more extensively diffused down the throat.  It is the
 canker of Dr. Thomson, the. effects of obstructed perspiration, and
 effectually treated with bayberry, gold-thread, slippery elm, the
 vapor bath &c.  The cure is very easily effected  by the Botanic
 practice.   Emollients, as slippery elm, should be freely used, both
 to soften the crusts and to protect from irritation the tender skin after
 the thrush or old coal  has been removed.   This should not be rub-
 bed off rudely before a new coat is formed under  it.   Light and
 easily digestible food  should be given, if the child is not supported
 by the breast.
   Sometimes the mouth is troubled  with ulcers of a more malig-
 nant character and a  darker hue; but they are to be  treated as
 directed above—remove  the  canker, keep the surface free,  and
 soothe the irritation—you know how.  Notwithstanding that phy-
 sicians are so much afraid of inflammation, and so constantly pro-
 claiming that our poison (cayenne &c.) will produce it; yet, while
 they prescribe cayenne  gargles in putrid sore  throat, they recom-
 mend, in the above cases, the giving of "Dover's Powers-' (opium &c.)
 and washesof"sugaroflead,nilrateofsilver,sulphateofcopper"&c.
 In one case, Dr. Eberle "ordered five grains of ipecac and two grains
 of calomel.  Active vomiting was induced and three or four alvine
 discharges  followed;'1 but, he adds, "In using caiomel, great care
 ought to  be taken lest it  affect the gums—an  occurrence which
 could hardly  fail  lo impart a dangerous character to the ulcera-
 tion."  Dr* Good of London, and Dr. Abercrombie of Edinburgh^
 sayr, of calomel and other poisons, that it depends on the operation
 of causes in the system entirely beyond the reach of our observa-1
tion, whether these articles act at all, act in accordance with our
 wishes, or in opposition to them, "with dangerous violence." Stilly
 Dr. Eberle docs not think the disease itself 'very "dangerous," except
in hospitals, and very crowded places where  many are afflicted with
it.  A writer in the Boston Medical and Surgical Journal^ lately in*
 quired whether some one had not found out a more excellent Way
 to cure this "chronic thrash" as it is vulgarly called, than is gen-
erally known to the profession.   Another answered, as is usually
done in such cases, that  he had succeeded in saving sundry cases,
(that is, he did not kill them,) by  varying the quantity and propor-
tion of the old doses, and by some other similar  "modern improve-
ments!"  In conclusion  of the article, I remark, I have known a
great many children, and mothers too,  die of something called
chronic thrush, or aphtha?, under the regular treatment, and I have 
177
seen a number of cases cured in three to six days, by the Botanic
practice,  that had been continually growing worse under the regtdar,
for as many months.
   Colic.—Pain  in the stomach or bowebjj, occasioned by gas ac-
cumulating in and  distending them.  The immediate cause is im-
perfect digestion.  A more remote cause is improper food or too
much of what is good, or both.   Some of it remains  so long un-
digested in the stomach, that it ferments and generates gas which
accumulates and produces the effects just mentioned.  If so, regu-
late the stomach and bowels, and correct the quality and diminish
the quantity of food.  If it proceed from a bad slate of the nurse's
system, take the child from her, and feed it with cow's milk.   If
from injury done lo the alvine canal, by the use of purgatives or
opiates, abandon them.  Says Dr. Eberle, "Active purging is often
decidedly injurious.  The habitual use of opiates in infantine colic,
almost always leads to very unfavorable, and often  to very dis-
tressing and dangerous consequences.  The dose must be progres-
sively increased; and thus a habit is soon formed which renders its
discontinuance a source of inexpressible inquietude, whilst its con-
tinuance in increasing doses, never fails to operate perniciously on
 the whole organization.  Under the habitual  use  of these treach-
erous  palliatives, constipation soon  ensues; the appetite and diges-
tive powers fail; the bodyr emaciates and the skin becomes  sallow,
 dingy and shriveled; the countenance acquires an expression of
languor and suffering; and a general state of apathy, inactivity and
feebleness ensues, which ultimately leads to convulsions, dropsy in
 the head, glandular  indurations, incurable jaundice or fatal ex-
haustion of the vital energies.   The pain may indeed be lulled by
the anodyne,  but the infant is  evidently under the  influence of
highly disagreeable sensations,  as is manifested by  the  sudden
 starlings, unnatural, whining cry,  and the  exceedingly irregular
 respiration, now very hurried for a moment, then slow and  moan-
 ing, with occasional intermissions of so protracted a duration that
 'one would think the breathing had  ceased altogether.'  All the
 usual soothing mixtures, such as Godfrey's cordial, Dalby's carmin-
 ative, so much  employed for allaying  colic pains and griping of
 infants, contain more or less opium, and innumerable infants have
 been irritrievably injured by the habitual use of these popular nos-
 trums."
    I believe this because I have actually seen it; but what a com-
 mentary is it on the invaluable remedy, opiuji!—a "treacherous pal-
 liative,"  that  produces "fatal exhaustion of the whole vital ener-
 gies,  irretrievably injurious to  innumerable  infants!"  What a
 curse to our country is opium!  The  person that gives it in any form,
 to an innocent and  defenceless infant,  after  such testimony from
              12 
178
 such high  authority,  ought to be totally  rejected as a  physi-
 cian.   Yet the very good*Doctor himself recommends its use by
 physicians, in almost every form of disease!  Surely "much learn-
 ing has made him mad!" for he continues this wickedness after the
 "ignorant," (such as ourselves, gentlemen, and "old women") have
 discarded it forever.
   It must not be forgotten that the "active" ingredient in Dover's
 powders, laudanum, paregoric, morphine, and all the "anodyne
 drops," aye, and the "styrax  pills" of Drs. Wood & Bache, too,
 U. S. Dispensatory, page 934, is this very "accursed thing," called
 opium.
   To cure this colic, then, when trifling, a little ginger tea or cay-
 enne or No. 6, will relieve the stomach from pain, or even pressure
 on that organ and a  mildly stimulating injection  will relieve it
 from the bowels.  Taking the child up by the body, holding the
 pelvis for a very short time higher than the chest, and pressing the
 viscera  in  different places alternately,  will remove it from the
 bowels.  The head must not  be held down till the face turns dark
 with venous blood, nor  need it be held much lower than the pelvis
 at any time.   If it return, give  a full  course of medicine and be
 more careful about the  quantity and quality of the food taken. I
 have always found ginger and raspberry, or, at most, a little bay-
 berry,  amply  sufficient for courses to infants; though cases may
 occur where cayenne and composition may be necessary.
   Give no poisonous physic, feed with  good food in reasonable
 quantity, and colic will rarely happen.   When it  does happen,
 remove it  by the above simple means: if it returns and is trouble-
 some,'give courses of medicine and strengthen the system.
   Constipation or  Costiveness.—Torpor of the bowels is  com-
 mon among infants, and though it may sometimes continue to seven
 or eight days without materially injuring the general system, yet I
 would recommend that in  no  case it be permitted to continue be-
 yond the second day.   The  cause is  said, by physicians,  to be
 sometimes constitutional habit, at others the improper character of
 the food, or accidental "circumstances."  Doctor Eberle says, "the
 giving of  opiates to make them sleep, that they  may not require
 much attention during  the night, is a frequent source of obstinate
 and injurious costiveness."  Dr. Dewees says that "nurses are now
 so familiar with this drug, [who taught them?] that they as regu-
 larly carry it about them as their scissors or thimble, and consider
 it  much more indispensable to their comfort, than either of those
 emblems of industry.   If the  child does not go to sleep, or if it is
 even feared that it will not at the exact  moment when it will suit
 the arrangements of the nurse;  or if it cry, from any cause,  so as
to give any additional  trouble,  laudanum is  given so as to make 
m
 *assurance doubly sure.'"  This "very frequent cause of costive-
 ness," I suppose, will  trouble  none of the  friends of Botanico-
 Medical reform, except the par excellence "scientific" ones of the
 Beach and Worthingion School, who use it very freely.  The treat-
 ment, according to Drs. D. and E.,  consists chiefly in cathartic or
 opening medicines, castor oil, senna, magnesia, calomel &c;  but,
 say they, "In moderate cases of constipation, relief may frequently
 be obtained  by the daily introduction of a soap suppositary, or of
 laxative encmata," instead of aperients; "fora long continued and
 frequent employment of even the mildest laxatives, is apt to injure
 the digestive functions, and give rise to some degree of intestinal
 irritation."-«-Ebcrle,  page 'ML
   As, therefore, in the worst cases, the opiates generally begin the
 "habit," and the  physic to  cure it  produces a still worse condition,
 we will just reject these two, and use the proper encmata, diet and
 exercise, and the  disease will not be troublesome   The encmata
 should be made of lobelia, bayberry, slippery elm, nervine and a
 little cayenne, from a wine-glass lull lo a  hall pint, and repeated
 till the effect is produced.  For diarrhoea, witch hazle or raspberry,
 and  cayenne should be used.
   Vomiting.—This is a vital operation and salutary in its tenden-
 cy, but, like all other disturbed  actions, is an  indication that some-
 thing is wrong.   When the infant is otherwise healthy and  cheer-
 ful, the vomiting indicates only that the stomach is overloaded, and
 the cure will  consist in preventing it from  taking so much.  It
 should be stopped  from sucking or  eating as soon as it manifests the
 least indifference in these matters.  Vomiting is a habit that ought
 not to be acquired, though  no medicine should be given to  stop it.
 When it arises from irritation of  the stomach, the suppression of
 morbid  discharges, the introduction of proper food &c, clear it by
 a lobelia emetic, and the warm bath, and  regulate  the diet both
 ns to quantity and quality.  No sedative should ever be given to
 stop  the vomiting, as laudanum  and paregoric; as recommended by
 Doctor Eberle.
   Diarrhcea.—The diarrhoea,  watery or mucous and frequent
 stools of children, generally  proceeds  from  eating too much, or
 from eating things indigestible, or  from taking cold.   In the first
 case, check the appetite, that is, limit the quantity; in the second,
 change the diet.   In both these cases,  cleanse the stomach and
 bowels, and restore the tone.   When it proceeds from cold, open
 the pores, by the vapor  bath or perspiration in some form.
  Diarrhoea is also a frequent result  of giving poisonous physic to
cure  costiveness.   To cure it when it arises from this cause, cay-
enne must be used pretty freely after the courses.
  Diarrhoea is very often a result of a sudden check to perspira- 
ISO
tion, and may be almost as certainly corrected as that secretion is
restored.  Physicians enumerate  many species of diarrhoea, pro-
ceeding from numerous causes, as indicated by a great variety of
symptoms, and requiring different  treatment; and they ridicule us
for treating them all upon the same general  plan  and with only
some twenty or thirty different remedial articles or processes. But
what, we ask, is the use of all their hair-splitting about the causes
of the affection, when, at last, they actually use less remedies than
we, and in a manner less varied?   Calomel,  magnesia,  rhubarb,
castor oil, ipecac, nitre, opium, blackberry, geranium, tartar, anti-
mony, hyoscyamus, charcoal, cantharides, and a few others; but
calomel  and  opium arc  the great articles more used and  relied on
than all the  rest.
   After prescribing, with great nicety, the quantity of the above
poisons, especially  opium and calomel, which seem to be the "sheet
anchors" of prophylactics, and the great levers of the curative pro-
cess, in  measures,  proportions, grains, fourths  or eighths  of grains,
according,to  the color, consistency, character, quantity and  fre-
quency  of the stools, (for the medical  indications of  which physi-
cians who can seldom see them, depend upon the testimony of pa-
tients or attendants no doubt often quite as ignorant of these scien-
tific distinctions, as the most ignorant steam doctors  in the land!)
and  especially cautioning his pupils against  giving these poisons
"injudiciously" or in too large quantities, Dr. Eberle says, that the
root of Geranium Maculatum, boiled  in milk and a strong decoc-
tion of blackberry root, have been the most  efficient remedies in
his hands, in the cure of some forms of this disease, and that they
possess the important recommendation that they may be used freely
without danger.  Of running blackberry briar root, I can say,
from my own knowledge, that its  aid in the cure of diarrhoea is in-
valuable; not merely because it is astringent, but because it  re-
moves canker from the  whole  canal. Of geranium, I know at
least that it is astringent  and not poison.
   In addition to full courses for diarrhoea, dysentery and other
looseness of the bowels, I have found that a syrup made of a strong
decoction of equal parts of  golden  seal and nervine, is  excellent.
After boiling the ingredients half an hour, strain, press, add a fourth
as much No. 6, and the same measure of  loaf sugar, boil it to a
syrup and use a tea-spoonful at  a  time for a child, or a table-
spoonful for a grown person.
   Worms.—One of the most troublesome complaints to children is
worms.  "Concerning their  origin," says Eberle, "much has been
conjectured, but little ascertained."   There are five  different spe-
cies.   The long thread-worm, an inch and a half to two inches;
the small thread-worm,  white, from two to five inches  long;  the 
181
long round worm, from two to twelve inches; the long tape-worm,
sometimes thirty to forty-feet long and nearly an inch wide, white,
flat and jointed; and the gourd-seed  tape-worm, which generally
comes away in  pieces, sometimes single, sometimes many feet of
them together.
   But, says the Doctor, "observation has revealed to us many cir-
cumstances that favor their production  and increase.   The  prin-
cipal of these are, a  general debility of the system, and a feeble
or deranged condition of the alimentary canal.  Whatever, there-
fore, disposes to these states, constitutes  a remote cause of worms."
   Now, as the Doctor had previously informed us, that frequent
doses of opium  and of calomel, oil, or any kind of physic, were cal-
culated to produce just these effects on the internal canal; therefore,
I conclude, from his facts and argument, that calomel, opium and
other poisons, (for they all check vitality) are "among the principal
causes of worms!" and that the most of the cases of worms found in
practice,  might have been prevented  by  refusing  all poisons as
medicines!   However, 1  must not  stop here.   These worms are
often found where no poisonous medicine or food has been know-
ingly taken.   The question is, then, rather, how shall they be re-
moved?   Dr. Eberle says, by the exhibition of calomel  and  other
physic,  the principal "remote causes" of their origin or existence!
This may be good science with regulars; I have not sense enough
to perceive its consistency or propriety.  My plan is  to clear out
all the  morbific matter,  by lobelia,  cayenne,  canker medicines,
steam &c, and then give strong laxative bitters,  with  cayenne,
which generally drive them from the system. Not having killed any
one by  this process, I have made no post mortem inspection to dis-
cover whether  the internal canal was  "burned up"  by it;  but if
it was,  I suppose, according to Dr. Eberle's argument, it might as
well have created inflammation and cured it; as calomel and other
poisons can be both the "remote cause" and the "proximate" cure
of worms!  The bitters  I have used,  were boneset, hoarhound,
motherwort,  balmony, poplar, golden  seal, bitter root, butternut,
pride of China, gum myrrh &c; placing great dependence  upon
hot enemata.  The  compound just  mentioned for dysentery, is
first rate for worms.   I once  cured a case with two tea-cupsful of
composition,  after a regular had administered calomel, wormseed
oil, spirits of turpentine  &c,  in vain, till he said "she could not
bear any more  medicine;"  and I  believed him for she could not
bear upright, even her own head!
   The sort of  worms called  ascarides, very small  and short, are
found low in the rectum.  To remove  these,  make a poultice of
the bitterest herbs you can get, as balmony, tansey,  motherwort,
bitter root &c, cracker,  cayenne and  No. 6,  or rather the  dregs 
m
of No. 6.   Use, three to six or eight times a day, three or four in-
jections of the decoction of the herbs, and, immediately after their
operation, apply the poultice to the outside and bind it close.  At
the same time, give the same bitter  tea, or the decoction above
nam^d to produce a slight action of the bowels,  or, at all  events,
to meet the worms,should they attempt to rise in the canal out of
the reach  of the lower applications.   Give a full course if neces-
sary,   Follow this plan immediately and faithfully, and you will
not need to follow it long.   If this  course fails,  you may  consult
the scientific Dr. Eberle, Professor of the Theory and Practice of
Medicine, late in the Ohio Medical  College, now in Transylvania
University, Kentucky, who says,
  "The complete removal of these worms (ascarides) is a work of
great  difficulty.  The ordinary vermifuges are of little avail  in their
destruction; acting more  particularly upon  the  upper portions of
the intestinal tube, they lose their virtue before they arrive at the
localion of these animals.   Even the most active cathartics are in-
sufficient to expel them.  Aloes, however, from the peculiar influ-
ence it exerts on the lower portion of the bowels,  frequently causes
their expulsion in large quantities, especially if assisted by the ac-
tion of proper encmata.
  "My usual mode of proceeding for the removal of these trouble-
some  worms, is to prescribe three or four aloetic purgatives every
second day, with two or three enemala composed with a mixture of
lime water and milk in equal proportions, daily.   Injections of a
solution of aloes or of infusions of any of the above  named  vegeta-
ble anthelmintics, will generally succeed in bringing away great
numbers.   In  a few instances I have procured their expulsion, by
large  quantities, by injections composed of a tea-spoonful of spirits
of turpentine mixed with  a gill of milk.  Injections of any of the
common o'ls will oftentimes sooth the extreme irritation, and  also
destroy the worms.   According to Rozin, a drachm of refined su-
gar, dissolved in warm milk, has been injected with great  success.
[Both of these had just been prohibited in the diet, on  account of
their  tendency to produce worms;  hence, their great success  in  des-
troying those animals!—in perfect keeping with  the use of poisons
to cure the sick and  to kill the well!]   Another  remedy highly
spoken of is a bougie  smeared over with  mercurial  ointment, and
introduced  into the  rectum.  Dr, Vanvert asserts  that  flour of
sulphur, taken in the  morning on an empty stomach, is one of the
most  efficacious remedies for the distribution and expulsion of as-
carides.   In obstinate cases, the fumes of tobacco, or an  infusion
of the male fern has been  recommended by Dr. Bremser.   The
same author states that injections of cold water, with a small  por-
tion of vinegar, is  the best remedy we possess."   [All common 
183
remedies, recommended directly after stating that they are of lit-
tle avail.]
  Is not the above vastly scientific? or will my readers agree with
me that it is a tissue of quackeries for the recommendation of which
to the trial of young physicians, Dr. E. ought to be expelled from the
Ohio Medical College, if he had not been called to Transylvania?
  Do our friends in "the great Western valley" really know  that
such is the beauty, such the certainty of the medical practice to be
spread over this whole wide western world, from that great source
of medical science to which the Doctor has lately  been with much
applause translated?  Humiliating fact!
  Ophthalmia, or  Sore Eyes.—Infants are very liable to have sore
eyes.  At first,  the eye-lids are glued together in the  morning,
slightly swelled  and red.   As the redness and the swelling  pro-
gress, the light is painful and "a thick, purulent matter  begins to
issue from  the eyes."  It sometimes extends to the ball, destroys
the coats, discharges the humors and ruins the eye.  Doctor Eberle
thinks the  exciting cause to be "some acrid or morbific secretion
in the vagina of the mother, applied to the infant's eyes" in partu-
rition; as "its occurrence is almost universally confined to the two
first weeks after birth, and, in a vast majority of cases, comes on as
early as the 4th day."   If this be the cause, our Botanic  friends
who keep  the mothers free  of "morbid  secretions"  during preg-
nancy, need  not fear it.  But it is sometimes ascribed to applying
the light to the  new born infant.  On this subject, Dr. Eberle re-
marks: "It may be observed that the good and all-wise Author of
nature has endowed every creature with a  capacity to accommo-
date itself to  the inevitable  changes and transitions, which it is des-
tined to undergo, in the regular process of its development; and it
seems inconsistent  with the perfect adaptation of the appointment
of Providence, that the new-born infant should be liable to serious
inconvenience or injury from this cause; though it cannot be doubt-
ed  that  unnecessary exposure of the infant's eyes to a bright and
heated light  [as a fire or a  candle] may do much mischief."  What
a pity that the Doctor could not reason  as well on every  subject.
   Treatment.—Cleanse the  eyes thoroughly  at  birth,  and  keep
them so.  Wash them often with milk and water and canker teas;
and, if the disease is obstinate, apply the ginger, cracker and elm
poultice, adding bayberry  to it.   Give also the teas to cleanse the
system.   "The occasional administration of a gentle emetic in the
early stage of the complaint, sometimes  proves decidedly  benefi-
cial," says Dr. Eberle.  So say I; therefore keep the stomach and
bowels  clean and the skin  open, the eyes clean and oiled, and
 there will  be no difficulty.
   The fact is, the cause of sore eyes, sore ears, sore neck,  sore 
184
hands &c, in infants, is morbific matter in the system.   True this
morbific matter is of different characters,  as  the  scrofulous, the
ophthalmic, the erysipelatous, <&c.;  but the plan of removing it is
in rll cases the same, viz., give it vent by warm, moist and slightly
stimulating appl La lions, absorb into poultices the virus discharged,
and  take ^rcper measures to cleanse  the canker from the alvine
canal. ?nd to f^rce to  the surface that which may be already  in
the circulation.   Nothing is more important than to remove from
the body every drop of poison virus as fast as it is discharged; lest,
by its corrosive power, it increase the size  of the orifices whence
it issues, or produce new lesions or sores, where none before ex-
isted.
  A case of sore ears, list summer, that had continued a longtime
under mercurial treatment, was soon  cured  by the application  of
absorbing poultices and the drinking of a little canker tea.  When,
however, these  slight  applications prove insufficient, the thorough
treatment recommended  before, w ill not fail to do the work, wher-
ever there is a constitution to build  upon.
  Cholera Infantum.—Sudden and  violent vomiting and  pur-
ging, generally commencing nearly  together, but rapidly exhaust-
ing the  strength  and extinguishing vitality.   "At  first, the dis-
charges from the  bowels  usually consist of a turbid, frothy fluid,
mixed with smail  portions of green  bile, or of a nearly  colorless
water, and containing small  fiocculi of mucus.  After the disease
is fully developed, the evacuations very rarely exhibit any  traces
of bilious matter;  that secietion being evidently entirely suspend-
ed.  In some instances death occurs in a single day.   This form
of disease undoubtedly proceeds  from some xery  irritating cause
in the alvine canal.  It is of little use  to kuow exactly what, but it
is very important  to know that its effect is to contract the folds and
pores in which  it  is lodge J,  so as to keep up a constant irritation
without producing its ejection, as in  cholera.
   The error in the treatment, to which our Botanic  friends are
most liable, is the suppdsition that the vomiting and purging should
be stopped by any other  means than by giving  lobelia and injec-
tions and the vapor bath.  Give lobelia in warm canker teas: this
will  relax the contracted  folds and pores, from which the irritating
virus will be released and soon be thrown out by a vomit.  Do the
same with the bowels, and they will cease their action, then steam
and  the stomach will become quiet, and may be fed with porridge
&c.  Now promote  perspiration and  give cayenne, lobelia seed,
bitter root and nervine, equal parts in pills, to act  upon the liver.
This and good nursing, will soon effect a cure from the firtt stages.
If the case be of long standing, we  must persevere.  This course,
seasonably, judiciously and  faithfully tried,  is sure.   Even Dr. 
185
Eberle says, no means will do any good that do not tend "to cor-
rect the morbid condition of the liver and skin."  But I beg leave
to be excused from using his calomel and blisters for these purposes.
   Fevers.—These, we know, whatever be their varieties, are the
results of efforts of the system to remove morbific obstructions; not
disease itself, but mere symptoms of disease.   They are all known
by inordinate heat, quickness of the pulse, restlessness, and, gene-
rally, thirst and pain.  The plan  of cure is  to remove  all obstruc-
tions to every secretion, carefully observing what part of the sys-
tem, whether the  head, the stomach, the lungs, the bowels, the
skin, &c, is most obstructed, and  directing  the proper means im-
mediately to these, at the same time that we use them to protect
the general system and aid it in removing all offensive matter.
   Dr. Gregory says that, though  fever is not present in every case
of disease, it is,  so generally, that "the physician ought to be al-
ways prepared lo expect it."  If this fever is found to attend teeth-
ing, I have already shown how  to treat it.
   Remittent Fever.—If it is of the remittent  kind, that is, constant
but variable, care must be taken  not only to clear out the mor-
bific causes, but to keep  up the action of the system to the healthy
standard, during the intervals.  In this form of fever,  there is gen-
erally a hot, dry skin, and much  uneasiness; loss of appetite, cos-
tiveness &c.  If the action of the pulse is too quick and the body
hot from  head to foot, much  cayenne at  first would be  improper.
Let the stomach and bowels be cleansed with emetics and injec-
tions, and the skin be relaxed by  moistening with warm water, and
 this state  be kept up till (he circulation is free and general, and the
 appetite is restored.  The head should be kept  cool  and the feet
 warm.  As long as the fever is kept up without the aid of artificial
 Btimulus, so long you may be sure that there  yet remain obstruc-
 tions somewhere.   When the stomach  and bowels  appear to be
 clear, and the skin to be easily opened, and yet the dejections are
 of a light color and the  feverishness continues,  there is  probably
 no action of the liver.   Make  pills of equal parts of lobelia seed,
 bitter root, cayenne, nervine, and slippery elm moistened, rolling
 them, if necessary, in butternut extract, and give enough of them
 to cause two or three dejections in 24 hours.  Keep up  the strength
 with bitters and cayenne, and light, nourishing food.
    Catarrhal  Fever.—This  is  the form  of fever that seems to
 proceed from cold in the head, though, in reality, it as often pro-
 ceeds from cold, wet feet, and is attended with much running of a
 watery fluid from the nose and eyes, with hoarseness, stopping of
 the nose  and  difficulty of breathing.  It requires more stimulation
 than the  preceding, as will be clear to any attentive observer who
 sees a case of each. Steaming,  or warm  fomentations, or warm 
186
flannels, about the neck and head, and breathing in the vapor of
vinegar, will be particularly serviceable, and expectorants should
be used to clear out the phlegm &c.  Be careful also to keep the
feet warm, the surface clean and active, and the alvine canal free.
The restorative treatment as above.
  Bronchitis.—This is an inflammation of th$ mucous tissue of
the bronchial tubes, and an accumulation of phlegm, in these and
the air cells  of the lungs.  The cough, difficulty of breathing &c,
make it sufficiently evident that the lungs arc obstructed.
  In addition to an emetic, or even before, if it can  be done spee-
dily, the vapor of vinegar should be freely inhaled,  and the neck
and  chest should be enveloped in the  same,  or some  warm and
moist application should be  made to them lo  relax  the strictures
and loosen the phlegm.   A small quantity of cayenne in the vine-
gar from which the vapor is inhaled, will enable the lungs  <o re-
move the phlegm and cankery coat, and cough it up.  Steam often
and promote the action  of the surface with friction, and stimulat-
ing liniments if necessary.  Continue this course with the emetics,
keeping the whole system warm.   In this way the judicious Bo-
tanic will cure  all the cases  to  which he is called in due season.
The regulars give us little hope in this case.  "The progress of the
disease," says  Eberle, "is generally rapid.  In some instances,  it
terminates fatally as early as  the third day; more frequently, how-
ever, its course is protracted  to the sixth day.  Great  drowsiness
or coma almost invariably precedes the fatal termination."   Chil-
dren, page  328.  It must be recollected  that this rapid progress
and fatal termination are what take place under the "blood-letting,"
"leeching,"  "blistering," "calomel," "antimonial," "opiate" and
**hyoscyamus" treatment recommended by Dr. Eberle—See pages
330 and 331,   The course of practice which I have recommended,
being entirely different, must necessarily produce different effects.
And, as the final effect of the Doctor's treatment, according to his
statement, is generally death, so it will be found that the general
 result of ours will be health.
   Pleurisy.—The symptoms of this form of disease, are much like
 those of the preceding,  with the addition of pain and  soreness  in
 the side, breathing rather in the  abdomen than the chest, the mu-
 cus in  the lungs not quite so  much,  but sometimes tinged with
 blood.  In this case, the same course of bleeding and poisoning is
 recommended by the regular faculty.  I have treated it with eme-
 tics, sudorifics, injections and  warm applications to the side, and
 cured it in  two or three days,  in cases where  it was 6aid,  by per-
 sons professedly very wise in these matters, that the patient must
 die.
   Mumps, Swelled Neck &c. {Cynanche Parotidaa.)—A course or 
187
two, and warm applications to the neck, on the first appearance
of the symptoms of this form of disease, wilbjjhsarni it of its terrors,
and reduce it to "a small affair."  If any swelling occur, let it be
fomented with steam from vinegar, and covered  with  relaxant
poultices.  Keep the patient comfortably warm, (though not ex-
cluded from fresh air,) and the secernants and excernants free of
obstructions.   Let the treatment be moderate,  but steady, and
adapted  to the current symptoms.
   Quinsy, {Cynanche Tonsillaris.)—An inflammation of the tonsils
and  fauces, attended with a stinging, cutting pain, first, only on
swallowing; afterwards more constant.  The tonsils swell and, un-
less preventives be used in time, ulcerate and suppurate.
   The  treatment of this form of disease, should be like that of
mumps,  adding gargles  of diluted No. 6. If the system be well
cleansed at once by courses, the  morbific matter will be  removed
and  the ulceration prevented.   Expectorants should be used from
the beginning.  These may consist of skunk cabbage, hoarhound,
cayenne and a little lobelia, made into a syrup.
   Croup—{Cynanche Trachealis,) may be defined, "an inflamma-
tion of the glottis, larynx and upper part of the trachea, attending
with a hoarse and ringing cough, sonorous respiration, and a sense
of impending suffocation."—Eberle.  This is one of the forms of
disease which Dr. Bigelow says, is "self-limited;" that is, that "it
is not known to be shortened in duration or materially mitigated
in violence,  by any  [regular] medical treatment." Its principal
predisposing cause, is sudden cold on the lungs, on the suspension
of violent exercise or on a very relaxed state of the system from
 some other  cause.   It is sometimes attended with inflammation
 and the supposed consequent formation, in the Bronchias, of a false
 membrane.  But, as I have known a severe attack only one hour
 after the patient appeared perfectly well; and this attack, amount-
 ing  almost to suffocation, broken in less than another hour, and
entirely cured in five or  six more, by steam, lobelia &c, I cannot
think that much inflammation existed in such cases.   Be that as
it may, steam and lobelia are seldom known to fail to  cure, when
promptly and faithfully applied.   The steam of vinegar and water,
 should be applied to the neck and received into the lungs.   When
the  paroxysm is relieved and the breathing becomes easy,  give a
 full course of medicines, and strengthen the system.   Dr, Eberle
 says, "In the whole catalogue of inflammatory affections, there  is
 no disease in which bleeding, when promptly and efficiently prac-
 tised, is  more likely  to prove beneficial."  Now, it will hardly be
 disputed that steam and lobelia are far more successful than the
 regular  practice, in the treatment of croup; therefore, blood-letting
 is, in no case,  either necessary  or proper in the  treatment of any 
188
form of disease; as other more  innocent means are proved to be
greatly superior.  DrdEberle says, (on children page 359,) (&• "I
have, in some cases, administered the lobelia inflata, with a view to
its emetic operation, with the happiest effect.  From its well known
powerful influence on the respiratory  functions in asthma, inde-
pendent of its emetic effects, there is reason for presuming that, in
relation to the prescnl disease, it may possess peculiar virtues; and
my limited experience with it, inclines me to this opinion."
  What a wonder the Doctor  did  not  kill his patient with this
0^7" "among the most  deadly poisons in the  materia medica?"
However, we must recollect that the article was used in connexion
with so many others that were calculated to neutralize its effects that
it could not be held responsible,  even if mischief had followed. We
cannot, after this, be surprised  to hear  the same  gentleman say,
page 367, "among the remedies that may be usefully employed for
the reduction of tracheal inflammation, the  warm  bath deserves to
be particularly mentioned!"
  Similar affections, that is, inflammations or spasmodic affections
of the larynx, should be treated as above.
  Dr. Eberle  says, page 367, "Although blood-letting does not
often  procure any prominent benefit, in  this affection, it is unques-
tionably decidedly indicated, and ought  always to be promptly and
efficiently practised."    Is not this "scientific?" It is unquestiona-
bly indicated although "it does not  often procure any prominent
benefit!"
  Dropsy of the Brain—{Hydrocephalus.)—Symptoms, irritable
temper, irregular bowels, variable  appetite,  irritated and quick
 f>ulse,  wakefulness, frowning expression of the countenance, fol-
 owed by pain  in the bowels, nausea  and vomiting, feverishness,
distressed expression of the countenance,sudden waking from sleep,
transient and severe pains in the abdomen, alternating with simi-
lar pain in the head, dislike for light, noise &c, then becoming
drowsy, numb  on one  side, vision  deranged, eye-lids paralyzed,
and, finally comatose or sleepy, and convulsive.
  To regular physicians, this is  a  most frightful form of disease. I
once  took with me a converted regular  to see a case.   After ex-
amination, he feared it could not be cured.   I asked Aim to treat
it exactly as I would prescribe,  and  I would "take the responsibil-
ity."   As a child had lately died  of the same form of disease, the
parents of this were very anxious.  The head was  hot and dirty
and covered with a cap, and the child exhibited the symptoms of
the last stage.   I took  off the cap,  called for cold vinegar and a
comb, wetted the head and combed it till I had gotten off all the
scurf  that had been left "to prevent the child from taking cold."
Before I had half cleaned and cooled the head,the  child fell asleep; 
189
and the before constant motions of the head and hands ceased.
The bowels were swelled, hot and sore.   I directed an injection
to them, and moistened cloths to the abdomen, to keep the feet
warm, and to cool the head with the vinegar whenever hot, till it
should be comfortable.  The effects of these two processes, were
prompt and great relief. A tea of ginger and raspberry leaves, was
then given, and perspiration induced; and, by the use of the.se and
similar articles, in three days the child was entirely well.   I forget
whether 1 directed an emetic of lobelia or not; but  I  certainly
should have done so, had not these measures proved amply suffi-
cient.  My  advice is, keep the feet warm, the head cool, the sto-
mach and bowels clear of morbific matter, and the skin open. Do
it and succeed.
   Dr. Eberle says, "The instances of recovery are, indeed, exceed-
ingly few.  In the course of twenty years practice, I have known
but two fully developed cases, which terminated in health, and it
has fallen to my lot to have seen and prescribed for a very consid-
erable number of patients ill with this appalling disease."
   Notwithstanding this bad success, the Doctor still prescribes the
same course of bleeding and poisoning which has so often stuck a
dagger to the very heart  of his professional ambition.   He  says
"The temporal artery or a vein in the arm should be opened, and
the blood allowed lo flow, until a very obvious impression is made
on the system," &c.  Then "leeches" and "purgatives are among
our most useful means;" Then, "mercury is undoubtedly a remedy
of valuably powers in the treatment."   "Dover's Powders have
found advocates," and "James's Powders have been spoken  very
 favorably of," and "tartar emetic has also been used with great
 advantage."  For what purpose, I ask, in mercy to the hecatombs
 of victims yearly sacrificed to this practice, for what  have all
 these remedies, been so useful?  Dr. E. says, virtually, To kill all
 the patients but two,  that he has treated in twenty years!  The
 man that, after such a succession of results, would not abandon a
 practice under which they occurred, even though he should know
 no other, ought to be considered no better than a thoughtless mur-
 derer!
    Peritonitis  and Dropsy.—Inflamed  peritoneum  and conse-
 quent effusion of serum into the cavity of the abdomen.  Known
 by swelling, and rattling of water in the  abdomen.
    Treatment.—Cleanse the  general system, and then give the
 warming medicines with but little if any fluid, as in pills, the bread
 of life «fec.   If this fail to  reduce the swelling, tap the patient,
 and  draw off the  water, then treat as before.
    Vaccination, or Cow Pox.—This is supposed to be the origin of
 the variola or small pox, continued through the bodies  of beasts, 
190
and of persons not much predisposed,  till it has assumed a  mild
form.  This is quite probable, and accounts for the action of the
one preventing the occurrence of the other.  To inoculate,  take
the virus from the sore and put it into a puncture in the arm.   To
preserve the matter, draw a needle full of silk slowly through the
full pustule, or press a little lint upon  the matter,  and inoculate
with bits of these, or preserve the scab,  and pulverize it for use.
It begins to inflame and fester the second day, grows larger and
sorer, but seldom produces any considerable derangement of the
system till the feth or 9th.   Keep the determination to the surface,
and the system clear of morbific  matter,  and no  evil will arise.
Children ought to be vaccinated  whenever there is danger of  their
taking the  small pox,  which disease it will render  milder,  if it
does not entirely prevent it.  Care should be taken that the virus
be obtained from a healthy person.
  Since writing the above, I have known  so many cases of mis*
chief from other forms of disease inoculated with the small  pox,
that I am  doubtful whether the danger  is not as great  as the
benefit.
  Small Pox, {Variola,)  Chicken  Pox,  {Varicella,) Measles,
{Rubeola.) and Scarlet Fever, {Scarlatina.)—Each  of  these
forms of disease is  produced by a specific virus which tends to the
surface, from  which it leaves the system.   Their appearance on
the surface  is preceded by fever and evident internal derangement.
  If there is evidence of much morbific  matter within, I  com-
mence the  treatment  with emetics and injection*.   These fiist
cleanse the  alvine canal, and then throw the remaining virus to
the surface, to which  a slight tendency should now be constantly
kept by mildly stimulant sudorifics.   The vapor bath is  good, till
the eruption comes out, but better omitted  while it  remains on the
surface.  Expectorants should be used to clear the bronchial tubes,
fauces and  glands, and gargles  of cayenne tea, or dilute No. 6,
when these are sore.  There is no necessity or propriety in  rais-
ing the action of the system very high, at any time, but to keep it
steady, is the most important point in the treatment of these affec-
tions.  If the action be  made at one time too great, there will
follow a fatigue and dangerous  depression.   If perspiration be
made too profuse, it  will  be followed by  too much absorption.
Therefore,  cleanse well the internal canal before the  breaking
out, and  then keep up a moderate but steady tendency to the sur-
face till all  traces  of the virus  have departed.   In scarlet fever,
cayenne, gum  myrrh and  kercuma, should be freely used  as a
gargle for the throat.
   Before the virus appears on the surface, the symptoms of these
different forms of disease, that is, the effects produced by the dif- 
191
fercnt species of morbific matter that thus obstruct the vital action,
have so little peculiarity about them, that the most experienced
practitioners  generally find it very difficult and often impossible,
from these ;ilone, to decide which is present.  But, as the means
to develope any one,  are  equally applicable to the exhibition of
all the rest,  the early decision is not very important.   When the
eruptions appear;  those of small pox are  coarse,  and sometimes
cover nearly  the whole  surface of certain  parts, particularly the
face;  but, more commonly, they are  isolated, there being some-
times not more than half  a dozen  pustules on  the  whole body.
The chicken  pox is much like the small pox in character, but more
mild in effect.  The measels extend more generally still over the
surface, but rise only a little above it,  while the exanthema of scar-
let fever does little more than inflame and scale off the skin.  Un-
der the regular practice, the small pox and chicken pox  often
much disfigure  the countenance; but, under a judicious Botanic
treatment,  this  seldom happens.  I  have treated many cases of
all  these affections,  except small pox; and, though one died of
phthisis and measles, and another of marasmus, dropsy and scarlet
fever, combined; I have yet to lose the first patient of any one of
these affections alone.  Of more than thirty cases of measles, I
have lost none, nor found  any difficulty in restoring them shortly,
on the above plan.
  Whooping Cough.—This is another of what Dr. Bigelow calls
"self-limited diseases."  This cough is convulsive and suffocating,
and  accompanied  by a shrill, reiterated whoop.  If the  treat-
ment proper  for its premonitory  symptoms, which are quite simi-
lar to those of catarrhal fever, be promptly and efficiently applied,
this form of disease will be rendered quite mild,  and its duration
much shortened, if it  should not  be altogether prevented.  Let it
be remembered, as a well known fact, that  some persons are much
more liable  to contagious affections than others, and much  more
affected by  them  when attacked, (because their  systems are al-
ready  diseased;) and it follows of course,  thai, if you keep the
system clear of morbific matter,  it will be much more able to ward
off an attack, or to sustain its actual pressure.  I knew not  a sin-
gle instance of an  attack of tlie cholera, in Richmond, Virginia,
in 1832, on a patient that had lately been taking courses of medi-
cine.
  The proper process for croup, will of course be thorough relaxa-
tion and cleansing by steam &c, then the proper tonics.   Some
antispasmodic and  expectorant preparation should be administered
whenever the lungs seem stuffed, till the affection entirely ceases.
Keep the chest and neck comfortably warm. 
192
   Convulsions.—Dr. Eberle says that convulsions are among the
most fruitful causes of death among infants; and  this arises from
the great susceptibility of their nervous systems to irritation.   So
far, 1 agree with him, and  hence draw an argument for keeping
the infantile system free from all those deadly  drugs with which,
if we were lo  follow  his advice, we should be stuffing them, on
every appearance of a little ailment.  I have  not a doubt that
calomel, administered  according to  his directions, is the cause of
more infantile convulsions  than all other irritating  agents  com-
bined.  To this, add  his other drugs, and you  will have at least
three quarters of all the causes of convulsions to which infants are
liable.  Now  our Botanic friends do not need  to  be told how to
avoid these causes of disease.  But  they may be told, and  would
that I could make them and others feel it, from the  crown of the
head to the sole of the foot, that, when once the calomel gets in, it
is a hard matter to prevent its specific effects or ever to eradicate
it from the system.   Even Dr. Eberle says, page 156, though "cal-
omel can seldom be omitted with propriety in infantile erysipelas,"
yet "it is necessary to proceed with caution in its use;" for, "when
given freely, at this tender age, it is apt to give rise to dangerous
irritation of the stomach and  intestinal canal."  On page 185, he
says, "In using calomel in this affection, [ulceration of the mouth,]
great care ought to be taken  lest  it affect the gums—an occur-
rence which could hardly fail to impart a dangerous character to
the ulcerations."   But what sort of "care"  can be taken in the
case?  Dr. Graham of Edinburgh,  says, page 137, "An improper
or excessive use of the generality of medicines, is  recovered from
without difficulty; but it is not so when the same error is fallen  into
in regard to the mercurial oxides.   They affect the human consti-
tion in a peculiar manner, taking, so to speak, an iron grasp of all
its systems, and penetrating even to the bones, by which they not
only change the healthy action of its vessels, and general structure,
but great ly impair and destroy its energies; so that their abuse is rare-
ly overcome.   When the tone of the stomach, intestines, or nervous
system generally has been once injured by this mineral, according to
my experience, (and I have paid considerable attention to this sub-
ject,) it could seldom afterwards be restored.   I have seen many
persons to whom it had been largely given for the removal of different
complaints, who, before they took it, knew  what  indigestion  and
nervous depression meant, only by the description of others; but
they have since become experimentally acquainted with  both; for
they now constantly complain of weakness and  irritability of the
digestive orgaos,of frequent lowncss of spirits and  impaired strength;
of all which, it appears to me they will ever be sensible.  Instances
of this description abound.  Many  of the victims  of this practice, 
193
are aware of this origin of their permanent indisposition, and many
more who are at present unconscious of it, might here find, upon
investigation, a sufficient cause for their sleepless nights and mis-
erable days.   We have often every benevolent feeling called into
painful exercise, upon viewing patients already exhausted by pro-
tracted illness, groaning under the accumulated miseries of an ac-
tive course of mercury, and by this forever deprived of perfect re-
storation.  A barbarous practice, the  inconsistency, folly and in-
jury of winch no  words can sufficiently  describe."—Page-138.
   Now all this might pass with me, for mere opinion, were it not
that I  have long  seen and daily see  the same thing with my own
eyes.  I lately saw a patient die under a  most dreadful mercurial
salivation and ulceration, who had not taken a grain for five years;
and there now sits by me a gentleman  whose gums are so sore that
he cannot eat solid food, and has been under  a free salivation for
several days, though he has  taken no mercury for  9 years.  The
mercury was  given, in both  these cases,  with great "professional
skill."  So much of Dr. E.'s "care"  was taken, that no great mis-
chief was immediately perceptible.  Bui, in  the  one  case, there
followed a life of five years suffering  far worse than death,  and
finally death  itself.  In the other,  a limb is forever ruined, and
misery entailed upon the system from which, 1 believe  with Dr.
Graham, he will  scarcely ever recover.   Oh the curse of mercury
as a medicine!   The sword, the pestilence, the famine,  yes, and
even the dram bottle, all fail in the comparison with it, in the de-
struction of the health and  life of civilized society!  Beware of it,
fellow-citizens as the deadly bohon upas  of the desert!   It biteth
like a serpent and stingeth like an adder.
   But these convulsions must be treated on our plan of relaxing
the system and removing  the obstructions; lobelia, cayenne, the
vapor bath, canker teas, &c, are the  articles;  and they must  be
faithfully applied till the system is cleansed, and  then  the tonics
must be used to keep what is gained.
   Epilepsy, or falling, sudden Exhaustion, fyc.—These arise from
internal obstructions, when the surface is much relaxed.   The heat
and moisture escape from the surface faster than the supply is fur-
nished within.  The balance of power is lost.  To correct them
for the moment,  lay the patient on the back, with  the head lower
than the body, dash cold water on the face and breast,  and  give
hot medicine within.  As  soon as the  balance is restored, give a
regular course, or more if necessary.
             13 
LAXATIVE BITTERS.
  Cayenne, Nervine, Bayberry, Poplar, Golden Seal,  Balmony,
Bitter Root, Boneset, Slippery  Elm, equal quantities, all in pow-
der, mix well.   A tea-spoonful  every night is calculated to keep
the bowels  free.   When not sufficient to  produce  this  effect, in-
crease the Bitter Root, Boneset and Golden Seal.   If very costive
or the liver torpid, add powdered lobelia seed.  It may be taken
in a little cold water or molasses, or may  be  prepared in hot wa-
ter, and suffered to cool and then drunk.   Or half as much pow-
dered sugar may be added, and then it can be eaten dry, which is
an excellent way.   If a little Bitter Root be added lo the com-
mon Spice Bitters, the mixture  will answer well for this purpose.
But the best article lo  keep the  bowels  open is unbolted wheat
bread.
  Physic.—There seems to be much diversity of opinion among
our Botanic friends about the propriety of using physic in any case.
As is usual  with enthusiasts,  the  champions on each side lean as
far from those on the other as their rope will let them.   Some say
that physic is  poison and death; others say that catharsis is one of
nature's most  common modes of removing disease.  For myself, I
believe that the truth is just about midway between them. Spon-
taneous purging is quite as common, and therefore quite as natural,
as spontaneous vomiting.  I never give cathartics merely to open
the bowels.  I always prefer enemata.  Nor do  I give them to
clear the stomach—I much prefer emetics.  But I now and tnen
find a case in  which, after the stomach and lower bowels are well
cleared, there seems to be a want of action in the  middle region,
especially in the liver.  The above compound takes hold of this
inactive part.  The bitter root, boneset and lobelia relax the parts;
and the cayenne and the bayberry stimulate them to action and
keep up the determination to the surface, and most of the articles
furnish the  bitter  principle  to  correct the bile.  Cayenne itself
produces, in most cases, all the action that is necessary on the bow-
els.  Though I have seen  much  good done by butternut physic,
yet, in general, I prefer emetics and enemata.   I have given very
few compounds in this  book, because I wish the reader to study
the principles so well that he can  make up at any time,  something
to suit the case, whether he has all the articles or not. 
TESTIMONIES
Of the Regular Faculty against  their  own Theory and Practice and
                      in favor of ours.

  Natural Laeors.—After the bold and free use of the lancet,
cool regimen, spare diet,  opium, cantharides  and profuse evacu-
ations from the bowels, "if convulsions succeed, they arc generally
mortal.  The vis vitee, in such  circumstances, must be supported
by  replenishing the vessels  with  the utmost speed;  this is to be
done by pouring in  nourishing fluids  as fast as possible by the
mouth and by clyster; warm applications should also be made to
the stomach and feet."—Edinburgh Practice, vol. 5, page 105.
  "Abortion is not easily prevented,  as it is often preceded by no
apparent symptom, till the rupture of the membranes and evacua-
tion of  the waters announce the  approaching  expulsion of the
fcetus.  Either to remove threatening sj mptoms, or to prevent mis-
carriage when there is reason to apprehend it, often baffles our ut-
most skill;  because it generally happens, that there is a ccs.-ation
of growth in the ovum; or, in other words, the extinction of life in
the fcetus,  for some time  previous to  an appearance  of abortion:
but, for the most part, very little can be done in  the way of medi-
cine.  Manual assistance  is seldom or never necessary  during the
first five months of pregnancy; the exclusion of fcetus and placenta
should very generally be  trusted to  nature.   The modical treat-
ment of abortion, must therefore be considered with a view only to
the  prophylactic  cure.  The preventive means, to which 1 would
wish to solicit the attention of practitioners in midwifery, consist in
strengthening the habit previous lo  a subsequent  pregnancy."'—
Pages 114 and  115.
  Of Natural Labor— "All efforts to press or strain, except what
nature excites, are improper, hurtful, and should be  avoided; the
membranes, if possible, ought  not to be ruptured till they almo»t
protrude at the os externum."—Page 121.
  "The separation of the  placenta is also the work of nature, a:id
seldom requires more  force to bring it along than if it lay entirely
loose in the  cavity of the uterus.  Thus, in  pulling,  no greater
force should be employed  than is just sufficient to put the funis on
a stretch; for, if it is already separate^ no violence is necessary to
extract it; and, if the adhesion  is very firm, all violent  efforts are
improper, and often followed with the most dangerous consequen-
ces."—Page 125. 
196
  "Though bad consequences sometimes follow from the retention
of the placenta, yet it is much to  be questioned, if these are not
less to  be dreaded than the dangerous floodings, convulsions, deli-
quia, inflammation of the uterus, fever, &c, that may be induced
from the too prevalent practice of passing the hand to make the
extraction.  Where the adhesion is so firm as to require force, or
where  its place of attachment is out of the reach of the finger, by
which, for the most  part, the edge may be brought down, is it not
by far  the safest, and the most rational practice, universally to trust
to nature?  Should the mouth or  body of the  uterus become con-
stricted before the separation is effected, no matter; little is to be
dreaded: it will afterwards kindly dilate, and the  separation and
expulsion will spontaneously be accomplished  with as much safety
as in other animals,  where no force is ever used.  Let every candid
practitioner acknowledge, that for one instance  where the reten-
tion of the placenta has been attended with dangerous consequences,
its precipitate extraction has proved fatal to hundreds."—Page 126
and 127.
  [I have read of one case in which the placenta was retained fif-
teen days;  of another where it remained  24  days; and I had one
myself, last winter,  where it was retained  22 hours.  In all  these
cases, the patients suffered no injury from this cause.   In the last,
she was about  the house the 5th day.]
  "In natural  labors,, almost our whole  business  consists  in en-
couraging the  patient,'and preventing the  fourchette or frenum la-
biorum from being torn, when the head is protruded through the
os externum.   For, although it is commonly said, that such a wo-
man was laid [delivered] by such a person, the delivery is general-
ly performed by the labor pains; and, if we wait with patience,
Nature of herself will do the work.   We  ought not, therefore, to
fatigue the patient  by putting her too soon in labor, according to
the common phrase; but to attend carefully to the operation of the
pains;  and, in  most cases, we shall have nothing else to do but re-
ceive the child."—Page 129.
  Laborious  Parturition.—"When a woman  is nervous, low
spirited, or weakly, from whatever cause, in general her strength
must be supported;  the pains at last will become strong and forcing,
and  the delivery, even where the patient is very weakly, will often
have a safe and happy termination.  In  these tedious labors, if
the strength of the woman be properly supported, every thing al-
most is to be expected from nature."—Page 1^5.
  "From mismanagement in time of labor, often arises great de-
bility; so that the patient's strength is exhausted, the pains at length
entirely cease, and  the head of the child remains locked up in the
pelvis, merely from want of force or pain to push it forward.   It is 
197
of the greatest consequence, and the advice  cannot be too much
inculcated, to avoid exhausting the woman's strength too much at
first.  Page 137.
   Alas!  and must  her strength be exhausted after she has gone
safely through?   This  is making her sick for fear she will get well
too soon.  How long will the lair sex consent to be made sick for
fear they will enjoy too much health?
   "Dryness and Constriction of the Vagina."—"Here all stretching
and scooping is to be avoided.   The natural  moisture is to be sup-
plied by lubricating with pomatum or butter, or by throwing up
injections of warm oil; the parts are likewise to  be  relaxed by the
application  of warm stupes, or by warm steam  directed to them.
Thickness and rigidity of the os tincce, is to be relaxed  in the same
way."—Pages 338 and 39.
   "If no obstacle appears, but the presenting  of the  fontanella,
the labor will, by proper management, generally  end well; and
much injury may be done by the intrusion of officious  hands."
   "Face cases are the most difficult and laborious  of  all kinds of
births; and our success in this will chiefly depend upon a prudent
management, by carefully supporting the strength of the woman."
Page 140.
   "The  os uteri, rarely, if ever, is capable of contracting upon the
neck of the child, and thus preventing the advance of the shoulders;
and, should this  be  the case, what can we  do  but wait with pa-
tience?"—Page 141.
   "Besides these," [cases cited] says Dr.  Smellie,  I have assisted
in a great number of cases where the membranes have opened the
os  externum, and the head has been delivered  before  they broke.
Indeed,  in all natural labors, I wait for this operation, which ren-
ders the passage of the child much more easy."—Pages 129,  '30
and '31.
   "We should always be exceedingly cautious of having recourse
to the common expedient of breaking the membranes, which ought
never to be  done till we be certain  the difficulty  depends upon this
cause; and, even then, the head of  the child should  be well ad-
vanced, and the membranes protruded almost as far as the os ex-
ternum."
   "Many inconveniences arise from a premature evacuation of the
waters; for thus the  parts become dry and rigid, a  constriction of
the os uteri for a time ensues, the pains often cither remit or be-
come less strong and forcing, though not less painful and fatiguing;
the dilatation goes on  so slow, ^nd the labor becomes so severe,
that woman's strength and spirits, by the unprofitable labor, are
quite overcome and exhausted; so that the head remains confined
in the passage, merely  for want of force or pain  to push it forward. 
198
The woman, in the beginning of labor, should therefore be treated
with the utmost delicacy and  gentleness.   The work of nature is
too often spoiled by officious hands.  She should be seldom touch-
ed while the membranes arc whole, lest they should bo ruptured;
and, even  when touching is necessary, this should only be done
when the pains begin lo remit, and  the tense membranous begin
to relax."   Pages 141 and '42.
   "When  the  funis umbillicus is too long, it forms circumvolutions
round the  child's neck, but it  is lime enough, in general, after the
child is  born, to slip the noose over the shoulders or head; there is
seldom occasion lo divide the  chord  on the birth;  a practice that
may be  attended with trouble and hazard.—Page  112.
   "To push up the head, and turn the child with a view to pre-
serve its life,  as  many authors recommend, is a practice by no
means advisable; we should seldom, in this position, be enabled to
save the child; and turning, under such circumstances, can never
be done but at the immediate hazard of  losing the mother."—*
Page 119.   This relates to the prolapsus of the funis before  the
head.
  "Jn many women  I have known the membranes brake several
days, weeks, and even months before labor; and, provided they
were not much weakened, they have been delivered with ease.—
Page 148.
  "An ineffectual attempt to  pull away the child,  with  a noose
over the head—which was safely delivered  by the natural  pains—
with the head  galled and inflamed," is recorded, page 184.
   "A safe delivery,  by trusting to nature, after the lady had been
delivered of four dead children—by force."—Case 4, page 191.
   "The unfavorable position of the head, i3 of itself a cause insuffi-
cient to justify the use of destructive instruments."—Page 205.
   "In whatever manner the  breech presents, the  delivery should
be submitted to nature, till the child be  advanced as far as the
thorax, when the feet are to be brought down and laid hold of, the
child, if necessary, pushed up, the mechanical  turns effected, and
the delivery otherwise conducted  as in a footing case.   There is
much less hazard in general, agreeably to an  old  observation of
Mauriceau, in allowing the child to advance double, than in preci-
pitating the extraction by pushing up to bring down the feet be-
fore the parts have been sufficiently dilated; a practice difficult and
troublesome to the operator;  painful and'sometimes dangerous to
the mother; and by which the child is exposed to the risk  of stran-
gulation, from the retention of the head-after  the delivery of the
body.  If the child be small, thcAigh doubled, it will easily pass in
that direction; if large, though the labor  be painful, the  natural
throes are less violent, and less  dangerous than the preposterous
help of the accoucher."—Page 283. 
199
  "A great effort was made to deliver a child with a breech pre-
sentation, but, not succeeding, the patient was nourished, and soon
delivered with great ease by the natural  pains.—Case 17, page

  Rash and preposterous management by an accoucher who had
acquired much celebrity.—9 page 339.
  Heart-moving and disgusting scenes recorded upon pages 360,
361, 362, 363 and 364.
  By their  fruits ye shall know them—Fruits in abundance  re-
corded on pages 364, 365, 366, 367, 368 and 369.
  From  page 372 to 379 inclusive, important lessons  are to  be
learned.
  From  page 384 to 389 and '90, are illustrated the injurious ef-
fects of too great haste.
  The Doctor pulled at the lower jaw and body until he felt them
give way—then said he could not save its life {as he had broken Us
neck)—The woman did well until—she died!—Pages 394 and 395.
   The danger of turning in ulero.—"Long-continued efforts have
sometimes succeeded in turning the child; but  too frequently the
event has been fatal: sometimes the  uterus has been ruptured in
the operation, and sometimes where the misfortune has not been
known to have happened, the uterus has suffered so much that fever
and death have  been  the consequence.  The more experience I
have had, the more I have been desirous of rather bringing away
the child in any  way I  could, than running the risk of these xety
difficult turnings."  Dr. Sims of London.—Page 405.
  "It may not be amiss to remark here, that, whenever there are
strong labor pains present, turning ought not to be attempted; and
that not only on account of the increased difficulty and  danger of
the operation; but because, whenever there are strong forcing pains
present, a favorable issue may, xmder all circumstances, be expect-
ed; for,  as if  Nature felt  her own  inability to accomplish the de-
livery in cross presentations, there are rarely any pains; and where
these exist to a certain  degree, I have always found that, from the
small size of the child,  or, which amounts to the same, the large
dimensions of the pelvis, the child was about to be expelled double,
or that the head or breech were coming down with the arm, though
not within the reach of  the  finger.   Often, when there  are  no
pains whilst the patient is left to her«elf, the uterus is immediately
thrown into strong action by  the irritation which  the attempt to
introduce the hand must occasion,  and this circumstance always
adds |p  the difficulty and danger  of the operation."—Page 405.
See, also, Dr. (Clark's letter to Dr. Sim, page 407.
  "The number of foetuses eventually destroyed with the intent of
preserving the life of the  parent, are incidents  of the utmost im- 
200
portance to the community, and claim a proportionate  share of
consideration from every accoucher concerned in these  unfortu-
nate occasions."—Page 434.
  "The implicit act of turning and delivering by the feet, is a prac-
tice, even in the most promising situations, always attended with
danger to the fcetus."
  "I think no one excusable who attempts premature delivery, in
cases of habitual miscarriage at a certain period of gestation beyond
which  the fcetus is supposed lo die, as instances are not wanling,
where, after a number of periodical immature births, the woman
has at  length gone her full period  of nine months, and become ma-
ter familias."—Pages 434 and 435.
  "The uterus is an organ in no respect governed by the will, and
the efforts of that viscus are most regular when left uninterrupted."
Page 435.
  "Should hemorrhage take place in the early  part of labor,"
Boudelocque says, and I fully concur with him, "Whatever abun-
dance of blood the woman may loose, nothing could justify the con-
duct of the accoucher who  would  persist in endeavoring to deliver
without delays  for it  would only  be creating new difficulties, in-
stead of relieving the existing  one."—-Dewees's Midwifery, page
236.
  "I believe that the frequent  mention of difficult, dangerous, and
rare operations, leads oftentimes to the unnecessary use of instru-
ments, not always so  much from  the necessity of  the case,  as the
eclat which attends them, however unsuccessful"—Dewee's Sys.
Mid., page 307.
  The  delivery of the Placenta.—"It would be in vain to attempt the
delivery of the placenta by any exertion made upon the cord,
though this is almost always  resorted to; and, as the whole of the ute-
rus  will sink lower in the pelvis by the effort, the inexperienced
practitioner imagines that the placenta is descending—he continues
his traction under this illusion, and,  thinking a little more force
will overcome the difficulty, he multiplies it; the cord  is ruptured,
and his difficulties are increased;  he now becomes  alarmed, and
the panic  spreads to the  patient and  her friends; every thing is
thrown into confusion; a  consultation is demanded; and a rival
practitioner robs him of the little reputation he may have acquired,
and thus interrupts his progress in business.  Or, fearing  the con-
sequences a discovery of this  accident might produce,  he disin-
genuously conceals it;  and attempts, without method, the delivery
of the  imprisoned placenta, to the immediate torture and subsequent
injury  of the patient—not knowing exactly what causes therlelay,
or the  nature of the difficulties which oppose him, after excrutiating
bis patient, by unavailing efforts, he, in a paroxysm of mental an- 
201
guish, abandons her, and declares the case must be left to nature."
Dewees's Sys. Mid., Page 417.
   Behold how these regulators  love their patients! how kind they
are to them, and careful not to do them any injury!  How kind to
one another, and how willing to assist each other!   How scientific
and learned, to bring their patients into so deplorable a condition,
by their folly and rashness!   Who can but  love  such physicians
and such a science?
  -"Turning must always be looked upon as of doubtful  safety to
the child; its adoption must therefore be constantly regarded as a
choice of evils.  In the case of prolapsus funis, it should be resort-
ed to with great caution, especially as there is no question that
children  are  frequently born alive after  the cord had been pro-
lapsed, and when the progress and termination of the labor was
confined to the natural  powers.  While, on the contrary, the fact is
equally well established, that they have perished during the extrac-
tion;  and I believe we may safely say, with Boudelocque, 'and all
this, in cases where they might have been born alive, notwithstand-
ing the exit of the cord, had the delivery been left  to nature.7  It is
not sufficient, because the pains are  frequent and long in return-
ing, to make us conclude that the powers  of nature ate incompe-
tent to the end, and  make us resort lo the doubtful expedient of
turning."—Dewees, page  525—'7.
   "Even under favorable circumstances, turning is, to the child, a
hazardous operation;  under perverse ones, it is but too often  fatal
lo it; and it must ever  be looked upon  as a doubtful  alterna-
tive, rather than as a probably safe resource."—Dewees, page 551.
   "Nothing can justify a violent entry  into the cavity of the ute-
rus."—Dewees, page  544.
   "The laborious and difficult labors, are by no means so frequent
as those who are inexperienced are apt to imagine."—Blundell's
Obslctricy, page 141.
   '•I strenuously dissuade you from making familiar companions of
your instruments; because they  are not wanted.   Noscitur a sociis
—(He is known by his companions.)  The very fact thai an ac-
coucheur, on all occasions, puts  the lever into his pocket when he
goes to attend a labor, proves that he is an officious, a meddlesome,
and, therefore, in my mind, so far, a bad accoucheur.   Some men
seem  to have a sort of instinctive impulse to put  the lever or for-
ceps into the vagina.   "Lead yourselves not into  temptation;" if
you put your instruments  into your  pocket, they  are  very apt to
slip out of your pocket into the uterus.  Patience and good nature,
arc two useful obstetric instruments which may  be fearlessly car-
ried to every labor."—Blundell, page 443.
   "When it was the custom to bring away the placenta immedi- 
202
ately after the birth of  the child, three reasons were assigned for
the practice; first, that it was a dead substance, without any power
like that which was supposed to be inherent in ihe child; 2ndly,
that it was an extraneous mass, which  Ifecame  pernicious every
moment it remained; and, 3dly, that, if not immediately extracted,
it would be almost impossible to bring it away, the os uteri closing
in such a  manner as absolutely to prevent the introduction of the
hand for the purpose of extracting it.   These  opinions  are proved
to be groundless, for.the placenta, we know,  may remain many
bours or several days.(15 or 20) without doing any mischief to the
uterus; and the opinion of the os uteri closing so soon after the birth
of the child, is without  foundation, as that seldom  or  never  hapr
pens."—Page 445.
   A case  is recorded upon page 494, of a complete inversion of
the uterus, without  the  labia, caused by the placenta haviug been
too forcibly extracted.
   Another page 495, "where Dr. Smellie was called to a woman,
who died before his arrival.  He found the uterus inverted, pulled
quite without  the external parts, and the placenta adhering firmly
to the fundus. This misfortune was occasioned by the midwife
pulling at the placenta  with too great force.
   "No excretion is of more consequence to the patient's recovery,
after delivery, than a free perspiration; which  is so absolutely ne-
cessary, that, unless she has a moisture continually on the surface
of her body for some days fifter the birth, she seldom recovers to
advantage: her health, therefore, in a great measure, depends upon
her enjoying undisturbed repose, and a constant breathing sweat,
which prevents a  fever by carrying off the tension and assists the
equal discharge of the lochia when these are obstructed, and when a
fever ensues with pain and restlessness, nothing relieves the patient
so effectually  as rest and moderate sweating.—Page 522.
   Puerperal or Child-bed Fever.—"Notwithstanding the prevalence
of this disease in all ages, its  real nature has remained lo the pre-
sent time, a subject of much dispute and uncertainty.  The cure is
gradually  effected, either  by a spontaneous  vomiting, or a long-
continued discharge by  stool of porraceous mailer, the existence of
which in  the  stomach is usually evinced at  the first attack of the
disease.  The five principal causes of this disease are, 'the  endea-
vors to dilate the os internum, a stoppage of perspiration, too hasty
separation of the placenta, and binding the abdomen too tight, and
the neglect of procuring stools after delivery."  Within these few
years, this fever has been treated by several writers, most of whom
have differed from  each other, and it has likewise been the fate of
puerperal fever, that no disease has more divided the sentiments of
physicians in regard to the method of cure.   The  apparent indica- 
203
tions and contra indications of bleeding and other remedies, arising
from a complication  of inflammatory and putrid symptoms; the
equivocal appearance of the vomiting and purging, and the differ-
ent causes whence symptibms similar to each other may arise  in
pregnant women;  all these  circumstances concur  to involve the
subject in great obscurity and indecision."—Pages 452—5.
   On the effects of the treatment of officious regulars.
   "By frequent and incautious touching, the  glands furnishing the
fluid to lubricate the vagina and os uteri, are over stimulated, nay,
sometimes  become inflamed.  In this case,  the  secretion ceases,
and the parts become tender and swollen, especially the mouth of
the uterus, should it not be fully dilated; the pains are less frequent
and less  protrusive; the woman is restless, and enjoys no  calm in
the intervals of the pains; fever is excited; head-ache, thirst, and a
hot skin  follow; in a word, a new condition  of the system arises,
and  almost suspends  the business of labor.   This state of things
can only be altered by rest and free blood-letting.  To the latter,
we must  have immediate recourse, if we wish to subdue the unne-
cessarily provoked inflammation; and to restore the uterus to the re-
enjoyment of its  suspended powers, in  many cases like those just
mentioned,  1 have seen this remedy act with the certainty and
promptitude of a charm"—Dewees's System of Midwifery, page
174.
   It seems then, thas Dr. D., in "many cases," by his "incautious"
and improper "touching,"  produces  the  most alarming symptoms,
and suspends the business of labor, but (oh, what a beautiful sci-
ence!) these dreadful effects can be  removed like "a charm"  by
"free blood-letting."   How long would  the  intelligent ladies  of
Philadelphia employ such an accoucheur, provided they knewr that,
by his "frequent  and incautious touching," he produced such dis-
tressing  effects, which  he  removes like a "charm"  by bleeding
them almost to death?
•  "In the management of labors, much judgment and caution are
required, that a simple and natural case, may not be converted into
a laborious and  dangerous one.   And, unfortunately for the  interest
of humanity, it requires more knowledge not to be officious, than
falls to the share of many of those  who pretend lo practice  mid-
wifery.   It is a vulgar prejudice, that great and  constant benefit
can be derived from the agency of an accoucheur, especially du-
ring the active  state of pain; and this feeling is but too often en-
couraged by the ignorant and designing, to the injury of the patient,
and to the disgrace of the profession.—Page  185.
  A small Mistake.—"A gentleman, once calling at my house, told
me, not'without some earnestness,  that  he had under his care a
case of labor about which he was very anxious.  'The mouth of the 
204
 womb," said he, 'is beginning to open, and I can feel the child, but
 the patient is somewhat weak, and labor makes but little progress.'
 On my enquiring bow long delivery had been  protracted—a few
 hours was the reply, and he added, that there was no very pressing
 symptom.  A meddlesome midwifery is bad,  I rejoined; therefore,
 it is better to wait, and not unwisely and rashly disturb the best
 accoucheur—Nature—the mother of us all.   A  day or two passed
 away, after which he called on me again, observing that his patient,
 still undelivered,  was getting  weaker and  weaker, and  lhat he
 wished me to give her a visit.  On entering  the apartment, I  saw
 the woman lying  in  state,  with nurses, accoucheur,  and all the
 formalities attending a delivery; one small point only was wanting
 to complete the labor, which was, that she should be pregnant; for,
 although the  practitioner, one of the omnipotent class, had distin-
 guished  the child's head  in the uterus, there was, in reality, no
 fcetus there.   A few hours after, the palient died, and, on exam-
 ining the abdomen, we found  the peritoneum full of water,  but
 the womb, clearly unimpregnated, was no  bigger than a pear.'
 Blundell's Obst., page 153.
  "To burst the membranes with the finger, instead of waiting for
 their spontaneous rupture, is faulty."—Page  151.
  "In labors generally, it is of very little importance whether the
 practitioner  knows or not what is the presentation; because, in
 general, it is  a natural one, and, notwithstanding his ignorance,
 the child will safely enough come away.—Page  155.
  "In ordinary  labors, it matters little whether  you are acquaint-
 ed or not with the situation of the cranium."—Page 156.
  "A meddlesome midwifery is  always  condemnable."  "When
the head is in the world, do not lay hold of the neck and endeavor
to drawdown the shoulders; for here, as  ever, a meddlesome mid-
wifery is bad.   The natural efforts, if fairly tried, will, in ordinary
labor, expel this part of the child; and it is  found that, when the
efforts are left, in this manner, to expel the shoulders as well as tlie
head, the womb contracts  afterwards more kindly and  effectually,
and the placenta becomes more safely detached.  When the child's
head is come into the world, therefore, remember  that a prudent
 practitioner ought not to interfere; but must still suffer  the uterus
 to act in its own way, when, by the natural efforts, the shoulders
 will be expelled."—Page  158.
  "Rarely is it requisite to examine whether delivery be or not be-
 gun.  With the rupture of the membranes, the less you interfere,
 the better."—Page 161.
  "Where the placenta is rudely and injudiciously torn away by
 the hand of the accoucher, the worst consequences may  be expect-
 ed to ensue.   Floodings, tremendous lacerations, inversions of the 
205
uterus—such  are the effects of obstetric violence—ferocious and
atrocious obstetric violence; that insatiate and gory Moloch, before
whose bloody shrines so many thousands have been sacrificed, to be
succeeded, in future years, by still more numerous victims. Observ-
ing these awful consequences resulting from the artificial separation
of the placenta, Ruysch first, and afterwards Denman and Hunter,
recommended that, in all cases, after the birth of the child, the ex-
pulsion of the placenta, like that of the fcetus, should be committed
to the  natural powers; for, they added, 'the same natural  powers
which  arc adequate to expel the child, are surely adequate to ex-
pel the placenta also!'   And there is no doubt that, if our women,
ferino more, unaided by art, were committed to the natural powers
altogether, like the females of barbarous hordes, in the great ma-
jority of cases the placenta would come away."—Page  167.
   "i hope that no one will needlessly thrust his hand  into the ute-
rus, yet I have  my misgivings.   I hope,  after all I have said, of the
tearing and  lacerating and sloughing of these parts, you will never
needlessly have recourse to this barbaric practice.   Some of my
obstetric friends, and whose talents  I esteem,  fall into this error;
they grate my  ears, by  boasting how frequently they have carried
the hand into the uterus,  and with what facility the  placenta has
been removed:  that this operation may be easily effected, I have
no doubt; but depend upon it, if you do carry your hand into the
uterus on every occasion, to get away the placenta, some women
will die at last, and die the victims of your mismanagement; at {his
moment, perhaps, some amiable but ill-fated creature,  blooms the
light and life of her  admiring circle, who must hereafter fall an
untimely sacrifice to some cruel and ruthless arm."—Pages 171—
'O
   "I have the  preparation of a uterus in  my  museum, in the un-
contracted state;  and,  looking on the inner surface to which the
placenta cohered, you find there is a number of large unclosed vas-
cular  orifices, yawning, as  it were,  destruction  on  the patient.
Now this preparation shows the condition in which the  vessels are,
if you tear away the  placenta before the womb is contracted, ex-
hibiting the formidable openings  at  which the effusions of blood
occur.  But here is another  preparation which is contracted; if
you look at the blood  vessels, you will find them all closed by the
abbreviation of the surrounding fibre, as by so many ligatures, and
this is the best prevention against hemorrhage; it is Nature's  tour-
niquet, her system of living ligatures.  You see, then, that it is not
 without good reason that I am so  anxious,  before you abstract the
 placenta, that  you should secure the contraction of the womb.
   Do not needlessly thrust the hand into  the uterus, is the voice
that issues from this preparation:—he that has  ears to hear, let
him hear it. 
206
   Do not needlessly thrust the hand into the vagina, is the voice
that issues from this preparation:—he that has ears to hear, let him
hear it.
   Do not needlessly pass the hand into the genital fissure; is the
voice that issues from this preparation:—he that hath ears to hear,
let him hear it.  Ah! that violence of an ignorant and  savage
hand!   After examining these preparations, tell me, is it too much
to assert that, in obstetrics, a thrust of the hand is more dreadful
than the thrust of a bayonet!  Could the field of Waterloo exhibit
injuries more dreadful than Ihese?"   Page 172.
   "When the face is lying forward on the symphisis throughout
the labor, many difficulties are occasioned;  what is it then thai
the accoucheur can do in order to diminish, surmount  or remove
them?   What is there that he can with prudence do, and without
committing the unpardonable sin of midwifery; the sin, I mean,
of those obstetric reprobates, the meddlesome and the pragmatic?
That turning the child is universally unjustifiable when the case
is indisputable, the dexterity great, and the circumstances are con-
ducive, I will not venture.  And, when the softer parts relax, and
the pelvis is capacious, and our dexterity, from long practice, such
that we can introduce the hand into the cavity of the uterus,  and
lay hold of the  child's  legs, and bring it away with facility, by
the operation of turning; I  will  not say  that under such circum-
stances, we may not now  and then be justified in making the at-
tempt.  Decidedly, however, and in the strongest language, I can
use,  I  would reprobate this turning as a general practice even in
these cases."  Page  180.
   "As a general rule of practice in face  cases, with  the  whole
weight of authority I may possess with you, I condemn it.   Do  it
ninety-nine times, successfully, and I condemn it still, because you
arc meddling—because you are cramming your hand into the ute-
rus without any sufficient cause; because you are, as it were, doing
your best to tear the vagina; becuuse ninety-nine operations un-
deservedly sucessful,  may lead to the hundredth and the destruc-
tion  of your patient.  It is the same with respect to rectification."
   "In  presentations of the face, the stoical rule will apply;  a rule
which  might be whispered into the ear at all times, when you are
at the  bed side, naturam sequere (follow nature;) delivery is  a  nat-
ural process;  give, therefore, a  fair trial to the  natural  efforts.
When, then, you find a face  case, frequently,  nay generally, you
have little to do; you need not send for another practitioner;  you
need not allow your minds to get into a stale of perturbation, as if
you had some mighty feat to achieve.  You have only to sit quietly
at the bed side, to support the confidence of the woman, to let the
uterus act, to protect the perinasum, to open your hands, as  it
were, to receive the  child which Nature deposits in them." 
207
  "Ear presentations also occur, but they arc so rare or so easily
conducted on the principles laid down, that I consider it unneces-
sary to enlarge on them."   Blundell's Obstetric?, Pages 182—'3.
  "Under breech presentations, if you give a fair trial to the nat-
ural efforts, in most instances the foetus of itself descends the out-
let, the accoucheur happily having little to do, except to sit at the
bed side, and lo  abstain from injury or mischief." Page 190.
  '•The first stage of labor, in breech presentations, is frequently
very slow; for,  though  the nates and thighs  do not take up so
much room as the head, yet cither they do not readily adapt them-
selves  to the shape of the pelvis, or the action of the uterus is
slower or less regular, in consequence of the awkward  position of
the fcetus.  No means,  however, can with propriety be employed
to hasten the progress of the labor, and by degrees the dilatation of
the parts is effected, and the nates arc forced lower and lower in-
to the  pelvis, till at length they protrude through theos externum."
Dr. Merriman's Synopsis, 4th edition, page 73.
   Cases  of  Transverse  Presentation.—"I was called,  some  few
months ago, to a case in the neighborhood  of the London Hospi-
tal, a  presentation  of the arm, attended by a gentleman  of some
obstetric tact and  talent.   In two  minutes  after I entered the
room,  with scarcely a complaint on the part of the woman,  the
arm presenting, the child was brought away.   As my predecessor
had been laboring without success to deliver, this speedy abstrac-
tion of the child occasioned no small mortification of  surprise;
and, when we were apart, my friend asked me how it was possible
I could deliver her so easily and speedily, after he had labored so
much  and to so little purpose?  To say the truth, said  I, I did not
deliver her at all;  for, on reaching  the bed side, I found the spon-
 taneous evolution was nearly completed, and I had only to hold
 forth  my hands till the child dropped into them.  To anolher case
 I was called, where two practitioners had tried lo turn the child
 and failed, and where I tried myself, and failed too.   Finding that
 pcrseverence would burst the uterus, let us wait, I said,  to sec what
 the natural efforts will accomplish; if they do not effect the deliv-
 ery, further measures may be used; but do not let us  distrust our
 great and kind mother too soon.   In the  course  of an  hour the
 child  came away, under a spontaneous evolution,  effected by the
 natural powers,  and the woman did very well; and we all found
 that we did more service by sitting down at the dinner table than
 by working at the bed side."
    In  the face of such testimonies, what value can we place on the
 boasted superior skill of the Mineralites in obstetrics?
    'However clumsy,  and however rough, and however dangerous
 the practice,  yet,  I am compelled to  admit that" sometimes "in 
208
 shoulder presentations, the practitioner must take off his coat, re-
 move the sleeve of the shirt,  lubricate the arm and particularly
 the hand,  and then arte,  non vi, with the fear of lacerating the
 womb before your eyes, relentingly, tremblingly, I had almost said,
 if indeed a surgeon may tremble,  you carry the hand into the
 uterus, and  draw down the feet of the child, always with the risk
 of tearing the genitals, when you operate in a manner the most
 skillful and dexterous."  Blundcll's Obstetrics, page 133.
  "For once, even in floodings, a meddlesome midwifery is bad."
 Page 207.
  "I acknowledge, whatever  opinion  might be formed by those
 about me, for myself, however,  I had rather feel within that the
 patient  perished under the operations of nature, than that my
 meddlesome  hand wa3 unhappily auxiliary to her destruction."
 Page 218.
  "For the sake of humanity, allow me again to remind you that,
 from whatever cause the flooding arises, whether in the earlier or
 latter months, before or after the birth of the child, before or after
 the birth  of the placenta, so long as the woman is lying  in  the
 state approaching to asphyxia,  the  disturbance of your  hand is
 death!   Ah, how I commiserate those unsuspecting  but ill-fated
victims, who are destined to perish  by your forgetfulness  of  this
 caution?   At this moment live the women  who must sink under
 this malpractice."   Page 227.
  "Should you carry your hand into the  cavity of the  uterus,
 now, over and over again, not however too often, I have told you
 that  such practice is to  be condemned; and if, in  defiance  of
 warnings, any one  of you still addict himself to these mal-prac-
tices, 1@£  him take  the consequences;  on his head be her blood!
 My hands are free, whatever befalls the patient."   Page 234.
  "The blood chills and curdles at the thought of tearing out the
intestines of a living fcetus.  By the people of England—the cen-
 sors and  monitors  of nations—wild  beasts  are caged,  but worse
 than these, the accoucheur,  meddlesome and vioient, yet responsible
 to none, has been unwisely let loose upon society, with all his in-
 struments about him."  Page 236.
  "The tremendous and heart-sickening operation of opening the
 cranium in the  uterus, can never be necessary, till fcetal life is ex-
 tinct.  'Thou shall do no murder.'   These words cannot too often,
tingle in obstetric ears."  Page 238.
  "Dreadful lacerations may result from rash attempts to intro-
 duce the hand."  Page 246.
  "A thrust of the hand, is  contusion, laceration,  destruction,
 death."
  "The grand error to which you are obnoxious, the error against 
209
 which you have been Cautioned so often on other occasions^ iSj the
 use of too much force—arte, non vi; ferocious, atrocious violence,
 is  to be exploded  from midwifery.  Contusions, inflammations,
 lacerations,  fractures,  decapitations—these  are  the tremendous
 consequences resulting from the error—consequences at once fatal
 to  the mother and  child.  Laceration of the womb, laceration of
 the vagina,  extensive laceration of the  perinaeum; one or  other
 of  these certainly will  occur if you operate  rudely, and now and
 then,  perhaps, when turning  is perlormed  with the nicest care.
 Those make a mock of turning who have  never seen its dangers;
 it is at best a fearful operation."   Pages 150—'1.
   "Beware of impatience and  violence.  Beware of lacerations.
 Have mercy upon the patient:  again, I  say, have mercy upon hen
 Remember that a thrust of the hand is as fatal as a thrust  of the
 bayonet.   Wounds more dreadful are  not inflicted in  the field of
 battle.   When the hand is carried into the os uteri to perform the
 operation of turning, you may find it necessary to repress a little
 the presenting part; to  push the fcetus back hastily and extensively,
 is fatal;  and you must not think of it;  you will tear the vagina,
 lacerate the uterus—do both perhaps—how  easily too—but, can
 you afterwards repair them?"   Page 154.
  "In all cases, the use of instruments contrived for the  extraction
 of the foetus, is to be looked upon as a great evil"  Page 295.
  "In tho'general, as I have observed on precedingoccasions, the
 best accoucheurs arc those who interfere the least with  the finger
 or band."
  "I now repeat what I  observed once before; in obstetrics, a thrust
 of the hand into the uterus may prove as fatal, and \\'\\\, generally,
 produce  a more extensive wound than the  thrust of the bayonet.
 Page 391.
  '•I do not like to see  an elegant pair of forceps.  Let the instru-
 ment look  like what it is, a formidable weapon."   Page  312.
  "Force kills the child, force  bruises the softer parts, force occa-
 sions  mortification, force  bursts open  the neck  of the bladder,
 force crushes the nerves; beware of force."  Page 317.
  k,The cases in  which patients may suffer  because instruments
 have not been employed when  they have really been required, are
 by no means frequent in their occurrence, and therefore it  is im-
 possible for men. in general practice,  to err frequently even by
 abstaining altogether from the use of instruments' in all cases."  Page
 327.
  "If you must err, then, take  my  advice, and  err rather by the
 neglect or rejection of instruments, that their too frequent use, for the
cases in which you may use  instruments, without need,  are as nu-
             14 
210
merous km the cases that may fall under your care, with the exception
of the few, very few, in  which these weapons are really required."
Page 327.
  "Of all obstetric operations, there is none, perhaps, more easily
performed, than that of perforation, or craniotomy; and many a life,
I ffar, has fallen a sacrifice to this facility of execution.   Of all the
operations of our art, however, there is none more dreadful, not to
say more awful; never suffer your minds,  on any account, to be di-
vested of that salutary horror, with which I conceive it ought at all
times to be contemplated."  Pages 330^—'1.
  "Cases have happened in which the cranium has been opened,
and  a part  of its contents have been  removed, the child coming
into the world alive, to look, a3 it  were, into the face of the opera-
tor, and reproach him for his cruel ignorance or negligence.  The
very image of these horrors is enough to make the  blood curdle."
Page 334.
  "I knew an instance in which the fillet had been used, and ac-
tually scalped the child; and another, in which the child's under
jaw  had been cut to the bone by the  force of pulling."   Blundelfs
Obstetrics, page 223.
  "I was employed in a case where, by using great force, in order
to save both mother and child, the  os uteri was torn; the woman
died soon after, from loss of blood, as I then Imagined, proceeding
from the lorn Vessels of the uterus."  Page 316.       *!»
  "In the number of those diseases which the skill of the physician
or the hand of the surgeon  is not  able to cure, may be counted
those dropsies peculiar to females, which originate in the append-
ages of the uterus.   These  dropsies are not  unfrequent."   Page
508.
  "Puerperal fever is not  unfrequenlly produced by too hasty sep-
aration of the placenta; the consequence is generally  a copious
discharge of blood."  Page 546.
  "Let us beware how  we  interrupt the  operation of nature by
rude and uncalled for handling."—Dewee1s  Practice of Midwife-
ry, page 174.
  "Much mischief is occasioned by the method too generally adopt-
ed  immediately after birth.* A child is scarcely dressed, when a
tea-spoonful ol castor oil is wantonly forced down the throat; or a
great deal of sugar and water is given for the unnecessary purpose
of purging away the dark matter  which collects in  the large  intes-
tim-s during the last two months  of its uterine life.  We ought to
be  in no hurry in producing the expulsion of this  matter, as if it
were a poison, the retention of which would carry  death to the vi-
tals.  We frequently see  fatal bowel complaints produced by thys
came, and it is no  uncommon thing to discover that drastic purga- 
211
 lives have been employed.  Not long ago I Was called  to see a
 child under a fortnight old, who was taking half a grain of calomel
 and two of scammony twice a day, although it had from fifteen to
 twenty stools during the course of twenty-four hours, notwithstand-
 ing the  exhibition of occasional doses of chalk mixture.  In such
 cases, the drastic purgativrs are given in the first instance to "clear
 out tlie bowels," and afterwards persevered in to 'improve  the eva-
 cuations."
   "Another cause  of the bowel complaints of children, proceeds
 from the absurdities constantly committed with  respect to their
 food.   Soon after the castor oil has been exhibited, food is given,
 consisting of thick gruel, which the stomach is totally incapable of
 digesting; flatulency is the consequence; they cry; Dalby's Carmin-
 ative is resorted to for relief, which produces ease for a  time, but by
 inducing constipation, which renders another dose of castor oil ne-
 cessary; this, in its turn, frequently gripes.  This is attributed to
 wind in the stomach and bowels; and again thick indigestible food
 is given, to drive out the wind, which, in its turn, again requires
 Dalby's Carminative.  In this manner, the functions of the stomach
 and bowels  are  too  often impeded,  and  not only impeded for a
 time, but the children are rendered ever afterwards liable to com-
 plaints in the stomach and bowels."
   "Daily do I see the advantage of pursuing an opposite plan with
 new-born children.  I allow no laxative to be given, unless an in-
 fant suffers  from distension of the abdomen, which is to be ascer-
 tained by examination."   Mackintosh's Pathology, page 219.
   "There is oftentimes much  mischief arising from over-purging
 newly born infants; they not only require very mild remedies, but
 proper doses of such remedies."  Dewees's System of  Midwifery,
 page 216.
   "My friend Dr.  Parrish, and myself, were called to attend a
 child ten days old.   It was a healthy baby when born, and  had
 had several sparing stools, of a very dark green  color; two  tea-
 spoonsful of castor oil were given in the  morning.   Two more tea-
 spoonsful of castor oil were given in the evening.   The  child, how-
 ever, gradually declined from our first visit, and died on the third
 day after."  Page 217.
   "Forceps oftentimes  become vcry'injurious to the patient, by
 including, while locking, either a portion of the soft parts, or some
of the capilli of the pudendum; thus creating a great deal of pain.
   "It is,  however, insisted that this objection can always be remov-
 ed, by carefully passing the fitfger round the lock; but this is a mis-
take; for it is in the act of locking that this inclusion takes place.
Now, it is certain that the  locking of the instrument requires the
U6e of both hands; consequently, we cannot  pass a finger round the 
212
locking portion, so as to extricate  the soft  parts$  or  capilli, if in-
cluded, or prevent them from insinuating themselves between the
joint; as the hands, and of course, the fingers, arc otherwise em-
ployed at this moment.  It is true, we may search for the included
part or parts, before we commence extracting; but, to relieve the soft
parts, would require the separation of the  blades to a certain ex-
tent, and this  without any security  that it will not happen  again,
when the handles are again pressed together; and the capilli can
only be relieved with certainty, by breaking them,  which would
be painful, or by cutting them, which is  not altogether decent/'
Page 278.
  '•The proper application of the forceps, in each situation of the
head, has ever been considered an achievement of difficulty.   It
will be necessary to the success of the operation, that  the  practi-
tioner understand the construction and mode of action of his in-
struments, and have, by  practice, acquired 9ome facility in placing
them.   It has been considered  by Dr. Denman, as uncertain, whe-
ther the art of midwifery has been benefited, or injured, by the in-
troduction of instruments into its practice.  That much mischief
has been done by the ill-judged, and worse conducted application
of the forceps, I have had reason to know.  But it would be unfair
to charge all the mischief which has followed the  use of forceps, to
the ignorance of those who employ them; or to the action of the in-
strument itself—much is justly attributable to the views which many
celebrated men have taken of their necessity or utility, as well as the
rules they have laid down for their application.  A severe proba-
tion awaits an  upright and conscientious man,  upon his introduc-
tion into the practice of midwifery; for, if he be such, it will be a
long time before he will dare to flatter himself that he can do what
is best for his patient."  Pages 282, 283.
   [Some of the advantages of using the forceps, are illustrated in
the case recorded by Dr. Dewees, page 283.]
   "Dr. Denman, more  perhaps than any other man, is chargeable
with perpetuating errors in the use of the  forceps, because he  is
considered the highest British authority upon the subject.   In his
attempt at precision, he has created confusion; and, in his desire to
generalize, he has  made so many exceptions, that his Aphorisms
are no longer rules."   [Reafty, what has Dr. Denman written that
is so very displeasing to the Professor in Philadelphia?   Just hear
the charge.]   "His aversion to instruments, made him restrict their
power to such narrow limits, as  to  render them scarcely subservient
to the art; and he reduced the'eases proper for their application to
so few,  and  so peculiar, that  they are scarcely to be met with."
 Page 284.
   Here is the rub.  This learned Professor would soon be out  of 
213
business, if the ladies in the United States knew, that the cases that
call for the use of instruments  are "so few, and  so peculiar, as
scarcely to be met with."  American obstetricians arc determined
to make the people believe that  it is necessary for them to examine
and finger over every  case'.for fear that it should be difficult, when
not one in a thousand ever needs  their assistance.   Dr. Denman,
as well as every other high-minded and benevolent man, has come
very near the truth; but, alas,  his opinions  must be opposed and
condemned, lest they should become known to the discerning people
of this Republic,  and  our famous accoucheurs should be compelled
to seek a living in some other way.   But again, says Dewees, page
288, "Dr. Osborn carries his reluctance to  the use of forceps still
further than Dr. Denman, but he has not done equal mischief, be-
cause  his authority was not equal."   Refusing to do mischief is to
do it, eh!
   "1 was once called upon to determine whether  any thing could
be done for a newly born child, which had been most unskillfully'"
[but scientifically, and by a regular M. D.] "delivered by the for-
ceps.   The frontal bone was severely indented by the edge of the
 forceps; and one eye  entirely destroyed, by the extremity of the
 blade being  fixed upon it; yet it was  born alive.   The case was, ot
course, a. hopeless one; and the child fortunately died in a few hours
 after its birth.  I was once shown a blade of the forceps,  which
 had been excessively bent,  by  an endeavor to make it lock!   In
 this case, the forceps  were exhibited  in triumph"  [By  whom?  Oh,
 a scientific M. D.]  "as a proof  of the great difficulty the  operator
 had to encounter, in  effecting  the delivery; and, as an additional
 evidence of this, he declared/that no strength was sufficient to de-
 liver the head, as both his (and he was a powerful man) and that of
 another practitioner [equally ignorant,] were unavailingly exerted,
 alternately and  collectively.   He at last  delivered her with the
 crotchet, after having experienced  very great difficulty in with-
 drawing the bent  blade of the forceps.   I have seen the whole
 length or nearly the whole length of the frontal bone cut through,
 by Sneofthe sharp edges of the  forceps, by an effort  to compress
 it; and.  in  another instance, I have seen the parietal bone in the
 same wretched plight, from the same cause."   Dewees, pages ~J1
 and 295.                                   ,  ,      ....
   "I  was once called to a poor woman who had had a considerate
 portion of the internal  face of the  right labium removed, by its
 having been included in the joint of the short forceps.   Dewees,
 page 299.                                        .  .  ,  ,.,
    "I  am aware that many respectable practitioners are in the habit
 of introducing the hand and bringing down the feet, mall  eases ot
  breech presentation; but I am  abundantly convinced that, as* 
214
general rule, it saves the mother nothing, and that it is highly dan-
gerous to the child."  Page 320.
  "In difficult labors, arising from a rigidity of  the os uteri, there
is an unnatural resistance to be overcome; and to effect this, un-
fortunately, mechanical and other equally improper means are re-
sorted lo, which, so far from  fulfilling the intention in view, often-
times increases the very evil, and  converts an otherwise safe labor
(were it properly managed) into one of great danger, or at least
into one of great tediousness."  Page 356.
  "When the os uteri remains unyielding  for a long time, it  is an
evidence that the  natural processes, which so beautifully, kindly
and safely effect the change, have, from some cause or other,  been
interrupted.  And, though  mechanical force  may be made to
usurp the organic  function, it nevertheless will always be at the
expense of the health, or even the integrity, (be this more or less,)
of that portion of the uterus to which force is applied."  Page
356.
  "I have lately been informed from very good authority, (namely,
a man to whom one  of these cases occurred,) of the  three unhappy
instances of error  in  forcing delivery  too soon, which happened
some years ago to  three surgeons of established reputation, who,
from the success they had met with in delivering several who were
reduced to the last extremity,  were encouraged to attempt it where
but very little blood  had been lost, (by  flooding) in hopes that their
patients' constitutions would suffer less injury, and their recovery
be more speedy, which, till  the experiment was made, was a very
reasonable supposition—-the women  died, and  they seemed con-
vinced thai their  deaths were owing to the violence of being de-
livered too soon, and not to the loss of blood, or any other cause.'1
Page 290.
   "There appears to be excited, at the present time, a passion for
novelty in  the treatment of uterine hemorrhage; but no remedy or
means that has hitherto reached  our knowledge, appears to have
any decided efficacy in themselves, in arresting this discharge.
Both therapeutical and mechanical  agents are anxiously sought
after; and  each inventor of a new  mode  of fulfilling an old* and
never-lo-be-deserted  principle, vaunts  his supposed improvement
with a confidence  that almost bids defiance to scepticism, until trial
is made of its boasted  powers; it is then found to have no superior-
ity over the remedial agents already  known, and heretofore relied
upon.  In all  these attempts, it appears to  be  forgotten,  that the
 only indication in a threatening hemorrhage, after the delivery of
 the child, is, to procure  the  tonic contraction of the uterus; yet,
 some of the means had recourse to, arc but ill calculated for this
 end. Of this kind, are "transfusions," the "filling of  the uterus with 
215
rags,"  the Compression of the aorta,"  "injecting the  umbilical
vein," &c. &c.  And the therapeutical means, such as the intro-
duction of vinegar or the acid of lemons, have no other power per-
haps upon the flaccid uterus, than as a kind of vehicle to the me-
chanical agents, if we may so express it; and a variety of these can
unquestionably be employed  with at least equal  success without
their assistance."
   "Messrs. Gorat, Evart, &c, propose the immediate application
of the citric acid to the internal surface of the uterus, with a view
to arrest hemorrhage after  delivery.  They describe this method
in the following terms; they strip a lemon  of it3  skin, and, having
rut one end of it, they carry  it into the uterus, and then express
the juice on the sides of its cavity.  They allow the decorticated
lemon to remain, until  the irritation produced by the juice, and the
foreign body, excites the uterus to contraction, which, constringing
the tissue of  that organ, stops the hemorrhage, and the lemon is
expelled with the coagulum formed about it.
   "This is one of  the  late improvements in the treatment of  this
formidable  complaint, and to  which we have just alluded."   De-
wees, pages 410—'II.
   "A woman aged thirty-two was taken  in  labor with her  first
child, on the 12th of February,  1825.  The pains soon ceased,
and, on the 15th, M. Bedel, physician at Schirmack, was consult-
ed, who speedily  delivered her with the forceps, of a dead child.
The hemorrhage was so considerable, that  he determined to deliver
the placenta immediately;  but the uterus did not contract, and the
bleeding continued, together with tremblings, syncope, cold sweats
&c.   Irritation on the internal surface of the uterus, cold water to
the abdomen, injections into the uterus of cold water and vinegar,
were unavailing."
   "Plugging the vagina, and also the uterus, were now resorted to,
as the only remaining means of safety.   The uterus was filled  with
rags, for fear the patient could not sustain the loss of blood neces-
sary to fill the cavity; while a  methodic compression  was at the
same time made upon  the abdomen.  This  is another instance of
attempting to arrest an alarming  uterine hemorrhage in a  new
w#."'  Page 413.
   ^An' instance is recorded on pages 436, '37 and '38,  Edinburgh
Practice, where the bladder was opened and a hole made into the
rectum, by the force employed  to hasten  delivery.  The  woman
lived  forty years with a constant dribbling of the urine, and in a
 most deplorable situation.   The writer remarks "that the wonder-
ful power of the  constitution to support life under the  pressure of
such a train  of accumulated injuries, seems truly astonishing; and
 that  accidents of this  nature, are by no means uncommon.   [We 
216
 saw a case in Virginia,  have heard of several in Ohio, one, in
 which the urethra was cut off and separated, so that the urine
 passed through the vagina!]  And what may not be expected from
 an unskilful use of instruments?"
   I ask. How happened it that this "scientific accoucher" was un-
 skillful?   if he could not use  them  skilfully, who can?  None!
 None!! None!!!
                   Of Puerperal Convulsions.
   "This truly  frightful disease may attack a woman, perhaps at
 any period of utero-gestation; but more frequently after the sixth
 month.  The causes assigned for convulsions have been various;
 some have supposed  they arise from some peculiar irritation of the
 uterine fibre during pregnancy; others considered them truly epi-
 leptic; while others regard them as nervous or hysterical.
   This difference in views, necessarily leads to a difference in treat-
 ment—the first, makes safety consist alone  in immediate delivery;
 the second, forbids this practice;  whilst the third relies upon  the
 use of opium.
   To be successful in the  management of  this complaint, it is ne-
 cessary that attention  be  paid to the species of the disease  with
 which the woman may be attacked."   Dewees, page 452.
   Here follow  cases quoted at length from  this learned Professor,
 which show the practice as taught in the  College at  Philadelphia:
   "Mrs.---— aged seventeen, pregnant with her first child, com-
 plained, on the  20th of.Iuly, 1824, of slight pains resembling labor;
 and  also a  generally diffused pain, but severest in  the limbs; so
 much so, in these parts, as to render her almost incapable of re-
 moving them; some fever,  though slight.  Dr. Shaw, under whoso
 care she was, ordered her to be  bled and  purged.  29tb, 3 o'clock
 P. M. she was attacked with labor pains; at first they were slight;
 but had much increased by the time the Doctor was called.  Upon
 examination, the os uteri was found a little  opened; at 8 A.  M.,
 she was attacked with  strong convulsions,  which were repeated
 about every twenty minutes.  She was bled about twenty ounces;
 convulsions continued to recur.   At ten o'clock the same morning,
 the os uteri was pretty well dilated;  and, from a belief that con-
 vulsions were at least maintained by uterine distention  and irrita-
 tion, Dr. Shaw  ruptured the membranes, with a hope of tranquil-
izing them.
  At this time I was called in. I found the patient totally insensible
to any sensibility after the second fit; breathing with much difficult
ty. and snoring pretty loud.  The pulse  was full,  frequent and
hard, and  the skin hot.  Upon examining per vaginam, the head
of the child was found at the lower strait, presenting with the pos-
terior fontanelle behind the left foramen ovale, and entirely within 
217
the uterus—up to this time, about thirty-five ounces of blood were
drawn.   She was attacked with a fit  soon after  examination.
There was something remarkable in the character of the convul-
sions: her eyes were but little agitated; the pupils much contract-
ed; her face was  but little suffused; there  was less frothing at the
mouth, and less sibilation than is usual.
   I applied the forceps, and delivered her in a few minutes with-
out the slightest difficulty.   She remained  after this for two hours
without a fit; at the expiration of this time, they recurred about
every half  hour, until 9 o'clock P. M. when they ceased, huiwith-
out any amendment in the  condition of the patient; she appeared
completely apoplectic  She continued much in this situation until
six o'clock  in the evening of the 31st,  at which  time  she  died.
Leave could not  be  obtained  to inspect the  body.  She  did not *
complain of headache until the 29th, and  this but a short time be-
fore she became convulsed.  She lost, altogether, [only] eighty-two
ounces of blood; was freely purged,  and once cupped."   Dewees's
System of Midwifery, Page 455—'6.
   Case 11.  Mrs.----, a delicate small woman, twenty-three years
of age, pregnant with her first child, was attacked on the  1 Oth of
November, 1809, at 8 o'clock  A. M. with epileptic convulsions.  I
saw her in an hour after the attack; previously to my seeing her,
she had had three fits, and a fourth  was just  coming on as I enter-
ed the door.  Three or four days previously to the attack, she com-
plained of a violent jaw or toothache, which was looked upon as
rheumalic, and no attention  was paid  to it.  On the fifteenth,
that is, the day before her illness, she was seized with an extremely
acute headache; and,during the night,  and just before the onset
of the fits,  she was violently sick at stomach, and vomited a large
quantity of thick glairy mucus; immediately  after this, she said she
could not see, and was, in a few  minutes more, seized with convul-
sions.   She labored under these violent and terrific symptoms in
an extreme degree.   1 instantly  bled her from a large orifice in
the arm, thirty-five ounces; this, as I have just said, was at 9 o'clock
A. M.   Eleven o'clock, had two fits during my absence, and was
now in the third—bled twelve ounces.   Ordered a strong infusion
of senna as an  enema—os  tincoe a  little opened, but rigid.  One
o'clock P.  M.;  had two fits since last visit; injection operated; pulse
still active; face flushed;very restless and uneasy, arising, I  believe,
from tlie pains  in the uterus—os tincoe rather more  dilated—to be
bled by cups 19 ounces,  Four o'clock  P. M.; one fit; cups drew
well; senna operated"again two  or three times; very comatose—or-
dered  cold applications to the head by  means of a  large bladder,
partly filled with water &nd some ice—blisters to the legs.   Seven
o'clock P.  M.;  no fit since  last visit; pulse very active;  very rest- 
213
less, constantly trying to get out of bed; os tincoe not much more
dilated; took ten ounces of blood; senna  continued  to operate.
Ten o'clock P. M.; no fit since last visit; pulse still too active; took
ten ounces more of blood; cold applications."  [Only seventy-seven
ounces of blood taken from a very "delicate, small woman" in 13
hours!]
  "Seventeenth.   Mr. Purnell, now Dr. Purnell, one of  my pu-
pils, staid all night with the patient.' He said she had one fit, after
which he took ten ounces of blood; senna continued to operate.  At
10  o'clock A.  M., I saw her; stupor much less; recognized her
friends, and asked some questions; she did not look so well, a slight
squinting was observable.   Seven o'clock P. M», better; pulse less
active; but had three stools since the morning visit.
  Eighteenth.  Mr. De la Motha, now Dr. De la Motha, another
of my pupils, staid with the patient last night.  She passed a good
night, was tranquil and rational; no return of fits during the night;
two stools.  Saw  her at 10 o'clock A. M.; skin dry and hot; face
a little swelled, but perfectly collected.  Eight o'clock P. M.; face
more swollen, and a little flushed; much headache, pulse very  ac-
tive; great thirst; took ten ounces of blood—much relieved by it;
pulse softened, and diminished in frequency; cold applications con-
tinued.
  Nineteenth; passed a good night, free from  fever and pain; no
return of convulsions; bowels rather tardy; ordered senna  tea.
Continued much in this condition until  the 23th, twelve days from
the first attack; this morning was seized with brisk labor pains, and
was soon delivered of a dead child.   From tlie degree of putridity,
it is presumable that the child died early in or before the attack*
There is by no means any certain proof that the child died before
this."   Dewees, pages 447—'8.
  [Only ninety-seven ounces of blood taken in three days!   Really,
what did kill the  child?]
  Case 2.  "Mrs.----, aged twenty-six rears, pregnant  with her
first child—a large plethoric, robust woman, was, on the  ninth of
September,  1811,  about  five o'clock A.M.,   taken with  labor
pains, and sent for her midwife; before We midwife arrived, she
was seized with terrible convulsions, and I was immediately  sent
for.  The fits were frequently repeated, and were, from their ex-
treme violence, very threatening; her face was immoderately swell*-
ed; her eyes fairly  protruded  from their sockets; her tongue terri-
bly wounded,  &c.  I instantly bled  her from  the  jugular  vein
more  than forty-eight ounces; examined  her and  found labor ap-
proaching; ordered a brisk injection; saw her two hours after; had
had several severe fits; pulse extremely active;  labor advancing;
bled her  twenty ounces; injection  repeated; a stream  of cold water 
219
was poured on her head during the interval of the fits.  Eleven,
o'clock A. M.; fits not so severe, but pretty frequent; pulse still,
very active; took [only] sixty four ounces of blood more; apparently
much relieved; lay  more quiet.  One o'clock P. M.; had had two
or three fits; very restless; mourned every few minutes; desirous of
getting from the bed; bled her twelve ounces; examined, and found
the head low in the pelvis, and delivered with the forceps; she had
two or three fits after delivery, and remained insensible to every
tning for forty-eight hours.   She now began to  show some signs of
returning sensibility; was bled twice in the interval—[How much,
Doctor? sixty-four ounces each  time?]—cold was  applied  to the
head, and legs blistered; she was  purged  freely with senna tea.
After this she gradually recovered  her  senses.   She was left com-
pletely blind for two weeks; she then began to see imperfectly, but
was six weeks before she could distinctly discern objects.   It may
not be amiss to observe, the child was still living!"  Page 460.
   fJDoes any one wonder that the Doctor was surprised to find the
child living?  If nature can endure this,  what can she not with-
stand?  Fits are efforts of nature to recover from prostration; is it
any wonder she should make them  as long as she is able, and cease
them when all her strength is exhausted by bleeding?  No; but it
is a wonder that she should so often recover after the exercise of
this barbarous practice!]
  Case 4.  "Mrs.-----was seized, at 1 o'clock P, M., November
10th, while  at the ironing table, with vertigo.  She fell, and was
immediately attacked  with  convulsions.   1  was living near, and
was instantly  sent for.  I found her  laboring  under  the general
symptoms of this disease.   I bled her from both arms at once, to
Ihe amount of about sixty-four ounces.  She appeared for  a time
much relieved; that is, the convulsions were abated.  An injection
was ordered, which operated well; about an hour after the bleed-
ing, her pulse rose very much; her breathing was more labored and
stertorous, and some convulsive twitchings over the body.   Fear-
ing a repetition of the convulsions, I again tied up the arms, and
took about twenty-five ounces more of bleed; this seemed to moderate
the symptoms!
  Four o'clock P. M.  the convulsions were renewed with  consid-
erable  violence-—twenty  ounces more of blood  were taken; cold
water was poured upon the head; she was more tranquil, but not
less comatose.   Six o'clock, P. M., had had several fits, but [for
want of power] not so violent as at first; pulse still  too active; took
eighteen or twenty ounces of blood.  As the pulse was considerably
reduced, applied a pair of blisters to the legs, and sinapisms to the
feet."   [Really, after taking one  hundred and thirty ounces of
blood in the space of five hours, I should think it  would  do to begin 
220
  to warm the feet with a mustard poultice.]  "At ten o'clock she
. was sick and made an effort to vomit.  At 6 o'clock next morning
  1 was suddenly called, as her breathing was becoming more labo-
  rious and loud, and face more flushed, with some convulsive agita-
  tions; pulse rather too active; took ten ounces of blood and applied
  a large blister plaster between the  shoulders.   She gradually re-
  covered her recollection,  but remained until some time after the
  delivery (one month after) with imperfect vision,  especially  with
  one eye.   She was, for many years  after this, subject  to  violent
  head-aches, which must be removed by bleeding.  [The cruel prac-
  tice that first caused it.]   Page 401.
    Case 5—"Mrs.-----, October 5th, 1803, had been in labor sev-
  eral hours; she had  every  appearance of being happily delivered,
  when, during a strong pain,  she instantly cried out "my  head!"
  and immediately fell into convulsions.  She was under the care of
  another physician, to whose aid I was instantly called by his own
  desire; the convulsions were strong and  often repeated; she was
  largely bled; on examination, the child  was found  to be  far ad-
  vanced, and was speedily  delivered  by the aid of forceps; the con-
  vulsions, however, continued in spite of every exertion  to relieve
  them, and she died in about three or four hours after the attack."
  Page 462.
    [I am astonished, Dr. D., that a man, so accustomed to use the
  lancet,  with an assistant equally skilled, should let  a  woman die
  because he could not let blood fast enough  to save her life, when
  he had three or four hours  to  do  it in.   Why did  you not  open
  both jugular veins and "tie up both arms" and open their veins;
  and, if that was not enough, you should have opened the carotids
  and brachial and femoral arteries, and then, it appears to me, you
  might have let  blood enough to save her life, as you assert that
  blood-letting is "the cure for convulsions."  If your theory is true,
  and your statement is correct, it follows that this woman died be-
  cause you were too indolent to let blood fast enough to save her life.
  You should have cut her head  off, if you could  not have let blood
  fast enough without, rather  than  had her die in  your hands, be-
  cause you were afraid to act according to your principles in blood-
  letting.]
    Another Case.—"I was  called on the 16th of April, 1810, lo Mrs.
  ----, said to be in strong convulsions.   I was from  home  when
  the messenger came, but went as  soon as it  was in my powrer.
  When I went  into jthe sick  chamber. I  found Dr.----with the
  patient.   He told me "Mrs.----had been  attacked about two
  hours before with convulsions, and was in the ninth month of preg-
  nancy; that, previously to the attacks of the fits, she had complain-
  ed of violent pain in the forehead, which she told her  husband she 
221
could cover with her  finger.   She was now  lying  senseless and
without motion on the bed; she breathed very heavily, and snored
loudly—the pulse  frequent and  small, and the extremities cold.
I enquired  what had been done,  and was informed by Dr.----he
had given her, twice, sixty drops of laudanum at a time; and that,
since  the last dose, she had had no fit, and was, in his opinion, very
much  better, requiring nothing but sleep to restore her.   1 told him
very plainly, that I thought  he had mistaken the patient's case,
atid had, in my opinion, scaled her fate by the use of laudanum.  He
appeared alarmed but not altogether convinced.   We did every
thing that  we thought might  be  useful; but all exertion was un-
availing, and the patient died in  about  three hours."   Page 463.
   [All the convulsions, in all the foregoing cases, might have been
relieved by a few doses  of the 3d preparation of  lobelia, and the
patients soon cured.]
   "Examinations of women who have died during  labor, or soon
after delivery, are not so frequent as  their importance seems to
demand."  One of the principal reasons  why they are not more
frequent, is to be attributed "to  the disingenuous  conduct of the
attending physician himself, who may not wish the cause of death
to be ascertained, lest it should do injury to his character, either
from his not having known or suspected the true one, or by expo-
sing some lesion for which he  fears  he would  be held accountable."
Page 466.
   "It is almost universally believed, that an  undue force applied
to the cord for the delivery of the placenta, is the principal cause
of the untoward and too fatal accident,  the inversion of the  ute-
rus."  Page  496.
   Presentation of the Arm.—"There is no presentation that give3
rise to so much bad practice, as the presentation of the arm; for its
mechanism is generally but very ill understood.   The  arm itself,
is almost constantly supposed to offer great difficulties, by its  pre-
sence in the vagina; hence it has been  scarified, twisted off, or am-
putated, to the disgrace of the profession.  It is true that, in most
instances,  these severe  operations have been performed after the
supposed death of the child; but, in many other cases, we fear that
the life of the child has not been  taken into consideration.   In arm
presentations, the amputation, or other operations upon it, should
always be  forbidden; especially as  the  signs of death are, in many
instances, equivocal, as the  evidences  of life are obscure.   Dr.
Chapman  relates an instance, where  an accoucheur amputated
the arm on the presumption that the child was dead; it was how-
ever, alive, and lived to manhood.  And, more recently, a surgeon
was sued for  amputating the protruding arms of a child which he
supposed had been long dead, but proved to be alive." 

   "It is therefore best not to meddle with the descended arm; for,
 if turning be attempted, it offers no difficulty to the passage of the
 hand."   Page 508.
   ". As regards turning, il must not be disguised, that it is an oper-
 ation of hazard to the child, even under the most favorable circum-
 stances of the uterus or position  of  the child;  and,  of course, the
 risk will be in proportion to the departure from the best conditions.11
 Page 515.
   "During labor, the uterus every now and then is ruptured; and,
 perhaps, even oftencr than at present we dare assert.  JNometimes
 this accident is concealed, from ignorance, and, at other times, from
 design; hence, many cases must occur of which  the public remains
 uninformed.   Concealment often arises from a  previously adopted
 theory upon the subject, and the supposed risk of professional repu-
 tation."   Page 535.
   "It  must, however, not be concealed, that  these instruments
 (forceps) are not safe, under the circumstances we  arc now con-
 sidering, (a deformity of the pelvis,)  but in the hands of a few; and
 are only rendered so to them, by their superior professional attain-
 ments, and the long habit of using them.  To the inexperienced
 practitioner, they should be entirely forbidden; not  only because
 they may destroy the child, but also because the mother may be
 severely or irreparably injured by their use."   Page 552.
   [It seems then, that those do  not know  how to use the forceps
 "scientifically" who have not been  in the habit of killing people
 with them, by way of acquiring skill "in their use!   Who are the
 victims of this quackery?  The poor deluded patients  who have
 resorted to the hospitals and the  alms houses, and others  who are
 the first subjects of every upstart doctor's obstetric skill.]
   "The most difficult operation  on  the living subject, is the scien-
 tific application of the forceps, when the head of the  child has de-
 scended so low as to occupy the vagina.
   "How much greater eclat do  most of the operations  of surgery
 obtain, than a delivery by forceps!  Yet we  do not fear,  nor do we
 hazard a contradiction when we say, there is no operation  in all
 surgery, that is not of more easy  attainment than the rational and
just application of the forceps.  We feel that it  hi proper that some
 delicate effort should be made to  elevate the character of the well
 instructed accoucher, and lo have a just value set upon the most
 difficult operation, in the range of medical science."   Page 555.
   [It i3 doubtless best to  have a law passed that only one in a hun-
 dred gentlemen of the faculty, shall ever use this  scientific instru-
 ment;  that he be called to every case in which nature is a little
 tardy, and receive from 10 to 500 dollars, "according to  the ability
 of the patient," for bruising the head, lacerating the labia?, or tear- 
223
ing out the capilli &c. &c.!   Dr. D. should be made President of
this company of "celebrated accoucheurs!"]
   "The two implicit reliance upon certain  of the signs which are
said to characterize the  death of the child in  utero, has been the
cause of the immolation of thousands."  Page 614.
   "We may with much truth declare, that the inertia of the ute-
rus is very apt to follow the use of such stimulants as opium, oil of
cinnamon, volatile alkali &c, or the mechanical stimulus of the
forceps, vectis, or the hand.   Thus  we witness hemorrhage some-
times follow the use of either of the remedies just named, though
they may have been  successfully exerted, as regards the mere de-
livery."   Page 616.
   Secale  Comutum.—"More children, I am satisfied from  what I
have seen and heard, have already perished by the injudicious use
of ergot, during the few years which have followed its introduction
into the practice of this  country, than have been sacrificed by the
unwarrantable use of the crotchet for a century past."  Page 621.
   "We have known the 'ergot' given where the pains were natu-
ral and powerful, to  render  them more effectual, when the uterus
became exhausted by  being thus  unduly urged; and the only  re-
source ultimately has been in the forceps."   Page 625.
   "The too free use of the 'ergot' in a certain physician's practice
in this city, has occasioned very very many cases of prolapsus uteri."
Page 626.
   "Contusion, laceration, sloughing, decapitation, dislocation, frac-
tures—these are the dreadful evils to which brute force may give
rise."  Page 185.
   Elizabeth Clark, aged 30,  was delivered (scientifically) and soon
after complained of sickness, and had a slight vomiting;  but, by
means of an anodyne, these symptoms abated, when she was im-
mediately affected with universal coldness over the whole body,
which  also abated by the application  of warm irons to the feet.
Next morning at 2 o'clock,  she complained of  considerable pain,
for which she was bled, and  an injection administered, but without
effect; for her pain increased, pulse became frequent, she was hot,
and complained of drought.  At 7  P. M. same day, the injection
was repeated, but with no  better success; eight  ounces more of
blood were taken  from the arm; a third injection given which also
failed to evacuate the foeces, and the pulse rose to 128.  Her pulse
being fuller at noon, she was bled  again.  At 3  P. M. her pulse
rose to  140.  She was much oppressed and complained of faintish-
ness, but the pain still  increasing,  twelve  ounces of blood were
taken away.  At  8  P.  M.  her pulse was small  and feeble, she
looked ghastly, and soon expired."   Page  453.
   Thus, in the space of 18 hours this delicate lady was bled large- 
224
 ly four times, had five injections administered, took medicine con-
 stantly at "short intervals,"  and was in constant suffering, until
 death'closed the dreadful scene.   She had a long and tedious la-
 bor and was greatly fatigued, and this is merely the closing scene.
 Now what was the cause of her death?  Her long, tedious labor,
 or the treatment after parturition?  What lady, setting aside the
 weakened and exhausted condition of the individual in the above
 case, could bear four large bleedings, and five scientific injections,
 besides quantities of poisonous drugs, in the short space of eigh-
 teen hours?
   "I was called," says Dr. Smcllie, "to a woman who was above
 eight months gone with her fourth child, when she was taken with
 a violent flooding which  almost filled her chamber pot.  When I
 came, the flooding was stayed, she was easier and not much weak-
 ened.   I told hdr friends the  danger to which she was exposed, if
 the flooding returned, and exhorted them, in that case, to send for
 me immediately,  //; the mean time I ordered ten ounces of blood to
 be taken from the arm!"   The flooding returned  (of course,) the
 Doctor was called, when he says, "I could scarcely distinguish the
 pulse; her extremities were cold; a cold sweat spread  all over her
 face and breasts, and she  could scarcely speak.  I immediately
 ordered a cordial, gave her some* warm red wine.  Her blood ves-
 sels were much emptied.   I ordered ligatures above the knees and
 elbows, and warm cloths  and  bricks to her feet.  All these steps
 were taken in order  to recover her strength and spirits; but, before
 my directions could  be put in  practice, she expired.  Page 4(i3.
   "Treatment of Elizabeth Thompson, aged 32, after she had en-
 dured  much suffering and been delivered  'secundum artem.,'  Af-
 ter she was delivered, on Monday night about ten o'clock, an opi-
 ate was administered, after which her pulse  beat 100  strokes in a
 minute.   On Tusday 3 grains of calomel, and one grain of purified
 opium were given, pulse 108.   Wednesday  at 7 A. M., pulse 120;,
 five grains of calomel were ordered.  At 4 P. M.,  pulse 144; half
 an ounce of castor oil was given, and an injection  given in which
 were two drachms of tobacco.   At 9 P. M. same evening her pulse
 was 140; five grains of calomel and one  grain of purified opium
 were ordered and a blister applied lo the abdomen.
  Thursday, 7 P. M., pulse 150.  Till  then the antiphlogistic re-
 gimen  had been  pursued, but  a stimulating one  was adopted.  A
suppository of soap was ordered.  At 2  V. M. her pulse was  16');
ten grains of hartshorn and  ten grains of musk were ordered, and
were to be repeated in four hours; soon  after which her pulse was
exceedingly weak and feeble, and she soon died.
  Post mortem examination revealed gangrene in the cervix uteri,
and  the physician gravely  concluded that was  the cause  of her 
                             225
                         i
death!  Page 170.  1 think any young lady would have the gan-
grene somewhere  if she should submit to such treatment for three
or four days!  The above course is  recommended as scientific by
the first accouchers in the world, and a rule  to direct the  student
in medicine.
   A Scientific Specimen, of the way to make Puerperal Fever.—"All
women, during and immediately after delivery, lose more or less
blood, from the quantity of half a pound to that of a pound  or even
two; but, should  it exceed this,  the  patient is  in great danger of
her life."  Page 528.
   "A lady aged  28, and of a delicate habit of body, was delivered
on the 7th of July.  The birth was not attended with any  danger-
ous or uncommon circumstance.   She was easy after delivery and
rested well at night.   The next (8th) day she complained of head-
ache, which  was  not relieved.  9th, headache worse,  with acute
pain in her right side; and, in the afternoon, there was great in-
ternal heat across the breast and stomach, with coldness of the ex-
tremities.   Her  pulse was exceedingly  quick, headache  violent,
tongue white and dry &c.  Half an ounce of blood  was taken
away, and antimonial powders given, and ordered to be repeated.
A clyster  was administered, and bladders of warm water put to
her sides and the soles of her feet.   There was  no abatement of
the pain that night."  [No wonder, Doctor, after you had taken
from this  lady of "delicate habit of body" half a pound of blood
and poisoned the remainder with antimony.  But  let us see what
must be done next.]  "10ch; pulse  full, hard and frequent; skin
dry, and respiration difficult and painful.  Haifa pound of blood
was again drawn,  antimonial powders repeated every four or five
hours, and a blister [of poisonous  cantharides]  applied.  She was
ordered to  drink  plentifully  of common  emulsion with  nitre!"
[Well, Doctor, how did she rest after this  kind treatment?]  "She
had no sleep lhat night."
   11th-   Is she  not easy and well this  morning, Doctor?   "Pain
in the head and difficulty of breathing still  increased."  [What
next!]  "Nearly another half pound of  blood was taken.  At this
time she began  to be troubled with cough, was much  oppressed
with  phlegm, and expectorated with  great  difficulty.   Saline
draughts,  emulsion of nitre, clysters &c. were repeated.  At night
all the feverish symptoms returned with violence.  She  was again
bled as  before."   [A pretty ..day's work for "a delicate lady," I
think.]
   "12th.  A little better in the morning;  but, in the afternoon,
the pain returned, with difficulty of  breathing,  for which she was
again bled."  Page 470.
  [Now, Doctor, you have, yourself, taken more than  twro pounds
             15 
226
of blood from a "delicate lady," after all she had lost in parturi-
tion, which you say is always from a half to two pounds, at the ut-
most, and that, should more than this quantity be lost, the "patient
is in the utmost danger of her life."   How shall I reconcile such
statements  with the treatment?  If I believe your fir3t statement.
I must believe that all this suffering, pain and distress, were caused
by your abominable treatment.]
  "In  the Westminster new Lying-in Hospital, between the 30th
of November and 15th of May, 63 women were delivered, nineteen
of whom had  the  child-bed fever,  of  which number  13  died."
Page 477.
  The reader may  wonder why I give so much testimony from the
professors in Edinburgh, London and Philadelphia.   I answer, be-
cause these colleges are the three  points from which radiate  the
principles and practices  of medicine that govern the  conduct of
practitioners, wherever the English  language is the vehicle of
thought.   If such  be the practice of these great professors, what
must be that of their satellites?  Have I not redeemed my pledge;
viz. to  give such a specimen of medical iniquity in obstetricy, as to
deter from a regular process, every sensible lady in the land?  Still
the stock of materials is scarcely broached!
  Many of the above extracts  are condensations of more prolix
accounts, by the omission of unimportant matter,  to bring them
within our space; but no injustice has been done lo  the authors, as
may be seen by reference to the original works.
                        RECIPES.

  Conserve,—or Woman's Friend.  To a pound  of fresh blossoms
of holly hock well bruised in a mortar, add four pounds of pow-
dered white sugar, pound them together till well mixed; then add
of poplar bark, bay berry, golden seal, nervine, cloves, and cinna-
mon, finely pulverized, each 2 oz., cayenne 1 oz., and bitter root i
oz., oil pennyroyal a table spoonful, mix and knead in a mortar till
it becomes thick like dough.  If too soft and moist, add more pop-
lar and gold seal; if too dry, more holly-hock flowers which should
always be carefully cleared of worms or bugs, calyxes or dead pe-
tals.  Roll it out thin, and cut it into  cakes to dry.
  This is a valuable stimulant and tonic to be used whenever these
effects are wanted.   As  the taste is agreeable,  patients  will be
quite  willing to take it.  Slippery elm mucilage will answer wh; n
holly-hock cannot be obtained.
  Couen  Powders.—Hourhound,  golden seal, unicorn, skunk 
227
 cabbage,  boneset* bayberry—nervine,  4 parts each;  cayenne,
 cloves and cinnamon 1 part each; lobelia seed 4 part; loaf sugar 12
 parts, all in powder.  Mix tea thick dough with mucilage of slip-
 pery elm, holly-hock blossoms or comfrey root.
   Cough Syrup.—See cough powders—The best thing for a cough
 is, first, a course of medicine,  and then close  attention  to  the ac-
 tion of the surface.   This directs the determination from the lungs,
 and leaves them to recover, but for present relief, the cough  pow-
 ders may be made into a syrup.
   Composition.-*^ parts bayberry, 1  part ginger, 1 part golden
 seal, 1-16 part each of cayenne  and cloves.   Shake together in a
 corked bottle till well mixed.   Dose a tea spoonful, sweetened to
 the taste.
   Other canker medicines may  be used where bayberry  cannot
 be had.   The red leaved sumach bark and leaves are excellent.
   Spice Bitters.—Poplar bark, golden seal, balmony and bone-
 set, equal  parts, cloves i part, all in powders, mix and sweeten to
 the taste.  Dose, a tea spoonful, to be taken in cold water.
   Cholera or Dysentery Syrup.—Equal parts of poplar,  bay-
 berry, golden seal and hemlock,  boiled, strained and pressed,  then
 boiled down  very strong and added to  the same measure of pow-
 dered loaf sugar.
   ANOTHER.-i-Grape  root bark,  (common sloe,) root of geranium
 muculatum, (crow foot,) root of running black berry *briar, equal
 parts, decoct, strain,  and  sweeten as above.   After an emetic or
 two, and the vapor bath, these preparations are a  sovereign  cure
 for cholera, dysentery, flux, summer complaint &c, and children
 like them.  Blackberry, raspberry and grape jelly  (not the seeds,)
 are excellent food as  well as medicines  in these cases.
   Eye Water.—A  weak  decoction  of willow  bark, (yellow
 ozier) or white maple bark, after the inflammation has  been re-
 moved by a poultice of slippery elm, cracker and a little lobelia,
 or a course of medicine.
   Tooth  Powder.—Fine bayberry, and golden seal, equal parts.
 Or fine powder of sumach leaves or bark, or of yellow poplar.
   Stimulant Bitter.—The bark of the root of Ptelea trifolia, or
 prairie grub.  Also prickly ash bark.
  Worm Syrup.—Take the most intense of our bitters, as bitter
root, butternut, boneset, poplar, balmony, meadow fern, &c,  and
make a decoction, strain, press,'and boil  down pretty strong. Add
as much loaf sugar.  After cleansing the system with courses, take
on an empty stomach, and drink freely of slippery elm tea.   Many
thing* are recommended for worms, but no specific is yet found.
Our system fails here,  because it  "wont  kill," even these vile little
vermin.  But, while calomel and arsenic kill worms, they kill the 
                            22S

patient too!   A strong tea of peach bark, leaves or flowers is good,
and we have used a tea of the leaves of the pride of China with
success.   We have also cut them to pieces by giving a powder of
burnt corn cob in molasses.  Wormseed oil or spirits of turpentine
in tea spoonful doses, often cures.   But we generally give courses
and use fhe above syrup,  and we have failed  in but one cas",  and
that was a consumptive given over by three M. Ds. before we  saw
it.  A medicine that will  kill  worms  and not injure the patient,
we fear  is not  yet  known, though our course of removing them
alive, by  emetics, injections, and the above syrup, is pretty sure.
  Balsui or Honey.—Simmer one part of Canada balsam, or bal-
sam of fir, with three parts of good honey.   Dose, a tea  spoonful
on an empty stomach,  for healing internal sores, also for applica-
tion external swellings or vvounds.  Mucilage of slippery elm alone
is good for internal sores and inflammation.
  1 have avoided here the use of  alcohol in all  cases, believing
that it is unnecessary as well as injurious.  A pound of gum myrrh
bruised with an oz. of bayberry or poplar bark and an oz. of cay-
enne, mixed, are as good to take on the stomach as No. 6, and in
no way objectionable.
  Elder Salve.—Make a strong decoction  of the green bark of
the sweet or white pithed  elder, add six parts of mutton tallow and
bees wax, and 1 of  balsam  of fir,  simmer till done sparkling and
box up for use.  If too hard add more tallow and balsam, if too soft
add  more wax and a  little rosin.   This  is an excellent healing
salve.
   See stimulating an antispasmodic liniment.

                        Spiced  Bitters.
   4 Parts each Poplar and Golden Seal,
   6 Parts Bayberry,
   2 Parts each Prickly Ash and Cloves,
   3 Parts each Unicorn and Nerve Powder,
   1 Part Cayenne,
  25 Parts Loaf Sugar, all finely pulverized and well mixed, make
good Spiced Bitters.

   Mr. Editor:  Subjoined, I send you several recipes, which I am
satisfied many of your readers will be happy  to posse.-s.   To all of
them I can add, probatumest,  [they have  been proved.]   You can
publish them whenever you have Space unoccupied or any matter
ypu may consider of less  importance.
     Consider me your friend,               A. C. LOGAN.
   Sommersville Farm, Pa.

        Stimulating Embrocation for contracted sinews fyc.
   Oil Monarda, (horsemint)                           2 ozs. 
»
229
Oil Sassafras	3 ozs.
" Wormwood	li "
" Turpentine	3 "
" Ncatsfoot	3 «
Gum Camphor	3 «
Mix.	
Recipe 2.	4
Opodeldoc (superior to that of the shops, as it contains several	
essential oils which the shop preparation does not.)	
White Spanish soap, shaved in very thin flakes	10 ozs.
Gum Camphor	2 "
Oil Origanum	4 drs.
" Amber	4 "
',' Rosemary	4 "
" Turpentine	1 oz.
" Monarda	4 drs.
" Sassafras	4 "
" Wormwood	2 "
Aqua Ammonia	2 "
Alcohol	2 qts.
Mix, put in a sand heat, shaking it frequently; or	set it in the
sun from 5 to 8 days in the summer.	
Stimulating oil and embrocation for Paralysis, RheRmatismsifc.
        {The oil must be used first, then the embrocation.)
OIL.
Oil, British			24	ozs.
" Amber			4	i.
" Spike			6	xi
" Olive			4	" 1
Tincture Capsicum		••	2	11
These articles to be diluted one-half		with	neatsfoot oil when	
used.	EMBROCATION.			
Oil Hemlock			24	ozs.
" Winter-green			li	u
" Lemon			I	a
" Cinnamon			li	a
" Origanum			2	u
Mix.—These articles	to be diluted one	■half	with whiskey	when
used.				
   Embrocation for Sprains and Lumbago, Rheumatism &;c.
Pulv. Sal. Almoniac                                1 oz.
Spirits Hartshorn                                    4 drs. 
230
  Spirits Lavender (or better) oil spike                 4 drs.
  Oil Turpentine                                    * Vu
   Mix.
                    Bleeding of the  Nose.
  Pulv. Bloodroot                                   M ozs.
  Gum Arabic                                      24 drs.
  Catechu                                          *■  *'
  Pulv. Aleppo Galls                                 * "
   Mix —Snuff a small pinch, or blow into the nose slightly with
a quill.
                  Tonic and Alterative  Pills.
  Pul. Green Lobelia                          1 tea-spoon,
   "  Nerve Powder                           2    do.
   «  No.  2                                  *    do.
   "  Gum Myrrh                             *     do-
  Add No. 6, and make into pills with Gum Arabic.

                        Tonic Pills.
  Capsicum                                         *  dr.
  Ginger                                          ^   "
  Rhubarb                                         ^ *  "
  Extract Gentian                                  2    "
    Mix and make into 150 pills.
  Red Bud Leaves (or Judas tree) may be used for canker when
No. 3 cannot be had.
                           S typtic.
  4th proof Brandy                                 2 ozs.
  Castile Soap                                      2 drs.
  Potash (not Pearlash)                              1  "
  Dissolve the soap in the brandy warm, then add the potash and
shake it well; when used for a wound or a bleeding gum, warm it,
and dip lint into it and apply it to the wound.

            Cure for Blindness from Gutta Serenna.
  Take best capsicum one grain, infuse in a wine-glass of distilled
water, let it stand 24 hours, and then filter it; and lay the patient
on the back and wash the eyes several times a day until cured.

                    Asthma.—{Practice.)
  Give composition, nervine, No. 2 and No. 3, in  bed,  with hot
bricks to the body and feet; when in a free perspiration, give a tea
spoonful of the  second preparation of No. 1 every ten or fifteen
minutes until cmesis or relieved.

                Cure for fresh Cuts and Burns.
  Take the fresh leaves of the  common snap or French bean, rub
them soft, and apply to the wound; they will heal in  a very short
time, without pain or inflammation. 
                     Polypus of the Nose.
   Take bloodroot, dried and pulverized, and  bloodvvort, (hiera-
 cium venosum,) the same, of each one tea-spoonful, mix thoroughly
 with half a tea-spoonful of pulverized alum; if the complaint is re-
 cent and not severe, one-fourth of a tea-spoonful will suffice.  This
 mixture to be taken as snuff, four pinches a day.

                       Cure of Quinsy.
   Take one  lea-spoonful of  the  best  capsicum, add one  table
 spoonful of water, and gargle the throat with it as long as the in-
 flammation continues, at the same time use a  dose of bitter root
 (a tea spoonful) 12 hours apart, three times.
   Infusion of hops, kercuma and life everlasting; an excellent wash
 for ulcers and eruptions on the skin.
   The May Apple Root, bruised, will act immediately as a styptic
 for external bleedings.
   Solomon's  Seal, the species that has seed on the end of the stalk
 (convallaria, stellata, vel trifolia, vel racemosa.)  The root bruised,
 an excellent application for  fresh cuts and swelled legs.
   Scullcap (Scutellaria Hyssopifolia.)   Infusion of  the leaves,
 (strong,) an excellent nervine, useful particularly in  tic doulou-
 reux.  Mix with  molasses, a gill a dose.
                  To stop Bleeding of the Nose.
   Make a strong decoction of witch hazle leaves and bayberry root
 bark, and add No. 6.  Drink and inject the same  up the  nose.
   A plaster of balsam fir will  immediately heal bad wounds.
                  For a settled Cold in the Face.
   Wormwood and hops, stewed in vinegar, and to be a little thick-
 ened with bran or Indian meal.
                            Burns.
   Yarrow, made into a poultice,  is an excellent remedy, (it is much
 used by  the Indians.)                       *
                           Tumors.
   Equal quantities of beef's gall and hog's lard, made into a salve
 and  rub  the part.
   Mechameck or bind weed.  In powder or decoction much used
 in the south for gravel; an infusion, in general,  will enable the pa-
 tient to pass calculus granules with much ease.
   To prove the soundness of the lungs.  Let the patient draw in a
 full breath, and then begin to count as far as he  can, slowly and
 audibly, without again inflating the lungs.  The number of seconds
 he can continue, is then to be carefully noted.   In confirmed con-
 sumption, the time does not exceed eight,  and is often  less than six
 seconds.   In  pleurisy and pneumonia, it ranges from  nine to four
 seconds.   But, when  the lungs are  sound,  the time will  range as
high as from twenty to thirty seconds. 
 A  DEFINITION  OF ALL  THE   WORDS  NOT  CONTAINED  IN

                         A  COMMON DICTIONARY.


   /Esophagus; the windpipe.  Accoucheur; male obstetrician.  Absorbent; a, taking up, receiv-
 ing;  n, a  tube  that  takes  up.  Astringent, contracting.  Antiasthmatic; opposed  to asthma.
 Ascites; dropsy of the abdomen.   \nasurca; Dropsy in the flesh, generally.  Anodyne; producing
 quiet or sleep.  Anthelmintic;  opposed to worms.  Asphyxia; want of pulse.

   Bronchia; the tube leading from the windpipe into each side  of the lungs.

   Crotchets; obstetric instruments.  Cantharides: Spanish flies for blisters.  Contrestior.; compres-
 sion of fluids in parts of the body  Calipre; an  instrument to measure the dimensions of the
 pelvis.. Callieter;  a tube to draw ofl' the urine.  Chyme;  the food as it leaves the stemmed.
 Coma'drowsiness, stupor.  Craniotomy, the science of piercing the skull of fa-fuses, and letting
 out the brains, in cases where  nature has forgotten to prepare the size of  the head to that of tin
 passage through which it must be discharged.  See page 210.  Coagulum;  clotted blood, or other
 thickened fluids.

   Duodenum; second stomach, small intestines.  Diarrhcea;  watery stools.   Diaphragm; dividing
 membranous muscle between  the chest and the abdomen.   Diuretics; medicines that promote the
 discharge of the urine.  Diaphoretics; medicines that  aid in producing insensible perspiration;
 Deobstruent;  removing obstructions.  Diagnostic; deciding the  disease by symptoms.  Deliquia;
 fluids suddenly reduced from solids.                                            *

   Emenagopue;  a, promoting menstruation; n, a promoter  #c.  Kinesis; vomiting.  Fsrhnrotia;
 caustic, a caustic   Embryotomy; the destruction of a  fcetus.  Exanthenialir;  producing cuta-
 neous eruptions. Expectorant; promoting discharges from  the lungs.  Emollient; soft, slimy,
 lubricating.  Enemata; injections.  Epileptic;  suddenly falling.  Forceps; instruments for clash-
 ing the head of  the child and  forcing delivery.  Fontanelles; the spaces in the fcetus, where the
 seams of the skull unite or cross each other, below  tlie crown and on the lop of the head.  Funis;
 navel cord. Fomentations;  warm and moist applications.  Fissure; noteh, or long, narrow, ex-
 ternal cavity.

   Ganglion; knot in the nerves.  Genital; relating to organs peculiar to males or female;.

   Intropelvimeter; see calipre. Ingcsta; food.

   Lvmphatics; vessels that commence with open tubes in all the fleshy  partsof the body, resem-
 ble the veins in structure, gather up or absorb the morbific materials or flnids, and carfy them into
 the veins, to be thrown out by  the secernants.  Larynx; upper  part of the windpipe.

   Mamma;; breasts.  Micturition; frequent desire  to urinate.  Monograph; a treatise on a parti-
 cular disease or genus of diseases.  Morbific; tending to produce disease. Marasmus;  wasting of
 the flesh, health  and strength,  without an apparent specific  cause.

 Nosology; classification of disease.  Nomenclators; tl.ose who give names  to things:

   Ossification; turning to bone. Os uteri, os tincce.  Defined,  page 26, 28.  Os externum; exter-
 nal orifice  or opening.  (Edematous; swelling with water, so as to leave a pit after pressure.

'*  Placenta; the rake that unite* the umbilicus to the uterus.  Pelvis; the bony rim that supports
 the abdomen.  Prophylactics;  preventives of disease.  Polypes; tumors projecting from internal
 cavities.   Plethora; fullneA  of blood die.  Prolapsus uteri; descent of the  cervix through the
 vagina to the perineum.  Pylorus; lower orifice of stomach.  Pruritus; itching about the genita's.
 Pathology; doctrine of disease.  Paralytic;  benumbing, destroying sensibility or muscular  mo-
 tion.   Plexus; a bundle of  nerves.   Parenchymatous; pulpy, fleshy.   Porraceous; greenish, re-
 sembling leeks.  Purulent; pus like.  Phthisis; pulmonary consumption.  Pathognomonic: cha-
 racteristic of specific disc;ises.  Parietal; inclosing like wall's,  as the high side bones of the cranium.
 Puerperal;  relating to child birth.

   Rima Glottidis; rim of the opening of the wind-pipe.  Rubefacients; irritants that being rubbed
 on it, will make the surface red.  Strangury; griping pain in ihe bladder and loins, with rl'ril bling
 of the urine.  Sedative; quieting excitement.  Sagittal suture; the  senm between tlie naiknnd
the upper  bones of the  head. .Secundines; placerita and  foetal membranes.   Sudorific;  pro-
 ducing  perspiration.  Seceinant;  carrying  off obstructions.   Sinlacogue;  discharging saliva.
suppuration; changing from inflammation to an ulcer or sore.  Schirrus; cancer, in its first stages
Sphincter; an  elastic band that, by contraction, closes up a tube.  Scrolula; a lumefcction nnd
s'lppurationofthe conglobate glands in different parts ofthe  body, particularly the neck.  Syphi-
lis; the venereal  disease,   s'ougl ing; dropping away in pieces  undissolved.  Syncope;  fainting.
bibilatio.li; a hissing.  Sinapisni; mustard pilaster.

  Tenesmus; a griping which  prevents  stool.  Trachea; the windpipe.  Therapeutic; curative.
i 'dicating cure.  The ring-worm #r.  Tourniquet; an inurnment to compress a limb, or vessels,
ami stop the flow of blood.  Transfusion; the  transfer of blood from a well person to  one  tiiat
is  bleeding, to supply the waste.

  Venesection;  blood-letting.   Vesication; blistering.   Vermifuge;  a  medicine  that expels
* 
¥.
                       INDEX
TO ALL THE  SUBJECTS TREATED  OF IN  THIS VOLUME.
                                                              Pages.
 Advertisement,                                                  3
 Antiphlogistic, depleting, cooling, starving &c.
 Age, death by,                                                  14
 Apparatus, 6ee organization.
 Abortion, or premature delivery, causes of,                 16, 17, 195
 Atmosphere,                                                    21
 Antero-sacral, from the symphisis to the sacrum,                   25
 Adhesion of labiae,                                               29
 Amnion,                                                ,        35
 Abdomen, enlargement of,                                       41
 Areola,                                                         42
 Abortions,                                                      46
 Accoucheur, conduct of,                                          47
 After Pain6,                                                    66
 Alarming Symptoms,                                            69
 Apparatus for steaming,                                          80
 Authors, Instructions of,                                         84
 Antispasmodic  Liniment,                                         97
 Acetate of Lead,                                                128
 Air and Exercise,                                         158, 161
 Ascarides,                                                     181
 Anti-spasmodic, opposed to spasm or stricture.
 Arm Presentation,                                              221
 Bleeding in Obstetrics,                               10, 21, 216—20
 Botanic Practice,                                            17  18
 Business of Physicians,                                 22, 112, 196
 Bladder,                                                    28  40
 Breasts in pregnancy,                                            41
 Bitter-root for worms,                             $            181
 Bilious dejections,                                               87
 Breasts, sore,                                              142—3
 Baths,                                                         T(J5
 Bowels,                                                        169
 Bronchitis                                                      jgg
 Breech Presentation,                                   49—51, 198
 Butchery,                                                 216—20
 Blood letting, how to cure scientifically the evil effects of,          234
 Cyclopaedia, Book of sciences,
 Cantharides,                                                    10
 Canker, any thing that tends to corrode the animal organs, to
    vitiate the fluids or otherwise to produce disease.
 Constitutional Taint, disease affecting the whole organic system.
Corsets &c.                                                16, 46
Clothing,                                              15, 104, 161
Causes of Cold feet,                                          15—16
Costiveness, inaction of the bowels. 
hi                         INDEX.

                                                              Pages.
Concoct, to digest, purify, ripen, sublime,
Congestion,                                                    21
Coccyx,                                                        24
Calipre,                                                        24
Carunculas myrtiformes,                                      25, 28
Canula, a tube, or a grooved instrument,
Catheter, an elastic tube, for insertion into the urethra*
Cancers.                                                       31
Catamenia, or menses,                                          32
Conception and  its consequences,                                31
    "      anomalous,                                          35
Chorion,                                                       35
Connexion of the ovum with the uterus*                          3{i
Changes in the uterus during pregnancy*                          3fJ
Cessation of the menses,                                      39, 40
Capricious appetite,                                             42
Courses durirfg pregnancy,                                      45
Child, treatment of,                                  53, 66,67, 151
Cutting the funis or  cord,                                       54
Cleaning the child,                                       53, 66, 164
Copper and zinc as emetics,                                     71
Cayenne,                                                   72,95
Canker medicines,                                              74
Choice of Medicines,                                           76
   "   of food,                                                 86
Course of Medicines,                                           77
   «    Uses of,                                                88
Constipation,                                          87, 110, 169
 Compounds,                                                    92
    "     Instructions for making,                                95
 Crude articles,                                                  93
 Case of Rheumatism cured by Cayenne,.                           95
 Character of Remedies,                                          99
 Cleanliness,                                               104, 164
 Chocolate as a laxative,                                         110
 Case of ovarian disease,                                         118
 Cauliflower,     #                                             120
 Carcinoma,                                                     ib.
 Calomel treatment,                                      18,  149—50
 Cribs and Cradles,                                             158
 Colic,                                                    169, 177
 Cholera  Infantum,                                              184
 Catarrh,                                                      185
 Croup,                                                    187, 191
 Chicken Pox,                                                  190
 Convulsions,                                                   192
 Craniotomy,                                                   210
 Concealment,                                                 222
 Dyspepsia, indigestion,  want of nourishment of the whole system,
      general debility, and wasting of the body,
 Delicacy, false,                                              22—3
  Diseases of Female orgaai,                                       29
  Dropsy of the Ovaries,                                           31
     "    Causes of                                               32 
INDEX,                          235
                                                              Pages.
Deformities of the pelvis,                                        34
Decidua,                                                       g
Duration of Pregnancy,                                          <*f
Diseases as Signs of Pregnancy,                                  4.1
Diarrhoea during Pregnancy,                                     44
Directions, for nurses,                                          49
     "    Accoucheur,                                           ^
Dressing the child,                                              66
Deductions from authors,                                        °f
Disease peculiar to Females,                                    193
Distinctions of diseases,                                        114
Depletion—cases,                                              *"9
Difference between the regular stimulating plan and the Botanic, 137-41
Disease of children,                                            151
Dentition,                                                     169
   "     diarrhcBa during,                                  169, 179
Dropsy of the Brain,                                           188
  "    "  "  Peritoneum,                                     189
Ergot,                                                     H, 223
Exercise, want of,                              22, Proper 157, 161
Enlargement of Abdomen,                                       41
Experience, the beat teacher,                                    85
Eating too much,                                               85
Extravasation,                                                 96
Eruptions,                                                     167
Erysipelas,                                                    174
Epilepsy,                                                     193
Enemata,                                                     194
Fashions, evils of,                                                 9
Fourchette,                                                   * 25
Fallopian Tubes,                                       27, 29, 120
Fimbriae of do.                                                 27
Fluor Albus,                                                   30
False Pains,                                                   37
Fajtus,                                 35, 37, motion of, 41—2, 55
Flooding                                                   56, 64
Force in Obstetrics, see violence,                 "         214,223
Food  for child,                                        67, 154—6
  "   for the patient,                                            82
  "   after the course,                                          83
  "   in cholera,                                                 83
Facts and cases,                                                115
Fevers,                                                        186 •
  "     Remittent,                                              ib.
  •*    Catarrhal,                                               ib.
  "     Puerperal,                               123—7,202, 225
Fits,  Epileptic,                                                193
  "     Puerperal,                                            216
Forceps,                                             209,  211—13
  "     Scientific use of,                                      222
Growth of the FoBtus,                                          37
History of Midwifery,                                            9
Hymen,                                                    25, 34 
m
236                       INDEX.

                                                            Pages.
Hymen, imperforate,                                      26, 34
Hydatids,                                               31, 121
Hemorrhages,                     56, 64,  108, 125—32, 214, 223
Heartburn,                                                  109
Hysterics,                                                   143
Hydrocephalus,                                              188
Hooping Cough,                                             191
Introduction,                                                  5
Improvements in Midwifery,                               9—11
Ignorance of their diseases, a source of female suffering,     22—3
Instruction from mothers,                                      23
Iliac bones, sides of the pelvis,                                 24
Inactivity,                                                    22
Inflammation of parts,                                   29, 132
Irritation of dq.                                       29,40,123
Instruments, evils of,                                 32, 201, 209
Imperforate Hymen,                                       26, 34
Interruption of menses,                                        39
Instruments,  proper,                                           50
Instructions of authors,                                        84
Intermediate Course,                                          87
Improvements in the regular practice,                          113
Injuries, inflicted in parturition,                               146
Injections,                                                   194
Inversion by force,                                      202, 221
Kine Pox,                                                   187
Luxury, its opposition to nature,                                9
Libia? pudendi,                                           25, 28
Ligaments, broad and round,                                   27
Labor Pains,                                              37, 45
Likes and Dislikes, or longings,                                42
Labor or parturition.                                      45  to 65
  "  Causes of    *                                           46
  "  Signs of approach,                                      47
  "  Showiof                                                ib.
  "  Treatment,                                      -   ib. 195
Lactation, or giving milk,                                      65
Lobelia, its character,                                         69
Lesion,  injury to organs,                                       77
Liniment, Stimulating,                                        96
     "    Anti-spasmodic,                                     97
     "    Tonic,                                             97
Lochia,                                                     141
Laxative Bitters,                                             194
Laborious Parturition,                                        196
Lacerations,                                         208—9—10
Lemons to cure Hemorrhage!                                 215
Midwifery—the art of assisting women in child-birth,             6 
INDEX.
237
                                                           Pages.
Midwife, first man midwife,                                    9
Mercury,                                           10, 150, 192
Menses, monthly discharges,                               13, 19
   "    Cause and use of,                           13,  14, 19, 20
   "    Suppression of,                                 19, 33, 40
   "    Cure of suppression,                                  20
        Time of appearance and cessation,                      14
Mothers, address  to,                                      15, 23
Mineral practice, evils of,                                 18, 192
        How it cures,                                         18
           "   escapes censure,                                19
Menses or catamenia,                                   32, 34, 39
Marriageable state,                                            33
Mistakes,  "regular,"                                     38, 203
Motions of fcetus,                                            41
Milk, cessation or diminution of,                                42
Manual examinations,                                    43, 210
Membranes,                                                  35
    "     Rupture of,                              52, 197, 204
Meconium,                                               54, 66
Mortification,                                             63—4
Milk,                                                        65
Materia Medicn,                                             100
Menstruation, as disease,                     .                 105
      "      Retention of,                                   106
      "      Excessive, Difficult, Decline of,                 107
      "      Bloody,                                        108
Milk-leg,                                                    141
Meitauer's treatment of Lacerations,                           147
Medicine for children,                                        156
Mumps,                                                    185
Measles,                                                    190
Mal-practice,                                               221
Natural ability of women to re-produce their species,           11,9
Nymph*,                                                25, 28
Nausea &c,                                            40, 109
Nursing,                                                    153
Nurses,                                                     154
Nursery,                                                   162
Obstetrics, Treatment of women in labor, Midwifery,         9, 12
Opium,                                    10, 18, 178, 211, 223
Organ, a peculiar structure, as a nerve, a muscle or ligament,
       the liver, stomach or lungs,
  "   Description of,                                          23
Organization, a series of organs, combining to perform the
    same  general  office, as the nervous  organization, the
    bony, the muscular, the ligamentous,  the digestive &c,
    called also an apparatus, 
238                        INDEX.

Obstructions to the healthy growth of children,             12 to 2d
            to perspiration,                                    19
Os, a bone,
Ossa innominata, hip bones,                                    24
Officiousness,                                            21,203
Orga"s peculiar to females,                               25—27
Ovaries,                                               27,29,31
  "     Disease of, Operations on,                            116
  "     Case of,                                        118,119
Obstetric violence,                                            59
Opium and bleeding for  spasm,                                °8
Operations, dangerous,                                  116—18
Ophthalmia, or sore eyes,                                     183
Plan of this work,                                              4
Parturition, delivery of  a child,
   "      Why women need aid in,                      12 to 23
Placenta,                                                 36, 53
Prophylactics, means and modes of preventing disease.
Physic,                                            10, 194,  210
Poisons,                                              18» 20, 21
        How act,                                             21
Physician, his business,                              22,112, 196
Pelvis,                                                24, 28, 34
Pelvimetre,                                                  25
Perineum,                                               25, 52
Peritoneum, the covering of  the intestines and of the internal
     cavity of the abdomen,
Polypus,                                                     30
Pregnancy,                                          35—37, 38
     "     When expected,                                    37
     "     Protracted,                                     35—6
     "     Duration  of,                                        38
     "     Certain signs of,                                    43
     "     Advantages of knowing,                             44
     "     Courses in,                                        45
 Positions of the uterus,                                     30,37
 Physician, conduct of,                                        47
 Position and  Presentation,                  22, 49—51, 113, 198
    "    Brqpch and Arm,                            ib.
    "    Natural,                                             51
         Transverse,                                         207
 Placenta,                                               55  to 65
    "    How formed,                                        35
     "    Tardy delivery of                                67, 196
     "    Injudicious removal 6i                                 59
     "    Rule for its removal,                               62—3
     "    Cause of,                                           195
     "    Use of the cord,                                      200
     "    Violent removal,                                     205 
INDEX.
239
                                                             Pages.
 Putting to bed, 65; Principles, 68;  Poultices, 89;  Pain relieved,  98
 Poisons,  105,  111,  149;  Pain  in  the  side, 109;  Piles,  111,  169;
 Palpitation of the heart,                                   113, 149
 Puerperal Fever,                                 123-7, 202, 225
 Phlegmasia Dolens,                                           141
 Phlebitis,                                                     143
 Pulling the arms of children,                                158—9
 Plays for  Children,                                       159^-61
 Pleurisy,                                                      18G
 Preparations, showing the  evils  of  premature removal of the  •
     placenta,                                             205—6
 Perforation of cranium,                                        210
 Plugging the vagina,                                           215
 Puerperal convulsions,                                         216
 Prolapsus by ergot,                                            223
 Quickening, 42; Quinsy, 187
 Recommendations,                                              3
 Reasons for  writing  this work,                                    5
 Rectum,                                                       28
 Retroversion,                                                  30
 Reclining,                                                    45
 Rupture  of  membranes,                               52, 197, 198
 Resuscitation,                                                  53
 Relax the pa^ts obstructed,                                     69
 Restoratives,                                                  75
 Remedies, simple,                                             91
     "      Compound, 92; Classification of,                     99
 Restlessness at night,                                         109
 Relax,                                                       169
 Remittent fever,                                              185
 Recto-vaginal  communications,                                 215
 Recipes,                                                226—31
 Surgery in Obstetrics,                                           9
 System, the whole body, a  complete scheme of practice, or of
      philosophy,
 Surface,  15, Sacrum, 24;
 Symphisis pubis,                                               24
 Sphinj^rs, circular muscles,
 Stricture of vagina,                               29, Urethra, 148
 Signs of Pregnancy,                                        38__43
 Swelling of lower extremities,                                   40
 Stale of  the Breasts,                                           41
 "Show"                                                       47
 Symptoms during Labor,                                       50
. Stimulate the sluggish,                                         71
 Steaming,                                                     7g
     "    Apparatus for, 80;  When necessary, 82; Substitutions for 86
 Sore eyes,                                                   183 
210
INDEX.
                                                              Pages
Stimulation, regular,                                            137
Skin, hot and dry,                                  87, Dirty,  165
Stimulating Liniment,                                          96
Secrecy in fiedicine,  .                                        98
Sores, 104,  17:», 183;   Swellings, 101—5;  Silivation,  109;  Sore
     Breasts, 142; Suppuration of, 143; Skin-binding, 175; Sore Mouth
     175; Small Pox,  190;
Signs o/ Death in utero,                                      223
Testimonies, against the Mineral practice and for the Botanic  6, 195
Tieatmtjnl.  injurious,                                           12
Tumors,                                                      31
Treatment of Disease during pregnancy,                        43
Tracheal pipe,                                                 54
Twins,                                                        55
Tumors, Inflammatory,                                          90
Tongue-tie,                                                  160
Thrush (Aphthae)                                             175
Testimonies of the regulars,                                    195
Turning a child,                                     199, 201. 222
Uterus,                                             26,  28—9. 36
Uterus, changes in,                                           <jC 30
  "    positions of, 30, 37; contractions of, 58, 214; conditions of^ib.;
        Displacement  of,  113; Inversion,  114—15;  Polypus,  115;
        Facts and cases, 115;  Diseases in,  116; Treatment of,  121 j
        Irritability of, 123;  Hemorrhage of, 125—132; Inanimation
        of,  132;
Urethra, the canal that leads into the bladder,
Uses of internal organs,                                      28—0
Utero gestation or pregnancy,                                   35
Umbilicus,                                        36, 52,  54, 198
Ulcers,                                                        69
Unbolted bread,                                               110
Urine,                                                   69, 168
Vivification, making alive,                                      15
Vagina,                                                   20,28
Vomiting during pregnancy,                                 40, 44
Violence, Obstetric,                   59, 64, 69,  195—20, 45, 209
Vesico-vaginal and recto-vaginal passages,                      147
Vertigo,                                                      149
Vegitalde Diet,                                               232
Vomiting, spontaneous,                                        114
Vaccination,                                                 189
Ways and Means,                                              G9
Weaning,                                                    105
Worms,                                                      180
Whooping cough,                                             191  *
Zelo-mathean, Desirous to learn,                                   3 
A. WELL FOIIMED PELVlS.
  Front view, as in the skeleton.   A A, (upper) Os*sa, innominata.
A Agflower) Iliac bones.   B, Ischiatic bones.  OD, Os sacrum.
E, Ws coccyx.  F, Lower vertebra.  K, Promontory of sacrum.
a a, Iliac fossa?, or false pelvis. II, Symphisis pubis, or joining of
the pubic feones over the arch.   I  6, P V,  b I,  Brim of the true
pelvis.  V, Head of the femur,   m, Acetabulum,  u, Ischiatic
holes.   12  3 1,  Holes through  which the  nerves pas*, into the
pelvis.
                         PLATE 2.                         *
PERPENDICULAR VIEW OF THE UPPER STRAIT.
   A Bj.Slibrt or sacro-pubic diameter.  D C, Long or Hiac diam-
eter,  a a, iliac fossas.  b, c, Lower vertebra,  d, Upper part of
 os  sacrum.   Prom, sacrum,   e e, Sacroiliac Symphisis.  //,
 Parts over the acctabula.  g, Symphysis pubis.
              16 
242
PLATE J.
AN ILL-rORJIED  PELVIS.
  a, Ossa innominata;fcc, Ossa Ischia; d, Last vertebrae, pressing
obliquely into tfie  sacrum,  f, Os ilia,   h h,  Foramina ovalia.
Here the diameter B B, is nearly the riy'it  length; A A, too nar-
row; C C, quite *oo narrow, and D I), rather too wide.   Such
pelves are'sometimes Ibrmed by the rickets, but that discasdlis not
common in this country.

                           PLATE 4.

A POSTERIOR  SECTION OF  THE  PELVIS, CONTAINING  THE INTERNAL
                           ORGANS.
10.  B, Ofcsa innominata. C, Acetabula.  D,
s-a ilia.  E, Fleshy parts covering  the coc- *
  A, The l,.?t vcri-:'b
Lower edges of the,'o
eyx.  G, Vagina cut and stretched open'. * II, part of the bladder.
I, The.neck of the uleru>.   K, The fundus.  L, FallopjA tube|p
M, O; aiics.  N,JBroad ligament?.  O, Upper parts of thoircctum.
The F^iHoptatf tubes and the ovaries are elevated from their natural
position beside the bodjr of the uterus, that they may  be seen. 
4
243
FLAT*1, J.
front  mew or Ttir:  postkihou *:!;'• hon of tub uterus  at thb
                FIRST MONTH OF PREGNANCY.
  A B, Front view ot the posterior section of tfec uterus at the first
month of pregnancy.   A, fundus; B, neck; C, cervix.   II K, G F,
Same view as plate 4th, with the uterus, K K, as it appears at the
seccfu^or third  month of pregnancy.  II II, Parts of the.bladdcr.
G, Vagina, with the cervix  uteri depending in it.  The fetus is
floating in  the  waters with the placenta attached to  the fundus
uteri between K and K.

                          PLATE 6.
"HE
THE  GRAVID UTERUS.
 A, the gravid uterus in the
8th or 9th month, strewed
by  the  waters,  the  foetal
head  in  the false  prlvi«,
pressing  down.  II,  The os
uteri, tlie-neck  being oblit-
erated.    G,  The  vagina.
K,  The-' placenta.   L, The
membranes.
 
244
PLATE 7.
%
A LATERAL VIFVT  OF THE LUMBAR REGIONS, TELVIS,  AND fCETUS*,
                WHEN LABOR HAS COMMENCED.
 C E F, Different forms
of the uterus before the
discharge  of the wa-
ters.  D, same after
discharge.   II. Os ute-
ri  opening before  ttu
sac of waters.   I, The
vagiHa.    K, the  left
nympba. L, the left la-
bia pudendi.  M, Part
of the bladder. N, An-
us.  O P, Left hip and
thigh.   E, The uterus,
as in a  pendulous  ab-
domen.  F, the uterus,
in  this  case, presses
on the diaphragm and
produces vomiting;  di6-
pnoea &e.
PLATE 8.
    -Labor far aDvaced.

  This is the most  convenient
and common  position.  A,  The
uterus, after the discharge of the
waters.   B C, Lateral view of
lower vertebras and the ischium.
I, Os pubis.   II, O* externum.
 
245
PLATE 9.
Twins.
A FRONT VIEW OF THE  POS-
  TERIOR HALF OF THE  PEL-

  VIS, (AS IN PLATES 4,  5, (5)

  WITH TWINS,  THEIR UM-
  BILICAL CORDS, PLACENTAS

  &.C.,  AT  THE  BEGINNING

  OF LABOR.
  H, Os uteri just opening
by the presence of the wa-
ters.  G, Vagina.
PLAtE 10.
A FACE  PRESENTATION.
 A, Lateral section of the vertebrae.
G, Uterus.  B, Os coccyx.  E, Pe-
rinaeum.   C, Os pubis.  F, Right
labium pudendi.   rlhe chin pre-
sents  at the  os externum.  More
tedious, but a natural and not dan-
gerous presentation.
 
246
#
PLATE 11.
    A... Breech  presentation
with  the  back  in  front and
the umbillicus wound round
the neck and  body.
 PLATE 12.—Breech presenti'ion w'.iVi th*
fac« forward.
        PLATE  13.

 Tlie head pressing through
a  distorted pelvis,  causing
the parietal  bones to  over-
lap each other.
 
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247
  The following are new and v
Madame Boivin:
FIG. 1.
POSTERIOR VIEW OF  THE VIRGIN

  UTERUS AND ITS APPENDAGES.
 a, a, The body; b, os tincae; c*
longitudinal fibres; o,  o, utero-
sacral ligaments; d, d, wings of
the uterus or ovarian ligaments;
e, e, ovaries; f, f, trunks of the
fallopian  tubes; g, g, enlarge-
ment of do.; h, h, timbriie of do.;
i, i, broad  ligaments,  or dupli-
catures of the  peritoneum; j, j,
cords of the ovaries;  k, internal
face of  the  anterior portion of
the vagina.            , ».
i cuti from the French of
 
248
         FIG. 2.



ANTERIOR VIEW OP THE  UTE-

         RUS &C,
  a, anterior longitudinal fibres;
ft, anterior lip of the  os tincce,
longer than the  posterior, and
obscuring it; e, e, origin of the
round  or sub pubic ligaments;
o, a, round ligaments; d, d, fal-
lopian tubes; e, e, fimbria?; /, /,
the ovaries  seen through the
tissue  of the  broad ligaments;
g, g, broad ligaments or folds of
the peritoneum. 
249'
         FIG. 3.

PROFILE  OF THE  UTERUS,
**>
  a, posterior surface, more extended and rounded than the oppo-
site; b, os tincoc; c, visico-uterine fold of the peritoneum; dt recto-
vaginal fold of d.o. 
*2§8
FIG. £
VIEW  OP THE INTERNAL  SURFACE OF  THE UTERUS, DURING THE
        MENSTRUAL DISCHARGE, OPENED  INTO ANTERIOR
                  AND POSTERIOR HALVES,
  n  the body,  containing  median  lines and drops  of red fluid;
6 the internal orifice of the neck; c, external do.; the whole organ
is here gathered into folds which are gradually obliterated during
pregnancy or dropsy. 
2ai
                  FIGS..  5,  6,  7,  8,  9.

       Oi TINCCK IN  ITS NORMAL OR HEALTHY CONDITION.

Fie.  5.—Infant state.              Fig.  6.—State of puberty.
 Fig. 7.-—After the loss of
her virginity.

Fi^. 8.—During menstruation.
Fig.  9.—Of a lady who has had a cliild.
 
25-2
FIG. 10.
THE  UTERUS SOON AFTER CONCEPTION.
 a a  the body; b, tne iniernal and c, the external orifice.  This is
the uterus of a lady  who  died  in the early  part of pregnancy.
The internal walls aj^ear of a deep red, and soft tissue; they are
marked with deep longitudinal lines or furrows, which run down
into the neck.  The neck is of a violet white, its cavity almost as
large  as that of the body, with many folds,  some simple, others
compound, running in various directions, among which are found
numerous mucous follicles.   There are often found also  globose
concretions containing sometimes transparent fluid, at others cal-
careous matter, and they have been found so abundant as to fill up
the whole cavity.  But  in the healthy state,  and the commence-
ment of pregnancy, these folds are filled with a thick, glairy hu-
mor which completely fills the cavity, and selves to close it, to the
end of the term; when it flows in  abundance  and lubricates and,
prepares the neck and vagina to  dilate during parturition, 
253
                        FIG.  II.

FIBROUS FOLDS OP  THE  UTERUS  AT THE COMPLETION OF THE
             UTERO-GESTATION, FRONT  VIEW.
  a, a, median line, the fibres from which instead of being paral-
lel, as in the first plate, arc now widely divaricate; b, b, the fibres,
forming, by their union the round ligaments.   The contraction of
these fibres which are inserted to the public bones, is the principal
means of expelling the child; c,  c,  fallopian  tubes; d, d, ovaries;
e, e, the neck of the uterus, containing the head of the foetus; /,
corpus lutem, or cicatrice whence the ovum issued; g, uterine veins;
h section of the vagina;  i, external orifice dilated so as to show
a portion of the membranes. 
'1H
FIG.  4.
ANTI-VERSION 0>" THM  UTErttS  IN  TilS EARLY TLHIODb Or
                    PREGNANCY.
  Right section of the pelvis; 6, the sacrum; c, the bladder; d, the
urethra; e, e, the rectum; /, view of the tube and ligament on the
left side of the ovary; g, body  of the uterus; h, lateral portion
not covered by the peritoneum; i, os lincoe; k, vagina. 
255
                       FIG.  5.

RETROVERSION  OF THE  UTERUS  IN TnE EARLY PERIODS  OF
                     PREGNANCY*
  a, right pubis; b, os tincoe; c, urethra;  d, vagina; e, body of tho
uterus;/,  the  bladder distended  to  the utmost; £,  the rectum;
b, promontory of the sacrum; i, view of the fallopian  tube, and of
the ligament of the left ovary. 
 
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