3    Medical Manscript 1852 10 10 11 100 10 1000 111 GlW18 Medical Manuscript 12 11 11 10 100 4)  [Be???] fort Bauguht for girls 3lb 6oz Butter at 12 1/2 et 4 doz eggs do 6 Sold for cash Whisky do do- 2 1/4 Butter 124 12 3/4 Lard 10 Sold for cash why [illegible] Sold for cash 1 pare shoes for 1 do do fine 1 do do cone 1 do do do 2 Ladies-fine 1. do--fine 1 pare fine 13 yd donut 4/ 3/4 yds Rum [illegible] May 11th 1851 [illegible] Benten Pill County Sc [?ast], [J???] B, Polk BEV Dedication Citizens of the united states-But more particularly that portion, with whom I have had personal acquaintance, and from whom I have always received a hearty welcome, and [illegible] [illegible] and also to all that portion of the medical profession who can so far divest themselves of [??gihst] education as to give to the following presentation [illegible] and impartial perusal, and it this [i????] by its author- [Pry??] At the present age of the [illegible] [prop???] a [illegible] illumination is advancing of the world , just so it the [illegible] [illegible] [p???] that that individual who [illegible] [illegible] the human family is intitled to the highest [illegible] Ancient History informs us that [illegible] [illegible] Philosophers hand ever [illegible] [illegible] for the highest distinctions [illegible] [illegible] although the sumit might [illegible] [illegible] by all, still this considiration [illegible] of mankind from doing whatever [illegible] [illegible] to ameliorate the suffering, [illegible] [illegible] human race. As it [illegible] [illegible] of human investigation, which [illegible] [illegible] and the cure of all those ills that [illegible] [illegible] frailties and imperfections inherent in the physical organization, [cross out] [repe??] [illegible] Now he who advances the just knowledge of his physical once a knowledge of the modifying powers of [illegible] it physical agents that act on his varied sensibility quit impressibilities, we consider as achieving and important step in the science of human happiness- The Author of This work has not vanity enough to believe, nor [illegible] it to be understood, that he consider as having claims above all others upon the great of mankind of anything that he has done, [illegible] yet he cannot resist the impression [??calic] which he now presents to the public [illegible] upon a fair trial to contain the most certain speedy, and effectual plan, for the cure of fevers, that has hitherto been offered to the public as this treatis is designed more for the benefit of the public [illegible] then the [cross out], profession, the author has [sh??] [???ly] [??diave] to avoid technicalities, and to present [illegible] the most simple and plain language the he could possibly employ, so that every reader may [illegible] and fully understand and comprehend his way on every subjet that he may treat- This work will be found to differ somewhat from the theories and [illegible] the [illegible] [illegible] indeed from all that have preceded it [illegible] [illegible] [illegible]. For whilst almost every physician is of [illegible] that the different forms of fever, are dissimilar in there [illegible] [illegible], and that notwithstanding this dissimilarity [illegible] [illegible], that they all have more or less inflammatory tendency, the [illegible] this work between them to depend upon a uniform law nature; which [illegible] only of disease, in accordance with the unity [illegible] [illegible] that they have there origin and progress in debility. [illegible] [illegible] of Physicians consider depletion either [illegible] [illegible] purging or by the use of nauseating medicines [illegible] [illegible] the means combind, as indispensably [illegible] for the cure of fevers, the author has limited their use very [illegible] [illegible] [disa?????] their use entirely in the last stage and relies abreast exclusively on Tonics and their auxiliaries [illegible] the same desirable object [illegible] [illegible] that all pukes and purgatves are irritant [illegible] stimulants, and that fever proper is a disease of irritation; and that it never was into active inflammation He likewise thinks that the peruvian bark or quine, is a tonic, and not a stimulant; as has generally been supposed._ Although he was himself taught that theory practice of medicine as was [cou??] [illegible], schools, in the day of his pupilage [illegible] imbibed them, but the result of his [illegible] experience in an extensive practice for [illegible] only years has fully satisfied him of the first [???pe??] this practice polar, that of either the depleting [illegible] stimulant so while this plan of treatment [illegible] speedy and more certain care without [pro??] systems that are based upon opposite [????e] prolong the disease and suffering of the patient And if a cure be effected at all, [illegible] [illegible] such treatment, and not unfrequently [illegible][illegible] The constitution, that the unfair treatment [illegible] in invalid throughout the bottom [illegible] The author is well aware of the responsibility assumed in daring to [illegible] [illegible] of this kind, differing as it [illegible] opinions on the theory and [illegible] [illegible] is likewise aware, of the [un??] [illegible] probably excite among the [illegible] [illegible] [A??] While he [cou???] [illegible] [illegible] Medicine he was after [illegible] [illegible] because he dared to differ [illegible] [illegible] practice that has been [empa??] [illegible] [illegible] the minds of the community [illegible] too; on justification of his practice [illegible] main supported the same physiologie, [illegible] that they themselves did, and [illegible] do, as [illegible] in the body of this Work. He thinks, [illegible] might say, on without doing them any [injust??] whatever, For without having any [illegible] for them as men, that they are very [illegible] them, who, no matter what a man's acquiantance sucess in practice might be, if he dared to differ from them, or their, favourite leaders in the [s??] whould either treat him with cold, silent contempt or attempt slily to defame his character This seems to be the effect of deep feelings, probably based on natural organization and, I suppose, being regarded as the result [illegible] fixed prime causes and the circumstances, Education, ought therefore to be excused But the Author, knowing the success of his theory from his own experience and observation, contrasted with [illegible] fully justifies himself, in the opinion, that ha hazards nothing as a man, or as a physician [ass?ding] that it is the safest [cross out] most speedy with successful practice extant for the care of fever, His opinion is further confirmed by [illegible] [illegible] [??xampled], success of his practice [illegible] in the north and south for the last ten years the [illegible] considers himself called upon to [illegible] [illegible] and practice to the public [illegible] [illegible] has [add?ssled] which will [illegible] [illegible] and fair opportunity of [illegible] [illegible] And also, a [illegible] of [illegible] [illegible] [Hix?can] was and his [illegible] [illegible] [?atasenie], & a [illegible] [illegible] the public he is willing [illegible] a fall- Authors Preface Chapter Fist On Fever, XX Theory and Practice of fevers Chapter first The opinion has been long since [cetert??] and by some eminent medical Philosophers [expr?fsor] that a theory founded upon nature, a theory that should bind together these scattered facts eg, medical knowledge and converge into one point of [?ie??] the [illegible] the [illegible] organic life, would they on many accounts [illegible] to the interest of society- It [al???] [illegible] of [illegible] men of moderate ability to practice the art of healing with real advantage to the public; [illegible] [illegible] literary acquirement to distinguish, the [illegible] [illegible] effrontery or of wiley address; and [illegible] [illegible] important, situations the [h???] [illegible] [illegible] Form of Practice does have being [illegible] [illegible] theory and practice in which [illegible] [illegible] are now, engaged in waiting again the it [illegible] proper that I should give my [illegible] [illegible] I commenced the study of medicine [illegible] That cook, cold and [illegible] [illegible] greatly at the head of their [re??] [illegible] and promulgating to the World their [illegible] Bloodletting and the modes of [illegible] by the follow, of the depletion or [ant??] Theories I was instructed in those [illegible] after having practised with my preceptor for about years, who was a scientific and experienced, and inclined to the Brownonian and [illegible] Tonics and stimulants earlier and more [g??] than was common, I entered one the duties of my profession on my own book and was at least as sucessful as those around me. But not being satisfied with the result of my own practice [c???] less so with that of others, which was chiefly that of bleeding and acting on the stomach and bowels, with emetics and cathartics, as we thought the patient could bear them; [illegible] [illegible] the case principally,with what we called [illegible] [illegible] phlogistic medicines which indeed was of little or no use, untill the patients died or recovered by the mere sanative operation of the constitution. After having practised medicine several years and having undergone a considerable change in my view, and opinions relative to the nature and [illegible] of some diseases, and some remedies attended [illegible] by medical lectures in the university at Philadelphia, where became confirmed in the opinion states was reasonably acquainted with the different [illegible] [illegible] had of the day, but which only [illegible] [illegible] of their error, in very many [p???] [illegible] [illegible] serious evil in society and [illegible] [illegible] that the ruling or [illegible] [illegible] medicine like that of bigots [illegible] [illegible] alway willing to edge and exterminate & [illegible] [illegible] any theory or practice that [illegible] [illegible] from their views of proprity! [illegible] [illegible] the principles upon which it is [illegible] [illegible] the result of the practice in [illegible] any way whatever. being aware of this [illegible] believing that I had made a valuable discovery [illegible] or thats had more fully developed the [illegible] and article of the materia medica that [illegible] been in use, but was still very imperfectly [??tard], I was an witting that it should be last to [??ly]. I therefore prepared and sent forth to the public large quanties of my magnetic, Gold Pills, and at the same time concealing their composition that they might acquire a reputation upon their own intrusie worth- Now that the virtue of these pills to the amount of at least ten thousand Boxes been tested by the people of the united states [illegible] of mexico, and up to this state have [???tained] an improving reputation; thereby [???turing] the correctness of my theory for the [??petery] is not now in the drug than the use I [illegible] made of it I presume that the public will begin to how strongly and unjustly the medical properties of the peruvian bark and its preparations have been perverted, and that instead of its being injurious when taken in the hot stage found all been frequently said of it it is not only entirely soft but it is the fibrefuge tonic and antiseptic human The truth of my position is still further [ma??] by the fact, that since the distribution of my magnetic Gold Pills (not (firm years [illegible] [illegible] announcing that their virtues reside [illegible] [illegible] tonic properties and that they did not contain any arsenic, many apothecaries [illegible] [illegible] not [illegible] have endeavoured to imitate them [illegible] vended the same or some similar [illegible] [illegible] used in all stages of fever- Now when I had established the fact that tonics [illegible] softy and with efficacy be used in all [illegible] [illegible] difficult task for practitioners to [illegible] [illegible] particular drying heat [cate??] [illegible] indications, hence all of them [illegible] [illegible] had more or less of quine in their costum I am led to these remarks from an [opp???] that so soon as these pages shall be [illegible] to the public eye, that the practitioners of medicine the venders of fever nostrums may not after [f??] to harass, the public mind be refusing to [illegible] the fact, that quine or some other vegetable constituted the basis of their specifics far from not toug after I commenced the practice of medicine, An old physician fell in company work one, an [illegible] Road from Wilmington leading to Elizabeth, he informed me that the practice in that Country did not see 4 The carious diseases of the Country and the reason was that they the physicians [illegible] not sure tonics soon [erough] enough, that are depletory practise intirely to much, [a??] his lecture with best of my recollection was as follows: A sect of religious people known by the name of jesuits, in their intercourse with the inhabitants of of South America, in passing through the state of Peru, were compelled to drink and use for cooking the waters of certain Ponds on their way,, The water in some of these ponds, was strongly impregnated with the properties of the bark of certain trees that grew around them,,, Other ponds in these waters which have none of those trees in or about [illegible] [illegible] resorted to for water,,, those persons who happened to fall sick at the latter [illegible] [illegible] remained there untill the tardy [illegible] [illegible] constitution enable them [illegible] their illness as to continue their [illegible] [illegible] of those persons who became [illegible] [illegible] where the trees grew [illegible] [illegible] for all purposes the [illegible] [illegible] rarely detained more than a few [illegible] they were cured, and enabled to pursue [illegible] these facts became so notorious, the cases of cure so numerous that it caused much enquiry and investigation; When it was ascertained [Soli??] that these cures were effected by the waters in consequence of its being impregnated with the medicial properties of the Bark of these trees Hence the first knowledge that we have of these trees or the Bark,, is under the name of jesuits or peruvian bark x Many of these unfortunate wore stricken down, at various Times, by fevers and in that hot climate it is reasonable to suppose that many were of the lowest grade and most malignant character & it is said, there was a time when the Peruvian barks (Acot the sulphate of quine) sold for its own weight in gold which is proof of it [illegible] esteemed value since my knowledge of medicine, the best quality of gold from five to ten dollars per pound,, But for the last fifteen years, it has varied from one dollar to fifty cents per pound,, From these facts all all might [illegible] that the use of it has been very much [illegible] In that short space of Time, and that [illegible] all other poisions and prostrating medicines had been substituted in its stead), all my times, have i set by the bed side of my patient for days together giving it & anxiously [illegible] to see the affect it would have upon [illegible] At the same time amousing their minds and the minds of their attendants rarely by giving some persons placebo that I new to be harmless and useless found no more used heat [illegible] arterial actions, nor any [illegible] that I could asscribe to the bark [illegible] contrary, in a few hours [illegible] most the skin would become [illegible] prehaps a free and generous [illegible] would ensue, the thirst whole [illegible] irritated condition by the pulse [illegible] and the feverish heat and restless anixety (alway more or less attendant on fevers Subsides, in much less time than [illegible] course of treatment, I had one [illegible] patients recover their health [illegible] with less prostration or debility- I have took the bark myself (in good health for a mere experiment,) in ounce doses which is equal to [illegible] or twelve grains of quinine, and although it produced some dizzyness or swimming, in the head, there was no increased heat in the skin or increased action in the pulse- I presume that it acts more directly on The brain, And the nervous system, but it produce no such effects, as an over portion of intoxication 6 liquors, on the preparation of opium [illegible] dose languor, or prostration follow as a [illegible] natural consequence as is the case [illegible] use of stimulant proper,, We think it [illegible] them probable that the back would [nev??] have last the reputation it posins too obtain at the, time of it first interduction, if we had then known wt we now do, how to separate its active medical properties from its cortical and [???t] matter_ The irritating and supposed stimulating effects, ascribed to it by the older practitioner, may in our opinions be more justly assignable to its bulk, and the presence of the cortical matter with which it was incumbered, them, to its salt, in which modern chemistry has shown its [illegible] to reside- Before the improved condition and highly concentrated preparation of the [illegible] the form of quinine, was known,I was in many occasions, much inconvenienced and sometimes defeated in getting as much [illegible] - Partly owing to the prejudices [illegible] them to fear that it would escape their fevers, and partly to the fact that in some instances the stomach would not retain it- or that it woul'd pass off on the bowels as a purgative- in either event any object was more or less defeated- The names of Pellitier and Caventou, who first seporated the pure alkaline salt called quina from the bulky and inert, mass in which nature had placed it deserves to be remembered by [cross out] with gratitude by all mankind- since that fortunate day in medicine I have been enabled to administer the bark at any stage, and in any quantities that I might think advisable as without fear of injury to my patients or exciting any fear in their minds- This discovery has not only afforded me- heart-felt for gratification- 1 for the reason that it enabled me to give more prompt and certain relief to the sick- but it has been instrumental in giving to me a character and standing in my profession all calculated to excite the envy of the Physicians around me- But this I desired not for I did not conceal from them, in our consultations, my views, on either the Theory or practice which gave me such superior success- It seemed [illegible] the most melancholy experience was not sufficient to convince them of their errors, and they still from the mere force of education, considered my practice as empirical- Far be it from us to censure any one for tenacious adhering to the prejudices may be; let the jew be jew still,- let the Bushite be Bushite: for we deem it a wise provison in the economy of [illegible] We only seek to apologize for the course we have as individual laborers in the cause of humanity have pursued- Every philosophic mind [illegible] that all innovations have to work their way to popular favour all their own intestine [illegible] The discovery of truth is a like open to [illegible] it is the exclusive property of [illegible] part of eternal bounty of nature, [au??] from beginning designed for all- Then let all and let no one be debarred the privilage of pas claiming whatever he may have found- We are well aware of the necessity and the importance of well-endowed-[illegible] establishments, for the purpose of mental [illegible] and manual discipline, in every deport of human thought, and of human actions- We know: also that one of the marked characteristics, are of the [cross out] advantage of civilization. consists in the division of labor- Such division tends unquestionably, to the perfection of science, and to the perfection of slice in the [illegible] manipulations of the arts Hence, in the earlier period of the World, as we see from the records of Egiyptian of Babylonion Grecian Roman and other historians,- resulted the establishment under state Authorities the laws of Castes, of trades, of professons and of privileged orders in society. Now such (was, such regulations such usages may have been rendered) necessary at those epoch, of time from the nature of the [??ment] of humanity than under progress of development But is is easy to trace in the downfall all of those states the deleterious influence of Castes and of chartered privileges, and protection upon [illegible] various branches of human occupancy- In proposition as trades and professions are [fa?tered] by law, in the same proportions do their [vota???] become indolent, and the wholesome [illegible] [illegible] dies away- The check thus [illegible] to the freedom of thought, causes the [illegible] [illegible] of law, divinity, [illegible] [illegible] arts to dwindle to lapse its [illegible] and the minds of men to become fixed [illegible] stereotyped into settled formularies [illegible] have been [illegible] into the preceeding train of [illegible] from the manifestation given by many of the states of this union, in their legislation enactments, chartering either directly or indirectly, sectarian colleges calculated to faster partisan religionist- [E??] those entitled acts to regulate the practice of medicine; many of these contrary to the spirit of this government, and calculated to promote the interest of a particular class, to the detriment of others- the effect of the one is to fetter to stagnate the advancement of the study of the spiritual nature and the spiritual happiness of man; While that of the other retards the progressive 9 knowledge of the Laws of his physical nature, [illegible] the true mode of improving his condition [illegible] happiness as based in his physical nature [illegible] influence by physical causes- What better evidence could be desired of the [illegible] and selfishness of all these petitions & petitioners for protection, than the universal fact that they spring from the professions, care not from the people whose welfare they hypocritically profess to guard and serve- Tis strange! Tis passing strange! at this enlightened day, at this half rational era of the world in This free, this new sepereated republic; that the people, the true the only legitimate sovereign of the earth, should not know what they needed what they wanted, what they desired, what was best for them, as well as the safely led- guardians of their bodies and their [illegible]- We do not wish to be understood [illegible] with or objecting to, any thing that [illegible] has transpired- Oh the past and [illegible] [illegible] has not controle, Whatever has [illegible] [illegible] it is; and whether right or wrong [illegible] it- Let us, then, gather [illegible] [illegible] from a knowledge of the past and the present; by which to direct our own future [illegilbe] [illegible] which alone an indulgent providence or has willed to man a modifying influence- Chapter 2,- Containing A Brief outline of the Animal- Economy- That those who may peruse this work may perfectually understand, the authors meaning- and have some idea of the offices of some of the most important organs the human systems 10 And that members of the profession may conceive more readily of the manner in which I suppose [illegible] are contracted, and the most natural and speedy way by which they may be cured, I deem it proper that I should give a short account of the functions of those ongoing, which are supposed to be mostly involved in fevers, as dull as most other diseases- It is the office of the stomach to receive all the ingesta both solid and fluid, designed for the nurishment and growth of the whole body It is by the very peculiar action of this organ and its secretions, that the first process, and important part of digestion, is performed- So soon as the stomach shall have performed its office on the varied aliment, and drink taken in, then the whole of the residual mass passes on the first portion of the intestinal canal called the duodenum, where the ingesta in its present state of preparation comes [illegible] with the peculiar fluids secreted by the liver and the pancreas, called bile and pancreatic juice- Through the agency of these secretions of the nutritious matter called chyle supposed to be elaborated from the food; and [illegible] lacteal and absorbents, situated in this [illegible] portion of the canal, stimulated by its [illegible] [illegible] take it up to carry it into the general circulation for the nourishment and the support of the whole- The digestion being thus principally performed by the stomach and duodenum, the food continues its passage downward through the remaining small and large intestines to make it exit from the bowels by stool, being no longer fit for the purpose of the economy; however affording more or less matter for the absorbents throughout its whole extent 11 The Lacteal and absorbents above mentioned, having carried the nutritious portion [illegible] which was taken into the stomach the chyle, into the receptacle of the chyle, where [??aming] a white or milky appearance, it is carried through this duct to be emptied into the left subclavian vein- at or near its junction with the internal jugular, and there mixing with the venous blood carried into the great descending vein called vena cava from thence into the two cavities of the heart, (the right auricle, and the right ventricle) from which latter it is propelled into the pulmonary arteries and carried by the various ramifications of the same strength the lungs, in which it is properly prepared for the action of the air for the [illegible] uses of the system- Being thus assimilated it is carried back by the pulmonary veins to the left auricle from thence the [illegible] and from thence, it is propelled into the artery on the spine called aorta. [illegible] thence [cross out] is distributed through its numerous branches to every part of the body- Having passed through this routine of elaboration and circulation and attained its highest state of vitality it reaches its final distination in the capillary Tissues. The fine net-work to be found in the parenchymae of all the glands- as well as all the surfaces- both internal and external called surfaces of relation, the most considerable of which is the external cuteaneous surface. Now the object to be accomplished in the [cross out] animal economy by the circulation of the blood, which has been justly called the vital fluid, or manifold: but for our present purposes it will only be necessary to dwell 12 On two of them- The one is the disposition of atomic molecules.- in other words nutrition the other is the preformance of the offices of depuration, or the elimination of useless or redundant matter from the system- In this latter capacity the skin and it auxiliary, the lungs, by their respective process of sensible and insensible perspiration, and Inhaleting or exhallations leave duties assigned them more extended, and equally important and imperious as any of the functions of the whole animal economy, that portion of the blood not expended or eliminated in the capillaries is returned to the heart and Lungs for further preparation, or retain and preserved in the circulation for the future [al??] of economy and not returned to the stomach and bowels, where it was first received where it was first elaborated [illegible] [illegible] since demonstrated by many [illegible] [illegible] What there is more [recumion??ious] [illegible] through the pores of the skin, and by its auxiliary, the lungs (for these surfaces in print or desperation, perform very analogous offices) than by stool by urine and by all other out lets of the human body united- this fact should never be lost [cross out] sight of for on it acts an important stept toward the knowledge and treatment of diseases,, There are many persons, individuals who enjoy good health,- usually of good digestion too,,- The exhalations from whose bodies, partake of the [illegible] of the excrementitious matter of the Bowels There are others, again whose perspiration has a desided urinous odor,, in such person, perspirat is usually abundant, while their healthy habits, act, to urinate but little and to defecate but seldom- it should be recollected, that every organ of the body- the liver the lungs 13 the kidney, the stomach, the bowels- the brain, the nerves, the muscles et cetera, [illegible] receive their support by and through [illegible] before mentioned process of digestion circulation an assimilation, and that of all these organs- perform their respective offices promptly and harmoniously when under the influence of their [cross out] appropriate stimuli, and when not obstructed or deranged by some offending cause or causes, but these causes; are numorous, in kind, character and quality as also variable in degree- We come now; to the investigation of that part of the body or animal structure [illegible] the encephalon or brain, and its appendages or elongations the nerves- Here we find both structural and functional phenomena [illegible] peculiar but in many respects- widely [illegible] from that of all other organs yet [illegible] portions, of organic matter inseparably connected with and depending or other organs other structures for its support- particularly that of the vascular and muscular systems the one peculiarity of the brain consists in its [ex??] from cellular reticular tissues and the deposits of adipose matter) Brain, though not affording adipose matter) in its common sense, furnished with (peculiar fatty acids containing phosphorus) the intermittent character of its functions and the function of the nervous system generally all is evinced by the emperian necessity of sleep While other functions of Animal life are in full force- such as circulation respiration digestion et cetera, Another peculiarity consists in its susceptibility of being acted on. and that in a very eminent degree by the instrumentality] of moral, and intellectual stimuli as well as physical 14 stimuli, which alone, make an impression on all other organs- it is to this latter peculiarity that we wish to draw the attention of medical men; its uses and its influence we think much more extensive and important than is generally supposed, by the members of the profession- We do not mean to enter into any enquire upon the spiritual or mental immaterial agencies in human phenomena; but shall consider the brain in a strictly natural and philosophic light, as the seat of all the sensations passion and emotions, and as the mutual organ of thought- it is by the instrumentality of this organ, through the medium of its nerves or that all sense of pleasure [cross out] or pain is felt that averson or desire is produced that every organ is made alive to as appropriate stimulis and every muscle [illegible] that body would be deprived of motion or sensation without its benign influence it [illegible] therefore, an all prevading power both in sickness and in health the animal machine is not governed by the laws of mechanics; no by these of hydraulics; nor those chemistry: nor by a union of them all; but by laws by forces peculiar to vegetable and animal existences called laws of vitality, and which are more or less modified by the influence of the before named laws or powers as we shall endeavour to explain- The machanic laws are recognized, and most aptly exemplified in the boney and muscular structure, in their aptitudes to the purpose for which they were designed and in the amenability of the whole both solids and fluids; to the powers of gravitation- The hydraulic laws are observable to a limited extent, in the valvular structure so common throughout the vascular and lymphatic systems and the influence of both must be admitted from the comfort and advantages of 15 position more especially the advantages of the recumbent position during sleep, thereby giving [illegible] to the solids while it facilitates the passage of the fluid elements through the whole body- As to chemical laws we conceive them to play still a much more important part in vital machinery- Physiologists and chemists have both long since concurred in the general belief that the oxygen of the atmosphere and the functions of respiration had a decided agency in the production of Animal heat, however widely they may have differed in their particular views as to the modus operandi, in producing the effect Whoever desires to keep pace with the progressive development of organic chemistry will be [illegible] with the recent experiments of professor [illegible] Europe, contained in his reports on organic chemistry applied to Physiology and Pathology_ The learned professor has gone into a careful [illegible] of every portion of the human body,then into the analysis of every description of [illegible] both fluid and solid, on which he [illegible] he might discover all those elements [illegible] food best suited to the products [illegible] necessary for the body- The results to which he has arrived are truly interesting some of which we will introduce He says:- that every notion every manifestation of force is the result of the transformation of the structures [??of at] substance_ every conception every mental affection is followed by changes in the [illegible] of the substances of the brain, it is to supply the [illegible]? Thus produced that food is necessary- Again vitality in the ruling agent by which the [ale??ical] powers are made, to subserves its purposes, but the acting forces are chemical The professor further observes: That the neutral action between the element of food and the 16 oxygen of the air in the source of animal heat- All living creatures whose existence depend on the [cross out] absorption of oxygen possess within themselves a source of heat independent of the medium, in which they exist I therefore believe that the oxygen is in its nature one of those properties which sustane Animal life This heat in professor Leibigs opinion is wholly due to the combustion of the Carbon and hydrogen contained in the food which they consume- To this last result of the professor, we are not entirely ready to give our assent, unless intends to include the galvanic and electric agency in the development of caloric, as coming under his veins of the union of Oxygen and carbon or oxygen and hydrogen and in this way account for the sudden developments of heat which we frequently witness under impressions of moral laws; such as the sudden flash of modesty on the virgins cheek, which we think to be too instantaneous to be achieved through the heart and the circulation- Another remarkable and useful result to which, the professor experiments- have led- is connection between the food on which we live- and the physiological result to the economy- From all the articles of diet which man, is accustomed to consume he has been enabled to point those that abounds most in the elements for the formation of bone of muscle of fat of cerebral mass or even the matter of heat, or in other words, the diet to give, strengths of bone of muscle of passion and of thought on which abounds in the elements of heat So important a part dose the phenomenon of clinic animal heat perform in the 17 Animal economy, That some deluded minds have been simple enough to contend, that heat is life that the want of it is death- they mistake a symptom a single penonenon for the [u???um] taken Perfect life perfect Health, consists not in the high degree of elevation of temperature but in [cross out] ability to maintain a proper degree under different circumstances and that degree is different in different orders of animated nature- What should we say of all those numerous families of insects, of reptiles, yea, of the whole round of cold-blooded creatures, that for the most part remain torpid, cold, and, even in many instances froz Through the whole winter, but yet revive again with the return of the genial heat of Spring! Shall we pronounce them dead or in a state of suspended animation merely? That the general reader may he better comprehend our Theme, and that our own particular views may be more fully carried home to their understanding all propose in the next place, to give a concise and as clear an account of the theories of medicines [cross out] that have at various periods of the world found favour in human estimation as the nature of the subject and the nature this work will permit- Engaged as we are in effort to cast what light we can on a particular class of diseases only, we do not feel ourselves under any obligation to a critical examination of the history of medicine or even to sew up in regular order a Classification of the varied chains of thought that have at different times occupied in the minds of distinguished professor, and writers; but to introduce and dwell on such only 18 as have gained or obtained the greatest notariety, and such as may best suit us our present purposes- What, then, should we understand by the science, of medicine; It is that science which treats of diseases and their remedies- The term medicine from the verb medios to heal, has given to the professor- the tittle of the healing art, with the greeks it was mostly confined to surgery and to the use of external remedies- let was for Hippocrates, to lay the foundation on which [cross out] succeeding ages and nations have built, He first separated it from Philsophy_ gave it the form of a destinct science and personally observed the progress of diseases as well as the effects of remedies on this account he is styled the inventor of the medicina clinica But we are endeavouring to lift the veil of mystery from the feature in the physiognomy of man called fever- Now, the theory of fever is inseparable from the theory of medicine, which comprises the doctrine of the nature of man the nature of his diseases and their remedies used this involves the doctrines of Vitality the laws of human life,-and these again the will of God as made manifest in man, in the lords the theology of humanity now man since his first introduction on the theatre has been ever subjected to great and perpetual changes, every condition of his existence stamps, its peculiar character on his physiognomy and with it corresponding moral and mental manifestations, he is the subject of continued change he is modified by climate by soil, by food, and even by the face of the country, in which he lives- To use the Language of Dunglingson, man changes 19 much near changes often, yet he changes not radically- On these facts is bassed the usefulness of history, whether it be of law medicine or divinity- The absolute truths, of humanity ever the sour in proposition as they became disengaged from the masses of error, with they are by nature encumbered are distined to flow from generation to generation- from nation to nation, in one continued stream of light in ceaseless and rapid augmentation to the end of Time; or to the terminus of all human truths. the full unfolding of man, to man, the complete development of the philosophy of humanity- The proceeding route of inquiry has been crowded with l'etaries, now more than two thousand years and though, the labor of no one individual have been entirely, crowned, with success, the world is still much indebted to every one for his particular toil for while in the distance of time- and the darkness of ignorance that overshadowed the earth any light was better than no light and the many lights enabled the latest Laborers to compound light and thereby obtain- a cleaner and a brighter view than feel to the lot of any of his individual predecessers- To what particular in this department in this position or department of philosophy is increased- and complicated circuit of ideas we may have reached will be for posterity to decide- That the terminous has not yet been reached is certained from the fact that none has stood the test of Time, and of criticism, not one has carried conviction to the mind of all, however lauded however popular many for season may have been_ 20 It seems that we ever have been, and still are, in a state of progresson [illegible] progression its self implies a position short of maturity- All absolute disembodied disencumbered spiritualized truths are pure elements of philosophy, from whatever source they may spring Law, medicine, religion fashions are the subjects of continued, because they partake of the changeableness of man, while the pure elements of truth which belong to them are the same to-day, yesterday and forever- Let us return to Hippocrates the coan sage: He was a philosopher, who turned his attention to medicine as one of its branches- Not all the portion of him which has withstood the test of time belongs to the philosophie element of which he was composed, or containg the particular truths of the science of medicine disencumbered by himself as we shall presently show- philosophy, was interior to medicine it is coeval with man with theology- Theology now, and philosophy when rightly understood are one and the same thing- It was it is it ever will be, a prime, a constant a universal want, a universal desire of humanity, while medicine, while medicine and Law are only secondary and accidental wants- Medicine as science: commenced with the coan sage. Anteriorly, all thing were under the dommion of theocracy, and the state But in proportion as time roled on population increased, wants multiplied, and the minds of men agitated in the cradle of civilization the ancient dynasty, gave way then from the elements of humanity sprang the profession commonly called the learned 21 profession of law medicine and divinity These assuming the guardianship of the people and the state branched off each in separate trackes to pursue it destine course; all professing, and with more or less sincerity too:- to be laborers in the cause of human good- each still standing apart has continued its assigned route up to this our time, our place. But springing originally from the elements of humanity they are doomed sooner or later necessarily to meet again, in her element, springing from special wants special necessities and from peculiar frailties common to her nature they can but in the general the universal wants, the philosophic element of humanity But it is time to leave the walks of general philosophy to enter on the examination of those that are peculiar to the task assign viz: the philosophy the theory the truth - of fever It was by the coan sage, we think the the first elementary and the first [cross out] [cross out] imperishable truths were spoken, when he affirmed that fever was an effort of nature to expel some offending cause, or humor, from the body- Now this sentiment, so far as it goes, we hold in the abstract to be true, but the has faild, in his explanation of its modus operandi- he was compelled to fail to fall short of the full clearing up of the subject for such a thing would have been without the pale of the circumsatances of his existence, going a head of the minutiae of the science. The knowledge of which minutae is indisposable with the full, the clear the transparent 22 View of theme- His notions of the four elements of blood, of phlegm, of yellow, and black, bile, modern reaches compel us to lay aside: while his leading his, elementary his philosophie element will stand- His views upon diet, exercise, and the influence of Malaria in producing diseases, are for the most part, based upon sound experience Here he errs again when he dips into the minutiae of explanation- From this doctrine of the four elementary humors have emanated the doctrines of Galen, and with varied modifications of all the humorists down to this day, receiving continually the lights of the minutiae of science, as the sciences progressed- But it would be trespassing on the time the patience, and the good sense of the reader to go into a detailed account of the varied grades and shades of light that belong to the different champions of the humoralistss, schools: suffice to say that disease was laid at the feet of the elements of fire, by others of water, of phlegm, of acid of Bile, and of flatus, &c. From the idea of flatus with the greeks, probably originated, those numerous conjecture phantoms, ideas, which at different times differ places, have assumed the various names of spiritus. Anima, Neuma, Soul, Spirit, Vita Motis, Phanus, Eros, Cronus, Ulomis, chusarus, Aura, Aroma Vis, Medicatrix, Naturae et cetera Now, under any or all of these titles do we recognize an element of truth but that element has not yet been fully evolved- At this time, at this every hour while we write, is this phantom, this phenomenon in one of its protean forms, held up in wonder to the admiring gaze of the populace by the followers of mesmer, but we have not time to expatiate on this feature in the phenomana of the neumena of humanity.- 23 that more properly belongs to our next series- For the sake of brevity we have thought fit to link together some of the [illegible] Rival chains of thought- Let us then hold up to view the Rushites the depletives, with the Brunonians in modern nomenclature, the Thompsonians, the steamers standing at the distance that we do, and beholding, the movements of these rival captains, and their well armed followers, on the battle-field, recalls to our mind a passage from a poet of Rome one of the favourites with us in the days of our boyhood (demr stali vetanl alia vitia current, in contraria) of planiea, as follows- While the one is running depletion to excess, the other is running on the opposite extreme- As though none could not perish, as well by suffocation as by exhaustion alias, as well by fire as by the sword_ Veritary [illegible] inter extremas explained) to wit- Truth lies in the middle- As to the [illegible], and the solidists, we see but little choice between, them; to us both parties seem to have taken results, in the depurative efforts of nature for their causes- The one locates fever in the liver, and attempts to prove it by a very fanciful flurish about the portal circle, in the circulation of the blood, while the other locates, it in the mucous membrane of the stomach and intestines, and rests its proof on the numerous autopses- As to the result of their different modes of practice again we see no choice- From our personal observations on the theatre of life we are led to believe that the one as many souls has purged away as the others bodies saved- But, a record to the enlightened founder of solidism- When the ancoatal, Broussais 24 of Paris has reviewed the history of medicine, and with great skill, and with great judgement enlisted the labors and the thearies of every predecessor, and upon them ruins based his localized views of fever he then went on to demonstrate its truth by his numerous autopses; he thought no doubt that he had reached the terminus of thought the handling he christened (as par excellence) the physiological doctrine, and the world has accepted it under that specious tittle- But to us only serves to recall to our mind a passage from the inspired author of our text- The wisdom of man is folly for he taught the wise in their own craftiness- The rigid mental discipline common in schools of medicine throughout continental Europe, while they tend to perfection in the manifestations of art, either in surgery or medicine, are well calculated to circumscribe [illegible] the native spontaneity of thought in general expanses of mind so indispensably necessary for philosophic generalization and progression in science- Thus we are enabled clearly to see the influences of the force of circumstances which compelled Broussais to blunder- His [crossed out] physiology is based on anatomy; his pathology on his Physiology, and his autoposes served only to confirm him in error he had not learned so to abstract himself from the purely physical man as to see and to comprehend the Laws of his neumana alias his vitality, or in other words-again, he could not compass the [cross out] whole man in connection with the whole series of causes and their consequence; therefore he took a result of fever for its cause 25 What then is fever; We conceive it to be an effort of nature inherent in all animated, creatures, to sustain its own integrity from the deleterious opererotions of causes, of whatever kind, by which it may be assailed; in this sense we make fever in its essence a unit, while in its phenomena, its physiognomy it is multiform and that multiformity of character proportioned to the peculiarity of constitutions send circumstances of existence and the nature of the varied causes or agents that are made to stamp diseased impressions on individual sensibility or the sensibility of particular organs, particular, [illegible] of his completed machinery, which machinery should ever be considered as a unit one whole- although composed of many parts while by indisoluble laws of unity; its nervous chords the true the only medium of that much used much abused and illy comprehended term called sympathy- The- difficulties we should not lay errors in the labors, of all who have preceeded me [illegible] consisted we conceive in two reasons: the one is, that the element of man, of medicine, and of nature, were not sufficiently evolved; the other in the want of development of mind, the ability the liberty, The expanse of thought to enable them at a single coup de ceil, to compass the whole man, to comprehend the harmony of contrariety, to be hold the unity of variety, that delved within him, or in other words they have been like unto certain eastern reviewers, of certain philosophic thoughts on certain earthly phenomena, called Cholera, asiatica whose intitled, being too 26 limited too local, to comprehend a phenomonan [crossed out] which encompassed the whole Earth very shrewedly suspected, that in the same category should be included the whole of the ballance of us= Now since the reviewers have failed to comprehend are thoughts on a feature in the physiognomy of humanity, we have concluded again to try them with some thoughts on a single phenomenon in the physiognomy of men; or using the wards of the inspired author of our text meats have we offered them, but find that to milk they must return,"- St. Pauls Epist to the Corinthains 3, Chap. 2, Verse- But it is time to leave the follies of the learned,, and look to nature as the fount of light- Too long now has man the World beguiled by promises of art, too few have looked, to natures watches, to see, to have the modest dame; the still, the secrect and the silent ways, the sure, the lasting operations of her laws- Through spectacles of books the world has looked from times begining down, it is time to lay aside the mask; let nature speak to nature now, unmasked,- But man, frail now, will say it is wrong to strip the damsel of her gown- We write for men; their voices we must obey- Then let the maiden stand not bare but covered with a veil- But to the labors of our task let us return once more, for on us the duties fall to make our footing sure,- We have thought [ap??] man into one complete, one perfect, wholesome living mass of organized machinery- Now in as much as His treaties, is intended for general, reading and extended usefulness to go to the families and friendes of the community the great body politice more than the learned World all conceive it to be our duty in the illustrations of our theme, in the applications of our theory to 27 practice, the result of which is the only proper test of truth, to dip as little at possible into the mysteries, of minutiae- that is into the play of atomic phonomena, atomic affinities- as such a cause would serve only to embarrass the tender mind, and be productive of no real utillity- What, then, is health, but the harmonious play of all the solid structure the equable and harmonious play of all the fluid matters, the healthy response of every surface, of every organ to its natural its healthy, and its appropriate stimuli? What, then, is disease, but an interruption of this play, in some in any way, in every way as the [c??] may be? Diseased action- that is a departure from the healthy action may result from many causes- and in very many ways- We shall in the first place, enumerate the avenues of offending causes, and than proceed to mention some of them merely for the purpose of illustration for it would be going intirely beyond the spirit, and intent of this treaties to attempt a full and complete narration of Causes or of their modes of operating as such a View would require the compass of many volumes- We shall therefore content[illegible] with citing such only as are best Calculated to give him a clearer view of the nature of disease[illegible] he may the better see, the indications of one, and be enabled, to vary his steps in the use of remedial agents, so as to bring about, a return to healthy action, in the safest way and the shortest space of time- and with the last possible detriment to the constitution of his patients- The prime causes of all febrile diseases no concern to operate on or to pass not the system through the following avenues, viz) 1st, through the nostril, the larynx, and the lungs- 2d The whole extent of the cutaneous surface that is, of the skin, in the light of a reflected membrane, so altered in structed as to perform an additional duty 38 to wit the medium of generating heat- 4th The senses- commonly called the five senses,- That is to say the sense of seeing, of smelling, of tasting, of hearing, and lastly, of touch- In the first place, let us take under consideration the liability to deranged action through the medium of the lungs, the breathing organs. Diseased action may be produced in the breathing organs themselves, from the mere extremes of temperature, or, What is more common from the sudden transitions of temperature; or it may again result from the presence of gases positively deleterious to the organization or from the absence of natural stimuli those elements that consitute pure atmospheric air, so indispensably neccessary to life and health, when fevers result from any of the above-named causes they are likely under proper treatment, to be of short duration but here is still another way in which fever ( commonly called essential fever) is produced [illegible] near those classes of fever produced by the absorption of Malaria- That is, the imbibing the mephitic gases; that emanate from the debris of vegetable and Animal matter or both combind- These fruitful sources of diseases insinuate themselves into the Animal organization to make a marked impression, on the whole man without leaving any demonstrable traces in the particular structure through which they pass or by which they are imbibed, viz. the skin and the lungs- Now the system may be changed, with the seed of disease that is Malaria, for weeks yea, for even months, and still never be ripened into action; because it generally requires the operation of some exciting or proximate cause or, causes acting on the predisposed organization, to develop the disease; that is to produce a departure from the natural, the regular, the healthy and 29 sympathetic, play of all the structure The prime impressions, then is made on the brain_ The centre, the fountain of the sentient the phenomena, Indeed, but for cerebral and nervous sensibility; we should not be the subject of disease at all- It has been asserted by Dr. Rush, that during the prevalence of epidemic, bilious and yellow fever, in the city of Philadelphia, that persons who were strongly Changed or predisposed to fever could readily, discover it in the odor of their hand, by merely rubing them together We have frequently experienced the same thing ourselves_ But we should not overlook the disturbances of the [dep??] process or functions of the lungs as a [illegible] of fever_ The deleterious effects of [illegible] transitions_ of temperature_ may so modify the timing of the internal aflicted membrane of the lungs as to impair its ability for receiving oxygen, of the atmosphere the same time, of transmitting the elements that should be thrown out through this worst way- Again, imperfect digestion disturbs the assimulations of the blood in the lungs and in this way may prove a source of disease to the lungs, and consequently give rise to few of this we shall speak more fully when we have under consideration the functions of the stomach and intestines at is we believe principally through the medium of the Lungs or breathing organs, that all these febrile disease called contagious diseases, are propagated such as measles, small pox mumps-whooping cough and the like_ We come [cross out] next to take under consideration the liability of the system to take on febrile diseases, through the medium of the cutaneous surface 30 What is the skin- The skin is well known through its own inter extent to be an absorbing surface under certain exigencies of the animal economy- For example when the comunication to the stomach through the gullet, or oesophagus, is obstructed and The individual is suffering much from thirst then that want can be measurably supplied by sponging the surface, of the body with water of suitable temperature, or by bathing- It is by verture of this law that we are enabled, to reconcile the fact that poultry sheep, hogs and even cattle can live for some time and even fatten too. When cutt off from their regular supplies of Water to drink They then take is from the atmosphere from it four going examples or facts, we are led to the belief that malaria may in like manner, be imbibed by the skin, and this enter the Circulation when the such malaria be held in solution or in a state of suspension, merely, in water or in atmospheric air,- But the most frequent, the most common, and the most demonstrable way, in which febrile action is induced through the interrupted function of the skin, is the sudden transitions of temperature, particulary the impression of cold and humid atmospheres; these causes operate by putting a stop to both sensible and insensible perspiration, which we have already shown to be the most extensive, and as essential an outlet or was way for the redundant or useless matters of the system, as any excretory organ of the whole animal economy,, But happily for man, skin possesses within itself, the power a most eminent degree, of adopting itself to the surrounding circumstances in which it is placed- There are however constitutional, peculiarities in the textures and faculties of the Cutaneous surface of different races of men, hence the stronger the odor of the exhalation from their bodies even under the same clime and the same mode of living, 31 The African race for example have more highly reticulated surface than the Caucasian or other races of men- Hence in all probability their comparative immunity from the deleterious impressions of malaria; the depurative offices of their skin being more actively performed- We come to the consideration of the mouth, the stomach, and the intestines, as natural inlets of disease, particularly the seeds of febrile diseases this we shall trace through the medium of of the food- By this term we mean to now, to include all the necessary ingesta to sustain life both solid and liquid and aeroform fluids- Food although it be continually required to meet the exigencies of the system, maybe and frequently in instrumental in the production of disease in one or many of the following ways, ([to??] first by too long fasting or the scantiness of nutritious matter in the food taken or its indigestible form or nature; or again the want of the particular, elements most needed at the time by the particular individual the first impressions of long fasting is the sense of hunger, then in the stomach. Then of fullness and pain in the forehead, with a general sense of langor or debility next comes- the fever- c vas This fever is the result of simple irritation of the brain from not having received its accustomed stimuli; the same results we have frequently witnessed from the stomach not having received its accustomed kind of food- for example milk in the place of coffee for breakfast What now is best to be done? The Doctor comes bleed puke, purge, and sweat or administers a mess of meats soup tea or coffee as the accustomed habits say- The food the ingesta, the alimentaria may be production 32 of disease from mere quantity whither it be in a solid or liquid form. The over-distention simply may paralyze the action of the stomach- Again when ingesta is too much for the gastric secretion to same from the play of chemic laws; that is of natural decomposition in other words, of indigestion, then the food becomes a source of disease; now, this result may take place in the stomach, or it may not be felt until the food reaches the intestines, then you may look out for colics and for bowels complaints and lastly for fevers. such fevers would be strictly symptomatic; but of this we can say no more as our business is to explain idiopathic or essential fevers- The uses of the saliva and the objects be accomplished, by mastication, we think have been but imperfectly understood untill now The recent experiments of the professor Deniglinger of Philadelphia, have thrown much valuable new light on this subject- The learned professor asserts that the viscid nature of saliva is intended in the economy of nature to envelope globules of atmospheric air, and thus by masticating our food, we introduce qualities of oxygen [illegible] stomach, to pass from thence into the circulation to maintain the slow combustion so necessary for the production of animal heat the professor further states that one main object in ruminating Animals is to unite an additional quantity of oxygen with their food- Now if this be the fact and we do not question it, the reader can readily conceive how it is that malaria which is inseparably united with the atmosphere, finds its way, with the food into the circulation- Who ever has witnessed the ravages of what is called milk sickness on cattle, horses, hogs, dogs, men, and Vultures of the air also can readily conceive that poison may enter by the mouth and stomach into the whole organic, mass- We have witnessed it effects repeatedly, and on 33 a pretty liberal scale, but of this we may speak hereafter= It would be going beyond [cross out] the intended limits of this treaties to attempt to show the many elements, and the many ways in which diseases or even febrile diseases may be induced through the medium of the extended catalogue of drinks and aliments; yet we will make one other remake, before we have this division of the subject, it is that a mere deficiency in the liquid elements in the system, may prove a source of disease as we have repeatedly witnessed when water was scarce, or was of such quality, that it only taken when pressed by very imperious calls of nature to allay thirst- Water is known to be continually, required to maintain a proper fluidity in the blood- In warm weather particularly and to laboring men, it is constantly expended by the exhalations from the skin and lungs It is a fact well known to the profession, that when the serum, the fluid element of the blood been wasted through the stomach, the bowels and the skin during the reign of the recent epidemic Asiatic cholera, that many individuals who had this run into collapse, were again resuscitated restored to life, and to health, by merely injecting simple water, or salt and water into their veins I promised to explain the five senses in this chapter) as avenues of disease- This investigation involves all mental emotions and phenomena, or to speak now properly, all encephalic, which is the brain movements and perturbations and the laws of sympathy these unto belonging- First, then let us commence with the olfactories the nose and the lining membrane through- while none but the natural sound and healthy generations, from fruits from flowers, from men, and animals floating in the atmosphere impinge on the organ of scent, all is well 34 Indeed who is it that has not a pleasurable exaltation of brain, of thought, and through it of the whole organism from in holding the odors of nature's laboratory, at the opening of the spring or on a ramble over the spice islands of the South and east- Now should we but change the scene, and let the olfactories, meet on every hill and every plain, in street alley and the main, nought but mephitic gases of the dead, of men, of animals and plants of whatever kind, of whatever hue, then the perturbation of the brain delirium, first and fever next succeeds also creations wild and horned fill the whole machine, and onwards onwards moves to death, from whence he came- Taste comes next The [illegible] direct and sympathetic associations of taste are either or both very frequent causes of mental perturbations, and even of physical convulsions, as we have frequently witnessed, and occasionally experienced ourselves. Who is there that has never lost a meal from having swallowed, or even having imagined themselves to have swallowed, with their meats, milk, or other drinks a fly or some more loathsome object? I recollect once in the days of my boyhood, to have taken a few grains of Calomel and jalope in a piece of preserved fruit pears, and how this seemed while I labored under inflamation of the stomach more than fifteen years have elapsed and to this day my stomach would reject a preseved pear, and if the calomel were added probably a gastritis would ensue. we have heard a story of a learned medical professor, whose native modesty in the juvenile period of his life once compelled him while at the festive board of a friend, to take down a chick from the egg, that have been cooked through mistake 35 (and what is still more strange as the story goes) it stuck- But we question much if that stomach has ever has a fondness for eggs in any way sense- Hearing next in course- The sense of hearing comes next in order, which is the last to die- That is to leave us- This sense play an important part, in the drama of life_ The deaf man is always serious- for the most part melancholy; will the blind man plays the fiddle whistles, sings, dances and is talkative and gay- The immortal Homer, the blind poet of Greece, sang his Iliad and ossian Odyssey too long after he had lost his sight, Milton wrote his paradise Lost after he had become blinds- The ear, then, as a medium of intelligence is not less important than the eye- Through this channel [illegible] The passions, the emotions, the neutral perturbations yea- all the manned of physical and moral action either for good or for evil,- be produced- The tones of the orchestra falling on the ears of the auditory are made to elevate or depress at the will of the performers- Just so the power of speech The narrator or orator, now inspiries with hope now gladens with joy, anon, he fills with dispair or maddens into rage: Then comes the fever of combat, or the fever of disease- Touch So still another sense which claims our especial regard, we mean the sense of Touch or the impressibility of man by the surrounding circumstances of factitious Causes- Men in a state of nature and of nudity is a very different animal, from man dressed up and put in houses- The well-dressed light headed, civilian hears of or beholds with astonishment, the debaucheries and excesses of the naked aboriginal or debased African the brutal. [illegible] or the inhabitant of remote Polynesia_ But not so with the philosopher: he comprehends, the reasons for all these things, and wisely concludes, that whatever is, is right," that it is of necessity: and then your [illegible] civilian, would be astonished to find with a change or circumstances- how soon you would learn to drink brandy, eat fish blubber and horse beef and appreciate the dilacacies of train oil- But it is time to come a little nearer home to every day experience- There are varied grades and shades of susceptibility and impressibility among ourselves for example; the stings of venomous insects or the handling of posionous plants do not affect us all alike, for one man is proof against spiders wasps and bees while another is laid up with a [illegible] by black gnats and mosquitoes_ some handle the posionous oak (rus toxacadendron) with impunity while other one laid up with eruptive fever by it, but none entirely resist the posion of the rattle-snake the cotton mouth or the [illegible] mad dog- now this is all a mystery yet no mystery too- That which is to [?oma] mystery is still mystery is to you- Again we observe very different susceptibility and impressibility in different individuals, and indeed in whole families to contagious, and infectious diseases, some taking on diseased action from the slightes contact while other resist entirely- These facts we have known exemplified in an eminent degree in syphilis- But to offer explanations of these things would be going beyond the limits of this work Chapter 3 An this chapter we shall endeavor to explain the authors Views and opinions in regard to the common theories and 37 practices heretofore adopted in the treatment of fevers; [illegible] endeavor to demonstrate the folly and irrationality of the varied modes of practice pursued under the influence of these theories- We shall commence with same [com??] in the depletion remedies- First. The use and abuse of the lancet. Second. The use and abuse of emetics. Third. The use and abuse of cathartics. Fourth. The use and abuse of diaphoretics- and conclude this chapter with some comments, or moral and intellectual views on the use of stimulants- Having in the preceeding chapter given a brief summary of the animal economy and death somewhat on the offices of those organs [illegible] in the phenomena of fever all shall now attempt to [illegible] to the satisfaction of every imprejudice mind, the error [illegible] impropriety of attempting to cure fever, by depletion that is by bleeding, puking, purging, sweating, nauseating medicines and the like- It will not be denied by the followers of the anti-phlogistic, schools, that they [illegible] that fevers are almost all, more or less of an inflammation character; or that febrile existence in their estimation implies a state of exaltation of one or more of the [illegible] life: and that they consequently infer, from this view of the subject, that relief is to be sought for and obtained by and through the agency of remedies more or less [dep??] in their opperations, that is to say, bleeding, puking, purging, sweating, nauseating remedies and so on! Now while we are free to admit of a state of irritation, a state of perturbation and even more a state of exaltation for the time being in one or more tissues, we shall endeavour to show that it is not best to depend on depletive measures to restore the system to its last salutary balance and healthy tonic action- For while we admit a perturbed, and even accelerated arterial action to exist in some of the organs, some of the tissues, during the paroxysms of fever we contend that this accelerated local or local and general arterial, both combined, in the result of a loss of balance of the whole system accompanied by a more or less [su?fecbled] tone and debilitated action of a 38 parts or of the whole economy- While we believe the use of remedies and give our assent to the salutary influence of remedial agents of the varied kinds that have been heretofore brought into use- we [we??d] [?igh] never to misunderstand or to run counter to the indication the calls, the laws of nature, as enfolded in every individual case= We already comprehend from our knowledge of the laws of supply and water, in what way the followers of the depletive, the antiphlogistic schools have [illegible] achieved the restoration of the lost balance (the cessation of febrile diseases) but we contend that the depletive cause alone, is not the safest the best The surest and the shortest way to esestablish the normal action so also we stand opposed to all those enthusiasts in the healing [illegible] who have been so rash as to think and even to [illegible] we should take the case out of natures hand [illegible] own, and treat it according to the rules of [illegible] when the indications of cure are not strictly [illegible] to the understanding, we then hold it safest [illegible] to adopt the maxim of an aged medical friend, that the error of omission is less [illegible] than that, of commission- Then let us [illegible] and carefully observe until nature speaks out her wants- The depletists continue that their treatment is necessary, and proper if not to subdue inflammation to guard against it; hence they take blood- to febrile heat and hurried action still continuing they admister pukes, they say to expell the morbific matter, and thereby subdue the disease- The heat to the skin and perturbed actions still continuing they administer purgatives- still to redue the fever and to rid the system of morbific matters- The fever still runs on. They repeat their bleeding emetics, cathartics, still to redue or to elimanate morbific matters from the stomach bowels, or gall-bladder; under the little vitiated bile- Well what next! Now comes either a cause of nauseating and sweating drugs, or else alterative 79 cases of blue mass or calomel- By this time the race is nearly run; the patient either begins to mend in spite of the doctors, or retreats from their custody- But cause there is evidently a hot and dry skin, thirst, often heat and burning sensation in the stomach and bowels a quick, fretful, and irritated condition of the pulse with more or less of pain, they contend that there is more or less of an inflammatory diathesis,- As plausible as this argument may appear it proves but little in support in the position taken, even in a theoretical point of view, as we shall attempt to show- In the first place, we hold that no fever proper, is strictly of an active inflammatory character- Our proof is as follows= All real and acknowledged inflammatory [affections] in the natural and unbiassed order of such phenomenon- run their course come to a crisis niether more nor less than eight or ten days- this law is so precise and notorious that the ancients from their experience settled [down]; on the nineth day as the fixed period to [arrive] at a crisis- But when the old practitioner attempt to apply this law, to fever proper they erred- Hence at this period of time the idea of critical days has nearly run out of use- Now we [did] contend contend that this law hold good in acute pleurisies fractures, and in all cases of fever from mechanic violence- The same laws is manifested in the [exanthemata] (eruptive diseases) Such as small-pox measles, &c These diseases are known to all medical men to have a prescribed course to cure, and the intelligent practitioner aims to conduct them to a solutory crisis- But not so with fever proper- Yellow fever- plague, cold plague, Typhoid fevers, and other forms of putrid fever such as camp, jail hospital and ship fever and the like (to which might 40 be added (cholera morbus) are all the natural and legitimate offspring of human folly. often kill their subject in a day, or two, while again they run ten, fifteen or twenty days, or more before the attending physician can say whether the patient will recover or not- Milder grades of disease such as common bilious, and mild typhus fevers through they sometimes terminate life in a few days not unfrequently run a month or six weeks before any one can say, that they have even reached a crisis- Fevers then bear some analogy to ill-conditioned sores and ulcers having no fixed period for coming to a crisis- Fevers however are always of a general character, while these [illegible] and ulcers may be either of a general or local nature, or both combined- But their continuence most probably depends on a [??lilated] and abnormal, or irregular action in [illegible] depurative, process of the system that is, the play of the secretory and absorbent vessels, the vital force being enfeebled or the vital fluid (the blood,) not containing the proper elements or its elements not being in their natural and healthy ratio, the consequence will be inaction, that is effective vital secretion hence in such cases we rarely see a due proportion of animal heat, soreness or inflammation in those parts; never the proper quantity and quaility of well digested pus (matter) well formed granulations untill some favourable change is produced either by nature or by art and this change is much more certainly and speedly made by such agents as will equalize the excitement and purify the secretions without debilitating the general system than by bleeding puking purging and nauseating medicines-- When the sores and an ulcers are of a local character general 41 treatment may not be necessary- But the application should be alterative one deobstruent astringent tonics, or medicines more or less stimulant should be applied- But it will be asked, if fever is not inflammatory what it its character? We would say that fever is a disease of irritation; or if you prefer it, and and allow the expression, we would go so far as to admit that it may be a disease of subacute inflammation- But fever never runs up into active inflammation Secondly although there is a hot, dry skin, thirst after heat and burning sensations in the stomach and bowels, a quick fretful irritated condition of the pulse, with more or less pain, still [illegible] there is not a general preternatural excitement [illegible] system- On the contrary, that there is a [ge??] diminished action, and a general [a??] of tone- When the organs of supply that is the absorbent vessels, act with abnormal energy is an energy too great for the organic [illegible] that is the organs of elimination and of [illegible] viz: the skin kindneys, and lungs; then the phenomenon of fever takes place that is the circulation is perturbed and the skin becomes hot and dry, in other words, the equilibrium disturbed, the healthy balance lost- Now [illegible] this state of things occurs from the cause that produce fever proper we contend, that while the vital action is in excess in the one class of vessels it is in a proportionate, torpor in the other class and vice versa so these oscillations continue to take place- constituting the [re??ssious] of fever of diseased phenomena: untill, by the [??adiden] conservative, powers of nature or through the wisely constructed agencies of art, the whole economy settles down to the natural equilibrium, the healthy balance again- or else terminates in death- Now this vessels, that is the vessels of 41 supply and waste, are in one sense antegenistical in their action so that when the stomach and bowels are acted on by pukes and purges, the exhalants of the skin, lungs and kidneys too are proportionally inactive or Torpid- suppressions of their accustomed functions takes place for want of the matter to eliminate, they have been thus directed to another channel, indeed the prime elements are released by this process- that is the regular supply for the time being cut off- But it is further [illegible] that thirst is again a sign of inflammation- It were probably the existence of this symptom in the epidemic asiatic cholera which [illegible] Braussais to administer cold drinks, to [illegible] even ice, to his patients- To disprove this [??tion], it will only be necessary to cite a few common occurrences, familiar to the experience of almost every man, any one of which facts is worth more, than a thousand Theories- Whoever has suffered long in hot [crossed out] weather [illegible] want of water, as many travellers and soldiers have done have found their skins hot dry, and the sense of thirst inffusably great, so also, whoever has witnessed the war- worn soldier or the citizen [??ttering] in his own blood, and dying for want of it could not fail to observe the animal heat departing from his skin, with the failing of his pulse while at the same time his cries for water ice water becomes greater and greater to the last- Now could any one be so stupid as the think or to say, in either of these situations because the skin was hot and dry so the thirst great, or both or, thirst with neither with neither of the other conditions that the subject or sufferer [crossed out] the subject of inflammation of any kind or in any tissue The thirst on 43 either of these situations is demonstrably the consequence of a deficiency of the fluid elements of the Blood- Some as hot and dry skins as we ever felt, were in low protracted cases of fever, where there was evident debility, and much prostration in every part of the body- Every man familiar with fevers must have witness the same thing- The hot and burning sensation occasionally experienced in the stomach [illegible] bowels are often more distressing in the last than in the first stages of [illegible] when there is evidently general debility- It rarely happens in fevers that the pulse is any other than a fretful and irritated increased in frequency to be sure a quicker pulse in frequently, indicative of a general debility- the circulation have to make up in speed what is relents in volume and in it may be full and soft but is rarely [illegible] increased in force_ The pain ever attendant on fever is much more frequently the [congog??] of too little than of too much action in the general system- Witness the long train of painful nervous affections acknowledged to be the offspring of the irritable condition of the nervous system, attended with more or less debility of the muscular fibres- The neuralgia for example, such as chronic rheumatisms nervous colics, nervous sick headach, periodical headach or sun pain (tic doulaureux) et cetera all of which are of this class of disease constituting a very considerable proportion of the pain that we suffer, From what has been heretofore said useful a confident assurance that the attentive reader will concur with less in saying that to attempt to cure fever proper, exclusively, or mainly by 44 by bleeding, puking and purging in [in??] unphilosophical, and at variance with acknowledged principles of human physiology_ Now review it is admitted by all enlightened physilologists, what the skin kidneys, and the lungs, are the three greatest ways for the redundant matters of the system. Though there be several others of minor importance in point of amount or weight of matter, eliminated such as animal secretions and the matter of thought, the passions & that is the imponderable fluids expended in thought and the encephalic (of the brain) phenomena, we think that with these facts, these lase constantly in view [illegible] not be a difficult task to demonstrate the [illegible] heretofore commited by medical men in to treatment of fevers when they have relied mainly on bleeding puking or purging or a [illegible] of them all to cure fevers- While we admit the efficacy of all these classes of remedies, in certain cases, we wish to show the errors of all those to have depended on them as remedies exclusively Blood letting Let us commence with the use of the lancet; whoever will real in mind the Physiological View of supply and wast,, can readily preceive, that since the blood is both in the medium of supply and wast, it should be abstracted with great caution, and that as should never loose sight of the necessity of supply [cross out] it with new elements; that is we should look the proper supply of food and of drink and the necessary performance of the function of digestion in due time Or meet the demand of the economy that is to supply its waste- The proper use of the lancet in all fevers proper, we conceive to be restricted to plethoric subjects; we mean persons of vascular plethora- and young subjects, whose recuperative powers will the 45 better justify it;- in such subjects when the victims of fever, our practice has been- and our sitter convictions still are, that it is best to take off so much blood only as may be necessary to relieve the circulating system of abnormal tension; that is to give to the circulatory fluids their nature and accustomed free and easy play, and no more; and this should be done at as early a stage of the disease as the its necessities may be pointed out This opinion is the natural result of a combind experience for nearly twenty three years that is to say, fifteen for the one and eight for the other-- Emetics. The medications for the rise of emetics we hold [illegible] two and two only viz- First the evacuations [illegible] contents of the stomach, either on account [illegible] excessive fullness, or on account of the [illegible] nature of its contents; secondly, with [illegible] [cross out] revolutionizing and relaxing affects, [illegible] the waste way of the system are unlocked first time, and the general economy is thus [aff??] an opportunity of resuming the healthy last [illegible] Now, when fever is symptomatic or even when [illegible] in its proper character and the cause both [illegible] and proximate, have been slight or the [cross out] constitutional stamina in the individual is very good we have frequently found the diseased action cut short by the simple operation of a single emetic- when such results follow it the use of An emetic the patients needs no more But when an irration fails of the accomplishment of so disirable an end- We are opposed to its repetition, because it has achieved of all the good that we had a right to expect from it, and the system is now prepared for the use of other remedies more natural and for more efficient, or our abundantly testified we now mean the class of remedies called tonics and sodorifics- Whoever will hear 46 in mind the operations of the natural law, that the waste ways of morbific or redundant matters is through the lungs, the kidneys and the skin, and the skin in the most considerable and important of the three cannot fail to comprehend the propriety of these remarks for so long as you irritate the stomach by emetics and nauseating drugs just so long as you suspend the action of the natural law of depuration; and so long too do you cut off the neccessary supply of new element any matters which can only enter through the digestive process- In other words he who repeats improperly, prodigatlely sports with vital organization; and when this course is persisted in as we to our motification have been compelled Occasionally to witness; under the direction of our intermeddling brethern until the organic [cross out] tissues were so much exhausted and the stock of vital elements, one hand had become so much reduced for the recuperative powers of life to reinstate itself death becomes the inevitable consequence. If any one should feel disposed to question the comparative utility of the two systems of practice, we have only repeat to him the following question and at his own experience answer it, Have you ever witnessed a genial and general perspiration coming over your patient whether from spontaneous or from the interference of art and continunig for five or six hours without a sensible mitigation of the symptoms- that too, without half the distress and the prostration that would have ensued, from the same a reduction of fever. (Could it be achieved) by the use of nauseating and puking agents? We are well aware of the fact. That the 47 suppression of the healthy depurations through their natural waste say in fevers not unfrequently indeed very commonly became a cause of local irritation to the stomach and bowels; the morbific or redundant matters seeking an exit through this cannel rather than through their natural outlet In this way we can readily perceive how it that that which- The commencement of disease is merely irritation [???n] after a short continuance inflammation consisting what Broussais and his followers call gastritis, or [cross out] enteritis or gastroenteritis the case may be; which occurrences they gravely lay down in their writing as the cause of fever- But we contend that the fever exists before it inflames and that is always coexistent with the power of irritation If these views be correct then how absurd must it not appear to increase the local irritation of the stomach and bowels by the repetition of emetics? It is [cross out] not uncommon to see an attack of Autumnal fever of any kind commence with a spontaneous, and distressing vomiting Now, could any one acquanited with the laws of healthy actions, and at the same time with the laws of revulsion of the repurative functions under such circumstances as have been just cited think of administrating tarter emetic or active emetics of any kind? Would not common sense and reason instruct them to throw or cast off the redundant matters from the stomach by the mere use of [cross out] diluents and then imediately set about the quest at morbid irritation and throw the force of circulation to the 48 surface of the body as soon as possible and there by save the suffering organ from the danger of inflammation! By gently moving the bowels, in any Day, under such circumstances, you might diffuse the irritation over so extended a surface of the alimentary canal as to relieve any particular points or portions of it from the danger of great local distress- This course which in many cases is necessary, and even the best step to be taken in at all Times preferable to relying on the repetition of emetics or even nauseating drugs- There is still another idea in febrile diseas which has long haunted the minds of practitioners and the people, that is the quantity and quality of the bile- Having but some vague notions of diseased secretion of the liver,- which have been expressed by the terms [??liated], and redundant bile,- They imagine that the patient should be puked or purged So long as the liver continued its morbid secretions, or that some had consequence most inevitablly follow- The thought seems to have occurred to them, that the secretions are partly [cross out] up by the use of their medicine as [cross out] as of the continuance of the disease and that there are other means of relieving the patient besides those of puking and purging- But of this we shall speak, more fully under the next head- We might be charged with having too little regard for public opinion, if While on this point, of our subject, we should pass unnoticed the practice of the steamers- The Thompsonians- The followers of Thompson placed great reliance on the virtues of the lobelia inflata- With this article of materia medica we have long since, had some acquaintance 49 acquaintance more or less of personal intimacy- Besides its emetic properties it possesses more or less the properties of a Dialogue- In its effects, and its operation, it bears a striking analogy to tobacco- We think from what have witness, of its effects, that it is much better adopted to the treatment of cramp, and catarrhal affections than to febrile disease- As an emetic in fevers we should give a preference to Ipecacuanha- Cathartics Purgatives in all ages and in all countries have been justly enrolled in the list of important remedial agents and in the hands of different practioners, the different articles of this class of [re???] have obtained a varied celebrity- [illegible] Some have preferred individual articles in their simple, uncombined state- either [t??] exerted their ingenuity to find the best and make the best possible combinations of Them- Hence has resulted the long catalogues of patent purgatives and anti-bilious pills. Whose miraculous Virtues have filled our papers with certificates of their infallible cures; from the celebrated Lee's antibilious, Down to Cooh's R.A.C. We find one sect of docters deriding the use of the mineral cathartics while another sect are extolling them as the sampsons of the materia medica: some contending exclusively for the offspring of the [cross out] vegetable Kingdom are asserting that all things else are poisonous to the animal economy (such are the Botanic, doctors- One would think that 50 Such men had not exactly kept peace with progress of organic chemistry;- some there are again who give a decided preference in the saline cathartics- So we find one class of practioners( The Hamiltonians and the Cookites for example) promising the greater possible good in the treatment of fevers, from the use of purgatives alone; while many of the French medical writers [illegible], admit their efficacy at all- In this labyrinth of doubt, Who shall dare assert, I am the light I am the way." In a word mankind have projected almost as many ways to health as to heaven, while in truth there is but the one way to [illegible] If we were permitted to give our opinion on the use of cathartics in fibrile diseases, we would dwell less upon the particular article than upon its dose and its repetition- As most any article of the class may by suitable combinations made to set easy on the stomach, and operate gently on the bowels; yet any individual stomach especially if it has often been under the care of docters has its aversions (We could not say its partialities) and these circumstances we think alway worthy of attention- In our choice, then, we should be in a great measure guided by the antipathies of the patient, and the circumstances and symptoms at the time being sometimes the mercurials should be preferred sometimes the vegetable, at others saline and not unfrequently a combination would be preferable, according to the particular modified action desired to be produced in the case-. With our settled physiological and pathological 51 views, we have but little use for carthartics at all- and when used we would desire to have them operate efficiently, but as mildly (that is giving as little local irritation) as possible. To us the indications fur their use would seem to be first, where there was constipation of the bowels, or fulness of the alimentary canal than evacuate, secondly, when the irritation of fire was spending its force mainly on the brain, then we should use cathartics, with a view not merely to evacuate and to diffuse the irritation over a larger surface of the systems, but to produce revulsions from the brain to the alimentary canal, and then prepare the patient for the better operations [cross out] other remedies- We are not ignorant of the fact that fevers have been repeatedly cured by the mere repetition of cathartics, [illegible] we have had the same thing occure occasionly under our own experience; we know that with good constitutions, the work of depuration and the ultimate restoration of the equilibrium, may be achieved through the medium of the stomach bowels & liver- But to accomplish this much time must be consumed great suffering endured considerable emaciation, and consequent prostration of physical tone produced and the constitutional, stamina of individual is defective= death is not unfrequently the result of such a circutous rout to health- But the depletists especially the purging sectarians, contend that there is great acrimony, vitiation and redundancy of bilious matter, in the system, that can only be eliminated by purging- We will not deny that the secretions in fever are generally abnormal; but we do contend that the departure from the healthy action as 52 frequently consists in a defective as in a redundant secretion- We are even writting to admit that the bile formed under the febrile action is not often strictly healthy in is properties but the admission of this fact those not lead us to infer, with many who have expressed their opinions, that the acrid bile is the cause of fever are conceive that to be a clearly a consequense as is the inflammation of the mucus membrane of the stomach and bowels, so much relied on as a [illegible] of the soundness of their doctrines, by the layers of the autopsic mode of setting the laws of phenomena,- Much has been said of the necessity of discharging morbific matters and the liver has been much more censured for the part it plays in febrile diseases than it really deserves- the mass of mankind have been all most urged to the belief, that the existence of bile was inimical to health- and if to it should be added the qualifying expression vitiated, from the likes of the grave medical philosophers, then it becomes truly alarming now while we admit that the liver in the discharges of its functional duties frequently departs during fevers from it, healthy labors, and that sick stomach, head-ach and vomiting are sometimes occasioned from this cause yet we know that a regular and plentiful supply of bile is as necesary to the process of digestion and a healthy existence as any other names secretion for its distine office nor is it more liable to vitiation or decay than other secretions it is known in its natural envelope, the gallbladder, or in an inspissated, state, under favourable circumstances, to be preserved for any length of time; indeed it has long since been in use as a vulgar and popular remedy for colics, disspepsias 53 and fever and we have such faith in the efficacy of sound healthy bile as to believe that it will [illegible] long, find [jo??] even with the learned, The [illegible] of high-colored urine, and the yellow tinge of the skin so common in bilious fever, jaundice, and yellow fever should not be ascribed so much to the suspension of the secretions of the liver as to the invention or retrograde action of the absorbents,, The bile in these cases we conceive to pass directly from the liver and the gall bladder back into the circulation, instead of first entering the alimentary canal and then passing through the absorbents and lacteals, whose mouths are spread out on the surfaces of the stomach and intestines, the unpleasant symptoms attendant, in the conditions of the [???al] we are disposed to ascribe more to the loss of balance in the great function of organic life, and the enfeebled [illegible] of the brain and nervous system than to the mere presence of missplaced secretions- for bile misplaces in [illegilbe] than any other secretion or element,- and the only reason why it has attracted so much attention, we conceive to be because of its color it being the only one of the numerous secretions which in becoming misplaced in rendered visible to the eye. Every body is familiar with the retrograde action of the lacteals, and absorbents in cholera morbus and more especially in Asiatic cholera where the lacteals and absorbents were not only employed emptying their own contents but through them blood vessels themselves were 54 exhausted of their serum then fluid elements to be thrown off by the stomach and the bowels- Now having witnessed these facts and comprehending as we do the operation of the natural laws of health, we object to treating fevers mainly by cathartics and emetics, our reasons are, first, because such a course would be inventing natures, laws, and secondly because, we have found a much better and [illegible] way to arrive at the same desired result,, namely the use of tonics and sudorific, But that sect of partisans known to the public under the imposing tittle of mercurial doctors, will contend that they have and [illegible] more good by the judicious and of mercurials than any one can do with Tonics and sudorifics such more often deceive themselves and the public too, from vague notions connected with the color and consistency of the stools. Those who have observed them closely in the routine of their professional toils, have found them administering calomel for almost all purposes; for example, if, the operations are thin, they give calomel if otherwise they give calomel sill; if white calomel if black calomel if green calomel; if yellow calomel sill; in a word they seem to have the same blind attachment, to calomel that certain topers have for whisky it is their toy for joy, their remedy for grief, Many Valuable lives we have no doubt have been sacrificed to the erroneous ideas attached to dark discharges such appearances being as much the effect of Calomel as of the nature of the disease To us the color and consistence of the evacuations serves to throw some light 65 not only on the condition of the organs themselves involved but on the state of perturbation of the general system likewise. The olor of the evacuations is more or less modified by the operations of three causes, to wit the food we eat, the nature of the secretions, for the time being and the chemical charater of the drugs taken,, will cause pale on even white [illegible] changes, others brown or blacking [illegible] and some a yellowish cast [illegible] may still be equally healthy, while we admit the virtue of calomel and Blue mass, we would wish to [illegible] the abuse of them- The calomel Docters who has made the [illegible] the focus of all fevers and calomel the panacea while they condem The [illegible] alicon in medicine, still continue to [illegible] Mercury, in some shape or other, in some [illegible] or other every stage and every [illegible] it is their carthartic, their alterative, their salivant, their solvent, and even their tonic There is one disease and one only which we have not been able to treat satisfactorily without it we mean lues venerea of French [illegible] This disease it seems to exercise some specific Virtues; but even in this disease we have been accustomed to use it very [cross out] guardedly- The great facility with which doctors are fabricate in this our day and the innumerable swarms that are turned out every day or annually from the many factories more scatered over the whole surface of the globe, or the civilized world in one of the many reasons that have induced us to place in the hands of the people the results of our research and experiances that they may be the better 56 enabled to understand the laws of self preservation and may the better appreciate the comparative value of the labors of their medical advisers-But have not yet taken our leave of the mercurialists- The extent to which calomel and blue mass have been administered during the last twenty five or thirty years is so great, and the ratio that has been mal-administered so enormous that it is high Time for humanity to raise her voice either to disarm her heroes of the weapons of death, or to withdraw her subjects from the field- In what part of the vast continents can any man cast his eyes and not behold the grave of some victim of its pestilential powers. where can a social club convene that dose not contain some living monument [illegible] it is indeed the most insidious of all known poisons- the poison tree [illegible] the serpent the arsenic are the [illegible] acid either gives timely [hlor???] of their present or distory their [illegible] or since- But not so with there [???y] or [lus?ingtis], those who [cross out] [cross out] listen with credulity to their wispers of fancy or powers with alacrity their phantoms of hope are doomed sooner or later to awaken in the realities of despare; for when once the victim of their remorseless grasp, neither prayers tears, time, nor antidotes will ever remove the spell, for every rain that falls every wind that blows will ever tell through their aching bones_ So such of our readers, as have dived deep into that department of the arcana of nature called laws of propagation we may 69 [cross out] safely assert that mercurial diseases is not solely confined to the individual sufferers but its effects are in a greater or less degree revived in their offsprings- Every body knows that [illegible] like yet all do not know that this law holds good even to the particular [illegible] of body or mind (we had like to have [illegible] brain) at the particular moment of vivification- But these things we must leave to posterity to settle- Diaphoretics We come next to treat of that class [illegible] whose action on the animal economy is [illegible] union with natures laws- In [illegible] in our minds the great ruling and controlling powers of organic life, we discover two very important movements in vital phenomena the one we shall call the centripetal the other the centrifugal; the one a concentration of the energies of the vital forces to the internal surfaces of relation; the other the [illegible] of the same forces to the external surface or what might be more strictly speaking to the periphery of vital action) there to eliminate or to bid adieu to all those [illegible] which having served the purposes of life are no longer needed and whose continuance indeed would be oppressive to the system In the right knowledge, and the right exercise of a controlling power over these phenomena of vital action, consist all the secrets of health and disease- sudorifics, and diaphoretics are those medicines which being taken internally increase the sensible and insensible exhalation [cross out] 59 from the skin- This effect may be produced in any one of many ways or more certainly by a combination of means to exemplify external heat alone may produce the effect; the use of diluents the use of stimulants proper (we mean not irritants see chapter on medicine) The use of the vegetable, mineral, and alkaline diaphoretics proper and the many combinations that may be made of them, of this numerous class of remedial agents the discoveries now in progress in organic chemistry will lead us [cross out] to make the most judicious choice- Our past experience has led us to give a decided prejudice to the vegetable and alkaline as a union [illegible]- This class of remedies when rightly [illegible] comprise two others- classes of [???rmmae] [illegible] [illegible] of expectorants, [crossed out], diuretics, for collectively those agents are used for the same purposes namely to unlock and to maintain the [illegible] action of the three great waste ways the [illegible] the kidneys and the skin, that is to say in the natural, order they are but different members of the same family, hence under one set of circumstances diaphoretics are made to act diuretically and vice versa- under another set of circumstances diuretics act as diaphortics- To explain more fully: Squill, digitalis, the alkaline salts of Potash Soda and ammonia, Any one or a combination of these articles- in conjunction with warm diluents such as flaxseeds, or others simple herb-teas with warm atmosphere a warmly clad skin- But use the same articles and change the circumstance to a cold skin, cold extremities- a passive condition or passive exercise, such as a ride of a cold day,- and substitue malt liquor- Give cider or even the free use of weak wines- and you may expect an increased diuresis- Again if you place a 59 patient in a medium situation as [reg??] the protection and temperture of the body and use the same articles in such combinations as will cause the [???ating] drug to make a sensible impression again [illegible] expect to have the greater [illegible] then of the office of depuration- Thrown upon the lungs that is you will have the expectorant effect In certain healthy conditions and natural exigencies of the body simple cold water in the most prompt and salutary sudorific [illegible] for example: In hot weather, [illegible] of great labor and fatigue, [illegible] from regular suplies of water untill the skin becomes hot feverish and dry and the sense of suffering from thirst excessively great a pint of more of good cold water, promply alays all sense of distress, and it administation is promptly followed by a general flow of perspirable matter from every pore of the skin or of the whole surface of the body [illegible] case just cited, the experience of the [illegible] goes to prove that the remedy is not only prompt but pleasurable; just so should be [illegible] the remedial agents in the treatment of fevers under the guidance of wisdom- But the folly of man. And the madness of medicine, have ever caused him to be too local to [circum??] too bounded and too much inflated with a partial discovery of isolated truth to see the harmony of all the truth which belongs even to a single series in the phenomena of nature- Hence when Brown [cross out] had discovered an element of truth, in the use of stimulants he ran his theory, this element of truth to excess and fortunately for the world, he fell an early victim to his own partial discovery from the ashes of a Brown have arisen the Theories 60 of w [???ing] and a Thompson and other members of the same family, To play a more rational part, and to approch some nearer to the temple of truth, in a modified and an extended scale- Hence the application of stimulants both externally and internally by drugs and by fire; and these too, aided by their distressing and depressing yet efficient ally, the far famed lobelia- The [illegible] of the steamers to us seem to consist first [illegible] not being able to discover the particular [cases] to which their routine was best adapted and their indiscriminated application of their remedies to all manner of class; secondly in the excess to which their remedies have been used When in their faint glimpses of the laws of life they had learned how to make an impression on the skin, and observed the salutary result which occasonally, followed there from they immediately prescribed too much; and were [illegible] to take up erroneous idea that by forcing the living actions through the instrumentality of pepper brandy Myrrh, and external heat to achieve whatever they desired by the mere [illegible] Like unto some simple men in every country to be found) relying on the [illegible] and strength of their purses to make [illegible] [??ise] men of their fans, or gentlemen by the mere power of wealth-As though the God of Nature, could be bribed to [illegible] his eternal laws [cross out] [cross out] to please the geathers of gold- Now [??ile] we admit the essential differences that belong to [cross out] stimulants, tonics, and diaphoretics, we at the same Time contend that they all act in union with natures Laws and that under proper restriction and right circumstances they constitute our chief reliance for 61 restoring to last balance to the [illegible] used the play of healthy action are the function of organic life- Where rightly used they all tend to excite sustain the healthy coneglated [illegible] of action in the whole system and to direct the energies of the [illegible] the surface of the body that to [illegible] the action of the natural and beautiful depurations which being rightly maintend will in due time acheive through [illegible] deranged irritated febrile [illegible]- From an attentive view of the [illegible] explanations in connection with what [illegible] have already said in our chapters are the laws of the general [illegible] as we are led to believe that the- intelliget reader cannot fail to [illegible] and the comparative value of the several modes that have been resorted to for the cure of febrile diseases- All these who have relied on bleeding puking or purging by using [rep??] any one of them or resorting to the whole of those means, conjointly have [pr??] an unnecessary waste of the element of life, and not that alone: but by the improper repetition of emetics or cathartics they have reverted the natural action of the system; thus producing a retrograde action of the lacteals and absorbents which inverted action in connection with local irritation made on he mucous membranes of the stomach and bowels by their use we conceive to be the real causes of the congestion and inflammations so commonly to be found on post mortem examination Before we take leave of this subject, it would be well to make some remakes for the controlling 62 powers of the moral agencies on the secretions- is all who have been attentive observers of human phenomena, the fact must be notorious, that the impression of fear not only increases the urinary secretion, but not unfrequently result in untimely evacuation from the bladder and the bowels such spectacles have we repeatedly witnessed in by [illegible] day under the uplifted Rod of the school master or the dog whip of the sportsman- These phenomena and always attended with more or less of a temporary chill, contraction, and consequent suppression of the exhalations from the skin, [illegible] the fluids are thrown, more abundantly on the kidneys- But when this same impression is [illegible] and carried to the highest pitch than [illegible] called to witness an inverted action of the lacteals and absorbents which are promptly followed by copious and rapid evacuations from the stomach and bowels But of this we shall speak more fully under the head- of [illegible]- We can receive of but Two general causes of diseases, that is febrile proper, and one a particular condition of the system the other a particular state of the atmosphere, and it is to the modifying influence of these causes separatly and jointly that we are to look for the [cross out] shades and grades of fever- Many are the volumes that have been already written on the subject of Malaria and the other predisposing causes of disease, yet still has this subtile element eluded our grasp; of its intrinsic essence we know but little; of its modus operandi, on the animal economy we are likewise in the dark. with its sources that is the felicitous circumstance for generating deleterious gasses, we have formed some acquaintance, with its effects on the human frame- have all had some more or less of 63 personal intimacy- It may be that to know, the prime sources of disease are to understand its effect is all that is neccesary and proper that we should know- he [illegible] we flatter ourselves the chemical and philosophical researches will not [illegible] made, untill all these mysteries, and [illegible] up to our view- One thing certain in that every breath we breathe, every step we take and every evolution of the [illegible] or less predisposing or exciting cause to either healthy or unhealthy action in the system Nor do we often know with absolute certainty whether they are to be for the better or the Worse- It is from the lessons of wisdom and experience alone, that we [c?u??] how best to deport ourselves- [illegible] whether of body or mind- (and is taken the two to make the whole man) are much more closely allied and more inseparably linked together than the mass of mankind have ever yet thought- Either or both under the guidance of reason, will find the greater share of health and of happiness in [illegible] a just medium in all things- He who shuts himself up in a house, from fear of the influence of the sun, the wind &c is at least as subject to disease as he who regularly and fearlessly face them all, or he that dose not take bodily exercise or live on two spare and meagre, a diet from a fear of wearing himself out, or under the vain hope of prolonging his existence, is about as likely to cut short the thread of life, as he who obeys the instructive impulses of his animal desires- (Stimulants.( 64 Sudorifics, tonics and stimulant are all centrifugal at in their effects all having a tendency to facilitate and sustain the circulation of the blood to excite airs to maintain the natural secretion and exhalations from the body; and not that alone but to counteract the enfeebled the irritated the irregular and the spasmodic actions attendant on fevers of sudorifics we have already spoken of tonics we shall speak more fully in our next chapter; But of stimulants we must have something to say before we close the present- The present state of [cross out] knowledge as conveyed in classification of remedies and the use of terms renders it necessary for us to explain what we mean by the expression stimulants proper- The words stimuli or stimulant has by most writers been indiscriminately applied to whatever would excite the living tissue- In this sense- emetics cathartics cantharides &c, are all stimulants- But we shall confine the use of the term to those articles only, which excite or exalt the system, in a manner only congenial to its own healthy laws; all other excitants we shall consider as irrtants- When we look to the origin, the history of stimulants proper, we find them springing only from those elements, that are capable of sustaining Animal life; and the quality of the stimulus always modified by the quality of elements from which it is obtained and the chemical aptitude and skill with which it is elaborated- The grades of nutriment, of permanency, of diffusibility of stimuli, is the result, of the formative powers of the processes of fermentation and distiliation and 65 the elements used- Thus we obtain Wine cider Malt liquors, rum brandy whiskey and their subdivisions- But the weakness of man in by his approximation to [illegible] ever kept kind vacillating from one extreme to another from the extreme of confidence to that of [dist??] [illegible] hope to unnecessary fear- [illegible] the [p??] of distillation, was first [illegible] put in use, some of the philosophers of that day verily believed, that they have discovered he secret of human immortality- So [pac???] indeed are its effects that it readily found favour in every land- too [se??] the distilled liquors have troubled the [illegible] been tasted tried used and [illegible] nations now while we write all [illegible] organized and public speakers [illegible] to proclaim to their fellow men, the dangerous and the deleterious and the deadly [illegible] of intoxicating drinks; the drinks [illegible] themselves calumniate [illegible] to public view as man [illegible] and are societies former ready and willing to expunge from the best [illegible] discoveries and important [illegible] baunties the name the laws of [dist??] Thus verifying the word of [illegible] Chem stilted vetant alia vetce [illegible] Contrarea- Whenever man shall acquire wisdom and venture rightly to see, and rightly to appreciate, his own ignorance, and his own folly, then, and not till then, will he cease to abuse. The munificence of Deity,, The very reasons for which the civilized world is now toiling to put down the use of stimulants to wit,, its excessive use, its abuse is to us the strongest possiable proof of its, salubrity of its efficacy; for if its elements its action on the living atoms, had 66 not been congenial to the laws of his nature Man would have never learned to have loved it so= But out opponents may say that all this is habit if so will they be so kind as to tell us why their patients and the world have not yet in like manner contracted a fondness for calomel, tartar emetic ipec- or any other [cross out] of the numerous drugs we call irritants? Malt liquors wine cider, contain in addition to their stimulant properties their alchoholic elements some nutritious matter; and even the alchohol itself we have reason to believe is consumed in the living action no portions of it having yet been [di??cked] in the excrements the sercetion or exhalations from the body By [illegible] of the lights of chemical [illegible] are we now enabled to solve the [illegible] that has been so frequently pronounced [illegible] slow poison- A thorough [illegible] of its modus operandi in the [illegible] economy, has enabled us to comprehend [illegible] way it operated beneficially in [illegible] [???ased] condition, When the vital forces [illegible] much enfeebled by disease, and a [illegible] of elementary matter necessary for the support of life and animal heat is much diminished, then the prudent use of stimuti operated beneficially, by allying irritation directing the vital forces to the capillaries thereby restoring the last equilibrium, while at the same time it either nourishes the system or at lease prevents that waste of the animal matter that would otherwise result for the necessary maintenance of animal heat- We hope that no one will infer from what we have said of the use or the modus operandi 67 of stimulants in the diseased conditions that we are advocates for it as a luxury far from it, we use it not ourselves Nor have we ever advocated its use in others= the result of our experience further more is, that however greatful and [h???] beneficial it may be to the [?nfabled] the diseased and the convolescent from fever that they invariably lose their appetite for it with the return of strength and of health We would have it consumption strictly confined to remedial purposes- We are [illegible] aware of the fact that many unfortunate individuals, have an ungovernable propensity for its use, even in their best health- This state of thing we can readily to two sets of prime causes; the the organization of the brain and others the circumstance of education; both of which could be easily remedied by the united efforts of philanthropy- and wisdom Chapter 8th The Autho's practice and general treatment, in the cure of fevers- Having stated in the preceeding chapter our objections to all the various systems doctrines and modes of practice, [illegible] have been heretofore pursued and dwelt at some length on some of the particular errors introduced, into practice by our predecessors such as the errors in blood letting- Puking Purging, &c in the varied degrees and modes in which these measure have been applied to the treatment of fevers 68 We will now endeavor to unfold to our reader a very different and as we honestly believe, a far better plan of treating fever of all types- from whatever causes: They may have the origin and under whatever forms they may appear, for to us since we have learned to view more as a unit all general diseases seem but a unit so consequently to us fever is a unit- Now let us look back for a moment to what we have already said of health and disease- Health is but the harmonious play of all the solid structure- The equable and harmonious play of all the fluid [illegible] the natural response of every [illegible] every organ to its natural [illegible] healthy and its appropriate stimuli [illegible] is disease, but and interruption of this play, in some way, in any way or every way as the case maybe What then is fever? We conceive it to be an effect of the conservative powers of nature inherent in all Animated Creatures to sustain its own integrity from the deleterious, operations of causes of whatever kind, by which it may be assailed In this sense we make fever in its essence a unit, while in its phenomena, its physiognomy, it is multiform, and that multiformity of character proportionate to the peculiarity of constitutions and circumstances of existence and the nature of the varied cause or ''gents, that are made to stamp a diseased impression on individual sensibility, or the sensibility of particular organs 69 Particular tissues of his complicated Machinery, which machinery should ever be considered, as a unit, one whole, although, composed of many parts. united by indissoluble laws of unity, the nervous chords, the [t???] medium of that much used, much abused, and illy comprehended [h??] called sympathy Now if the reader is capable of comprehending what has been already said and will hold the truths already unfolded to his view ever present in his mind, he will find no difficulty in understanding and giving his assent to this which is to follow- The phenomenon of fever you will [illegible] we have said is the result of [illegible] debility, attended with a loss of balance in the functions of supply and [w??] This state of things impresses on [illegible] individual sensibility of the individual sufferer the assemblage of phenomena called fever, such as lassitude, heat, thirst, pain, restlessness, with more or less perturbed and interupted performance of all the functions of [illegible] vegetative, animal and intellectual in a word, a diseased of abnormal manifestation of some or all the function of organic life, For centuries past have the industry and ingenuity of man been fruitlessly essayed to fid the shortest, the safest and surest, way to remedy this state of things Born and raised as we have here under this state of collision of thought, 78 80 and decieved by our calling, as collaborators in the cause of science and of truth, we now find ourselves compelled by the lights both of experience and research, to fall confirmed in the the propriety of discarding the thoughts of every predcessor. and with them their practices also- [illegible] our investigation of the Laws of organic life, we think that we [illegible] some modifying or [???al] agent capable of making [illegible] prompt, more specific, and more salutary impressions, on the diseased subject than any of the numerous [illegible] measures heretofore relied on for the accomplishment of the same and [illegible] agents are called the vegetable [ahal??ids])- To this family belong [illegible] such as the sulphate of Quinine cinchonine, morphia, a class of remedies occupying the middle ground between that of the depletive and the [illegible], stimulating remedies= [??pent] the timely and judicious use of this class of remedies, do we chiefly rely on the cure of all fevers, not [d??yeting] [???eves], however, the benifit of any or all other remedies) That sciences or experience may have pointed out as salutary and proper. Thus you see that we have admitted the propriety of blood letting in certain cases, and under certain restrictions; so also have we admitted, and recommended the use emetics and cathartics, under, particular circumstances and with suitable restrictions)" 81 But our main auxilliaries to the use of quinine and the vegetable and alkaline diaphoretics [illegible] of extreme prostration the [illegible] stimulants with the [illegible] In all cases of local [illegible] inflammation, we have [illegible] acid advocated, the propriety of topical bleeding by cups or by leeches [illegible] the use of sinapisms and blisters still, however, holding on to the regular use of tonics with such [illegible] as might be indicated in the [pa??] case of state of the patients. The Gold pills which the author has prepared for sale, for [illegible] past and distributed under [illegible] name of Ward's Gold [illegible] And has deservally acquired for efficacy in the cure of fevers disease far surpassing that of [illegible] article ever offered to the public [illegible] plan of treatment before adopted [illegible] simply, composed of one grain of quinine to each pill three fourths of a grain of aloes and one fourth of a grain of Rheubarb to which was added just so much of the oil of cloves, as would gave them an agreeable odor) The aloes and Rheubarb, were cheap and convenient articles of which to make the mass= they were not intended as articles of medicine at all, nor could they have had any very material, the whole virture of the pills consisted in the quinine alone the The medium dose directed in his prescription being uniformly one grain of quinine to an adult, and in that proportion for children 82 [illegible] unpleasant effects have ever within [illegible] resulted resulted from [illegible] being made in the use of the [illegible] they have been placed in [illegible] all descriptions and [illegible] and used in all stages and in every form of fever to be met with in the [illegible] united states- particularly [illegible] states lying in the great valley of the [illegible] Mississippi for the space of eight [illegible] years- [illegible] author has vended pills to a larger [illegible] realized some money by his [illegible] have also saved a great many [illegible] by using them,, been relieved of much [illegible] suffering, and very many lives no [illegible] been saved and prolonged,, The [illegible] himself driven to this [illegible] more from motives of benevolence [illegible] than those of self interest= [illegible] as he did, the prejudices that existed against the medicine he also new that had he [illegible] his opinions to the world in any [illegible] than as he had done, and is now [illegible] neither the public nor himself would [illegible] [??ted] much, if any by it [illegible] the manner, that has been adopted the full benefit is now given to the world [illegible] with a great deal of other useful [illegible] that could not well have formed to place in a newspaper or common hand bill The obsticles with our predecessors cotemporaries to the discovery and adoption of what we hold to be truths, that is the aptitude, of quinine to the cure of fever are two fold, namely, a belief in the inflammatory nature of fever, in the first place, and, secondly of [ag??imutaing] 83 or inflammatory properly in the value of quinine, The error of their motion in [illegible] we hope, has already been [illegible] proven to the understanding of every [illegible] reader and it now only remains from to show the fallacy of the other imaginary obstacles, and then the whole [m??] [illegible] may be considered as [despe???] We know of but two ways by which [illegible] settle, or put to the test our [illegible] or our understanding- the properties of bodies of material things,, The one is the [im??] to be drawn from there [sen??] [imp??] on living matter the other is the chemical manifestations displayed in relation to or in conjunction with the other thing and circumstances,, suppose now, we submit the article of quinine to the tribunals, and see what will be [illegible] our examinations,, Let us first [illegible] in a chemical point of view. What is quinine? it is the salt of the [illegible] of a tree, indigenous to the elevated lands of Peru,,, in South America, It is obtained by the process of [illegible] desiccation and crystalization- but is not then a produce of [illegible] fermentation or of distillation it is [illegible] volatile; it is a fixed salt, not [tia??] waste by evaporation From where [illegible] stimulants proper derived. They are at either directly or indirectly the offspring [cross out] of nature, through the vegetable process; and are elaborated purified and concentrated by human contrivances under the natural Laws of fermentation and of destillation Hence comes camphor, porter ale, 84 Cider, Wine, rum, brandy whiskey the essential Oils of all scented plants of which might be added aumonia, all stimulating [a??ts], and all Votatile and [illegible] less [illegible] by evaporation, [illegible] the [???cal] view of the subject, [illegible] infer, from the processes of [illegible] and from the fact of its [illegible] exemption from change [illegible] common atmospheric influences [illegible] that passess those qualities, common to the list of articles universally [illegible] as stimulants,, But there is still another way by which to arrive at truth, it is the testimony of the facts of human experience, or of [illegible] observation on human sensibility alias the phenomena in living human matter, where we consult the pages of history, from the period of the first [illegible] of the virture of the peruvian [illegible] 1560,, we find febrifrege properties ascribed to it from that period to the present, in the hands of different chemists and different practitioners, have its properties and its varied remedial uses, been differently presented still we find that the sum of the testimony- the sum of the experiments [illegible] researches, up to this day, have tended rather, to advance, than to detract, from its virtues nearly all writers admiting its antiseptic, and its Tonic properties while some in a limited sense were willing to ascribe to it febrifuge and atterative Vitues for which it has, as yet, obtained credit and even more,, In our hands for years past, in some form or other 85 has it succeeded in a far more eminent degree then any other article of the whole materia medica in contending successfully with fever,, of whatever type and in whatever stage it has come before us = it would be respassing both in the patient and the good sense of the [illegible] reader to attempt to lay before him any thing like a detailed account of our personal experience,, But for the satisfaction of those [i??] [illegible] with the reports of cases, we have thought fit to cite the following, when we [c??] were attending medical lectures in the city of Philadelphia during the winter of 1834, +5, there was a man in the hospital laboring under simple bilous fever, the part [sy??] not severe I thought, this patient had been there at least four weeks, had no other disease, this case had been treated all the time with the [illegible] remedies; that is with occasonal pukes and purges, and with what [illegible] call refrigerating mixtures such as a solution of salts of tartar [cross out] or cream of tartar,, with nauseating doses of emetic tartar or Ipac, and when the fever, would somewhat abate, they would give, small doses of the, bark, and but seldom repeated for fear of aggravating the fever I do not recollect distinctly, but think it probable that the lance had been occasonally used also the Bark and laudanum were gradually increased the disease continued but not sufficiently to make a sensible 86 Impression on the system to as to obtain an ascendancy over the disease as should always be done in the treatment, of this fever The Hospital Physician, Sir R S Hartshorn [illegible] and evening, to take tea with him- In the [illegible] of our conversation he [illegible] had been practising medicine for several years) He then mentioned to me the [illegible] uncertainly of the cure of ague [illegible] general and named this case, [illegible] [part??],, was much pleased when he [illegible] and with some reserve, stated [illegible] his patient in North Carolina [illegible] lived that I thought I could [illegible] in forty eight, hours at furthest, [illegible] at me with some degree of astonish [illegible] said he if it is not a secret, [illegible] the case: I advised the [illegible] and Wine shortly after the sweating [illegible] and to use as much of the [illegible] as the stomach could bear, untill a short [illegible] [??or] the chill was expected to return [illegible] to increase the dose of laudanum [??pium] at least two or three fold= The [illegible] made,, the experiment (as he called it.) patient had no return of either fever or [illegible] he was cured immediately,, It should be recollected, that at that time quinine was not known, some time during the summer of 1850 and one I was called to see a Lady in to Town of Columbus Kentucky whose life was said to be disporic) of,, I found her the subject of a Typhoid fever of ten or twelve days standing, She was much emaciated, and very feeble and suffering with great restlessness, with 87 occasonal fits of delirium [illegible] tongue dry skin hot and dry thirst great, I learned that there were [illegible] physicians in attendance; they have been and were they giving of [illegible] historally blue mass) I [he??] [illegible] lady that could not wait [illegible] in attendance in [con??] might say to them that I [d??] [illegible] course of treatment,, that [illegible] the use of mercury and put [illegible] the use of tonics and [diaph??] [illegible] thought fit they could adopt that [illegible] not and she thought fit to [ad?p??] [illegible] send her the medicine and [illegible] the might treat the case herself Furthermore, that I was of opinion [illegible] presisted, in the corse, they [illegible] lose her daughter; but that if she in execution my prescription [illegible] mending in a few days,,, That pass [illegible] the good old lady and the [de??] little importance to the reader [illegible] say, that I was promptly applied [illegible] and prescription)) I simply [??hr?] of Quinine to be given every two [illegible] and a solution of the alkaline may [illegible] of the supercarbonate of potash and [s??] such quanties as would allay the patient a few hours use of these remedies [?x??] genial perspiration, with a return of healthy to the tongue and faces I learned that by the next morning all signs of fevers was entirely gone or fled, the patient commenced and continued to convalesce untill her health was entirely restored.. She has continued to enjoy good health ever sence up to this period Here there any motive or any utility in it. We could go on to fill thousands of pages with 88 [illegible] to similar cases) We have [illegible] [illegible] belief that the salt of [illegible] take was the best tonic, The be [auto??] [illegible] alterative and [deobst??] [illegible] acquanited and that [illegible] conjuction with [illegible] [??ies] to meet particular [illegible] achieved more good [illegible] of fevers, that with any [illegible] article of the whole materia [illegible] expressed an opinion [illegible] belief of its possessing [???ating] properties, its efficacy [illegible] resides purely in its tonic [illegible] other words,, in its aptitude [illegible] of the brain and the [illegible] system,, which in truth is the [illegible] mobile of all vital phenomena,, [illegible] possible that it may neutralize [illegible] of fever.) [illegible] desire a more extended view [illegible] understanding, of the part of our [illegible] consult the lights of organic [illegible] the recent labors of [illegible] Leibic) Before we take leave [illegible] general view of the subject, it would [illegible] to [add??] still another argument support of the correctness of the general [??ples] contended for)- The argument is this, [illegible] followers of the strictly depletive doctrines the [?liushits] and looking, have done much good, succeeded well in the treatment of fevers, and if also their antipates, the Brunonians, the Thompsonians &c have achieved half the wonders that they claim occupying as we do the middle ground, the Lust Millieue, so it not reasonable to infer that we who accept the lights of Both 89 extreams and of all extreams, but who tenaciously hold on for the middle course might be intitled to a modicum of the laurels [illegible] to be placed at the feet of tonics and [im?ho??] in the temples of Esculapius)- We are not only satisfied as to the curation [pa??] [illegible] quinine, but we are disposed to [illegible] preventive, Vitrus also) To this [con??] [illegible] led not only from experiments [illegible] author's own family; but from fact occurring in his experience in [illegible] in different portions of the united states [illegible] all seasons of the year, I generally [illegible] early in the spring, and seldom [illegible] than June or July and sometimes [illegible] August, and not unfrequently [illegible] set out again in the heat [illegible] to the most sickly region of country" I also had agent out at the same [illegible] They were all instructed to use the [illegible] occasonally as a means of protecting [illegible] the influence of Malaria, [illegible] yet occured a single instance [illegible] one of them has contracted a [illegible] kind), From There facts we are [illegible] than if quinine was judiciously [illegible] sickly countries, and in sickly [illegible] that such a thing as fevers, if any [illegible] would rarely if ever occur except circumstances of the combind [op??l] of the many causes)). When quinine is used as a preventive, and adult should take a dose three or four times a day untill he takes twenty five or thirty grains)) This quantity, should be taken every two three or four week untill the sickly season is over or the epidemic has subsided) 90 [illegible] should take less in proportion to [???age) Chapter 5 [Th??] Author's views on the subject of the [illegible] of fevers) [illegible] expresses the opinion that fever [illegible] some general reasons for [illegible] But we shall, in this chapter [illegible] into the details of the argument [illegible] show that all fevers are of one [illegible] the mildest form of intermittens [illegible] fever, down to the lowest [illegible] most malignant type, of yellow [illegible] nervous, typhous or whatever nomenclature, you may please to adopt [illegible] fevers as one continued chain [illegible] phenomena and the varied symptoms [illegible] [???ions] as only so many different [illegible] [???uced] by some particular conditions [illegible] [???pher], or state of the system [illegible] of these modifing causes are [???lly] changing and from these changes [??ate] all the apparent dissimilarity [illegible] the feature of disease, while in its essential [illegible] it is ever the same and every variety [illegible] should he treated pretty much alike, that is with the same classes of remedies, varing them only to suit the peculiarities of cases, with the grades of diseased manifestations)) We speak, here, of diseased manifestation when left unbiassed, under the controling agencies of natural causes, very many of the worst features assumed in fever 91 are the result of med [prac???] or hyper medication,, for are such [illegible] we have over been of opinion that the [illegible] should have fared [mu??] better [illegible] [??arels] of dame nature the [illegible] under the officiauness of [illegible] and inter medillering Doctors,) [illegible] immortal [Brou??ais] of [illegible] said that there is one disease at [illegible] which any practice is better [illegible] (Asiatic cholera) [illegible] speak hereafter, its a kind of [illegible] in fever, and that the reader may [illegible] satisfy himself of that fact,, we [illegible] summary of the most common and [illegible] symptoms in all fevers which [illegible] sevely, that the symptoms of all [illegible] sand, differing only in degrees of [illegible] that they are in proportion to the [illegible] severity of the causes, and the [illegible] impressibilities of the constitution are manifested, There are generally days of indisposition previous to [illegible] all fevers,, This is calld the premonitory [illegible] This state is known by the loss of appetite lassitude, a general restlessness [illegible] and an unusual drowsiness, [mor??] disturbed sleep with a disinclination [illegible] action of any kind,, In the [all??] in the onset of fevers, it rarely happens but that there are more or less of [illegible] sensation, attended with flushes of red, Sometimes these chilly feelings run into ague or shakes, but with the advance of disease or as the fever rises the chilly sensations subside) In the commencement of all fevers it rarely happens, that there is not more or less of aching pains over 92 the whole body predominating, however in [??cular] portions such as the head best [illegible] sometimes this pain is exquisite [illegible] is apt to moderate as the [illegible] as in the Language [illegible] reaction becomes establish [illegible] all fevers, there is more or [illegible] sometimes it is intensely [illegible] [??ptom] also continues as an [illegible] all fevers, but it is apt [illegible] disease progress although [illegible] and even fauces or throat [illegible] in such cases, the desire of [illegible] [???ings] more from the unpleasant [illegible] of dryness, or suspended [illegible] the structure just named [illegible] the actual cravings of [illegible] stomach, since patients in this [illegible] take only a swallow or two [illegible] while in some other conditions [illegible] that could be retained by [illegible] would satisfy by desire, [illegible] onset of all fevers there is [illegible] less appetite for food sometimes [??ior] as food, amounting to, [illegible] sick stomach without vomiting [illegible] times with vomiting and [???nally] with both puking and [???ing] [ar?el] it is well known, that there is little or no appetite for food during that time or the progress of fever In the first and earlier stages of all fevers except in the lowest grade of cold plague, yellow, putrid or typhous, fever, and even sometime in these, the pulse is apt to be not only quicker than natural, but irritated and fretful 93 giving often times the [illegible] ounce of increased force to [illegible] the force is diminished [illegible] action in such cases [b???] [illegible] up in frequency [illegible] wants in force,, [illegible] advances the patient [illegible] the pulse becomes, [st??] [illegible] and smaller, making, [illegible] resistance to the [pres??] [illegible] and evincing clearly [illegible] In the first stage of all [illegible] becomes covered with a whitish [illegible] fur) This however is not [illegible] in onset of the disease, but [illegible] observable, in the cause of [illegible] if the fever, is not checked, [illegible] to run into another stage, than [illegible] is apt to assume, a yellow [illegible] appearance,, But should [illegible] lower grade, or more [illegible] particuly, should it partake of [illegible] form such as yellow fever [illegible] or the like- then the tongue is apt to assume a dark brown to black [illegible] The casting off these apparent [illegible] coat from the tongue should [illegible] considered a favourable [illegible] In the last stages of all fevers [illegible] tongue teeth and lips are apt to [illegible] exceedingly dry, and oftentimes [illegible] with a dark stickey gummy Matter,, In some, more rare cases, the tongue assumes, a different appearance, from any of that have been mentioned that is it assumes a smooth glossy and appearance),, 94 This is apt to take place after many days continuance of [f??] [illegible] last stages of the disease [illegible] when ever this state [illgible] have generally [fa??] [illegible] tedious and more dangerous [illegible] [???nes] there is a roaring Laund [illegible] this is most common in [illegible] fevers but it daze [illegible] occur in any form of [illegible] is a common and a very [illegible] symptom in all fevers, this [illegible] symptom is more the offspring [illegible] organization, than the nature [illegible] cause, some individuals [illegible] whole famelies being prone [illegible] under fever from whatever [illegible] under whatever type; while [illegible] individuals are capable of [illegible] through any form of fever [illegible] much or any very [illegible] [???able] derangment of the function [illegible] organs of thought, [illegible] first stage of all fevers there is to be a kind or grade of destrubance [illegible] not amounting to delirium, that [illegible] slumbering or dozing condition, that the patient is more concious of than [???dant],, This symptom indicating [illegible] a slight departure, from the normal [illegible] is of but little consequense [illegible] as the disease progress in its stage and grades of prostration, the delirium assumes, a different, and more distressing character observing attended now discover a considerable derangement, in the faculties of the brain 95 the patient himself [illegible] conscious) the frequently [illegible] extent in a state of sleep [illegible] hard of hearing so much [illegible] efficent to arouse [illegible] make yourself [cou??][illegible] indifferent, to the [ex?e??][illegible] you short response [illegible] slumbers again) [illegible] stages you find him [illegible] fingers, and at the best [illegible] entirely stripping himself [illegible] again we hear him [illegible] [??ores] and manifesting [illegible] and going about, when [illegible] able to stand on his feet,, [illegible] patients we are apt to witness [illegible] twitching of the muscles of [illegible] legs) What is call'd sub [illegible] by the Doctors) the voice [be???] and sometimes unnatural [illegible] wild vacant expression of [illegible] There is still another form of [illegible] which also occasionally attend the [illegible] of fevers and indicates, a more [illegible] condition, than the one just [ment??] This is attended with [cross out] [illegible] watching the patient sleep leaves [illegible] this hearing becomes even more [ac??] than natural he is startled at [ev?y] and has imaginary and for the most [illegible] distressing images continually passing before his eyes) In all other particular his condition is pretty much the [?arn??] as in the state just before mentioned) Now as the delirium and Muscular agitations or twiching increase in proportion to the duration of the disease and physical 96 [illegible] of the patients these [illegible] to the general [illegible] [???ast] debility [illegible] organizations and no [illegible] of the brain, the head [illegible] other part of the [illegible] of the medical [illegible] have you to believe, [illegible] we observe some [illegible] of heat in the stomach and [illegible] also an increased color [illegible] [???ly] secretion of urine, [illegible] of all powers we occasionally [illegible] discharges by stool and by [illegible] forms of fevers these are alike [illegible] symptoms though not necessary [illegible] individuals have recovered [illegible] discharges from all manner [illegible] on all fevers the salutary changes [illegible] usually announced [illegible] very much the same [illegible] that is nearly all the cases yeild [illegible] of the salutary action of [illegible] deparative functions [illegible] the skin, Although the [illegible] [???tion] of the blood has been long under [illegible] and the indications to be drawn from [illegible] of the pulse long studied, and [illegible] grave lengthy and learned discourses delivered from pulpit of the schools yet still are the discrepancies of opinion upon this subject, as great even of this day, as at any former period of time) Such too must necessarily be the case, for two important reasons- The first is that the faculty have not yet agreed, even in the abstract, as to what constitutes the, 97 propriety or impropriety of [illegible] Blood; the second [illegible] the mass of practitioners [illegible] influence of physical, and [illegible] the phenomena, of [cir???] [illegible] patients) For want of [illegible] of all these things [illegible] and observant practitioners [illegible] blunders) In the [exam??] [illegible] with a view to the [ind??] [illegible] should never fail to [tak??] [illegible] all the symtoms of the [illegible] circumstances of causation) [illegible] signs which lead us to a [illegible] condition of the sick, [th??] [illegible] uniformly important, than [illegible] tongue, and the skin, [illegible] should therefore be paid to [th??] [illegible] condition) As a proof that [illegible] know less about fever than [illegible] supased, and less even than [illegible] imagine, all hear them continually [illegible] about the names of fevers of [illegible] or a season such as typhoid, [illegible] and billious fever, just [illegible] were all distinct, diseases and to be [illegible] widely varied remedies) The truth [illegible] the similarity of symptoms in the [illegible] of all fevers is so strikingly great not a matter of astonishment that to often dispute about their [class???] Many practitioners prescribe more from the appellation which they shall give the assemblage of symptoms than from a knowledge of what taking place in the economy of their patients [?bey] as often or oftener form their opinions as to the name or nature of a fever from the season 98 [illegible] in which it occurs [illegible] the symptoms which attend it, [illegible] known the fever of [sm??] [illegible] of malignant fever [illegible] healed for bilious fever [illegible] matter of supprise to us [illegible] mistaking one shade of [illegible] for another, nor [illegible] mistakes be a matter of [illegible] provided they under [illegible] of the fever in the general, [illegible] accostomed to see fevers assume [illegible] bilious in warm seasons and [illegible] countries, while typhoid fevers are [illegible] in the colder seasons and in the [illegible] Countries) We have thought that fever [illegible] its protoype, never stationary [illegible] in a state of progression or of [illegible] after saying very much in its [illegible] never fundamentally changing [illegible] running regularly through the different [illegible] of the particular type it may assume [illegible] and running from one type to [illegible] from a higher to a lower, or from [illegible] to a higher that is from the simple [???ing] form to bilious or even typhus [illegible] [???time] while at another time from [illegible] bilious, and finally ending in [illegible] and fevers) Such things are not [illegible] request occurrences in cases of relapses [???standing] our conviction as to the truth [illegible] the position, that there is a natural chain of connexion which bind all fevers together, yet still do we find it convenient for the purpose of making ourselves the easier understood), by the reader, to adopt the common classification of fevers) Hence 99 the succeeding chapters we shall treat of the several [illegible] commencing with the [illegible] of what is called summer [illegible] fevers and ending with [illegible] of fevers, called cold [plagu??] [illegible] fevers) The objects in [illegible] of this chapter, have [illegible] show by a brief summary of [illegible] symptoms attendant as [illegible] unity of disease and in a [illegible] the identity of all fever proper [illegible] attempt we have either failed [illegible] are still living and important [illegible] and will speak for themselves Chapter 6, Chapter 6 Of Intermitting or Ague and [illegible] We believe it is now universally [ad???] [illegible] low marshy lands, and all [illegible] or situation where the surface of the [illegible] such as to retain, the water that [illegible] either by virture of its depression it, [illegible] of surface, or by the impervious nature [illegible] clay or where the waters of creeks and [illegible] stagnated, either by artificial [illegible] obstructions, are ever fruitful source of [illegible] condition of atmosphere which [illegible] in the human subject the types of [illegible] called intermitting and remitting [illegible] as we are engaged in writing solely with a view to practical utility, we would consider it an unnecessary wate of the readers time, here to enter into any investigation of the laws of Malaria the laws of Vegetable and Animal decomposition 100 [illegible] the theories of the agency of water and calorie in disolving elevating the [???ing] the ultimate elements of with [illegible] the [illegible] matter) [illegible] or ague and fever is [illegible] which is characterized [illegible] [???ct] intermissions or pain [illegible] febrile symptoms,, [illegible] able to discover any [illegible] [??gant] time as was [illegible] verbal displays, which has [illegible] nosologists to affix a name [illegible] a little to every symptom [illegible] otherwise that might [illegible] accompany this form of fever [illegible] ourlves, with the interduc- [illegible] that are the most common [illegible] natural periodicity; such as [illegible] tertian quartan and their [illegible] into double trible and [illegible] and this divison even so far [illegible] alment is concurnece, for consider [??plance], since in whatever form it [illegible] appear its nature is the same, and the [illegible] treatment, with but slight all difientirn [illegible] ever be the same also,) We consider [???ers] at intermittent in character, which [??ally] coal off between each paroxysm [illegible] preceded by chill or not or [cross out] [illegible] chill and fever rise together [??s] a paroxysm of fever of this time continues not more than are four or two returning after a [cross out] lapse of about twenty four or forty eight hours without an intermission, and again, sometimes run on for three or four days but whenever a paroxysm continues for two or three days and then goes off entirely it is not apt to return 101 the most [commen??]/[???tel] of intermittents [h???] [illegible] chill or shake every day [illegible] every other day, or every [illegible] and if allowed by [illegible] two to ten or twenty [illegible] A large portion of [illegible] united states, [par??] [illegible] the intermittent [char???] [illegible] in the southern and [illegible] Symptoms, The symptoms or ague and [illegible] similar; to than of other [illegible] in the onset of the diseases [illegible] generally several day [illegible] or premonitory indicating [illegible] the attact unless in case [illegible] the attact usually commences [illegible] of lassitude and weakness [illegible] and stutering: quickly followed [illegible] rigors, and trembling; then [co??] [illegible] and lividily of the extremities [illegible] respiration anxity nausea, [illegible] vomiting, pulse frequent small [illegible] though sometimes more 'staw, [illegible] the skin generally sensibly [con???] and of a more or less livid pale and scanty,) these symptom [illegible] the first or cold stage, which often [illegible] for a longer or shorter time, is [suc???] by a heat, or redness of the skin particularly of the face, the respiration becomes fuller and stronger, these still great, with more of less pain of the head back and the limbs, this stage is again succeeded by the third or sweating stage when a remission of all 102 the symptoms takes place untill a [m??] abaundant perspiration [illegible] with an increase [illegible] and objections from [illegible] intermittent is justly consider [illegible] fever, and when rightly [illegible] [???cement] or before [illegible] many days is usually the [illegible] form of fever that we [illegible] with but when neglected [illegible] run its course for a [illegible] of formidable diseases [illegible] follow; in its train [illegible] [???nients] and enlargements [illegible] pancreas and liver attended [illegible] indigestions, and not unfrequent [illegible] [???ay] watery effusions of dropsies [illegible] [??en] and of the whole body,, [illegible] intermittent form of fever occupies [illegible] wider range than the medical [illegible] the populace have as yet been [illegible] of) This type of disease do we [illegible] the many anomalous cases of [??ical] pains in various parts of the [illegible] attended with more or less of [crossed out] [illegible] symptoms such as sore pain [illegible] very nearing muscular and [neur???] affection, of the limbs and other [illegible] of the body) Treatment,, Bleeding,, This remedy has at no period in the history of medicine found many [crossed out] advocates in the treatment of intermittents yet it has occasonally found favour with particular individuals, Dr. Rush, for example reports favourably of its use, and we are not sure, but that there are even at this 103 Time some individual practitioners who are [illegible] of this remedy) The can [illegible] of but a very few cases or [situa???] [illegible] it would be admissable [illegible] cases are when the [illegible] send plethoric individual [illegible] subjects as have a [constit??] [illegible] to particular congesting every [illegible] such as disposition to [illegible] congestion, of the lungs [illegible] we have thought it would be a [illegible] practice to abstract [crossed out] just [illegible] and no more as to take off [illegible] [????tion] in vascular system [illegible] be certainaly done by one [illegible] bleedings and then proceed to [illegible] with the proper doses of Tonics (Emetics and Cathatics) For these classes of remedies [illegible] find but little use in the [illegible] intermittents) should spontaneous [illegible] occur then we cause no necessity [illegible] tion of emetic forth stomach [?mp??] and when there is no sick stomach nor [illegible] are still unable to see any good reason [illegible] such symptoms) But whenever paroxysm occurs on a stomach overloaded with [illegible] a puking ensues There from, then is is [a???] The organ to empty itself before we attempt [illegible] compase it,) Tried to the use of cathartics we are well aware that some of the banned profession of the schools have strongly advocated and placed great reliance on them under a belief, that the disease was caused by a congestion in the liver and that the use on 104 [???stice] cathartics constituted the [illegible] [???ing] that viscus) bid [illegible] [illegible] [??ady] succeeded in [illegible] [???der] of the falacy of [illegible] principal inducement [illegible] the use of an aperient [illegible] the patient of constipation [illegible] of things exist for we [illegible] the proper treatment the [illegible] should be left or kept [illegible] the normal or healthy condition [illegible] in cases of looseness of [illegible] use small cases of laudanum [illegible] six [cross out] eight or ten drops of [illegible] six or eight hours until [illegible] an equivalent of paregorie, but [illegible] sick stomach or vomiting then use [illegible] peppermints or some other cordial) [illegible] we conceive necessary to be done [illegible] question) simply to abate the four [illegible] [??tiny] remedies) during the [illegible] For this purpose we have found [illegible] quinine, every two hours both way [illegible] regularly administered through [illegible] and by this course, the author has [illegible] [???ed] to releive, his patients in the course [illegible] three days) We have aided its [illegible] the skin, during the hot stage [illegible] of warm diaphoretic teas such [illegible] Virginia snake root, to which [illegible] added a little red pepper, or [??tinus] the alkaline salts) So soon as general perspiration in excited or the fibrile symptoms, are caused to abate than discontinue the use of the sudorifics and continue that of the tonic alone) it's this form of fever the patient is more liable to relapse, than in any other 109 When once the disease [illegible] he warned do well to take two or three [illegible] of quinine, a day united his strength complexion is restored) We have been [illegible] than suprise) at the very liberal, not to [illegible] uses that some of our [illegible] and even made of the [illegible] He born from the medical [illegible] that the sulphate of quinine has [illegible] in from fifty to one hundred grain [illegible] with a view to remove [illegible] spleen &c, for the cure of [intermi?], We consider this a [illegible] [illegible] of [illegible] of the best remedial agents [illegible] profession, We are at a loss to [illegible] On what grounds such [illegible] justified in any kind of cases, It reminds us of the [c???mours] [illegible] mass, and of calomel, that [w??] administered in many cases, and in many [p???] there united states, during the [illegible] of the Asiatic cholera,, Dr [?brite] [illegible] of 4320 grains of Calomel being given twenty four hours to one patient and the recommended [illegible] to be [???p??] in the next twenty four hours of cholera, Eberle's practice [p???] In a letter from Lewis to [prop???] [illegible] of Philadelphia dated Paris, character following interesting statement is [illegible] At the hospital of De La Petie, I [ha??] the sulphate of quinine uses in a wholesale manner, for the treatment of [inter???] fevers, supposed to be caused and dependent on the enlargement of the spleen. The doctrine is held that the fever cannot exist without the enlargement and derangement 106 of this [???s]) His theory has many disciples [illegible]) To relieve this state of things [illegible] to one hundred [illegible] given, and with [illegible] I have often very satisfed [illegible] and marked it [illegible] the administration of the [illegible] doses and in twenty [illegible] administration I have seen this organ very perceivably reduced in its whole circumstance, and the [illegible] or pattiated in an [illegible] short line) [illegible] wisdom to be drawn from [illegible] practice, yet to establish there very [illegible] first, the safty and [illegible] quinine, secondly a deobstruent [illegible] that drug, thirdly, that such is the [illegible] happy construction of the animal [illegible] that life is not necessarily the [illegible] not practice,, The immunity [illegible] in such cases, we would [???pt] to account for, on the supposition [illegible] force of the drug could not [illegible] once be brought into action on the [illegible] structure and in this the most [illegible] view that we can take of the [illegible] would seem (to say the least of [illegible] of economy, in the use of the [illegible] Chapter 7 Of Common Billious or Billious Remittent Fever From what has been already said of the unity of fever in Chapter 4th 107 the readers mind must be [illegible] prepared to receive the [??pertion] now sustained by [illegible] [illegible] [illegible] med practitioners, that all fevers are more or less liable to [illegible] according to the influence of [ex???] causes and the [susceptibilities] and imprissebilities of individual [illegible] that that observation, has [illegible] the fact, that intermittents [illegible] inflamatory, billious, [ci??] typhus, and malignant yellow fever have all in many instances [illegible] each, so also have [m??] in the [illegible] locality, and at the same time, the [s???] season different [individuals] the subjects of all the [???sities] of [illegible] example, one patient has intermitted another remittent, a third [illegible] a fourth typhus, and so on with the endless subdivisions, which [illegible] generally, [compression] [illegible] [cross out] is through [cross out] [cross out] From these remarks it will be readly inferred that fevers are almost infinite in the varieties of [shades] [illegible] which they assume= It is through the instrumentality of these truths that the world has been kept so long in the dark, by the wonderful fascinations of [illegible] (the magic of words:) while fever has [ever] been a unit, one and the same phenomenon from the days of Hippocrates, or even of Adam, down to the present time; with, in truth, but slight appreciable changes or shades of difference, to correspond with the development of humanity, man has created for it as many names, tittles and dress, as would fill the wardrobe of a modern city dandy- The doctors and dandies have both been laboring, to the maximum of their wits, but with this marked difference in the moving 108 spirit of their toils the one has even beer laboring to discover the truth while the other is laboring to discover the best mode to conceal it Now, this state of things has originated from the limited and banded nature of the human mind, which has ever compelled him first to toil to develope and to propagate isolated elements of truth, as a step preparatory to the ultimate explanation of the whole; since the harmony of these elements can only be seen by him who comprehends each and every individual atom or element of truth,, We come now to the consideration of that part of our theme which we have thought fit, to call the second link in the general chain of fever, viz: summer or autumnal fever There has been about as many names given to this link, in the chain as there have been modes of practice prescribed for its cure- It has been called bilious, malignant bilious &c Of late years we have seen it crowned with a new title, the congestive fever, or the congestive bilious or congestive intermittent, as though it were a new disease- The term congestive, used as a discriminating symptom, as though it did not belong to all other fevers for we cannot conceive of any fever without more or less congestion somewhere; the only difference then that we can perceive is that this particular feature is more marked, more prominent, than usual, for the disease all the time is the same old acquanitance, we recollect often times have not with on the lowlands of Maryland and Virginia, in the days of our boyhood The doctors then called it malignant intermittent This form of fever is most prevalent in the marshy situations of warm countries, and in the warm summer and autumnal seasons of all countries,, Like other fevers it is usually preceeded by more or less of premonitory symptoms such as are common to other fevers, The attact is usual announced by chilly sensations 109 more or less distinct of a longer or shorter duration sometimes [???ding] to an ague; these symptoms are suceeded by the ordinary symptoms of hurried inspiration pulse fretful and quick for the most part full and soft: pain of the head back and limbs a general restlessness nausea and sometimes a vomitting of bilious matter: this is sometimes quite an obstinate and distressing symptom The skin now becomes hot and dry the their considerable the patient usually desiring drink more than the stomach can bear)) Those symptoms remit or abate [illegible] twenty four hours, sometimes twice, but never go entirely off before a fresh attact ensues, so that the patient, is now without some fever, the remissions usually occur during the latter part of the night, or the early part of the day,, In the unbiased or natural order of things, this form of fever usually runs its course in ten or fifteen days,, but as we have said, we never have yet been able to satisfy, ourselves of the [illegible] of critical days in fever proper and are forced to believe, that his projections has arision from observance of such a law in the exanthemata, of eruptive fever such as most small pox and the like,, since this form of fever is most common, and from the the extended theatre of its action interesting a larger portion of our population than then other forms- being common not only to country situation in all climes, but also to cities, and to Towns, assailing all ages and all sexes- but we have thought proper for these reasons, to dwell more upon this than any other link in the chain)) causes It is partly produced from [o??arsh] 110 Exhalations, or from breathing an atmosphere impregnated with the exhalations arising from the decaying remains of vegetable and animal substances, and partly from the debilitating influences of excessive fatigue of any kind, the relaxing and debilitating effects of a meager or unwholesome diet, and partly from the relaxing influence of continued heat on our systems, and partly also from the sudden transitions of temperature,, hence, it is that this fever is more common and more fatal as we approach hot climates and low situations, and most prevalent in the hottest season of all climates,, This remitting or continued form of fever as you may please to call it, though the most common, is the least dangerous- or in other words, the most manageable, form of all the fevers except that of ague and fever, there are occasional cases and even occasional, seasons in which it assumes a violent or malignant, character from the commencement or cases and seasons, in which under our best effect, the disease is apt, to run into a low and dangerous grade,,) But the cause of these things being for the most part comprehended and more or less under our Controle might be obviated in due time to save the lives of the sufferers- To explain, the fatal tendencies in the most cases arising from malpractice of remedial [illegible] neglect neglect an error in diet, crowding the sick too much together, or the sick and well together, neglect of proper cleanliness [illegible] the want of a free circulation of wholesome air, and a proper attention to the release of the patient, sleep being as necessary for the well being of the sick as his food or his physic, since fever of all kind and grades, have been known to take life and are always attended with more or less danger they should 111 ever be promptly attended to and if possible fully managed for many cases that should yield under two or three days judicious management in the [???tic] disease something becoming manageable after [illegible] of that [illegible] [???naw] the [illegible] We are well aware of the fact that the fever of different seasons from the peculiar [illegible] defying influences of the producing causes, assume different types and different [??endi??] that is, that in some seasons the congestion or engorgement of the varied organs [neces???] the offspring of the febrile action, are more apt to result, in local congestions [illegible] other seasons, they are more prone to degenerate, into vitiations [p???] [illegible] in the secretions and ultimately to [illegible] in gangrene, or mortification [illegible] witness! in some fatal causes fevers Blood letting The propriety of abstract [illegible] judges of from the type of [illegible] the age and constitution [illegible] and the symptoms [illegible] For example when cases occur in young [illegible] subjects and the symptoms indicate such local [illegible] with a full free and active circulation [illegible] expect to practice one or two moderate [illegible] advantage; say Take just blood enough to [illegible] excess of toutione from the pulse) This we [ha??] [illegible] can be achieve by the lass of about three [illegible] more, of blood at a bleeding and should be [illegible] practice in the course of the first Two or three days from the attack; The use of this remedy we have confined to particular types, and particular discriptions of cases, If the general bleeding have 112 have been neglected at their proper [illegible] as if after having been [illegible] put in practice some local pain continues still [?aslress] the patient we should then seek further relief by the use of cups or blisters applied to the parts most affected as the judgement of the operator or practitioner the [ca??ects]) (Emetics Next to consider) In the early stages, and more especially in the onset, or forming stages of the fever, have we occasonally succeeded in cutting short, the disease by the use as simple emetic of ipecacuanha, is tarter emetic, antimonial wine, [illegible] be any choice, in the case, followed by the prompt, and [f???] of suitable diluent and diaphoretic drink, such as flax seed sage chamomile, or black snake root, Tea) We ascribe the efficacy of emetics in such cases more to the concusion or revolutionizing effects on the system whereby the circulation of the blood, and consequent equilibrium of animal [illegible] of the secection of the skin, [illegible] is effected, than to the [illegible] evacuation of any matter that may take [illegible] In most cases, it is best [illegible] of the action of the emetic by such auxiliaries as will unlock the pores of the skin and thereby mitigate the violence of the fever such as above cited but in those cases where we learn that the patient is in a state of greater or less constipation of the bowel, then we should endeavor to make a gentle impression on the bowels, by the use of little epsom salts and gruel the senna tea; Taking care at all, times, to guard against so great or so hurried an action of these organs as to produce much sensible debility in the patient; In the use of emetics as in every other step in the treatment, we should always look well to all the circumstances of the case not use them where peculiarity or 113 Idiosyncracy would forbid or when the delicacy of the constitution or the already irritated condition of the stomach would oppose it Cathartics Next in order While we stand opposed to the practice of attempting the care of bilious fever by the exclusive use of cathartics all are still willing to admit the fact that such thing have been repeatedly done,, But we do contend for the practicability of accomplishing the same thing by a less distressing, less debilitating and [illegible] them equally safe and short route,, In the early stages of the disease, we approve the use of one or two mercurial cathartics; especially if the stomach be too irritable to bear the administration of more bulky cathartic drugs. In those cases we recommend eight or ten grains of calomel with a half grain opium, or its equivalent in laudanum or paregoric or an equivalent of blue mass, in lieu of the calomel should the patient prefer it [cross out] [cross out] [cross out] [cross out] Such doses should or should not be repeated according to the exigencies of the case [illegible] or doses fail to operate in due time [illegible] with a dose of some more common [illegible] such as epsom salts, castor oil, [illegible] as such like) So soon as we shall [illegible] in evacuating the stomach and [illegible] the patient in a situation to [illegible] on the use of another class of remedies, vis, the use of [illegible] and sudorifics= The fact, the either, [illegible] had much experience in the treatment of that [illegible] of fever case not hesitate, to commence the Treatment by the immediate use of quinine, aided by sensible diaphoretics, at any stage and without preparatory depletion 114 the extended safe and the salutary response from those who have use the authors, gold pills throughout the southern and western states of this union, in all form and small stages, go to the facts repeated] from his own experience) Now Tonics and diaphoretics, Our objectives to depending on the depletive practice for the [illegible] billous fevers by repeated [illegible] purgings are first because we consider such practices contrary to an inverting the order [illegible] secondly if experience has taught [illegible] purges, when used in health [illegible] the individual, and bring on the necessary [illegible] [illegible] disease [illegible] drink, should, then be [illegible] [illegible] that these effects to a [illegible] [illegible] ensue on the use of [illegible] in a diseased conditions [illegible] the [illegible] [illegible] already great from [illegible] condition, to be still increased by the [illegible] irritation of the mucous membrane of the [illegible] [illegible] a consequence of the [illegible] [illegible] of the fluid elements [illegible] with this view of the subject, the [??one] of cure would seem to us to be [illegible] [illegible] to the circulation, reinstate [illegible] support the enfeebled system [illegible] morbid irritation,, [illegible] accomplishment of these desirable [illegible] [illegible] found the judicious and united [???tonics] a new diaphoretic remedies aided [illegible] [illegible] and properly combined opiate [???ing] in efficacy all other means,, [??ing] already stated the time increase and circumstances, under which we conceive bleeding puking or purging or any one or more of these remedies necessary, at the 120 discretion of the practitioner or attendant we will now proceed to say before the reader in as plain and simple terms as possible and a special plan of treatment We proceed at [once] with the administration of one grain of quinine every two hours, regardless of fever [regularly] by day and by night, after however the ceases with some suitable diaphoretic such as the vegetable sweating teas the virginia snake root, balm sage, or the like the sweet spirit of nitre, the supper carbonate of potash or soda, or a animal the alkalies with [some] one of the vegetable teas) These drinks [may] be used either warm or cold, as the [patient] appetite may prefer, watching the effect, of the diaphoretics and so regulate the [illegible] their repetitions, as to proceed a slight but general action on the skin, [illegible] [illegible] maintain such motion without running to any excess, Hence as should suspend the use of sudorifics whenever there was any [illegible] of excessive, perspiration, while we continued that of the tonics,, This course of treatment should be continued untill [illegible] crisis on a marked [auidi??] [illegible] [illegible] But it not unfrequently happens, [illegible] some unpleasant symptoms, in [illegible] with the state of the stomach and [illegible] occurs to interrupt the progress [illegible] [illegible] as intended course of treatment [so??] continuance of or a return of sick [illegible] and vomiting- symptoms constituting what the learned writers have been pleased to call a gastric fever, in such cases we [illegible] endeavour in the first place to correct or allay such morbid irritation before we can expect to obtain the benefits of the strictly febrifuge remedies,, continuing however; 116 the use of the quinine whenever the stomach will retain it This will be most effectually done by one or the other of following [desst?], should the patient be troubled the [illegible] sense of heat in the stomach with the casting of bilious or acid matter there administer what is called a saline mixture or effervescing draught a fallacy,, Take of saleratus, bicarbonate potash, a common salt to tartar have an ordinary tea-spoonful-fresh lemon juice or vinegar a moderate size tablespoonful,, Put the lemon juice or vinegar into a wine glass and fill it with water, then add, that saleratus, or bicarbonate of potash made fine, to immediately [illegible] or dress in the state of effervescence or foaming,, This dose may be repeated as often as necessary, to compose the stomach,, Should we fail by the case- to obtain the desired relief, Than we might make use of any one of the following remedies, such as essence of pepermint the aromatic spirits of parts from the compound spirits of lavender a few drops of the spirits of turpentine, taken in a little cold water, or on a lump of sugar, or an opiate portion of Morphine opium Laudanum or paregoric,, of these remedies we have the opiates most uniformly [cross out] successful, In all cases of irritation of the stomach more or less benefit maybe expected from exturnal applications such warm applications either wet or dry mustard, plasters blisters, cupping or leaching In some instances the irritation of the stomach is kept up or rendered more abstinate from a torpid or inactive State of the bowels,, in such cases we should not fast to make some impression on the bowels either by the 117 use of suitable aperients or by repeated use of injections,, If on the other hand, we should have to continue with a wasting from excessive looseness of the bowels then we restrain such evacuations by the use of small doses of Dover's powders paregoric compound spirits of lavender, tincture of kino are infusion of the root of dewberry or of the common blackberry or some other suitable astringent combind or not with a few drops of laudanum as the present or absence of pain might, indicate, In all stages of disease and under all circumstance of cases the practitioner should never lose sight of the utility and even importance of any minor consideration of comfort or of case, to the patient such as occasionally bathing the feet, especially at night in warm water, the application of cold cloths or cloths satuated with cold water and vinegar to the head while there is much excess of heat, and pain or occasionally springing for the same purpose, But this mode of palliating distress should be practiced, with caution and with judgement, for cold application are made in any part of the body at or about the [illegible] of the decline of fever or when the patient is [illegible] feeble, these unpleasant weaknesses restless and sometimes chilly sensations are the immediate consequences,, We should at all Times allow a reasonable indulgence in light and easy to digest food; when called for by the natural-sensation of the stomach Never officiously press the patient that which he dose not desire or more or even quite as much as he may desire to should pay some regard to the accustomed habits of individuals about taking nourishment as to point of time 118 administering our medicines so as to interfere a little as possible with the acustomed period of eating and sleeping,,, In this the reader will not fail to observe an [illegible] of an practice over that if the irritating piece of using emetics and cathartics, which are not only irritating to the digestive organ, exausting to the patient but at the same cutting off supply of the continually, require new element of life another very important requisite to the sick is that they be not molested by unnecessary conversation or even the presents of unnecessary company= carefully remove all among and of either sight or sound,,, give to them all proper opportunity of receiving the refreshing benefits of sleep,, and case of a loss of sleep from disease, or morbid vigilance or the annoyance a pain do not hesitate to procure natural rest by the use of a few drops of laudanum particular at sight, say twenty or twenty five drops,, the strength of the patient, the condition of the tongue, skin and of the pulse will ever in our surest and best guides as to the indications in the administerations of the remedies,,, The Tongue usually covered with a white coat, in the commencement of fever, with the progress of symptoms be comes yellow then brown, and sometimes dark brown, [??d] dry it sometimes sheds a first coat and then becomes red black and glossy, and in extreme cases becomes dry, and crack from a deficiancy of its natural secretion,,, [illegible] then unfavorable symptoms continue to manifest, themselves on the tongue a corresponding want of healthy action exists on the surface of the whole body the skin continuing for most part hot and dry as in a later or tenser stage becoming covered 119 with a more or profuse sticky and clammy perspirable matter with extremities frequently to cool. the pulse during the time becoming weaker with the decline of strength While in pregnancy is apt to be increased, whenever in the progressive course of a fever the attendant observes that the patient is declinig that is that he is sinking to a still lower grade in spite of the use of the quinine and the ordinary diaphoretics whether delirium exists or not the author has found great benefit result from the use of from three to five grains of camphor in union with a quarter of a grain of opium or six or eight drops of laudanum to be taken once in every six or eight hours in lieu of the other diaphoretic remedies already recommended adhering, however still to the regular use of the quinine and giving a moderate portion of toddy milk toddy or wine[illegible] every two or three hours,, Delirium,,, under our general view of fevers, we have already given some account of this symptoms as an occasional attendent on fevers,, It now becomes necessary to speak of it in particular form of fever with a view to the most appropriate mode of combatting it,, We have already conveyed the idea that [illegible] which arrest, the fever, arrest its individual manifestations or symptoms,, But this symptom has been shown to be partly the affect of [illegible] fever proper, and partly the result of a patient's organization, or particular temperment when it occurs in the first stage it is to be relieved as already directed in the first stage of fever and on the same general principle When this symptom, occurs in the later stage of the fever then we have found relief from the use of blisters to the back of the neck and the use of opiates while in all other respects 120 we continue to treat the case as though no such symptom has occured,,,, Deliarium varid and aggravated in its manifestations, and one in which little or no conciousness exits not unfrequently occurs at a later or in the last stage of the fever,,, Here is the result of prostration and irritation then the indications will be to sustain the vital energies and to [illegible] its irritations,, these indications can be best fulfilled by the use of suitable nourishment tonics, opiates, blisters, and lastly stimulants or nourishment, in the form of stimulating drinks such as wine whey milk toddy panada malt liquors and the like,, There is still another symptom which not infrequently occurs in this form of fever, that is internal irritation with or without more or less of wasting discharges from the [illegible] When such irritation exists without evacuation that is, when the natural evacuations are retained, then we should procure the necessary and healthy evacuations by the use of laxatives, or in case of such weakness by injections, alone,, But if on the other hand the patient is wasting from too frequent or too plentiful discharges There we should endeavor to correct such a state of things, by the use of small and repeated doses of opiates and astringents, such as small doses of laudanum paregoric tincture of kino or any of the vegetable astringent teas [illegible] there [cross out] cases of local distress in the bowels, we find warm application or application of mustard so used as to stimulate without blistering valuable agent In proportion, to the exaustion or depression of the patient is the liability to witching of of the muscles a kind of feeble spasmodic action What the medical writers called 121 sub suttus tendinum,, This symptom is the mere consequence of extreme weakness and we here draw the attention of the reader to the fact, that he may the more fully see the importance of sustaining his patient in this situation by all of this means in his power,, While we steadily aim to sustain we should be careful not to [co??] not, [st??] although a very dangerous symptom is not necessarily a dangerous case We have occasionally witnessed cases in which the patient passed no urine for eight or ten days, and still suffered no pain or inconvenience from it, in such cases the secretions are suspended or the absorbent and exhalants, take on an unusual and increased action- Involuntary discharges by stool or urine occasionally occur in low and protracted cases of fever, and although it is a dangrous symptom or circumstance it dose not necessarily follow that the case must prove fatal- Let your patient then just so much of the varied, stimuli that sustain life, as the judgement of the practitioners or attendant the organization in it pregnant state can manage, or requires and no more and careful so to time the repetition of your doses as to meet the continually [illegible] wants of the system- In case of coldness of the extremities we should maintain the natural heat by warm applications or the stimulus of mustard so used as to heat without blistering These remarks, applicable to the last stages of disease will be found equally applicable to all stages- 121 Before closing the present chapter we deem it proper to make some general remarks as and additional guide to whoever may attempt to put in execution our views to wit- They should ever bear in mind the healthy [?g?] [illegible] the healthy needs of the system, and let the object of every step, the use of every agent be to assist either directly or indirectly in bringing back [???inde] every organ of life to the discharge of its healthy function [illegible] all cases, which the sick are able and competent to give us clear and satisfactory responses as to their want [d??es] and sensations, we should never fail patiently to collect such information and apply it to the benefits of the patient and in case of mental alienation or such torpor of mind as cuts off the aid of the sufferer in explaining himself, then exercise your ouwn judgment on all such other lights, as may be brought before you-,,, [illegible] more full and explicit in the detail of [illegible] their applications, to particular symptoms, [illegible] any other chapters for reason already [illegible] we have thought it proper, hare, to remark, that [illegible] [???tions] with application of remedies to [illegible] symptoms, contained in this chapter [illegible] [??tted] in other chapters may with [illegible] be applied to the treatment of like [illegible] of system occurring in other fevers [illegible] the doses and modes of administering all the remedies recommended in this chapter. The [illegible] see in the last chapter, in This Work,, viii/,, 122 The authors Treatment on Cholera Infantum, The Author considers cholera Infantum as a species of fever peculiar to children say from six Months too two or three years old,, This he infers from the fact that children this age are seldom the Subjects of either bilious or typhus fevers, but are subject to ague and fever, and from the additional fact that cholera Infantum is much more common in the summer and fall months, and in sickly seasons-- When grown persons, suffer most from bilious affections The reasons for the occurrence of cholera Infantum in lieu of bilious fever, would to be the peculiar irritability of the stomach, and bowels of children at this period of life, being at this age more liable to take on unhealthy action, under any circumstance than at any other period of [illegible] affection of stomach and bowels, which take care in the winter months being usually slight, & of short duration [??it] those of the hot seasons are more protracted [illegible] serious in their nature, proving sometimes fatal in a short period, while in other cases they are protracted for many weeks, and even months untill the little suffers are reduced to mere living skeletons The puking and purging in cholera Infantum [illegible] some analogy to the cholera morbus of adults, but is not often so violent, so rapid in its progress or so fatal in its tendencies, although for the diseases [illegible] from the same or similar causes,, [illegible] infantum something the vomiting continues without purging but most generally the purging continues without vomiting, and it is not uncommon both symptoms to subside for six eight or ten days with every appearance of a speedy recovery and then return or relapse again after the manner of an [cross out] intermittent fevers As in other fevers the violence and the danger of the attack is proportioned to the circumstances of causation and the constitutions of the subjects hence its greater prevalence and greater 123 [illegible] fatality in [cross out] cities Towns and in [warm] climates, than in county situations and in more [salub??] [illegible],, In cholera Infantum as in other fevers and as in other [cases] of irritation of the stomach and [illegible] the sense of thirst is distroying [q???] the patient at as [d??ining] more [dim??] from the stomach [??ak] digest,, In the early [illegible] the disease the fevers [sometimes] considerable, the skin is [illegible] [illegible] in other fevers, the continued watery [illegible] [illegible] seem to suppress the natural [illegible] and moisture of the skin.) Towards the close of the disease, and when the patient is much [illegible] [illegible] are apt to be cold,, the [illegible] apt to be covered with a white fur and [illegible] [illegible]) It sometimes becomes [illegible] [illegible] it assumes a dark or [illegible] [illegible] as is more apt to prove fatal, [illegible] [illegible] Treatment) [illegible] [illegible] an attact, we deem it [illegible] see or the spontaneous evacuations to present [illegible], untill the stomach and [illegible] [emptied] themselves of their common [illegible] [such] generally accomplished in [illegible] [???ers],, something in a shorter [illegible] should proceed to allay the [illegible] stomach and bowels by means of [illegible] applied over the stomach so [illegible] blistering and the internal [illegible] [illegible] of small doses of paregoric essence [illegible] [illegible] laudanum or any greatful [illegible] should with the vomiting or purging [illegible] [???ss] than weeks such discharges, by the [illegible] of some astringent, that is should an [illegible] [illegible] of the bowels require it,) [illegible] unfrequently since then, pale and water discharges a very obstinate symptom,) In such cases in addition to translating the irritation the skins [illegible] plasters we have found it necessary to use 124 [??f??ted] [illegible] [illegible] such [illegible] the [illegible] [illegible] [illegible] [illegible] This [illegible] as [illegible] it may [illegible] [tak??] in toddy [illegible] [illegible] in [la??] if the [illegible] [illegible] [illegible] [illegible] [illegible] of [admi?t] [ag??] [illegible] [?ase?] able [illegible] again [illegible] [illegible] seldom intances, [ag??] [illegible] [illegible] prohibits the administration [illegible] [illegible] [illegible] [illegible] and bowels and [illegible] [illegible] a little starch and [laud??] [illegible] The teething process being [illegible] [illegible] mutch to the increased [illegible] [illegible] and whenever any tooth or both [illegible] [illegible] so as to be masked success of [illegible] [illegible] of a pen knife should [illegible] [illegible] so as to divide the natural [illegible] [illegible] tooth). The coldness the [extre??] [illegible] an attendant, should be [illegible] [illegible] covering or occasional friction [illegible] [illegible] on the skin,) If the patient [illegible] recover after using, the [forc??] [illegible] a few days, but continues to be [illegible] [illegible] suffering from a feverish state, or [illegible] exhausted, then [ca???nce] [illegible] [illegible] or tonics, such as quine peruvian [illegible] suitable Tonic, and repeat at [illegible] [illegible] hours, untill there is solution [illegible] [illegible] action- a complete crises) [she??] [illegible] between doses two or doses [illegible] its use in this way untill the little [illegible] [illegible] reinstated in health and strength- During the contiunance of the warmer season- children are very liable to relapses,) This [illegible] effectually guarded against by seeing a [purerat??] attention to cleanliness diet and exercise) 125 [illegible] [illegible] [??tion] [illegible] and [illegible] [illegible] [illegible] [illegible] and [illegible] [illegible] [???a] the [illegible] [illegible][illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [dis???] [illegible] [illegible] [illegible] [??a?i??] [illegible] [illegible] [???ag?]) [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] in the on [illegible] [illegible] [??ed] and [illegible] [illegible] teeth was natural [illegible] [illegible] growth of bones [illegible] [illegible] are produce) [illegible] [illegible] processes, if so [wh??] [illegible] [illegible] disease) [illegible] [illegible] would seem to us to be [illegible] [illegible] [??is], the other [illegible] [illegible] the [illegible] the makes its exit [illegible] [illegible] lasts but a few days, while [illegible] [illegible] liable to continue during the [illegible] [illegible] the opposition will say [illegible] [illegible] [??ies] too,) To this we reply [illegible] [illegible], dose not commence the [th?] winter season, or [?ven] run into the winter, months [illegible] [illegible] teething process is still going on, [illegible] [illegible] changes of, the seasons moreover [illegible] [illegible] children who get their teeth without [illegible] [illegible] [???laint] or indisposition of any [illegible] [??ular] those who pass through the [illegible] process while very young) again we hear [illegible] [??laint] about the stomach and bowels [??lant] in the sheding of teeth when there is not [illegible] a need growth, in process but the additional [illegible] of casting off the Hot ones) He readily admit the greater liability of children to disease and to [illegible] during the first two years of existence 126 than at an [illegible] [illegible] of time for the [illegible] [illegible] [??hi?] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [P???] as to the [illegible] [illegible] frequently to exist [illegible] [illegible] a [H???] [illegible] [illegible] sound and rigorous [illegible] [illegible] the [illegible] origin or [mad??] [illegible] [illegible] of [illegible], it is a matter [illegible] [illegible] The weight of [fest??] in [illegible] [illegible] favor of the idea [of??] [illegible] [illegible] in the human intesting, [illegible] [illegible] of life most, [illegible] such [illegible] would seem to be [??u??], [illegible] [illegible] more especially the use [o???] [illegible] indigestible food, [illegible] [illegible] that may tend to derang the [illegible] [illegible] digestion or of [asimil??] [th?] [illegible] view of the subject we are [illegible] that the existence of [illegible] [illegible] a result, than a cause disease) [illegible] when they have been generated [illegible] [illegible] when they exist, in great [munk??] that they then became an additional cause of [illegible] and ciation and of febrile disease [illegible] [illegible] not only so promptly, expelled [illegible] [illegible] suitable vermifuges, but that [illegible] [illegible] should afterwards be placed on the [illegible] of such remedies, as would most [illegible] prevent their return, as generational The symptoms ascribed to, and that [illegible] be attendant on worms in children, are almost as numerous and very much resembling the symptom of many their diseases to which they are subject; 127 [illegible] [illegible] [illegible] [chse??] [illegible] [illegible] from the symptoms [illegible] [illegible] [???ust] be left [illegible] [illegible] [???dant], and [illegible] [illegible] proof of it [illegible] [illegible] the presence of [illegible] [illegible] by variableness of [illegible] [illegible] [???ness] and [illegible] [illegible] the sleep picking of the [illegible] [illegible] of the upper lip, more or less of [illegible] [illegible] disturbance of bowell [illegible] [illegible] about the navel,, febrile [illegible] [illegible] of worms) When [illegible] [illegible] point to the presences [illegible] [illegible] administer, vemifuges [illegible] [illegible] of spigelia or Carolina [illegible] [illegible] two or more grains of Calomel [illegible] [illegible] the patient, Should be [illegible] [illegible] second morning for two doses [illegible] [illegible]; two or three times per day [illegible] [illegible] succession or a few drops of spirits [illegible] [illegible] a little sugar, and water two [illegible] [illegible] per day) Should there exist a costive [illegible] [illegible] while using, the warm Medicine [illegible] [illegible] purges gently with a little senna [illegible] [illegible] or a dose of calomel, provided [illegible] has not been used) in every case of worms [illegible] suceeding in expelling them the patient [illegible] [??ed] on the use of some better tonic [illegible] [illegible] to good health and to good digestion [illegible] suppose we know of nothing perferable [illegible] of suitable doses of quinine, in [illegible] we have reason to believe that it [itself] is itself a good vemifuge vither from its better principles or its tonic effects on the system The Some preparations of iron are also well suited to such cases.) The particulars as to remedies and their doses, the reader will see chap 16 128 Chapter ninth On yellow fever, description, [illegible] classification of fevers, this is the [illegible] and most malignant type of [illegible] disease it is to common [illegible] fever [illegible] plague or [illegible] fever is to typhus [illegible] fever, and much will [illegible] be called the typhoid bilious fever of cities [illegible] since it never appears in [illegible] in hot seasons and in crowded illy ventilated and filthy places, and even [illegible] tropical regions its ranges are checked by the coming on of the cold season of the year it is more violent in its attacks more rapid in its progress and more putressent and fatal in its [illegible] than any other form of bilious fevers Causes The concentrated virus of [illegible] with the exhalations from human [illegible] civic life that is to say, the debilitating [illegible] effects resulting from a violation of organic laws [illegible] by the continued and relaxing influence of [illegible] other words the external causes [illegible] influence of heat, with a peculiar vitiation [illegible] while the internal causes are violations of organic laws) The united effects of these are [illegible] modifying causes are to debilitate, to [illegible] and derange, the functional actions of [illegible] in brain nerves, muscles and all the glandular tissues) Hence, we see such rapid [illegible] secretions to vitiations and [illegible] in the solids, particularly in the stomach and [illegible] is a rapid running into gangrene, and [illegible] as is evinced by the black and putrid matters [illegible] from them, and the speedy triumphs of death and decomposition that we are occasionally called to witness) We are aware that a prejudice exists not only the minds of the populace but of the profession 129 [illegible] [illegible] of the [S???] [illegible] [illegible] [illegible] [illegible] [illegible] quantity [illegible] [illegible] [???ally] [dist??] [illegible] [illegible] [illegible] it [illegible] [illegible] [illegible] or [?iten] [illegible] [illegible] such [rapi?] [illegible] [illegible] jaundice evident [illegible] [illegible] yellow fever which [illegible] [illegible] all seasons is so [illegible] [illegible] or occurs in [illegible] [illegible] it [rea??y] produces [illegible] [illegible] freely [diffus??] [illegible] [illegible] system, the patient in [illegible] [illegible] [??ly] concious of being [illegible] [illegible] color of the skin, Symptoms, The [illegible] [illegible] most particulars like that [illegible] [illegible] ushered in by sensations of [illegible] [illegible] stiffiness or soreness of the [illegible] [illegible] head, back and limbs, generally [illegible] [illegible] degree of chilliness, these [illegible] [illegible] succeded increased pain of the [illegible] [illegible] sinuses, giddiness or dizziness [illegible] [illegible] face, a sense of fulness in the eye [illegible] [illegible] expression of distress in the countinence [illegible] [illegible] suffused, with tears a general [illegible] [illegible] with thirst, either great restlessness [illegible] delirium or a tendency to lethargy [illegible] [illegible] scanty and turbid perspiration [illegible] interrupted and diminished pulse irregular [illegible] [??izs] or too slow full fretful and [illegible] often giving a delusive feeling of [i??ased] force seldom strictly tense,, tongue covered [illegible] a whitish mucous coat great irritability of stomach, with nausea and vomiting of bilious matter usually found, epigastrium Tender 130 [??prepure]) [illegible] [illegible] [illegible] as [illegible] [illegible] first [para???] [illegible] [illegible] [???p] [illegible] [illegible] [illegible] [illegible] yellow [wh??] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??ter] [illegible] [illegible] [illegible] [??ll] the [dis?a??] [illegible] [illegible] [illegible] [??ih] generally [illegible] [illegible] [illegibe] hours, when an [illegible] [illegible] [illegible] times, which such [illegible] [illegible] [illegible] induce the patient [illegible] [illegible] [illegible] of danger. But [illegible] [illegible] [illegible] with an aggravation of symptoms [illegible] [illegible] [illegible] of this error) As the [disea??] [illegible] [illegible] more and more indicative [illegible] [illegible] [illegible] manifest themselves, the patients [illegible] [illegible] to decline, the Skin becomes [illegible] [illegible] and hue,, patches of livid spots [illegible] [illegible] different parts, of the body [de???] [illegible] [illegible] secreations begin to [illegible] [illegible] the tongue becomes dark and [illegible] [illegible] incrusted, with a dark [illegible] [illegible] hickups ensue haemorrages [illegible] [illegible] forth from the mouth, nostrils [illegible] [illegible] foetid and involuntary, discharge [illegible] [illegible] from the bowels, the pulse sinks [illegible] [illegible] closes the scene.) Such are the ordinary [illegible] [illegible] in those cases which [termi??] [illegible] [illegible] In this fever as in all fevers proper [illegible] [illegible] marked critical days the duration of [di???] terminating favorably or otherwise [illegible] [illegible] proportion to the violence of the causes and [illegible] constitutions of the subjects of disease) Being [illegible] malignant, disease it usually runs it [ca??] from two to five or seven days,, recovering from [illegible] protracted beyond this period are for the most part tardy and imperfect the patients suffering [m??] 131 from indgistion the necessary result of injuries [s???] [illegible] [illegible] [illegible] of the [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??pular] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] those who [illegible] [illegible] [??in] [sub??] [illegible] [illegible] of distinguished [illegible] [illegible] [??its] of illustrious [illegible] [illegible] unbiassed love of [illegible] [illegible] we have been forced [illegible] [illegible] a course ( [illegible] [illegible] is the exclusive property [illegible] [illegible] of thought either in [illegible] [illegible] [???ent] of human researcher [illegible] [illegible] [??hed], and that when reached [illegible] [illegible] forced to rest in simple [illegible] [illegible] [illegible] have ventured to raise [illegible] [illegible] [??ition] certanily in accordance [illegible] [illegible] [??ions] predecessors) We shall [illegible] [illegible] plain and simple view in [illegible] [illegible] disease, than any heretofore [illegible] [illegible] too, which we conceive to be [illegible] calculated cauintuact the virus [illegible] [illegible] in accordance with the [illegible] [illegible] life if In consulting the pages of [illegible] [illegible] we find the weight of authority [illegible] [illegible] favour of the depletive practice at least [illegible] of the [cross out] (immortal Rush,) [illegible] [???tal], because to him we are indebted [illegible] measure for the demonstration of its [illegible] origin, to him are we indebted for [illegible] [illegible] clearest lights, on the subject of contagin [illegible] the earliest the freest and the fullest [???ents] in the depletive practice. (When the [illegible] made its appearance in Philadelphia [illegible] Dr Rush seems to have been much at a less [illegible] that course of treatment, he should 132 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] give [illegible] [illegible] [illegible] distressed [illegible] [illegible] in the [???ment] of [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] happened, [illegible] [illegible] [illegible] advice and [illegible] [illegible] [illegible] disease as his [illegible] [illegible] [illegible] Indies, would [n???] [illegible] [illegible] me that he had [illegible] [illegible] [illegible] of all kinds, [illegible] [illegible] found to be hurtful, and that [illegible] [illegible] readily to bark, [illegible] and above [illegible] cold bath (He [ad??ed] the bark to [illegible] large quantities, by way of [illegible] [illegible] usual ways and he informed [illegible] [illegible] the cold bath should be used [illegible] [illegible] benefit from it (The made of [illegible] [illegible] appeared to be reasonable [illegible] [illegible] manner he had recommended it, [illegible] [illegible] sporadic yellow fever, with [illegible] [illegible] I had moreover the authority of [illegible] [illegible] of reputation in its favor) Dr [illegible] [illegible] sometimes gave the bark, when the [illegible] [illegible] vicious humors, these humor,, he says, [illegible] by the fault of the circulation,) The [illegible] [illegible] solids enables them to throw off [illegible] [illegible] excrementitious, fluids by their [illegible] [illegible] I began the use of Dr Strong, remedies [illegible] after my interview with him with [illegible] of their success,, I prescribed back in [fa??] [illegible] one case ordered it to be injected into the [illegible] four hours. (I directed buckets full of cold [illegible] to be thrown frequently upon my patients, ( The [illegible] was offensive to the stomach or rejected by it in every case in which I prescribed it, (The cold bath was greatful and produced relief in several cases 133 [illegible] [illegible] [??l] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??ment] [??und?] [illegible] [illegible] him in the course [illegible] [illegible] opposite extreme,, [illegible] [illegible] [??ely] of free and [illegible] [illegible] are, (One dose was [illegible] [illegible] bowels, but from [illegible] [illegible] [illegible] for that purpose,, [illegible] [illegible] were frequently rejected [illegible] [illegible] and inconvenience from [illegible] [illegible] [??lass] (It was always without [illegible] [illegible] and it served to discharge [illegible] [illegible] the stomach,, (Nor did I rest the [illegible] [illegible] the bowels on the issue of the one [illegible] [illegible] (There is in all bilious fevers, a [illegible] [illegible] life, as fast as it is discharged [illegible] [illegible] every day, while the fever continued [illegible] [illegible] from tartar and rhubarb, [illegible] [illegible] purges, had preformed their office [illegible] [illegible] of my patients, in all these cases [illegible] [illegible] easily moved,, when this was not the case [illegible] [illegible] dose of Calomel and jalap every day [illegible] [illegible] maybe supposed to be it was often [illegible] [illegible] especially after the 20th of September, [illegible] become neon obstinatly constipated of [illegible] place of the jalap I now added gamboge [illegible] [illegible] two grains and a half of each made into pills [illegible] to an adult, every six hours, until they [illegible] four or five stools) on the 133 page ( [illegible] doctor, we have said on abandoning the Tonic [illegible] of treatment, suggested by Dr Stevens, [???ty], [???pon] the opposite extream, (he now not 134 [illegible] practices [illegible] and [illegible] purgings [illegible] [illegible] [illegible] use of the lancet [illegible] [illegible] sage [illegible] in the [illegible] [illegible] thrown was [illegible] [illegible] temperature [illegible] [illegible] [??nd] one [illegible] [illegible] [??due] the [f???] [illegible] [illegible] the diminution [illegible] [illegible] fever put on [illegible] [illegible] diathesis more frequent [illegible] [illegible] I bled many patients [illegible] [illegible] a day,, (I prefered, [illegible] [illegible] bleedings, in the [illegible] [illegible] the hight and class of [illegible] [illegible] -nce, from the loss of a [illegible] [illegible] of blood at a time ([illegible] [illegible] seventy and eighty ounce [illegible] [illegible] a few much larger quantitys, [illegible] [illegible] in front street, last by ten bleeding [illegible] [illegible] blood Mr George a carter, in [illegible] [illegible] same quantity, in five bleedings, [illegible] [illegible] one hundred and fourteen [illegible] [illegible] in the last of the above named [illegible] taken it as determined by weight, ( [illegible] near Dock street, was eight times [illegible] seven days, the quantity taken [fro??] [illegible] hundred ounces.) The blood in all [illegible] and in the last, very sizy, (They [illegible] the month of October, and chiefly [illegible] [illegible] Mr Fisher,, and they were all year, [illegible] [illegible] and healthy instance, of the efficacy [illegible] [illegible] bloodleting, and of the intrepidity, and [illegible] this young Physician (Again [illegible] Vol 2, P.147, Now that we have patientaly [illegible] Doctor through, some of his Transitions of opinon [illegible] witnessed the processes by which he has been [illegible] erarers, we will next call the attention of the reader [illegible] 135 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??set] the [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] stage [illegible] [illegible] [illegible] [ons?untly] [illegible] [illegible] in her stomach [illegible] [illegible] were prescribed [illegible] [illegible] [???ing] of the next [illegible] [illegible] discovered, to me at [illegible] [illegible] which Dr Faulke [illegible] [illegible] which had been [illegible] [illegible] the adjoining Hoch on [illegible] [illegible] with Mr Le Margre's [illegible] [illegible] [???fied], there to the great [illegible] [illegible] [???hood, (After this [illegible] [illegible] trace all the cases of fever [illegible] [illegible] to this cause of diseases ( [illegible] [illegible] a conviction, that the disease [illegible] [illegible] exhalations, from the damage [illegible] [illegible] American daily, advertiser to August [illegible] [illegible] citizens of Philadelphia with a [illegible] [illegible] attention to the spot where the [illegible] [illegible] checking the progress of the [illegible] [illegible] continued by the original caused [illegible] [illegible] when received into the body, were [illegible] [illegible] into action in a few days-(Im with [se??] cases, in which they acted so as to produce a fever [illegible] some day in which they were received into the [illegible] [illegible] I heard of two cases, in which they [illegible] [???ss], fainting and fever with in one hour, [illegible] [???ns] were exposed, (I met with no instant [illegible] [illegible] there was a longer, interval than sixteen [illegible] between their being received into the body, and [??tion] of the disease. This poison acted [illegible] different constitutions according to [illegible] the degree predisposing 136 [illegible] [ar?] the quanity [illegible] [???tin] of [cross out] [illegible] [illegible] [illegible] [illegible] [illegible] that in [illegible] the [pois??] [s??] the [??tmosphere] the [illegible] [??as] excited to [illegible] the [illegible] [illegible] upon the [dys???] [illegible] [illegible] [illegible] [illegible] [illegible] (first great [lat??] [illegible] [illegible] [illegible] [??din] walking [?idiny], [illegible] [illegible] [illegible] Second, ([illegible] from [illegible] [illegible] [illegible] heat of the sun; [illegible] [illegible] [illegible] of the [dis??] Third [int???] in [illegible] [illegible] [T???ion] (Tear ([illegible] [illegible] sudden [par??] of [illegible] [illegible] [illegible] seventh sleep right [illegible] [illegible] all these [illegible] [illegible] [illegible] debilitate, the body [a??] [illegible] [illegible] [illegible] purges, repeated [illegible] [illegible] [illegible] call it by what [nam??] [illegible] [illegible] putrifying, [vegat??], [a??] [illegible] [illegible] damaged [illegible] [illegible] [illegible] be the real cause and [p??] [ha??] [illegible] [illegible] than it most rational to [???t] [illegible] [illegible] infected, with such [p??] [illegible] [illegible] bleeding, and purging to [illegible] [illegible] such poison) But the [oppo??ion] [illegible] [illegible] are the attacks, so rapid the [pr??] [illegible] [illegible] to words a fatal [ex??e], that [les?] efficient [illegible] [illegible] remedies would be of [illegible] [illegible] [illegible] become the subjects of disease [fr??] [illegible] [illegible] exposure, to the infected almosphere, [illegible] [illegible] and frequently become its [vi?ting] in [illegible] [illegible] from the period of the attack, ([illegible] [illegible] The effects of poisons of many kinds and [inter????] upon the animal economy,) We here seen individuals suddenaly into fevers with vomiting into cramps [cons??] syncope or fainting, from breathing for a time [n?p??h] gases, of different kinds, such as whit the [illegible] call damps or damp airs, we have seen individuals [ferati?] 137 divested of all the ordinary signs of life, yet we have never relied in bleeding and purging for the restoration of such [p???] (We have been calld to witness the effects of animal poisons such as the life of spiders and venemous serpents (We have witnessed the rapid [tu??] faction, The sudden inflammended of you [illegible] the [exp??sint] the spasms (heard the oft repeated, cries of pain observed the tears of [illegible], yet still we have not relied on bleeding purging for the relief of such cases, and then vegetable animal, [???al] poisons have [illegible] [illegible] allowed, we have not relied on [illegible] or [???in], remedies, than the case of such [antidet??] known to neutralize or [illegible] [illegible] of the particular poisons taken [illegible] [illegible] chief reliance, upon these measures [illegible] [illegible] (Doctor Rush in the first [illegible] [illegible] [???enc?] of 1793, treated them with the [illegible] [illegible] swelling and purging with calomel [illegible] [illegible] Rush's Works page 41, Vol. 2 [illegible] [illegible] dose not say, but we find him [illegible] [illegible] [???ing], with ipecacuanha bark wine [illegible] [???ally], blankits dipped in warm vinegar [illegible] rubed on the right sides) his works [illegible] [illegible] him asking counsel of Dr Steven's [illegible] [illegible] St Orix, The recommended the [illegible] [cold bath],(This made of treating, The [illegible] [illegible] [???able], to the Dr,, he has use bark in the [illegible] [illegible] several cases of sporadic yellow fever [illegible] years, (In fact the Dr was so will pleased [illegible] [illegible] Stevens, that he proceeded to put his [illegible] [illegible] the very next days (Now to you it may [illegible] [illegible] Rush Should so soon change his opinion [illegible] Dr Stevens, so far as we know and to believe [illegible] (It may be that there is as much in the skill judgement, with which scientific, labors are [??ed], as in the power of intersect in which the truth of [illegible] conceived (In his first experiments with the [ten?] 138 [illegible] stimulating [illegible] [illegible] 123 vol [illegible] [illegible][illegible] seemed [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [???g] [illegible] [illegible] [illegible] [s?pp??] [illegible] [illegible] [illegible] [illegible] the reason [illegible] [illegible] [illegible] he did, [illegible] [illegible] [illegible] [??st?] experiments [illegible] [illegible] without judgement, ([illegible] [illegible] infer, that he [ex??] [illegible] [illegible] second experiments, [illegible] [illegible] [illegible] Dr,,Stevens he failed [illegible] [illegible] [illegible] the clear inference of his [illegible] [illegible] [illegible] paid no attention to the state [illegible] [illegible] [illegible] the consequences (The [?ark] [illegible] [illegible] [illegible] or rejected by it in every case [illegible] [illegible] [illegible] We have been taught to [beli??] [illegible] [illegible] [illegible] understand or not to read at all ([illegible] [illegible] [illegible] patent agent either for good [illegible] [illegible] [illegible] too carelessly, directed, (His [illegible] [illegible] cold water to be thrown frequently [illegible] [illegible] good could any one expect from [illegible] [illegible] [illegible] at most under such vague [instr???] [illegible] [illegible] baffled, in every atempt, to step the [?a??] [illegible] [illegible] took himself to intense study ([illegible] [illegible] [illegible] pored every book,, that treated of [illegible] [illegible] [illegible] overhauled, a manuscript, that had been [illegible] [illegible] by Dr Franklin, a short time before his [illegible] [illegible] [illegible] the aid of Dr Mitchell resulting in leading him [illegible] [illegible] [illegible] to the depletive, particularly the purgative [illegible] [illegible] [illegible] see him enraptured, with the virtues of [cal??][illegible] [illegible] [illegible] of ten and ten, are now, distributed in a wholesale [illegible] [illegible] the city, indeed so great in his confidence in the [illegible] [illegible] that he directed his patients, to be purged every day [illegible] [illegible] His next remedy in the lancet, he bled may patients [t??] [illegible] three times a day, he prefered frequent, and small to large [illegible] [illegible] in the month of September, but towards the height and [illegible] [illegible] 139 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [???tant] with [illegible] [illegible] [illegible] [???b??d] [illegible] [illegible] [??ssition], that, [illegible] [illegible] [illegible] basinss of they [illegible] [illegible] [??eto], to remove [illegible] [illegible] as the circumstances [illegible] [illegible] a assist nature, when [illegible] [illegible] [??ets], but never too officious [illegible] [illegible] nights, (But the Dr,, says [illegible] [illegible] hands, (Took in [illegible] [illegible] expressions like these to [illegible] [illegible] [??ltraism], such individuals [illegible] [illegible] natural law to maintain or [illegible] [illegible] (We have been induced to twice [illegible] [illegible] of yellow fever for the reason [illegible] [illegible] of the [??sudar] prejudices, that have [illegible] [illegible] stand opposed to us, but the names of [illegible] [illegible] in office, individually, whose named [illegible] [illegible] have been received as [illegible] [??tors] in the stage of usefulness [illegible] [illegible] (Dr James Johnson of London, who [illegible] [illegible] [???anc] of the soundest medical Philosopher [illegible] [illegible] [??ssicat] and talented author of Tropical [illegible] Change of Air, and some other works of [illegible] [illegible] as inn the tropical climates, Vol.2 [illegible] [illegible] signature of Archibald. Robertson [illegible] [illegible] Medica (society of Edinburgh as [illegible] [illegible] the [??al] treatment of the epidemic fever I [illegible] [illegible] [???ake,]regarding this disease to be all practical [illegible] [???oses], inflammatory and the affection of the head [illegible] and essential, which is evenced, by headach [??bir] lueis, and red eyes, is how generally an index state of the Brain in the same manner as the tongue is of 140 stomach, I have [illegible] [illegible] [illegible] [???ins] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [s???] [?nd] large [illegible] [illegible] [???a] ([illegible] [illegible] [illegible] the patients [illegible] [illegible] of the [illegible], I have generally [illegible] [illegible] [illegible] [illegible] can be [illegible] [illegible] [illegible] be [tak??] ought [illegible] [illegible] [illegible] [illegible] order to [illegible] [illegible] and induce a [sp??] [illegible] [illegible] that it is not only, by [illegible] [illegible] [s??] I cannot [exp??] it in [philoso??] [illegible] [illegible] to the whole system nervous [illegible] [illegible] letting efforts, the magical, [illegible] [illegible] [illegible] it is also cheifly, by the in [exp??] [illegible] [illegible] word shock, (That cold effusions [illegible] [illegible] from in tropical climaty, where the [illegible] [illegible] is generally from 80.to 82, its [s???ig??] [illegible] [illegible] much abated (The state of the [illegible] [illegible] than the urgency of the other [illegible] [illegible] imperiously, around renewed [de???] [illegible] [illegible] former is thready spreading, or [illegible] [illegible] demand must be complied with, [illegible] [illegible] An a disease like this, where the danger [illegible] [illegible] in twelve, or fifteen hours, it is often [illegible] [illegible] apparent character may be altered [illegible] [illegible] again he says (Is is a [hucul??] [illegible] [illegible] that almost omnimpotent, remedy, the [illegible] [illegible] said to in counter A remedy for all other [illegible] [illegible] second of force, (It requires all the [illegible] [illegible] [illegible] [illegible] will gain ground on uswith rapid strides, [illegible] [illegible] to bleed again and again this is the mainstay [illegible] [illegible] anchor of hope, (Without it many very [ma??] [illegible] infallibly be lost. (Would I could say [illegible] [illegible] The same writer further remakes. Page 341. [illegible] [illegible] [??urging] I have not hitherto, mentioned, the [illegible] [illegible] much a matter of course (A stimulus ought to be [illegible] [14?] [illegible] [illegible] than [illegible] [illegible] [illegible] [illegible] [illegible] [????tion] of fevers [illegible] [illegible] [illegible] [co???ted] [illegible] [illegible] [illegible] [a???] [illegible] [illegible] [illegible] [illegible] [illegible] [???ment] [ar???] [illegible] [illegible] that it is the [illegible] [illegible] [illegible] [???er] to result [illegible] [illegible] [illegible] [illegible] [confi?t??] [illegible] [illegible] [???illy] [sustained] [illegible] [illegible] make appeals, ( [illegible] [illegible] say [illegible] 335. Vol 2. Tropical [illegible] [illegible] he says, elsewhere is [illegible] [illegible] continues.) I found the vessels [illegible] [illegible] [???ous], than natural and filled [illegible] [illegible] an distinct traces of [illegible] [illegible] and other viscera of the thorax [illegible] [illegible] appearance of inflammation whatever [illegible] [illegible] ready be accounted for [illegible] [illegible] brain [illegible] membranes, I found [illegible] [illegible] action save in its basilar portion [illegible] [illegible] and adhered pretty firmly to the [illegible] [illegible] of coagulable lymph were [illegible] [illegible] living together, the inferior, convolution [illegible] [illegible] with dark colored, and appearently [illegible] [illegible] the other cerebral nerves from the [illegible] [illegible] the sustance of cerebrum pons and [illegible] [illegible] exit by the cranial foramina,(- [illegible] [illegible] has found in each one of the lateral [illegible] [illegible] was in the cerebellum, and medulla [illegible] [illegible] chief morbid appearances were directed [illegible] [illegible] a degree of vascularity, indicative of [illegible] [???irly] it was covered with a plexus of [illegible] [illegible] and the later together, with the pons varolii [illegible] medulla oblongata, was enveloped by tenacious [illegible] of fibres, which could scarcely be removed with [illegible] [illegible] substances, underneath,(about [illegible] spoonfuls of serum also were found effused in the fourth 142 [illegible] [illegible] [illegible] medulla [illegible] [???g] [illegible] [illegible] [illegible] [???tions] [illegible] [illegible] [illegible] of [illegible] [???p] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] less to know [illegible] [illegible] strictly [???able], to the [illegible] [illegible] [???pe?is] or [illegible] [illegible] [illegible] [???duced] by the [illegible] [illegible] we do know that [illegible] [illegible] [illegible] the laws of [illegible] [illegible] will die, in spite of [illegible] [illegible] [illegible] could be adopted; [illegible] [illegible] [illegible] of treatment might be [pur???] [illegible] [illegible] by him, (For if the danger of [illegible] [illegible] tendency to inflammation, and [illegible] [illegible] [illegible] and purged nearly to death, to [illegible] [illegible] the inference, seems at [illegible] [illegible] [illegible] is not the same, and [pre??] not [illegible] [illegible] it, (Dr. Rush we shown [illegible] [illegible] [illegible] and liberal depletion) and has [illegible] [illegible] several dissections made by Dr [illegible] [illegible] to sustain the doctrines-( [illegible] [illegible] [illegible] great importance, of the disease [illegible] [illegible] in the investigation of diseases, we [illegible] [illegible] [illegible] that some of these dead, of the present [illegible] [illegible] fevers should be examined, and [illegible] [illegible] observations, it appears at present [suff??] [illegible] [illegible] following facts, (Fast that the brain, in [illegible] [illegible] found in a natural condition, ([illegible] [illegible] viscera of the thorax are perfectly sound [illegible] [illegible] in the heart and veins, is fluid, similar [illegible] [illegible] of the blood of persons who have been [hang??] [illegible] [illegible] by electricity, (That the stomach, and [begin??] [illegible] [illegible] duodenum arc the parts that appear most [dis??] [illegible] in Two persons that have dies, of the disease on the [illegible] the villous membrane of the stomach especially [a???] 143 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [d???] [illegible] [illegible] [illegible] [sim??] [illegible] [illegible] [illegible] by [illegible] [illegible] [illegible] in a [f???] distroyed by it ([illegible] [illegible] of its [illegible] [illegible] [illegible] died [illegible] [illegible] [???ation] [illegible] [d???] [illegible] [illegible] [???arly] about [illegible] [illegible] [illegible] [???tion] of which [h???] [illegible] [illegible] [illegible] beginning of the [illegible] [illegible] [illegible] this part is as [illegible] [illegible] [illegible] at a more advanced [illegible] [illegible] inflammation disappeared [illegible] [illegible] [illegible] intestines, a black liquor, which [illegible] [illegible] [illegible] death, (This black liquor [illegible] [illegible] altered secretion from the liver [illegible] [illegible] [illegible] quality was found in the [illegible] [illegible] [illegible] [???s] acrid that it produced [illegible] [illegible] and swelling, on the operator's hand [illegible] [illegible] [illegible] (The villous membrane of the [illegible] [illegible] [???dis], was found inflamed in sever [illegible] [illegible] [illegible] its natural appearance, erupting [illegible] [illegible] the surface of which a very [illegible] [illegible] [illegible] seen all the other abdominal [illegible] [illegible] appearance, (The external surface of [illegible] [illegible] of the intestines, was quite free from [illegible] veins being distended with blood which [illegible] through, the transparent peritoneum gave [illegible] [illegible] (The stomach of those who died early in [illegible] [illegible] always contracted, but in those who died [illegible] [illegible] period of it, where extravasation appear [illegible] [illegible] with, air (Rush's works Page 92, Vol 2 [illegible] [illegible] Physick and P. Cathrall [illegible] [illegible] interduce, these reports of post mortem [illegible] [illegible] for purposes already mentioned, but further [illegible] [illegible] reports-(First that the disease in question has 144 fixed [illegible] [illegible] [illegible] [illegible] [illegible] [??ated], [illegible] [illegible] [illegible] be [illegible] [illegible] stomach and duodenum [illegible] [illegible] [illegible] organs, ( [illegible] that [illegible] strong indication of [putrese??] [illegible] decomposition and [illegible] [illegible] [illegible] sometimes procedes [illegible] [illegible] Healthy inflammation [illegible] [illegible] and the term inflammation [illegible] [illegible] be nightly used or the [illegible] [illegible] changes of structure [illegible] [illegible] we are well aware of [illegible] [illegible] the very many imposing [illegible] [illegible] addition to those already [cel???] [illegible] [illegible] still another of which standing [illegible] [illegible] [illegible] Surgeon Lawson (Pork, in [illegible] [illegible] [illegible] perpared under the [der???],of Surgeon General 2 OL) [illegible] [illegible] [illegible] appearance late in the season [illegible] [illegible] [illegible] character, but is in [illegible] [illegible] disease of highly arterial ([illegible] [illegible] at lease one more and [illegible] [illegible] medicine for four of five days [illegible] [illegible] Calomel is the cathartic [conn???] [illegible] [illegible] decidedly the most efficient [illegible] [illegible] of from sixteen to twenty ounces of [illegible] [illegible] the extent of twenty or twenty five [illegible] [illegible] for several days, the doss is repeated, [illegible] [illegible] oil and enemata according to [circu???] [illegible] [illegible] After the first day the calmel in [addi???] special administration as a purgative [illegible] [illegible] in doses of five grains every three hours [illegible] [illegible] irritating the salivary glands and this [illegible] [illegible] from more vital organs, (Those is no [dang??] [illegible] [illegible] the patient by excessive purgation, as it is very [di???] excite the intestinal cannal into action and 145 [illegible] [illegible] [illegible] [par??] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [d???] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] day [illegible] [illegible] [illegible] [stop???] [illegible] [illegible] [illegible] must [res??] [illegible] [illegible] [illegible] [???darble] our [illegible] [illegible] the lowest [illegible] [illegible] to employed with [illegible] [illegible] which is frequently [illegible] [illegible] symptom, to require [illegible] [illegible] [???sion] cerebral excitement [illegible] [illegible] [??ailed] in connection with [illegible] [illegible] constition; the main and [illegible] [illegible] in this fever, ( [illegible] [illegible] not necessary none but the [illegible] [illegible] infusion can be administered [illegible] [illegible] such as the sulphatic of quinine [illegible] [illegible] ( This disease runds its course [illegible] [illegible] fatal, in few days by a [illegible] [illegible] organ or being itself [illegible] [illegible] seventh day, having once [illegible] [illegible] the conflict, (The surgeon's [illegible] [illegible] use of quinine, stand in direct [illegible] [illegible] even Thinks quinine is inadmissible in [illegible] [illegible] the fever, while we use it in every stage [illegible] [illegible] inflammation or aggravating [illegible] [illegible] gives to it opposite effects( We [illegible] [illegible] [??fuige] antiseptic and touic vertues [illegible] [illegible] reliance, upon the [super??tion] of [??tydis?] [illegible] [illegible] witness, ( 147 148 148 149 150 153 157 158 159 160 161 162 163 164 188 Polish For Furniture In 1 quart Boil Lint seed oil 1 pt Alcohol One lb Gum Shelac 2/3 [illegible] Mix it as below When mixing this polish it must be warm, that is the oil And put in the other articles And the polish is ready to put on 187 A fine tonic for [illegible] Persons caused by chills and fever or otherwise R. hyposulfate of Soda 2 oz Elixer viteral 2oz Sulphate quinine 90 gr pure Aqua 1 [illegible] let it stand one hour and it is ready for use. Dose for an adult a table spoonfull 3 times a day Children in proportion- Fine Cement R 4 Tablespoonfulls of Salt; water 1 pt gum Shelac 1/2 lb let it boil Slow until all is melted and where it is about a consistency of Shoemakers wax draw it in long Strips and break it into six inch Sticks it is now ready to mend with by heating the stick and applying it to the glass as dish and pressing the parts together and then let stand 12 or 24 hours and the vessel is ready for use [1??] [illegible] [illegible] [illegible] [illegible] Tinc [comp??] [illegible] [illegible] [illegible] to be [app??] [illegible] per day, [illegible] be taken internalle in [illegible] 3 or 4 times [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] Acit 3X [illegible] [illegible] [illegible] 3ii Tinc Lavender [illegible] 3 [illegible] Aqua [illegible] 3XXi Muc gum [illegible] 3 [illegible] i Dose to [illegible] [illegible] Tonic [Al???] [illegible] [illegible] Rx Rad sarsaparilla [illegible] [illegible] xii sassafras cont-[g???] Rad Gb Mezeron Cont Dulcamara [Eupa??] [illegible] 3vi aqua congt to [illegible] [illegible] then boil half an [illegible] [illegible] mix with simple sys, [iilegible] [illegible] Anodyme, and 1/2 dz [illegible] [illegible] Cong-Dose 1 tablespoon [illegible] [illegible] a day- Rheamatic [m??] D. Tinct semini [Colc?ici] each 3Xvi tinc opii Tinc lavender Compound [illegible] Aqua cinnamon 365- spoonful every 4 [hou??] cases, a teaspoofull every [illegible] not so urgent 195 [Ha??] [W???] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [?his] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] Pills [illegible] [?il] [??t???th] [Comp] ℥i [illegible] [illegible] [illegible] Grs 20 [sub??] [illegible] grs 15 [illegible] [illegible] [illegible] gr i [illegible] [illegible] [illegible] gr3 [illegible] [illegible] [illegible] gr, 6 [illegible] [illegible] [illegible] pills [illegible] [illegible] [illegible] bed Time [8??] [illegible] the [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] 197 [illegible] [illegible] [illegible] 9 1/4 [y???] [illegible] [illegible] [illegible] 35 [illegible] [illegible] [illegible] 34 [illegible] [illegible] [illegible] 33 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] 37 [illegible] [illegible] [illegible] 36 [illegible] [illegible] [illegible] 41 [illegible] [illegible] 87 [illegible] [illegible] 20 [illegible] [illegible] 6,, 08 [illegible] [illegible] [illegible] '' "" 60 [illegible] [illegible] [illegible] Ru 80 [illegible] [illegible] [illegible] " 25 [illegible] [illegible] [illegible] " 60 [illegible] [illegible] [illegible] " 30 [illegible] [illegible] 16 2/3 1 00 [illegible] [illegible] 6 1/4 85 [illegible] [illegible] 61 21 [illegible] [illegible] [illegible] " 75 [illegible] [illegible] -2,25- 1" 13 [illegible] [???hs]-" 85 [illegible] [???e] 1 50 [illegible] [illegible] paper 2" 00 [illegible] [illegible] " 40 [illegible] 10 20 [illegible] [illegible] 12 1/2 " 25 [illegible] [???s] 18 3/4 " 37 [illegible] [illegible] 35 " 70 [illegible] [illegible] 50 c " 37 1/2 [illegible] [illegible] " 05 [illegible] [illegible] [???a], 25, " 25 [illegible] [illegible] 6, " 54 [illegible] [illegible] " 30 [illegible] [illegible] Buttons 3 " 45 [illegible] [illegible] 15 " 15 [illegible] [illegible] cutter 25 " 35 185/ 198 [illegible] [illegible] [illegible] [illegible] [illegible] 43 [illegible] [illegible] 25 [illegible] [illegible] 40 [illegible] [illegible] 25 [illegible] [illegible] 20 [illegible] [illegible] 30 [illegible] [illegible] 36 [illegible] [illegible] 85 [illegible] [illegible] [illegible] [illegible] [???d] [illegible] 60 1 [Bla???] [illegible] 0 1 [alue] [illegible] 6 [illegible] Red 48 15 1/ do Cofee- [illegible] 33 1 Whisky [o???] [illegible] [illegible] 2 do3 Butter 1 Powder Can 1 Load-haling Tb R. Guthbertseu [illegible] For Harrison [Hamil??] [illegible] 197 [pu???] [illegible] [illegible] [illegible] [B????] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [4??] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [5??] [illegible] [illegible] [illegible] [3??] [illegible] [illegible] [illegible] [4??] [illegible] [illegible] [illegible] [?1] [illegible] [illegible] [illegible] 12/ 400 [illegible] [illegible] [illegible] 1 369 [illegible] [illegible] II 308 [illegible] [illegible] 25 750 [illegible] [illegible] 20, 315 [illegible] [illegible] 10, 352 [?oe] Cure For, (?) Take [??rid] of [j??k] [illegible] [illegible] [illegible] Sanguinary [?earsa?ll??]) [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [Sli?k] [???her] Work it [illegible] [illegible] And [sp??d] it [illegible] a [p?ace] of strong [c??t] [?a???] [illegible] to easer the [(illegible)] [illegible] it remain [illegible] and [illegible] remove the plaster, [illegible] [illegible] (6) is dead, [???nce] [p??ing] and it will matter [cross out] and come out in a few days Paltice with flax [illegible] [illegible] day, and slippery [illegible] [illegible] the next day, and so an [illegible] [illegible] out then keep pathing untill it heals up [??ellard] 201 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [a???] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] glove, [illegible] [illegible] ratio of its [illegible] [illegible] rejected and [illegible] [illegible] [??ick], [illegible] [illegible] [??ghly] rubbed [illegible] [illegible] drops of water [illegible] [illegible] [??encis] more, [illegible] [illegible] [??ar], two teaspoonfuls [illegible] [illegible] adult, a child are [illegible] [illegible] [???ers.] and should the [illegible] [illegible] which is rarely ever the [illegible] [illegible] compound powder [illegible] [illegible] of the herb or fox glove [illegible] [illegible] given as above directed [illegible] [illegible] and soon as the pustules [illegible] [illegible] and clean off [illegible] [???pply] the liquid and your [illegible] [illegible] did put on as good a [illegible] [illegible] made of gun cotton and [20?] [illegible] [illegible] [per??] [illegible] [illegible] [illegible] you [?et] up in [illegible] [illegible] to what [illegible] to [d??] [illegible] must be [illegible] the break of [??ery] & [sin??] [illegible] [illegible] [illegible] straight [illegible] can to [illegible] [illegible] best to try [illegible] [illegible] [illegible] [d?y] [illegible] say exting [c???] you will [?ak?] [illegible] [illegible] a half of the [?ord] of the [c?d???] of the north east side of the [illegible] [illegible] take hold of the [li?t] [illegible] [illegible] [illegible] and in a [pi???] manner it would be well to have a place [illegible] [illegible] three feet square cleaned off the [illegible] side of the bush to throw your twig down, when [illegible] [illegible] step up to the [illegible] taking [illegible] [??g] say cedar brush have come [illegible] you through [illegible] to try to cure a blister [illegible] the [illegible] of WG. left hand, [illegible] [illegible] [illegible] Father the son and [illegible] [illegible] [illegible] the last word you [?ill] [p??] [illegible] [illegible] it down where you cleaned [illegible] [illegible] raunel to your right [han??] [illegible] [illegible] to act, as near as you [c??] [illegible] [illegible] started from,, it is of [illegible] [illegible] [illegible] or cloudy raining [illegible] [illegible] [illegible] warm it will do very well [illegible] [illegible] time, between the middle of [illegible] [illegible] if the day be very worm and [illegible] the same words in trying [illegible] [illegible] that you may try for, [illegible] [illegible] you try and find out the [illegible] [illegible] if you can. [20?] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] patient can [illegible] [illegible] [illegible] in the water, untill [illegible] [illegible] [??pply] [illegible] [illegible] [illegible] 4 [illegible] [illegible] [illegible] [illegible] [illegible] the [illegible] [illegible] [illegible] diet [illegible] [illegible] [illegible] of [illegible] [illegible] 2 or 3 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] and use [illegible] [illegible] [??nty] of loaf [illegible] [illegible] burnt allum [illegible] [illegible] [illegible] about 1 inch in [illegible] [illegible] [illegible] altogether and then [illegible] [illegible] [illegible] [???tion] and than [illegible] [illegible] [illegible] the juice, which [illegible] [illegible] 2 drops to each eye 3 times [illegible] [illegible] [illegible] [illegible] [illegible] Remedy [illegible] [illegible] quaciam [illegible] [illegible] and [illegible] [illegible], all put into [illegible] [illegible] whisky and take one [illegible] [illegible] [illegible] per day it is a very [illegible] [illegible] [illegible] GW Ward MD [??4] Hooping Cough Tincture Digitalis 2 dram Lobelia 2, do ℥ij opium- 1,gr ℥i syrup 1 oz ℥ss water 4, do ℥rv [illegible] [illegible] [illegible] [sp???] [illegible] [illegible] [C???] [illegible] [illegible] oil [p???] [illegible] [illegible] [camph???] [illegible] [illegible] Teething [illegible] [illegible] [illegible] [Cuast??t] [illegible] [illegible] [illegible] Aple Vinegar [illegible] [illegible] [illegible] Spts serpentine [illegible] [illegible] Again Creasote 1, 8 Suepleuric either 1 clo Laudnum 1 1/3 chloriform 1/2 spt niter 1, do Recept for [pr???] 20 prd, red 1 1/2 gallay [illegible] 1/2/[illegible] 1 pint oilum- hagus 11 handful Ban gelling- Mullin Leaves And Eldor, Cerid [illegible] [illegible] Black Salve take 3 quarts of Olive Oil Common Rasin 3 oz Beeswax 3 do Red precepitate 1/4 lb And Raise all to a boiling heat and then put 1/2 oz gum camphor into id Red just before the mixture get, Cold, put in the Red precipitate llued its then ready for use Caryophyllus Sweet Gum Bark 4 oz Red oak 40, d Caynrim Peper 1/4 S.S Laudnum 4 oz Cuminum 4,, Cloves 4, Brandy-from 1/2 to 1 pt Brandy Cough syrup squills paragoric Spt, neter equal parts, Tricopherous Alcohol 7 Pts Water 1 do Caster Oil 8 oz Tincture of Canthardies 3 oz Perfumery Tasting 3    Medical Manscript 1852 10 10 11 100 10 1000 111 GlW18 Medical Manuscript 12 11 11 10 100 4)  [Be???] fort Bauguht for girls 3lb 6oz Butter at 12 1/2 et 4 doz eggs do 6 Sold for cash Whisky do do- 2 1/4 Butter 124 12 3/4 Lard 10 Sold for cash why [illegible] Sold for cash 1 pare shoes for 1 do do fine 1 do do cone 1 do do do 2 Ladies-fine 1. do--fine 1 pare fine 13 yd donut 4/ 3/4 yds Rum [illegible] May 11th 1851 [illegible] Benten Pill County Sc [?ast], [J???] B, Polk BEV Dedication Citizens of the united states-But more particularly that portion, with whom I have had personal acquaintance, and from whom I have always received a hearty welcome, and [illegible] [illegible] and also to all that portion of the medical profession who can so far divest themselves of [??gihst] education as to give to the following presentation [illegible] and impartial perusal, and it this [i????] by its author- [Pry??] At the present age of the [illegible] [prop???] a [illegible] illumination is advancing of the world , just so it the [illegible] [illegible] [p???] that that individual who [illegible] [illegible] the human family is intitled to the highest [illegible] Ancient History informs us that [illegible] [illegible] Philosophers hand ever [illegible] [illegible] for the highest distinctions [illegible] [illegible] although the sumit might [illegible] [illegible] by all, still this considiration [illegible] of mankind from doing whatever [illegible] [illegible] to ameliorate the suffering, [illegible] [illegible] human race. As it [illegible] [illegible] of human investigation, which [illegible] [illegible] and the cure of all those ills that [illegible] [illegible] frailties and imperfections inherent in the physical organization, [cross out] [repe??] [illegible] Now he who advances the just knowledge of his physical once a knowledge of the modifying powers of [illegible] it physical agents that act on his varied sensibility quit impressibilities, we consider as achieving and important step in the science of human happiness- The Author of This work has not vanity enough to believe, nor [illegible] it to be understood, that he consider as having claims above all others upon the great of mankind of anything that he has done, [illegible] yet he cannot resist the impression [??calic] which he now presents to the public [illegible] upon a fair trial to contain the most certain speedy, and effectual plan, for the cure of fevers, that has hitherto been offered to the public as this treatis is designed more for the benefit of the public [illegible] then the [cross out], profession, the author has [sh??] [???ly] [??diave] to avoid technicalities, and to present [illegible] the most simple and plain language the he could possibly employ, so that every reader may [illegible] and fully understand and comprehend his way on every subjet that he may treat- This work will be found to differ somewhat from the theories and [illegible] the [illegible] [illegible] indeed from all that have preceded it [illegible] [illegible] [illegible]. For whilst almost every physician is of [illegible] that the different forms of fever, are dissimilar in there [illegible] [illegible], and that notwithstanding this dissimilarity [illegible] [illegible], that they all have more or less inflammatory tendency, the [illegible] this work between them to depend upon a uniform law nature; which [illegible] only of disease, in accordance with the unity [illegible] [illegible] that they have there origin and progress in debility. [illegible] [illegible] of Physicians consider depletion either [illegible] [illegible] purging or by the use of nauseating medicines [illegible] [illegible] the means combind, as indispensably [illegible] for the cure of fevers, the author has limited their use very [illegible] [illegible] [disa?????] their use entirely in the last stage and relies abreast exclusively on Tonics and their auxiliaries [illegible] the same desirable object [illegible] [illegible] that all pukes and purgatves are irritant [illegible] stimulants, and that fever proper is a disease of irritation; and that it never was into active inflammation He likewise thinks that the peruvian bark or quine, is a tonic, and not a stimulant; as has generally been supposed._ Although he was himself taught that theory practice of medicine as was [cou??] [illegible], schools, in the day of his pupilage [illegible] imbibed them, but the result of his [illegible] experience in an extensive practice for [illegible] only years has fully satisfied him of the first [???pe??] this practice polar, that of either the depleting [illegible] stimulant so while this plan of treatment [illegible] speedy and more certain care without [pro??] systems that are based upon opposite [????e] prolong the disease and suffering of the patient And if a cure be effected at all, [illegible] [illegible] such treatment, and not unfrequently [illegible][illegible] The constitution, that the unfair treatment [illegible] in invalid throughout the bottom [illegible] The author is well aware of the responsibility assumed in daring to [illegible] [illegible] of this kind, differing as it [illegible] opinions on the theory and [illegible] [illegible] is likewise aware, of the [un??] [illegible] probably excite among the [illegible] [illegible] [A??] While he [cou???] [illegible] [illegible] Medicine he was after [illegible] [illegible] because he dared to differ [illegible] [illegible] practice that has been [empa??] [illegible] [illegible] the minds of the community [illegible] too; on justification of his practice [illegible] main supported the same physiologie, [illegible] that they themselves did, and [illegible] do, as [illegible] in the body of this Work. He thinks, [illegible] might say, on without doing them any [injust??] whatever, For without having any [illegible] for them as men, that they are very [illegible] them, who, no matter what a man's acquiantance sucess in practice might be, if he dared to differ from them, or their, favourite leaders in the [s??] whould either treat him with cold, silent contempt or attempt slily to defame his character This seems to be the effect of deep feelings, probably based on natural organization and, I suppose, being regarded as the result [illegible] fixed prime causes and the circumstances, Education, ought therefore to be excused But the Author, knowing the success of his theory from his own experience and observation, contrasted with [illegible] fully justifies himself, in the opinion, that ha hazards nothing as a man, or as a physician [ass?ding] that it is the safest [cross out] most speedy with successful practice extant for the care of fever, His opinion is further confirmed by [illegible] [illegible] [??xampled], success of his practice [illegible] in the north and south for the last ten years the [illegible] considers himself called upon to [illegible] [illegible] and practice to the public [illegible] [illegible] has [add?ssled] which will [illegible] [illegible] and fair opportunity of [illegible] [illegible] And also, a [illegible] of [illegible] [illegible] [Hix?can] was and his [illegible] [illegible] [?atasenie], & a [illegible] [illegible] the public he is willing [illegible] a fall- Authors Preface Chapter Fist On Fever, XX Theory and Practice of fevers Chapter first The opinion has been long since [cetert??] and by some eminent medical Philosophers [expr?fsor] that a theory founded upon nature, a theory that should bind together these scattered facts eg, medical knowledge and converge into one point of [?ie??] the [illegible] the [illegible] organic life, would they on many accounts [illegible] to the interest of society- It [al???] [illegible] of [illegible] men of moderate ability to practice the art of healing with real advantage to the public; [illegible] [illegible] literary acquirement to distinguish, the [illegible] [illegible] effrontery or of wiley address; and [illegible] [illegible] important, situations the [h???] [illegible] [illegible] Form of Practice does have being [illegible] [illegible] theory and practice in which [illegible] [illegible] are now, engaged in waiting again the it [illegible] proper that I should give my [illegible] [illegible] I commenced the study of medicine [illegible] That cook, cold and [illegible] [illegible] greatly at the head of their [re??] [illegible] and promulgating to the World their [illegible] Bloodletting and the modes of [illegible] by the follow, of the depletion or [ant??] Theories I was instructed in those [illegible] after having practised with my preceptor for about years, who was a scientific and experienced, and inclined to the Brownonian and [illegible] Tonics and stimulants earlier and more [g??] than was common, I entered one the duties of my profession on my own book and was at least as sucessful as those around me. But not being satisfied with the result of my own practice [c???] less so with that of others, which was chiefly that of bleeding and acting on the stomach and bowels, with emetics and cathartics, as we thought the patient could bear them; [illegible] [illegible] the case principally,with what we called [illegible] [illegible] phlogistic medicines which indeed was of little or no use, untill the patients died or recovered by the mere sanative operation of the constitution. After having practised medicine several years and having undergone a considerable change in my view, and opinions relative to the nature and [illegible] of some diseases, and some remedies attended [illegible] by medical lectures in the university at Philadelphia, where became confirmed in the opinion states was reasonably acquainted with the different [illegible] [illegible] had of the day, but which only [illegible] [illegible] of their error, in very many [p???] [illegible] [illegible] serious evil in society and [illegible] [illegible] that the ruling or [illegible] [illegible] medicine like that of bigots [illegible] [illegible] alway willing to edge and exterminate & [illegible] [illegible] any theory or practice that [illegible] [illegible] from their views of proprity! [illegible] [illegible] the principles upon which it is [illegible] [illegible] the result of the practice in [illegible] any way whatever. being aware of this [illegible] believing that I had made a valuable discovery [illegible] or thats had more fully developed the [illegible] and article of the materia medica that [illegible] been in use, but was still very imperfectly [??tard], I was an witting that it should be last to [??ly]. I therefore prepared and sent forth to the public large quanties of my magnetic, Gold Pills, and at the same time concealing their composition that they might acquire a reputation upon their own intrusie worth- Now that the virtue of these pills to the amount of at least ten thousand Boxes been tested by the people of the united states [illegible] of mexico, and up to this state have [???tained] an improving reputation; thereby [???turing] the correctness of my theory for the [??petery] is not now in the drug than the use I [illegible] made of it I presume that the public will begin to how strongly and unjustly the medical properties of the peruvian bark and its preparations have been perverted, and that instead of its being injurious when taken in the hot stage found all been frequently said of it it is not only entirely soft but it is the fibrefuge tonic and antiseptic human The truth of my position is still further [ma??] by the fact, that since the distribution of my magnetic Gold Pills (not (firm years [illegible] [illegible] announcing that their virtues reside [illegible] [illegible] tonic properties and that they did not contain any arsenic, many apothecaries [illegible] [illegible] not [illegible] have endeavoured to imitate them [illegible] vended the same or some similar [illegible] [illegible] used in all stages of fever- Now when I had established the fact that tonics [illegible] softy and with efficacy be used in all [illegible] [illegible] difficult task for practitioners to [illegible] [illegible] particular drying heat [cate??] [illegible] indications, hence all of them [illegible] [illegible] had more or less of quine in their costum I am led to these remarks from an [opp???] that so soon as these pages shall be [illegible] to the public eye, that the practitioners of medicine the venders of fever nostrums may not after [f??] to harass, the public mind be refusing to [illegible] the fact, that quine or some other vegetable constituted the basis of their specifics far from not toug after I commenced the practice of medicine, An old physician fell in company work one, an [illegible] Road from Wilmington leading to Elizabeth, he informed me that the practice in that Country did not see 4 The carious diseases of the Country and the reason was that they the physicians [illegible] not sure tonics soon [erough] enough, that are depletory practise intirely to much, [a??] his lecture with best of my recollection was as follows: A sect of religious people known by the name of jesuits, in their intercourse with the inhabitants of of South America, in passing through the state of Peru, were compelled to drink and use for cooking the waters of certain Ponds on their way,, The water in some of these ponds, was strongly impregnated with the properties of the bark of certain trees that grew around them,,, Other ponds in these waters which have none of those trees in or about [illegible] [illegible] resorted to for water,,, those persons who happened to fall sick at the latter [illegible] [illegible] remained there untill the tardy [illegible] [illegible] constitution enable them [illegible] their illness as to continue their [illegible] [illegible] of those persons who became [illegible] [illegible] where the trees grew [illegible] [illegible] for all purposes the [illegible] [illegible] rarely detained more than a few [illegible] they were cured, and enabled to pursue [illegible] these facts became so notorious, the cases of cure so numerous that it caused much enquiry and investigation; When it was ascertained [Soli??] that these cures were effected by the waters in consequence of its being impregnated with the medicial properties of the Bark of these trees Hence the first knowledge that we have of these trees or the Bark,, is under the name of jesuits or peruvian bark x Many of these unfortunate wore stricken down, at various Times, by fevers and in that hot climate it is reasonable to suppose that many were of the lowest grade and most malignant character & it is said, there was a time when the Peruvian barks (Acot the sulphate of quine) sold for its own weight in gold which is proof of it [illegible] esteemed value since my knowledge of medicine, the best quality of gold from five to ten dollars per pound,, But for the last fifteen years, it has varied from one dollar to fifty cents per pound,, From these facts all all might [illegible] that the use of it has been very much [illegible] In that short space of Time, and that [illegible] all other poisions and prostrating medicines had been substituted in its stead), all my times, have i set by the bed side of my patient for days together giving it & anxiously [illegible] to see the affect it would have upon [illegible] At the same time amousing their minds and the minds of their attendants rarely by giving some persons placebo that I new to be harmless and useless found no more used heat [illegible] arterial actions, nor any [illegible] that I could asscribe to the bark [illegible] contrary, in a few hours [illegible] most the skin would become [illegible] prehaps a free and generous [illegible] would ensue, the thirst whole [illegible] irritated condition by the pulse [illegible] and the feverish heat and restless anixety (alway more or less attendant on fevers Subsides, in much less time than [illegible] course of treatment, I had one [illegible] patients recover their health [illegible] with less prostration or debility- I have took the bark myself (in good health for a mere experiment,) in ounce doses which is equal to [illegible] or twelve grains of quinine, and although it produced some dizzyness or swimming, in the head, there was no increased heat in the skin or increased action in the pulse- I presume that it acts more directly on The brain, And the nervous system, but it produce no such effects, as an over portion of intoxication 6 liquors, on the preparation of opium [illegible] dose languor, or prostration follow as a [illegible] natural consequence as is the case [illegible] use of stimulant proper,, We think it [illegible] them probable that the back would [nev??] have last the reputation it posins too obtain at the, time of it first interduction, if we had then known wt we now do, how to separate its active medical properties from its cortical and [???t] matter_ The irritating and supposed stimulating effects, ascribed to it by the older practitioner, may in our opinions be more justly assignable to its bulk, and the presence of the cortical matter with which it was incumbered, them, to its salt, in which modern chemistry has shown its [illegible] to reside- Before the improved condition and highly concentrated preparation of the [illegible] the form of quinine, was known,I was in many occasions, much inconvenienced and sometimes defeated in getting as much [illegible] - Partly owing to the prejudices [illegible] them to fear that it would escape their fevers, and partly to the fact that in some instances the stomach would not retain it- or that it woul'd pass off on the bowels as a purgative- in either event any object was more or less defeated- The names of Pellitier and Caventou, who first seporated the pure alkaline salt called quina from the bulky and inert, mass in which nature had placed it deserves to be remembered by [cross out] with gratitude by all mankind- since that fortunate day in medicine I have been enabled to administer the bark at any stage, and in any quantities that I might think advisable as without fear of injury to my patients or exciting any fear in their minds- This discovery has not only afforded me- heart-felt for gratification- 1 for the reason that it enabled me to give more prompt and certain relief to the sick- but it has been instrumental in giving to me a character and standing in my profession all calculated to excite the envy of the Physicians around me- But this I desired not for I did not conceal from them, in our consultations, my views, on either the Theory or practice which gave me such superior success- It seemed [illegible] the most melancholy experience was not sufficient to convince them of their errors, and they still from the mere force of education, considered my practice as empirical- Far be it from us to censure any one for tenacious adhering to the prejudices may be; let the jew be jew still,- let the Bushite be Bushite: for we deem it a wise provison in the economy of [illegible] We only seek to apologize for the course we have as individual laborers in the cause of humanity have pursued- Every philosophic mind [illegible] that all innovations have to work their way to popular favour all their own intestine [illegible] The discovery of truth is a like open to [illegible] it is the exclusive property of [illegible] part of eternal bounty of nature, [au??] from beginning designed for all- Then let all and let no one be debarred the privilage of pas claiming whatever he may have found- We are well aware of the necessity and the importance of well-endowed-[illegible] establishments, for the purpose of mental [illegible] and manual discipline, in every deport of human thought, and of human actions- We know: also that one of the marked characteristics, are of the [cross out] advantage of civilization. consists in the division of labor- Such division tends unquestionably, to the perfection of science, and to the perfection of slice in the [illegible] manipulations of the arts Hence, in the earlier period of the World, as we see from the records of Egiyptian of Babylonion Grecian Roman and other historians,- resulted the establishment under state Authorities the laws of Castes, of trades, of professons and of privileged orders in society. Now such (was, such regulations such usages may have been rendered) necessary at those epoch, of time from the nature of the [??ment] of humanity than under progress of development But is is easy to trace in the downfall all of those states the deleterious influence of Castes and of chartered privileges, and protection upon [illegible] various branches of human occupancy- In proposition as trades and professions are [fa?tered] by law, in the same proportions do their [vota???] become indolent, and the wholesome [illegible] [illegible] dies away- The check thus [illegible] to the freedom of thought, causes the [illegible] [illegible] of law, divinity, [illegible] [illegible] arts to dwindle to lapse its [illegible] and the minds of men to become fixed [illegible] stereotyped into settled formularies [illegible] have been [illegible] into the preceeding train of [illegible] from the manifestation given by many of the states of this union, in their legislation enactments, chartering either directly or indirectly, sectarian colleges calculated to faster partisan religionist- [E??] those entitled acts to regulate the practice of medicine; many of these contrary to the spirit of this government, and calculated to promote the interest of a particular class, to the detriment of others- the effect of the one is to fetter to stagnate the advancement of the study of the spiritual nature and the spiritual happiness of man; While that of the other retards the progressive 9 knowledge of the Laws of his physical nature, [illegible] the true mode of improving his condition [illegible] happiness as based in his physical nature [illegible] influence by physical causes- What better evidence could be desired of the [illegible] and selfishness of all these petitions & petitioners for protection, than the universal fact that they spring from the professions, care not from the people whose welfare they hypocritically profess to guard and serve- Tis strange! Tis passing strange! at this enlightened day, at this half rational era of the world in This free, this new sepereated republic; that the people, the true the only legitimate sovereign of the earth, should not know what they needed what they wanted, what they desired, what was best for them, as well as the safely led- guardians of their bodies and their [illegible]- We do not wish to be understood [illegible] with or objecting to, any thing that [illegible] has transpired- Oh the past and [illegible] [illegible] has not controle, Whatever has [illegible] [illegible] it is; and whether right or wrong [illegible] it- Let us, then, gather [illegible] [illegible] from a knowledge of the past and the present; by which to direct our own future [illegilbe] [illegible] which alone an indulgent providence or has willed to man a modifying influence- Chapter 2,- Containing A Brief outline of the Animal- Economy- That those who may peruse this work may perfectually understand, the authors meaning- and have some idea of the offices of some of the most important organs the human systems 10 And that members of the profession may conceive more readily of the manner in which I suppose [illegible] are contracted, and the most natural and speedy way by which they may be cured, I deem it proper that I should give a short account of the functions of those ongoing, which are supposed to be mostly involved in fevers, as dull as most other diseases- It is the office of the stomach to receive all the ingesta both solid and fluid, designed for the nurishment and growth of the whole body It is by the very peculiar action of this organ and its secretions, that the first process, and important part of digestion, is performed- So soon as the stomach shall have performed its office on the varied aliment, and drink taken in, then the whole of the residual mass passes on the first portion of the intestinal canal called the duodenum, where the ingesta in its present state of preparation comes [illegible] with the peculiar fluids secreted by the liver and the pancreas, called bile and pancreatic juice- Through the agency of these secretions of the nutritious matter called chyle supposed to be elaborated from the food; and [illegible] lacteal and absorbents, situated in this [illegible] portion of the canal, stimulated by its [illegible] [illegible] take it up to carry it into the general circulation for the nourishment and the support of the whole- The digestion being thus principally performed by the stomach and duodenum, the food continues its passage downward through the remaining small and large intestines to make it exit from the bowels by stool, being no longer fit for the purpose of the economy; however affording more or less matter for the absorbents throughout its whole extent 11 The Lacteal and absorbents above mentioned, having carried the nutritious portion [illegible] which was taken into the stomach the chyle, into the receptacle of the chyle, where [??aming] a white or milky appearance, it is carried through this duct to be emptied into the left subclavian vein- at or near its junction with the internal jugular, and there mixing with the venous blood carried into the great descending vein called vena cava from thence into the two cavities of the heart, (the right auricle, and the right ventricle) from which latter it is propelled into the pulmonary arteries and carried by the various ramifications of the same strength the lungs, in which it is properly prepared for the action of the air for the [illegible] uses of the system- Being thus assimilated it is carried back by the pulmonary veins to the left auricle from thence the [illegible] and from thence, it is propelled into the artery on the spine called aorta. [illegible] thence [cross out] is distributed through its numerous branches to every part of the body- Having passed through this routine of elaboration and circulation and attained its highest state of vitality it reaches its final distination in the capillary Tissues. The fine net-work to be found in the parenchymae of all the glands- as well as all the surfaces- both internal and external called surfaces of relation, the most considerable of which is the external cuteaneous surface. Now the object to be accomplished in the [cross out] animal economy by the circulation of the blood, which has been justly called the vital fluid, or manifold: but for our present purposes it will only be necessary to dwell 12 On two of them- The one is the disposition of atomic molecules.- in other words nutrition the other is the preformance of the offices of depuration, or the elimination of useless or redundant matter from the system- In this latter capacity the skin and it auxiliary, the lungs, by their respective process of sensible and insensible perspiration, and Inhaleting or exhallations leave duties assigned them more extended, and equally important and imperious as any of the functions of the whole animal economy, that portion of the blood not expended or eliminated in the capillaries is returned to the heart and Lungs for further preparation, or retain and preserved in the circulation for the future [al??] of economy and not returned to the stomach and bowels, where it was first received where it was first elaborated [illegible] [illegible] since demonstrated by many [illegible] [illegible] What there is more [recumion??ious] [illegible] through the pores of the skin, and by its auxiliary, the lungs (for these surfaces in print or desperation, perform very analogous offices) than by stool by urine and by all other out lets of the human body united- this fact should never be lost [cross out] sight of for on it acts an important stept toward the knowledge and treatment of diseases,, There are many persons, individuals who enjoy good health,- usually of good digestion too,,- The exhalations from whose bodies, partake of the [illegible] of the excrementitious matter of the Bowels There are others, again whose perspiration has a desided urinous odor,, in such person, perspirat is usually abundant, while their healthy habits, act, to urinate but little and to defecate but seldom- it should be recollected, that every organ of the body- the liver the lungs 13 the kidney, the stomach, the bowels- the brain, the nerves, the muscles et cetera, [illegible] receive their support by and through [illegible] before mentioned process of digestion circulation an assimilation, and that of all these organs- perform their respective offices promptly and harmoniously when under the influence of their [cross out] appropriate stimuli, and when not obstructed or deranged by some offending cause or causes, but these causes; are numorous, in kind, character and quality as also variable in degree- We come now; to the investigation of that part of the body or animal structure [illegible] the encephalon or brain, and its appendages or elongations the nerves- Here we find both structural and functional phenomena [illegible] peculiar but in many respects- widely [illegible] from that of all other organs yet [illegible] portions, of organic matter inseparably connected with and depending or other organs other structures for its support- particularly that of the vascular and muscular systems the one peculiarity of the brain consists in its [ex??] from cellular reticular tissues and the deposits of adipose matter) Brain, though not affording adipose matter) in its common sense, furnished with (peculiar fatty acids containing phosphorus) the intermittent character of its functions and the function of the nervous system generally all is evinced by the emperian necessity of sleep While other functions of Animal life are in full force- such as circulation respiration digestion et cetera, Another peculiarity consists in its susceptibility of being acted on. and that in a very eminent degree by the instrumentality] of moral, and intellectual stimuli as well as physical 14 stimuli, which alone, make an impression on all other organs- it is to this latter peculiarity that we wish to draw the attention of medical men; its uses and its influence we think much more extensive and important than is generally supposed, by the members of the profession- We do not mean to enter into any enquire upon the spiritual or mental immaterial agencies in human phenomena; but shall consider the brain in a strictly natural and philosophic light, as the seat of all the sensations passion and emotions, and as the mutual organ of thought- it is by the instrumentality of this organ, through the medium of its nerves or that all sense of pleasure [cross out] or pain is felt that averson or desire is produced that every organ is made alive to as appropriate stimulis and every muscle [illegible] that body would be deprived of motion or sensation without its benign influence it [illegible] therefore, an all prevading power both in sickness and in health the animal machine is not governed by the laws of mechanics; no by these of hydraulics; nor those chemistry: nor by a union of them all; but by laws by forces peculiar to vegetable and animal existences called laws of vitality, and which are more or less modified by the influence of the before named laws or powers as we shall endeavour to explain- The machanic laws are recognized, and most aptly exemplified in the boney and muscular structure, in their aptitudes to the purpose for which they were designed and in the amenability of the whole both solids and fluids; to the powers of gravitation- The hydraulic laws are observable to a limited extent, in the valvular structure so common throughout the vascular and lymphatic systems and the influence of both must be admitted from the comfort and advantages of 15 position more especially the advantages of the recumbent position during sleep, thereby giving [illegible] to the solids while it facilitates the passage of the fluid elements through the whole body- As to chemical laws we conceive them to play still a much more important part in vital machinery- Physiologists and chemists have both long since concurred in the general belief that the oxygen of the atmosphere and the functions of respiration had a decided agency in the production of Animal heat, however widely they may have differed in their particular views as to the modus operandi, in producing the effect Whoever desires to keep pace with the progressive development of organic chemistry will be [illegible] with the recent experiments of professor [illegible] Europe, contained in his reports on organic chemistry applied to Physiology and Pathology_ The learned professor has gone into a careful [illegible] of every portion of the human body,then into the analysis of every description of [illegible] both fluid and solid, on which he [illegible] he might discover all those elements [illegible] food best suited to the products [illegible] necessary for the body- The results to which he has arrived are truly interesting some of which we will introduce He says:- that every notion every manifestation of force is the result of the transformation of the structures [??of at] substance_ every conception every mental affection is followed by changes in the [illegible] of the substances of the brain, it is to supply the [illegible]? Thus produced that food is necessary- Again vitality in the ruling agent by which the [ale??ical] powers are made, to subserves its purposes, but the acting forces are chemical The professor further observes: That the neutral action between the element of food and the 16 oxygen of the air in the source of animal heat- All living creatures whose existence depend on the [cross out] absorption of oxygen possess within themselves a source of heat independent of the medium, in which they exist I therefore believe that the oxygen is in its nature one of those properties which sustane Animal life This heat in professor Leibigs opinion is wholly due to the combustion of the Carbon and hydrogen contained in the food which they consume- To this last result of the professor, we are not entirely ready to give our assent, unless intends to include the galvanic and electric agency in the development of caloric, as coming under his veins of the union of Oxygen and carbon or oxygen and hydrogen and in this way account for the sudden developments of heat which we frequently witness under impressions of moral laws; such as the sudden flash of modesty on the virgins cheek, which we think to be too instantaneous to be achieved through the heart and the circulation- Another remarkable and useful result to which, the professor experiments- have led- is connection between the food on which we live- and the physiological result to the economy- From all the articles of diet which man, is accustomed to consume he has been enabled to point those that abounds most in the elements for the formation of bone of muscle of fat of cerebral mass or even the matter of heat, or in other words, the diet to give, strengths of bone of muscle of passion and of thought on which abounds in the elements of heat So important a part dose the phenomenon of clinic animal heat perform in the 17 Animal economy, That some deluded minds have been simple enough to contend, that heat is life that the want of it is death- they mistake a symptom a single penonenon for the [u???um] taken Perfect life perfect Health, consists not in the high degree of elevation of temperature but in [cross out] ability to maintain a proper degree under different circumstances and that degree is different in different orders of animated nature- What should we say of all those numerous families of insects, of reptiles, yea, of the whole round of cold-blooded creatures, that for the most part remain torpid, cold, and, even in many instances froz Through the whole winter, but yet revive again with the return of the genial heat of Spring! Shall we pronounce them dead or in a state of suspended animation merely? That the general reader may he better comprehend our Theme, and that our own particular views may be more fully carried home to their understanding all propose in the next place, to give a concise and as clear an account of the theories of medicines [cross out] that have at various periods of the world found favour in human estimation as the nature of the subject and the nature this work will permit- Engaged as we are in effort to cast what light we can on a particular class of diseases only, we do not feel ourselves under any obligation to a critical examination of the history of medicine or even to sew up in regular order a Classification of the varied chains of thought that have at different times occupied in the minds of distinguished professor, and writers; but to introduce and dwell on such only 18 as have gained or obtained the greatest notariety, and such as may best suit us our present purposes- What, then, should we understand by the science, of medicine; It is that science which treats of diseases and their remedies- The term medicine from the verb medios to heal, has given to the professor- the tittle of the healing art, with the greeks it was mostly confined to surgery and to the use of external remedies- let was for Hippocrates, to lay the foundation on which [cross out] succeeding ages and nations have built, He first separated it from Philsophy_ gave it the form of a destinct science and personally observed the progress of diseases as well as the effects of remedies on this account he is styled the inventor of the medicina clinica But we are endeavouring to lift the veil of mystery from the feature in the physiognomy of man called fever- Now, the theory of fever is inseparable from the theory of medicine, which comprises the doctrine of the nature of man the nature of his diseases and their remedies used this involves the doctrines of Vitality the laws of human life,-and these again the will of God as made manifest in man, in the lords the theology of humanity now man since his first introduction on the theatre has been ever subjected to great and perpetual changes, every condition of his existence stamps, its peculiar character on his physiognomy and with it corresponding moral and mental manifestations, he is the subject of continued change he is modified by climate by soil, by food, and even by the face of the country, in which he lives- To use the Language of Dunglingson, man changes 19 much near changes often, yet he changes not radically- On these facts is bassed the usefulness of history, whether it be of law medicine or divinity- The absolute truths, of humanity ever the sour in proposition as they became disengaged from the masses of error, with they are by nature encumbered are distined to flow from generation to generation- from nation to nation, in one continued stream of light in ceaseless and rapid augmentation to the end of Time; or to the terminus of all human truths. the full unfolding of man, to man, the complete development of the philosophy of humanity- The proceeding route of inquiry has been crowded with l'etaries, now more than two thousand years and though, the labor of no one individual have been entirely, crowned, with success, the world is still much indebted to every one for his particular toil for while in the distance of time- and the darkness of ignorance that overshadowed the earth any light was better than no light and the many lights enabled the latest Laborers to compound light and thereby obtain- a cleaner and a brighter view than feel to the lot of any of his individual predecessers- To what particular in this department in this position or department of philosophy is increased- and complicated circuit of ideas we may have reached will be for posterity to decide- That the terminous has not yet been reached is certained from the fact that none has stood the test of Time, and of criticism, not one has carried conviction to the mind of all, however lauded however popular many for season may have been_ 20 It seems that we ever have been, and still are, in a state of progresson [illegible] progression its self implies a position short of maturity- All absolute disembodied disencumbered spiritualized truths are pure elements of philosophy, from whatever source they may spring Law, medicine, religion fashions are the subjects of continued, because they partake of the changeableness of man, while the pure elements of truth which belong to them are the same to-day, yesterday and forever- Let us return to Hippocrates the coan sage: He was a philosopher, who turned his attention to medicine as one of its branches- Not all the portion of him which has withstood the test of time belongs to the philosophie element of which he was composed, or containg the particular truths of the science of medicine disencumbered by himself as we shall presently show- philosophy, was interior to medicine it is coeval with man with theology- Theology now, and philosophy when rightly understood are one and the same thing- It was it is it ever will be, a prime, a constant a universal want, a universal desire of humanity, while medicine, while medicine and Law are only secondary and accidental wants- Medicine as science: commenced with the coan sage. Anteriorly, all thing were under the dommion of theocracy, and the state But in proportion as time roled on population increased, wants multiplied, and the minds of men agitated in the cradle of civilization the ancient dynasty, gave way then from the elements of humanity sprang the profession commonly called the learned 21 profession of law medicine and divinity These assuming the guardianship of the people and the state branched off each in separate trackes to pursue it destine course; all professing, and with more or less sincerity too:- to be laborers in the cause of human good- each still standing apart has continued its assigned route up to this our time, our place. But springing originally from the elements of humanity they are doomed sooner or later necessarily to meet again, in her element, springing from special wants special necessities and from peculiar frailties common to her nature they can but in the general the universal wants, the philosophic element of humanity But it is time to leave the walks of general philosophy to enter on the examination of those that are peculiar to the task assign viz: the philosophy the theory the truth - of fever It was by the coan sage, we think the the first elementary and the first [cross out] [cross out] imperishable truths were spoken, when he affirmed that fever was an effort of nature to expel some offending cause, or humor, from the body- Now this sentiment, so far as it goes, we hold in the abstract to be true, but the has faild, in his explanation of its modus operandi- he was compelled to fail to fall short of the full clearing up of the subject for such a thing would have been without the pale of the circumsatances of his existence, going a head of the minutiae of the science. The knowledge of which minutae is indisposable with the full, the clear the transparent 22 View of theme- His notions of the four elements of blood, of phlegm, of yellow, and black, bile, modern reaches compel us to lay aside: while his leading his, elementary his philosophie element will stand- His views upon diet, exercise, and the influence of Malaria in producing diseases, are for the most part, based upon sound experience Here he errs again when he dips into the minutiae of explanation- From this doctrine of the four elementary humors have emanated the doctrines of Galen, and with varied modifications of all the humorists down to this day, receiving continually the lights of the minutiae of science, as the sciences progressed- But it would be trespassing on the time the patience, and the good sense of the reader to go into a detailed account of the varied grades and shades of light that belong to the different champions of the humoralistss, schools: suffice to say that disease was laid at the feet of the elements of fire, by others of water, of phlegm, of acid of Bile, and of flatus, &c. From the idea of flatus with the greeks, probably originated, those numerous conjecture phantoms, ideas, which at different times differ places, have assumed the various names of spiritus. Anima, Neuma, Soul, Spirit, Vita Motis, Phanus, Eros, Cronus, Ulomis, chusarus, Aura, Aroma Vis, Medicatrix, Naturae et cetera Now, under any or all of these titles do we recognize an element of truth but that element has not yet been fully evolved- At this time, at this every hour while we write, is this phantom, this phenomenon in one of its protean forms, held up in wonder to the admiring gaze of the populace by the followers of mesmer, but we have not time to expatiate on this feature in the phenomana of the neumena of humanity.- 23 that more properly belongs to our next series- For the sake of brevity we have thought fit to link together some of the [illegible] Rival chains of thought- Let us then hold up to view the Rushites the depletives, with the Brunonians in modern nomenclature, the Thompsonians, the steamers standing at the distance that we do, and beholding, the movements of these rival captains, and their well armed followers, on the battle-field, recalls to our mind a passage from a poet of Rome one of the favourites with us in the days of our boyhood (demr stali vetanl alia vitia current, in contraria) of planiea, as follows- While the one is running depletion to excess, the other is running on the opposite extreme- As though none could not perish, as well by suffocation as by exhaustion alias, as well by fire as by the sword_ Veritary [illegible] inter extremas explained) to wit- Truth lies in the middle- As to the [illegible], and the solidists, we see but little choice between, them; to us both parties seem to have taken results, in the depurative efforts of nature for their causes- The one locates fever in the liver, and attempts to prove it by a very fanciful flurish about the portal circle, in the circulation of the blood, while the other locates, it in the mucous membrane of the stomach and intestines, and rests its proof on the numerous autopses- As to the result of their different modes of practice again we see no choice- From our personal observations on the theatre of life we are led to believe that the one as many souls has purged away as the others bodies saved- But, a record to the enlightened founder of solidism- When the ancoatal, Broussais 24 of Paris has reviewed the history of medicine, and with great skill, and with great judgement enlisted the labors and the thearies of every predecessor, and upon them ruins based his localized views of fever he then went on to demonstrate its truth by his numerous autopses; he thought no doubt that he had reached the terminus of thought the handling he christened (as par excellence) the physiological doctrine, and the world has accepted it under that specious tittle- But to us only serves to recall to our mind a passage from the inspired author of our text- The wisdom of man is folly for he taught the wise in their own craftiness- The rigid mental discipline common in schools of medicine throughout continental Europe, while they tend to perfection in the manifestations of art, either in surgery or medicine, are well calculated to circumscribe [illegible] the native spontaneity of thought in general expanses of mind so indispensably necessary for philosophic generalization and progression in science- Thus we are enabled clearly to see the influences of the force of circumstances which compelled Broussais to blunder- His [crossed out] physiology is based on anatomy; his pathology on his Physiology, and his autoposes served only to confirm him in error he had not learned so to abstract himself from the purely physical man as to see and to comprehend the Laws of his neumana alias his vitality, or in other words-again, he could not compass the [cross out] whole man in connection with the whole series of causes and their consequence; therefore he took a result of fever for its cause 25 What then is fever; We conceive it to be an effort of nature inherent in all animated, creatures, to sustain its own integrity from the deleterious opererotions of causes, of whatever kind, by which it may be assailed; in this sense we make fever in its essence a unit, while in its phenomena, its physiognomy it is multiform and that multiformity of character proportioned to the peculiarity of constitutions send circumstances of existence and the nature of the varied causes or agents that are made to stamp diseased impressions on individual sensibility or the sensibility of particular organs, particular, [illegible] of his completed machinery, which machinery should ever be considered as a unit one whole- although composed of many parts while by indisoluble laws of unity; its nervous chords the true the only medium of that much used much abused and illy comprehended term called sympathy- The- difficulties we should not lay errors in the labors, of all who have preceeded me [illegible] consisted we conceive in two reasons: the one is, that the element of man, of medicine, and of nature, were not sufficiently evolved; the other in the want of development of mind, the ability the liberty, The expanse of thought to enable them at a single coup de ceil, to compass the whole man, to comprehend the harmony of contrariety, to be hold the unity of variety, that delved within him, or in other words they have been like unto certain eastern reviewers, of certain philosophic thoughts on certain earthly phenomena, called Cholera, asiatica whose intitled, being too 26 limited too local, to comprehend a phenomonan [crossed out] which encompassed the whole Earth very shrewedly suspected, that in the same category should be included the whole of the ballance of us= Now since the reviewers have failed to comprehend are thoughts on a feature in the physiognomy of humanity, we have concluded again to try them with some thoughts on a single phenomenon in the physiognomy of men; or using the wards of the inspired author of our text meats have we offered them, but find that to milk they must return,"- St. Pauls Epist to the Corinthains 3, Chap. 2, Verse- But it is time to leave the follies of the learned,, and look to nature as the fount of light- Too long now has man the World beguiled by promises of art, too few have looked, to natures watches, to see, to have the modest dame; the still, the secrect and the silent ways, the sure, the lasting operations of her laws- Through spectacles of books the world has looked from times begining down, it is time to lay aside the mask; let nature speak to nature now, unmasked,- But man, frail now, will say it is wrong to strip the damsel of her gown- We write for men; their voices we must obey- Then let the maiden stand not bare but covered with a veil- But to the labors of our task let us return once more, for on us the duties fall to make our footing sure,- We have thought [ap??] man into one complete, one perfect, wholesome living mass of organized machinery- Now in as much as His treaties, is intended for general, reading and extended usefulness to go to the families and friendes of the community the great body politice more than the learned World all conceive it to be our duty in the illustrations of our theme, in the applications of our theory to 27 practice, the result of which is the only proper test of truth, to dip as little at possible into the mysteries, of minutiae- that is into the play of atomic phonomena, atomic affinities- as such a cause would serve only to embarrass the tender mind, and be productive of no real utillity- What, then, is health, but the harmonious play of all the solid structure the equable and harmonious play of all the fluid matters, the healthy response of every surface, of every organ to its natural its healthy, and its appropriate stimuli? What, then, is disease, but an interruption of this play, in some in any way, in every way as the [c??] may be? Diseased action- that is a departure from the healthy action may result from many causes- and in very many ways- We shall in the first place, enumerate the avenues of offending causes, and than proceed to mention some of them merely for the purpose of illustration for it would be going intirely beyond the spirit, and intent of this treaties to attempt a full and complete narration of Causes or of their modes of operating as such a View would require the compass of many volumes- We shall therefore content[illegible] with citing such only as are best Calculated to give him a clearer view of the nature of disease[illegible] he may the better see, the indications of one, and be enabled, to vary his steps in the use of remedial agents, so as to bring about, a return to healthy action, in the safest way and the shortest space of time- and with the last possible detriment to the constitution of his patients- The prime causes of all febrile diseases no concern to operate on or to pass not the system through the following avenues, viz) 1st, through the nostril, the larynx, and the lungs- 2d The whole extent of the cutaneous surface that is, of the skin, in the light of a reflected membrane, so altered in structed as to perform an additional duty 38 to wit the medium of generating heat- 4th The senses- commonly called the five senses,- That is to say the sense of seeing, of smelling, of tasting, of hearing, and lastly, of touch- In the first place, let us take under consideration the liability to deranged action through the medium of the lungs, the breathing organs. Diseased action may be produced in the breathing organs themselves, from the mere extremes of temperature, or, What is more common from the sudden transitions of temperature; or it may again result from the presence of gases positively deleterious to the organization or from the absence of natural stimuli those elements that consitute pure atmospheric air, so indispensably neccessary to life and health, when fevers result from any of the above-named causes they are likely under proper treatment, to be of short duration but here is still another way in which fever ( commonly called essential fever) is produced [illegible] near those classes of fever produced by the absorption of Malaria- That is, the imbibing the mephitic gases; that emanate from the debris of vegetable and Animal matter or both combind- These fruitful sources of diseases insinuate themselves into the Animal organization to make a marked impression, on the whole man without leaving any demonstrable traces in the particular structure through which they pass or by which they are imbibed, viz. the skin and the lungs- Now the system may be changed, with the seed of disease that is Malaria, for weeks yea, for even months, and still never be ripened into action; because it generally requires the operation of some exciting or proximate cause or, causes acting on the predisposed organization, to develop the disease; that is to produce a departure from the natural, the regular, the healthy and 29 sympathetic, play of all the structure The prime impressions, then is made on the brain_ The centre, the fountain of the sentient the phenomena, Indeed, but for cerebral and nervous sensibility; we should not be the subject of disease at all- It has been asserted by Dr. Rush, that during the prevalence of epidemic, bilious and yellow fever, in the city of Philadelphia, that persons who were strongly Changed or predisposed to fever could readily, discover it in the odor of their hand, by merely rubing them together We have frequently experienced the same thing ourselves_ But we should not overlook the disturbances of the [dep??] process or functions of the lungs as a [illegible] of fever_ The deleterious effects of [illegible] transitions_ of temperature_ may so modify the timing of the internal aflicted membrane of the lungs as to impair its ability for receiving oxygen, of the atmosphere the same time, of transmitting the elements that should be thrown out through this worst way- Again, imperfect digestion disturbs the assimulations of the blood in the lungs and in this way may prove a source of disease to the lungs, and consequently give rise to few of this we shall speak more fully when we have under consideration the functions of the stomach and intestines at is we believe principally through the medium of the Lungs or breathing organs, that all these febrile disease called contagious diseases, are propagated such as measles, small pox mumps-whooping cough and the like_ We come [cross out] next to take under consideration the liability of the system to take on febrile diseases, through the medium of the cutaneous surface 30 What is the skin- The skin is well known through its own inter extent to be an absorbing surface under certain exigencies of the animal economy- For example when the comunication to the stomach through the gullet, or oesophagus, is obstructed and The individual is suffering much from thirst then that want can be measurably supplied by sponging the surface, of the body with water of suitable temperature, or by bathing- It is by verture of this law that we are enabled, to reconcile the fact that poultry sheep, hogs and even cattle can live for some time and even fatten too. When cutt off from their regular supplies of Water to drink They then take is from the atmosphere from it four going examples or facts, we are led to the belief that malaria may in like manner, be imbibed by the skin, and this enter the Circulation when the such malaria be held in solution or in a state of suspension, merely, in water or in atmospheric air,- But the most frequent, the most common, and the most demonstrable way, in which febrile action is induced through the interrupted function of the skin, is the sudden transitions of temperature, particulary the impression of cold and humid atmospheres; these causes operate by putting a stop to both sensible and insensible perspiration, which we have already shown to be the most extensive, and as essential an outlet or was way for the redundant or useless matters of the system, as any excretory organ of the whole animal economy,, But happily for man, skin possesses within itself, the power a most eminent degree, of adopting itself to the surrounding circumstances in which it is placed- There are however constitutional, peculiarities in the textures and faculties of the Cutaneous surface of different races of men, hence the stronger the odor of the exhalation from their bodies even under the same clime and the same mode of living, 31 The African race for example have more highly reticulated surface than the Caucasian or other races of men- Hence in all probability their comparative immunity from the deleterious impressions of malaria; the depurative offices of their skin being more actively performed- We come to the consideration of the mouth, the stomach, and the intestines, as natural inlets of disease, particularly the seeds of febrile diseases this we shall trace through the medium of of the food- By this term we mean to now, to include all the necessary ingesta to sustain life both solid and liquid and aeroform fluids- Food although it be continually required to meet the exigencies of the system, maybe and frequently in instrumental in the production of disease in one or many of the following ways, ([to??] first by too long fasting or the scantiness of nutritious matter in the food taken or its indigestible form or nature; or again the want of the particular, elements most needed at the time by the particular individual the first impressions of long fasting is the sense of hunger, then in the stomach. Then of fullness and pain in the forehead, with a general sense of langor or debility next comes- the fever- c vas This fever is the result of simple irritation of the brain from not having received its accustomed stimuli; the same results we have frequently witnessed from the stomach not having received its accustomed kind of food- for example milk in the place of coffee for breakfast What now is best to be done? The Doctor comes bleed puke, purge, and sweat or administers a mess of meats soup tea or coffee as the accustomed habits say- The food the ingesta, the alimentaria may be production 32 of disease from mere quantity whither it be in a solid or liquid form. The over-distention simply may paralyze the action of the stomach- Again when ingesta is too much for the gastric secretion to same from the play of chemic laws; that is of natural decomposition in other words, of indigestion, then the food becomes a source of disease; now, this result may take place in the stomach, or it may not be felt until the food reaches the intestines, then you may look out for colics and for bowels complaints and lastly for fevers. such fevers would be strictly symptomatic; but of this we can say no more as our business is to explain idiopathic or essential fevers- The uses of the saliva and the objects be accomplished, by mastication, we think have been but imperfectly understood untill now The recent experiments of the professor Deniglinger of Philadelphia, have thrown much valuable new light on this subject- The learned professor asserts that the viscid nature of saliva is intended in the economy of nature to envelope globules of atmospheric air, and thus by masticating our food, we introduce qualities of oxygen [illegible] stomach, to pass from thence into the circulation to maintain the slow combustion so necessary for the production of animal heat the professor further states that one main object in ruminating Animals is to unite an additional quantity of oxygen with their food- Now if this be the fact and we do not question it, the reader can readily conceive how it is that malaria which is inseparably united with the atmosphere, finds its way, with the food into the circulation- Who ever has witnessed the ravages of what is called milk sickness on cattle, horses, hogs, dogs, men, and Vultures of the air also can readily conceive that poison may enter by the mouth and stomach into the whole organic, mass- We have witnessed it effects repeatedly, and on 33 a pretty liberal scale, but of this we may speak hereafter= It would be going beyond [cross out] the intended limits of this treaties to attempt to show the many elements, and the many ways in which diseases or even febrile diseases may be induced through the medium of the extended catalogue of drinks and aliments; yet we will make one other remake, before we have this division of the subject, it is that a mere deficiency in the liquid elements in the system, may prove a source of disease as we have repeatedly witnessed when water was scarce, or was of such quality, that it only taken when pressed by very imperious calls of nature to allay thirst- Water is known to be continually, required to maintain a proper fluidity in the blood- In warm weather particularly and to laboring men, it is constantly expended by the exhalations from the skin and lungs It is a fact well known to the profession, that when the serum, the fluid element of the blood been wasted through the stomach, the bowels and the skin during the reign of the recent epidemic Asiatic cholera, that many individuals who had this run into collapse, were again resuscitated restored to life, and to health, by merely injecting simple water, or salt and water into their veins I promised to explain the five senses in this chapter) as avenues of disease- This investigation involves all mental emotions and phenomena, or to speak now properly, all encephalic, which is the brain movements and perturbations and the laws of sympathy these unto belonging- First, then let us commence with the olfactories the nose and the lining membrane through- while none but the natural sound and healthy generations, from fruits from flowers, from men, and animals floating in the atmosphere impinge on the organ of scent, all is well 34 Indeed who is it that has not a pleasurable exaltation of brain, of thought, and through it of the whole organism from in holding the odors of nature's laboratory, at the opening of the spring or on a ramble over the spice islands of the South and east- Now should we but change the scene, and let the olfactories, meet on every hill and every plain, in street alley and the main, nought but mephitic gases of the dead, of men, of animals and plants of whatever kind, of whatever hue, then the perturbation of the brain delirium, first and fever next succeeds also creations wild and horned fill the whole machine, and onwards onwards moves to death, from whence he came- Taste comes next The [illegible] direct and sympathetic associations of taste are either or both very frequent causes of mental perturbations, and even of physical convulsions, as we have frequently witnessed, and occasionally experienced ourselves. Who is there that has never lost a meal from having swallowed, or even having imagined themselves to have swallowed, with their meats, milk, or other drinks a fly or some more loathsome object? I recollect once in the days of my boyhood, to have taken a few grains of Calomel and jalope in a piece of preserved fruit pears, and how this seemed while I labored under inflamation of the stomach more than fifteen years have elapsed and to this day my stomach would reject a preseved pear, and if the calomel were added probably a gastritis would ensue. we have heard a story of a learned medical professor, whose native modesty in the juvenile period of his life once compelled him while at the festive board of a friend, to take down a chick from the egg, that have been cooked through mistake 35 (and what is still more strange as the story goes) it stuck- But we question much if that stomach has ever has a fondness for eggs in any way sense- Hearing next in course- The sense of hearing comes next in order, which is the last to die- That is to leave us- This sense play an important part, in the drama of life_ The deaf man is always serious- for the most part melancholy; will the blind man plays the fiddle whistles, sings, dances and is talkative and gay- The immortal Homer, the blind poet of Greece, sang his Iliad and ossian Odyssey too long after he had lost his sight, Milton wrote his paradise Lost after he had become blinds- The ear, then, as a medium of intelligence is not less important than the eye- Through this channel [illegible] The passions, the emotions, the neutral perturbations yea- all the manned of physical and moral action either for good or for evil,- be produced- The tones of the orchestra falling on the ears of the auditory are made to elevate or depress at the will of the performers- Just so the power of speech The narrator or orator, now inspiries with hope now gladens with joy, anon, he fills with dispair or maddens into rage: Then comes the fever of combat, or the fever of disease- Touch So still another sense which claims our especial regard, we mean the sense of Touch or the impressibility of man by the surrounding circumstances of factitious Causes- Men in a state of nature and of nudity is a very different animal, from man dressed up and put in houses- The well-dressed light headed, civilian hears of or beholds with astonishment, the debaucheries and excesses of the naked aboriginal or debased African the brutal. [illegible] or the inhabitant of remote Polynesia_ But not so with the philosopher: he comprehends, the reasons for all these things, and wisely concludes, that whatever is, is right," that it is of necessity: and then your [illegible] civilian, would be astonished to find with a change or circumstances- how soon you would learn to drink brandy, eat fish blubber and horse beef and appreciate the dilacacies of train oil- But it is time to come a little nearer home to every day experience- There are varied grades and shades of susceptibility and impressibility among ourselves for example; the stings of venomous insects or the handling of posionous plants do not affect us all alike, for one man is proof against spiders wasps and bees while another is laid up with a [illegible] by black gnats and mosquitoes_ some handle the posionous oak (rus toxacadendron) with impunity while other one laid up with eruptive fever by it, but none entirely resist the posion of the rattle-snake the cotton mouth or the [illegible] mad dog- now this is all a mystery yet no mystery too- That which is to [?oma] mystery is still mystery is to you- Again we observe very different susceptibility and impressibility in different individuals, and indeed in whole families to contagious, and infectious diseases, some taking on diseased action from the slightes contact while other resist entirely- These facts we have known exemplified in an eminent degree in syphilis- But to offer explanations of these things would be going beyond the limits of this work Chapter 3 An this chapter we shall endeavor to explain the authors Views and opinions in regard to the common theories and 37 practices heretofore adopted in the treatment of fevers; [illegible] endeavor to demonstrate the folly and irrationality of the varied modes of practice pursued under the influence of these theories- We shall commence with same [com??] in the depletion remedies- First. The use and abuse of the lancet. Second. The use and abuse of emetics. Third. The use and abuse of cathartics. Fourth. The use and abuse of diaphoretics- and conclude this chapter with some comments, or moral and intellectual views on the use of stimulants- Having in the preceeding chapter given a brief summary of the animal economy and death somewhat on the offices of those organs [illegible] in the phenomena of fever all shall now attempt to [illegible] to the satisfaction of every imprejudice mind, the error [illegible] impropriety of attempting to cure fever, by depletion that is by bleeding, puking, purging, sweating, nauseating medicines and the like- It will not be denied by the followers of the anti-phlogistic, schools, that they [illegible] that fevers are almost all, more or less of an inflammation character; or that febrile existence in their estimation implies a state of exaltation of one or more of the [illegible] life: and that they consequently infer, from this view of the subject, that relief is to be sought for and obtained by and through the agency of remedies more or less [dep??] in their opperations, that is to say, bleeding, puking, purging, sweating, nauseating remedies and so on! Now while we are free to admit of a state of irritation, a state of perturbation and even more a state of exaltation for the time being in one or more tissues, we shall endeavour to show that it is not best to depend on depletive measures to restore the system to its last salutary balance and healthy tonic action- For while we admit a perturbed, and even accelerated arterial action to exist in some of the organs, some of the tissues, during the paroxysms of fever we contend that this accelerated local or local and general arterial, both combined, in the result of a loss of balance of the whole system accompanied by a more or less [su?fecbled] tone and debilitated action of a 38 parts or of the whole economy- While we believe the use of remedies and give our assent to the salutary influence of remedial agents of the varied kinds that have been heretofore brought into use- we [we??d] [?igh] never to misunderstand or to run counter to the indication the calls, the laws of nature, as enfolded in every individual case= We already comprehend from our knowledge of the laws of supply and water, in what way the followers of the depletive, the antiphlogistic schools have [illegible] achieved the restoration of the lost balance (the cessation of febrile diseases) but we contend that the depletive cause alone, is not the safest the best The surest and the shortest way to esestablish the normal action so also we stand opposed to all those enthusiasts in the healing [illegible] who have been so rash as to think and even to [illegible] we should take the case out of natures hand [illegible] own, and treat it according to the rules of [illegible] when the indications of cure are not strictly [illegible] to the understanding, we then hold it safest [illegible] to adopt the maxim of an aged medical friend, that the error of omission is less [illegible] than that, of commission- Then let us [illegible] and carefully observe until nature speaks out her wants- The depletists continue that their treatment is necessary, and proper if not to subdue inflammation to guard against it; hence they take blood- to febrile heat and hurried action still continuing they admister pukes, they say to expell the morbific matter, and thereby subdue the disease- The heat to the skin and perturbed actions still continuing they administer purgatives- still to redue the fever and to rid the system of morbific matters- The fever still runs on. They repeat their bleeding emetics, cathartics, still to redue or to elimanate morbific matters from the stomach bowels, or gall-bladder; under the little vitiated bile- Well what next! Now comes either a cause of nauseating and sweating drugs, or else alterative 79 cases of blue mass or calomel- By this time the race is nearly run; the patient either begins to mend in spite of the doctors, or retreats from their custody- But cause there is evidently a hot and dry skin, thirst, often heat and burning sensation in the stomach and bowels a quick, fretful, and irritated condition of the pulse with more or less of pain, they contend that there is more or less of an inflammatory diathesis,- As plausible as this argument may appear it proves but little in support in the position taken, even in a theoretical point of view, as we shall attempt to show- In the first place, we hold that no fever proper, is strictly of an active inflammatory character- Our proof is as follows= All real and acknowledged inflammatory [affections] in the natural and unbiassed order of such phenomenon- run their course come to a crisis niether more nor less than eight or ten days- this law is so precise and notorious that the ancients from their experience settled [down]; on the nineth day as the fixed period to [arrive] at a crisis- But when the old practitioner attempt to apply this law, to fever proper they erred- Hence at this period of time the idea of critical days has nearly run out of use- Now we [did] contend contend that this law hold good in acute pleurisies fractures, and in all cases of fever from mechanic violence- The same laws is manifested in the [exanthemata] (eruptive diseases) Such as small-pox measles, &c These diseases are known to all medical men to have a prescribed course to cure, and the intelligent practitioner aims to conduct them to a solutory crisis- But not so with fever proper- Yellow fever- plague, cold plague, Typhoid fevers, and other forms of putrid fever such as camp, jail hospital and ship fever and the like (to which might 40 be added (cholera morbus) are all the natural and legitimate offspring of human folly. often kill their subject in a day, or two, while again they run ten, fifteen or twenty days, or more before the attending physician can say whether the patient will recover or not- Milder grades of disease such as common bilious, and mild typhus fevers through they sometimes terminate life in a few days not unfrequently run a month or six weeks before any one can say, that they have even reached a crisis- Fevers then bear some analogy to ill-conditioned sores and ulcers having no fixed period for coming to a crisis- Fevers however are always of a general character, while these [illegible] and ulcers may be either of a general or local nature, or both combined- But their continuence most probably depends on a [??lilated] and abnormal, or irregular action in [illegible] depurative, process of the system that is, the play of the secretory and absorbent vessels, the vital force being enfeebled or the vital fluid (the blood,) not containing the proper elements or its elements not being in their natural and healthy ratio, the consequence will be inaction, that is effective vital secretion hence in such cases we rarely see a due proportion of animal heat, soreness or inflammation in those parts; never the proper quantity and quaility of well digested pus (matter) well formed granulations untill some favourable change is produced either by nature or by art and this change is much more certainly and speedly made by such agents as will equalize the excitement and purify the secretions without debilitating the general system than by bleeding puking purging and nauseating medicines-- When the sores and an ulcers are of a local character general 41 treatment may not be necessary- But the application should be alterative one deobstruent astringent tonics, or medicines more or less stimulant should be applied- But it will be asked, if fever is not inflammatory what it its character? We would say that fever is a disease of irritation; or if you prefer it, and and allow the expression, we would go so far as to admit that it may be a disease of subacute inflammation- But fever never runs up into active inflammation Secondly although there is a hot, dry skin, thirst after heat and burning sensations in the stomach and bowels, a quick fretful irritated condition of the pulse, with more or less pain, still [illegible] there is not a general preternatural excitement [illegible] system- On the contrary, that there is a [ge??] diminished action, and a general [a??] of tone- When the organs of supply that is the absorbent vessels, act with abnormal energy is an energy too great for the organic [illegible] that is the organs of elimination and of [illegible] viz: the skin kindneys, and lungs; then the phenomenon of fever takes place that is the circulation is perturbed and the skin becomes hot and dry, in other words, the equilibrium disturbed, the healthy balance lost- Now [illegible] this state of things occurs from the cause that produce fever proper we contend, that while the vital action is in excess in the one class of vessels it is in a proportionate, torpor in the other class and vice versa so these oscillations continue to take place- constituting the [re??ssious] of fever of diseased phenomena: untill, by the [??adiden] conservative, powers of nature or through the wisely constructed agencies of art, the whole economy settles down to the natural equilibrium, the healthy balance again- or else terminates in death- Now this vessels, that is the vessels of 41 supply and waste, are in one sense antegenistical in their action so that when the stomach and bowels are acted on by pukes and purges, the exhalants of the skin, lungs and kidneys too are proportionally inactive or Torpid- suppressions of their accustomed functions takes place for want of the matter to eliminate, they have been thus directed to another channel, indeed the prime elements are released by this process- that is the regular supply for the time being cut off- But it is further [illegible] that thirst is again a sign of inflammation- It were probably the existence of this symptom in the epidemic asiatic cholera which [illegible] Braussais to administer cold drinks, to [illegible] even ice, to his patients- To disprove this [??tion], it will only be necessary to cite a few common occurrences, familiar to the experience of almost every man, any one of which facts is worth more, than a thousand Theories- Whoever has suffered long in hot [crossed out] weather [illegible] want of water, as many travellers and soldiers have done have found their skins hot dry, and the sense of thirst inffusably great, so also, whoever has witnessed the war- worn soldier or the citizen [??ttering] in his own blood, and dying for want of it could not fail to observe the animal heat departing from his skin, with the failing of his pulse while at the same time his cries for water ice water becomes greater and greater to the last- Now could any one be so stupid as the think or to say, in either of these situations because the skin was hot and dry so the thirst great, or both or, thirst with neither with neither of the other conditions that the subject or sufferer [crossed out] the subject of inflammation of any kind or in any tissue The thirst on 43 either of these situations is demonstrably the consequence of a deficiency of the fluid elements of the Blood- Some as hot and dry skins as we ever felt, were in low protracted cases of fever, where there was evident debility, and much prostration in every part of the body- Every man familiar with fevers must have witness the same thing- The hot and burning sensation occasionally experienced in the stomach [illegible] bowels are often more distressing in the last than in the first stages of [illegible] when there is evidently general debility- It rarely happens in fevers that the pulse is any other than a fretful and irritated increased in frequency to be sure a quicker pulse in frequently, indicative of a general debility- the circulation have to make up in speed what is relents in volume and in it may be full and soft but is rarely [illegible] increased in force_ The pain ever attendant on fever is much more frequently the [congog??] of too little than of too much action in the general system- Witness the long train of painful nervous affections acknowledged to be the offspring of the irritable condition of the nervous system, attended with more or less debility of the muscular fibres- The neuralgia for example, such as chronic rheumatisms nervous colics, nervous sick headach, periodical headach or sun pain (tic doulaureux) et cetera all of which are of this class of disease constituting a very considerable proportion of the pain that we suffer, From what has been heretofore said useful a confident assurance that the attentive reader will concur with less in saying that to attempt to cure fever proper, exclusively, or mainly by 44 by bleeding, puking and purging in [in??] unphilosophical, and at variance with acknowledged principles of human physiology_ Now review it is admitted by all enlightened physilologists, what the skin kidneys, and the lungs, are the three greatest ways for the redundant matters of the system. Though there be several others of minor importance in point of amount or weight of matter, eliminated such as animal secretions and the matter of thought, the passions & that is the imponderable fluids expended in thought and the encephalic (of the brain) phenomena, we think that with these facts, these lase constantly in view [illegible] not be a difficult task to demonstrate the [illegible] heretofore commited by medical men in to treatment of fevers when they have relied mainly on bleeding puking or purging or a [illegible] of them all to cure fevers- While we admit the efficacy of all these classes of remedies, in certain cases, we wish to show the errors of all those to have depended on them as remedies exclusively Blood letting Let us commence with the use of the lancet; whoever will real in mind the Physiological View of supply and wast,, can readily preceive, that since the blood is both in the medium of supply and wast, it should be abstracted with great caution, and that as should never loose sight of the necessity of supply [cross out] it with new elements; that is we should look the proper supply of food and of drink and the necessary performance of the function of digestion in due time Or meet the demand of the economy that is to supply its waste- The proper use of the lancet in all fevers proper, we conceive to be restricted to plethoric subjects; we mean persons of vascular plethora- and young subjects, whose recuperative powers will the 45 better justify it;- in such subjects when the victims of fever, our practice has been- and our sitter convictions still are, that it is best to take off so much blood only as may be necessary to relieve the circulating system of abnormal tension; that is to give to the circulatory fluids their nature and accustomed free and easy play, and no more; and this should be done at as early a stage of the disease as the its necessities may be pointed out This opinion is the natural result of a combind experience for nearly twenty three years that is to say, fifteen for the one and eight for the other-- Emetics. The medications for the rise of emetics we hold [illegible] two and two only viz- First the evacuations [illegible] contents of the stomach, either on account [illegible] excessive fullness, or on account of the [illegible] nature of its contents; secondly, with [illegible] [cross out] revolutionizing and relaxing affects, [illegible] the waste way of the system are unlocked first time, and the general economy is thus [aff??] an opportunity of resuming the healthy last [illegible] Now, when fever is symptomatic or even when [illegible] in its proper character and the cause both [illegible] and proximate, have been slight or the [cross out] constitutional stamina in the individual is very good we have frequently found the diseased action cut short by the simple operation of a single emetic- when such results follow it the use of An emetic the patients needs no more But when an irration fails of the accomplishment of so disirable an end- We are opposed to its repetition, because it has achieved of all the good that we had a right to expect from it, and the system is now prepared for the use of other remedies more natural and for more efficient, or our abundantly testified we now mean the class of remedies called tonics and sodorifics- Whoever will hear 46 in mind the operations of the natural law, that the waste ways of morbific or redundant matters is through the lungs, the kidneys and the skin, and the skin in the most considerable and important of the three cannot fail to comprehend the propriety of these remarks for so long as you irritate the stomach by emetics and nauseating drugs just so long as you suspend the action of the natural law of depuration; and so long too do you cut off the neccessary supply of new element any matters which can only enter through the digestive process- In other words he who repeats improperly, prodigatlely sports with vital organization; and when this course is persisted in as we to our motification have been compelled Occasionally to witness; under the direction of our intermeddling brethern until the organic [cross out] tissues were so much exhausted and the stock of vital elements, one hand had become so much reduced for the recuperative powers of life to reinstate itself death becomes the inevitable consequence. If any one should feel disposed to question the comparative utility of the two systems of practice, we have only repeat to him the following question and at his own experience answer it, Have you ever witnessed a genial and general perspiration coming over your patient whether from spontaneous or from the interference of art and continunig for five or six hours without a sensible mitigation of the symptoms- that too, without half the distress and the prostration that would have ensued, from the same a reduction of fever. (Could it be achieved) by the use of nauseating and puking agents? We are well aware of the fact. That the 47 suppression of the healthy depurations through their natural waste say in fevers not unfrequently indeed very commonly became a cause of local irritation to the stomach and bowels; the morbific or redundant matters seeking an exit through this cannel rather than through their natural outlet In this way we can readily perceive how it that that which- The commencement of disease is merely irritation [???n] after a short continuance inflammation consisting what Broussais and his followers call gastritis, or [cross out] enteritis or gastroenteritis the case may be; which occurrences they gravely lay down in their writing as the cause of fever- But we contend that the fever exists before it inflames and that is always coexistent with the power of irritation If these views be correct then how absurd must it not appear to increase the local irritation of the stomach and bowels by the repetition of emetics? It is [cross out] not uncommon to see an attack of Autumnal fever of any kind commence with a spontaneous, and distressing vomiting Now, could any one acquanited with the laws of healthy actions, and at the same time with the laws of revulsion of the repurative functions under such circumstances as have been just cited think of administrating tarter emetic or active emetics of any kind? Would not common sense and reason instruct them to throw or cast off the redundant matters from the stomach by the mere use of [cross out] diluents and then imediately set about the quest at morbid irritation and throw the force of circulation to the 48 surface of the body as soon as possible and there by save the suffering organ from the danger of inflammation! By gently moving the bowels, in any Day, under such circumstances, you might diffuse the irritation over so extended a surface of the alimentary canal as to relieve any particular points or portions of it from the danger of great local distress- This course which in many cases is necessary, and even the best step to be taken in at all Times preferable to relying on the repetition of emetics or even nauseating drugs- There is still another idea in febrile diseas which has long haunted the minds of practitioners and the people, that is the quantity and quality of the bile- Having but some vague notions of diseased secretion of the liver,- which have been expressed by the terms [??liated], and redundant bile,- They imagine that the patient should be puked or purged So long as the liver continued its morbid secretions, or that some had consequence most inevitablly follow- The thought seems to have occurred to them, that the secretions are partly [cross out] up by the use of their medicine as [cross out] as of the continuance of the disease and that there are other means of relieving the patient besides those of puking and purging- But of this we shall speak, more fully under the next head- We might be charged with having too little regard for public opinion, if While on this point, of our subject, we should pass unnoticed the practice of the steamers- The Thompsonians- The followers of Thompson placed great reliance on the virtues of the lobelia inflata- With this article of materia medica we have long since, had some acquaintance 49 acquaintance more or less of personal intimacy- Besides its emetic properties it possesses more or less the properties of a Dialogue- In its effects, and its operation, it bears a striking analogy to tobacco- We think from what have witness, of its effects, that it is much better adopted to the treatment of cramp, and catarrhal affections than to febrile disease- As an emetic in fevers we should give a preference to Ipecacuanha- Cathartics Purgatives in all ages and in all countries have been justly enrolled in the list of important remedial agents and in the hands of different practioners, the different articles of this class of [re???] have obtained a varied celebrity- [illegible] Some have preferred individual articles in their simple, uncombined state- either [t??] exerted their ingenuity to find the best and make the best possible combinations of Them- Hence has resulted the long catalogues of patent purgatives and anti-bilious pills. Whose miraculous Virtues have filled our papers with certificates of their infallible cures; from the celebrated Lee's antibilious, Down to Cooh's R.A.C. We find one sect of docters deriding the use of the mineral cathartics while another sect are extolling them as the sampsons of the materia medica: some contending exclusively for the offspring of the [cross out] vegetable Kingdom are asserting that all things else are poisonous to the animal economy (such are the Botanic, doctors- One would think that 50 Such men had not exactly kept peace with progress of organic chemistry;- some there are again who give a decided preference in the saline cathartics- So we find one class of practioners( The Hamiltonians and the Cookites for example) promising the greater possible good in the treatment of fevers, from the use of purgatives alone; while many of the French medical writers [illegible], admit their efficacy at all- In this labyrinth of doubt, Who shall dare assert, I am the light I am the way." In a word mankind have projected almost as many ways to health as to heaven, while in truth there is but the one way to [illegible] If we were permitted to give our opinion on the use of cathartics in fibrile diseases, we would dwell less upon the particular article than upon its dose and its repetition- As most any article of the class may by suitable combinations made to set easy on the stomach, and operate gently on the bowels; yet any individual stomach especially if it has often been under the care of docters has its aversions (We could not say its partialities) and these circumstances we think alway worthy of attention- In our choice, then, we should be in a great measure guided by the antipathies of the patient, and the circumstances and symptoms at the time being sometimes the mercurials should be preferred sometimes the vegetable, at others saline and not unfrequently a combination would be preferable, according to the particular modified action desired to be produced in the case-. With our settled physiological and pathological 51 views, we have but little use for carthartics at all- and when used we would desire to have them operate efficiently, but as mildly (that is giving as little local irritation) as possible. To us the indications fur their use would seem to be first, where there was constipation of the bowels, or fulness of the alimentary canal than evacuate, secondly, when the irritation of fire was spending its force mainly on the brain, then we should use cathartics, with a view not merely to evacuate and to diffuse the irritation over a larger surface of the systems, but to produce revulsions from the brain to the alimentary canal, and then prepare the patient for the better operations [cross out] other remedies- We are not ignorant of the fact that fevers have been repeatedly cured by the mere repetition of cathartics, [illegible] we have had the same thing occure occasionly under our own experience; we know that with good constitutions, the work of depuration and the ultimate restoration of the equilibrium, may be achieved through the medium of the stomach bowels & liver- But to accomplish this much time must be consumed great suffering endured considerable emaciation, and consequent prostration of physical tone produced and the constitutional, stamina of individual is defective= death is not unfrequently the result of such a circutous rout to health- But the depletists especially the purging sectarians, contend that there is great acrimony, vitiation and redundancy of bilious matter, in the system, that can only be eliminated by purging- We will not deny that the secretions in fever are generally abnormal; but we do contend that the departure from the healthy action as 52 frequently consists in a defective as in a redundant secretion- We are even writting to admit that the bile formed under the febrile action is not often strictly healthy in is properties but the admission of this fact those not lead us to infer, with many who have expressed their opinions, that the acrid bile is the cause of fever are conceive that to be a clearly a consequense as is the inflammation of the mucus membrane of the stomach and bowels, so much relied on as a [illegible] of the soundness of their doctrines, by the layers of the autopsic mode of setting the laws of phenomena,- Much has been said of the necessity of discharging morbific matters and the liver has been much more censured for the part it plays in febrile diseases than it really deserves- the mass of mankind have been all most urged to the belief, that the existence of bile was inimical to health- and if to it should be added the qualifying expression vitiated, from the likes of the grave medical philosophers, then it becomes truly alarming now while we admit that the liver in the discharges of its functional duties frequently departs during fevers from it, healthy labors, and that sick stomach, head-ach and vomiting are sometimes occasioned from this cause yet we know that a regular and plentiful supply of bile is as necesary to the process of digestion and a healthy existence as any other names secretion for its distine office nor is it more liable to vitiation or decay than other secretions it is known in its natural envelope, the gallbladder, or in an inspissated, state, under favourable circumstances, to be preserved for any length of time; indeed it has long since been in use as a vulgar and popular remedy for colics, disspepsias 53 and fever and we have such faith in the efficacy of sound healthy bile as to believe that it will [illegible] long, find [jo??] even with the learned, The [illegible] of high-colored urine, and the yellow tinge of the skin so common in bilious fever, jaundice, and yellow fever should not be ascribed so much to the suspension of the secretions of the liver as to the invention or retrograde action of the absorbents,, The bile in these cases we conceive to pass directly from the liver and the gall bladder back into the circulation, instead of first entering the alimentary canal and then passing through the absorbents and lacteals, whose mouths are spread out on the surfaces of the stomach and intestines, the unpleasant symptoms attendant, in the conditions of the [???al] we are disposed to ascribe more to the loss of balance in the great function of organic life, and the enfeebled [illegible] of the brain and nervous system than to the mere presence of missplaced secretions- for bile misplaces in [illegilbe] than any other secretion or element,- and the only reason why it has attracted so much attention, we conceive to be because of its color it being the only one of the numerous secretions which in becoming misplaced in rendered visible to the eye. Every body is familiar with the retrograde action of the lacteals, and absorbents in cholera morbus and more especially in Asiatic cholera where the lacteals and absorbents were not only employed emptying their own contents but through them blood vessels themselves were 54 exhausted of their serum then fluid elements to be thrown off by the stomach and the bowels- Now having witnessed these facts and comprehending as we do the operation of the natural laws of health, we object to treating fevers mainly by cathartics and emetics, our reasons are, first, because such a course would be inventing natures, laws, and secondly because, we have found a much better and [illegible] way to arrive at the same desired result,, namely the use of tonics and sudorific, But that sect of partisans known to the public under the imposing tittle of mercurial doctors, will contend that they have and [illegible] more good by the judicious and of mercurials than any one can do with Tonics and sudorifics such more often deceive themselves and the public too, from vague notions connected with the color and consistency of the stools. Those who have observed them closely in the routine of their professional toils, have found them administering calomel for almost all purposes; for example, if, the operations are thin, they give calomel if otherwise they give calomel sill; if white calomel if black calomel if green calomel; if yellow calomel sill; in a word they seem to have the same blind attachment, to calomel that certain topers have for whisky it is their toy for joy, their remedy for grief, Many Valuable lives we have no doubt have been sacrificed to the erroneous ideas attached to dark discharges such appearances being as much the effect of Calomel as of the nature of the disease To us the color and consistence of the evacuations serves to throw some light 65 not only on the condition of the organs themselves involved but on the state of perturbation of the general system likewise. The olor of the evacuations is more or less modified by the operations of three causes, to wit the food we eat, the nature of the secretions, for the time being and the chemical charater of the drugs taken,, will cause pale on even white [illegible] changes, others brown or blacking [illegible] and some a yellowish cast [illegible] may still be equally healthy, while we admit the virtue of calomel and Blue mass, we would wish to [illegible] the abuse of them- The calomel Docters who has made the [illegible] the focus of all fevers and calomel the panacea while they condem The [illegible] alicon in medicine, still continue to [illegible] Mercury, in some shape or other, in some [illegible] or other every stage and every [illegible] it is their carthartic, their alterative, their salivant, their solvent, and even their tonic There is one disease and one only which we have not been able to treat satisfactorily without it we mean lues venerea of French [illegible] This disease it seems to exercise some specific Virtues; but even in this disease we have been accustomed to use it very [cross out] guardedly- The great facility with which doctors are fabricate in this our day and the innumerable swarms that are turned out every day or annually from the many factories more scatered over the whole surface of the globe, or the civilized world in one of the many reasons that have induced us to place in the hands of the people the results of our research and experiances that they may be the better 56 enabled to understand the laws of self preservation and may the better appreciate the comparative value of the labors of their medical advisers-But have not yet taken our leave of the mercurialists- The extent to which calomel and blue mass have been administered during the last twenty five or thirty years is so great, and the ratio that has been mal-administered so enormous that it is high Time for humanity to raise her voice either to disarm her heroes of the weapons of death, or to withdraw her subjects from the field- In what part of the vast continents can any man cast his eyes and not behold the grave of some victim of its pestilential powers. where can a social club convene that dose not contain some living monument [illegible] it is indeed the most insidious of all known poisons- the poison tree [illegible] the serpent the arsenic are the [illegible] acid either gives timely [hlor???] of their present or distory their [illegible] or since- But not so with there [???y] or [lus?ingtis], those who [cross out] [cross out] listen with credulity to their wispers of fancy or powers with alacrity their phantoms of hope are doomed sooner or later to awaken in the realities of despare; for when once the victim of their remorseless grasp, neither prayers tears, time, nor antidotes will ever remove the spell, for every rain that falls every wind that blows will ever tell through their aching bones_ So such of our readers, as have dived deep into that department of the arcana of nature called laws of propagation we may 69 [cross out] safely assert that mercurial diseases is not solely confined to the individual sufferers but its effects are in a greater or less degree revived in their offsprings- Every body knows that [illegible] like yet all do not know that this law holds good even to the particular [illegible] of body or mind (we had like to have [illegible] brain) at the particular moment of vivification- But these things we must leave to posterity to settle- Diaphoretics We come next to treat of that class [illegible] whose action on the animal economy is [illegible] union with natures laws- In [illegible] in our minds the great ruling and controlling powers of organic life, we discover two very important movements in vital phenomena the one we shall call the centripetal the other the centrifugal; the one a concentration of the energies of the vital forces to the internal surfaces of relation; the other the [illegible] of the same forces to the external surface or what might be more strictly speaking to the periphery of vital action) there to eliminate or to bid adieu to all those [illegible] which having served the purposes of life are no longer needed and whose continuance indeed would be oppressive to the system In the right knowledge, and the right exercise of a controlling power over these phenomena of vital action, consist all the secrets of health and disease- sudorifics, and diaphoretics are those medicines which being taken internally increase the sensible and insensible exhalation [cross out] 59 from the skin- This effect may be produced in any one of many ways or more certainly by a combination of means to exemplify external heat alone may produce the effect; the use of diluents the use of stimulants proper (we mean not irritants see chapter on medicine) The use of the vegetable, mineral, and alkaline diaphoretics proper and the many combinations that may be made of them, of this numerous class of remedial agents the discoveries now in progress in organic chemistry will lead us [cross out] to make the most judicious choice- Our past experience has led us to give a decided prejudice to the vegetable and alkaline as a union [illegible]- This class of remedies when rightly [illegible] comprise two others- classes of [???rmmae] [illegible] [illegible] of expectorants, [crossed out], diuretics, for collectively those agents are used for the same purposes namely to unlock and to maintain the [illegible] action of the three great waste ways the [illegible] the kidneys and the skin, that is to say in the natural, order they are but different members of the same family, hence under one set of circumstances diaphoretics are made to act diuretically and vice versa- under another set of circumstances diuretics act as diaphortics- To explain more fully: Squill, digitalis, the alkaline salts of Potash Soda and ammonia, Any one or a combination of these articles- in conjunction with warm diluents such as flaxseeds, or others simple herb-teas with warm atmosphere a warmly clad skin- But use the same articles and change the circumstance to a cold skin, cold extremities- a passive condition or passive exercise, such as a ride of a cold day,- and substitue malt liquor- Give cider or even the free use of weak wines- and you may expect an increased diuresis- Again if you place a 59 patient in a medium situation as [reg??] the protection and temperture of the body and use the same articles in such combinations as will cause the [???ating] drug to make a sensible impression again [illegible] expect to have the greater [illegible] then of the office of depuration- Thrown upon the lungs that is you will have the expectorant effect In certain healthy conditions and natural exigencies of the body simple cold water in the most prompt and salutary sudorific [illegible] for example: In hot weather, [illegible] of great labor and fatigue, [illegible] from regular suplies of water untill the skin becomes hot feverish and dry and the sense of suffering from thirst excessively great a pint of more of good cold water, promply alays all sense of distress, and it administation is promptly followed by a general flow of perspirable matter from every pore of the skin or of the whole surface of the body [illegible] case just cited, the experience of the [illegible] goes to prove that the remedy is not only prompt but pleasurable; just so should be [illegible] the remedial agents in the treatment of fevers under the guidance of wisdom- But the folly of man. And the madness of medicine, have ever caused him to be too local to [circum??] too bounded and too much inflated with a partial discovery of isolated truth to see the harmony of all the truth which belongs even to a single series in the phenomena of nature- Hence when Brown [cross out] had discovered an element of truth, in the use of stimulants he ran his theory, this element of truth to excess and fortunately for the world, he fell an early victim to his own partial discovery from the ashes of a Brown have arisen the Theories 60 of w [???ing] and a Thompson and other members of the same family, To play a more rational part, and to approch some nearer to the temple of truth, in a modified and an extended scale- Hence the application of stimulants both externally and internally by drugs and by fire; and these too, aided by their distressing and depressing yet efficient ally, the far famed lobelia- The [illegible] of the steamers to us seem to consist first [illegible] not being able to discover the particular [cases] to which their routine was best adapted and their indiscriminated application of their remedies to all manner of class; secondly in the excess to which their remedies have been used When in their faint glimpses of the laws of life they had learned how to make an impression on the skin, and observed the salutary result which occasonally, followed there from they immediately prescribed too much; and were [illegible] to take up erroneous idea that by forcing the living actions through the instrumentality of pepper brandy Myrrh, and external heat to achieve whatever they desired by the mere [illegible] Like unto some simple men in every country to be found) relying on the [illegible] and strength of their purses to make [illegible] [??ise] men of their fans, or gentlemen by the mere power of wealth-As though the God of Nature, could be bribed to [illegible] his eternal laws [cross out] [cross out] to please the geathers of gold- Now [??ile] we admit the essential differences that belong to [cross out] stimulants, tonics, and diaphoretics, we at the same Time contend that they all act in union with natures Laws and that under proper restriction and right circumstances they constitute our chief reliance for 61 restoring to last balance to the [illegible] used the play of healthy action are the function of organic life- Where rightly used they all tend to excite sustain the healthy coneglated [illegible] of action in the whole system and to direct the energies of the [illegible] the surface of the body that to [illegible] the action of the natural and beautiful depurations which being rightly maintend will in due time acheive through [illegible] deranged irritated febrile [illegible]- From an attentive view of the [illegible] explanations in connection with what [illegible] have already said in our chapters are the laws of the general [illegible] as we are led to believe that the- intelliget reader cannot fail to [illegible] and the comparative value of the several modes that have been resorted to for the cure of febrile diseases- All these who have relied on bleeding puking or purging by using [rep??] any one of them or resorting to the whole of those means, conjointly have [pr??] an unnecessary waste of the element of life, and not that alone: but by the improper repetition of emetics or cathartics they have reverted the natural action of the system; thus producing a retrograde action of the lacteals and absorbents which inverted action in connection with local irritation made on he mucous membranes of the stomach and bowels by their use we conceive to be the real causes of the congestion and inflammations so commonly to be found on post mortem examination Before we take leave of this subject, it would be well to make some remakes for the controlling 62 powers of the moral agencies on the secretions- is all who have been attentive observers of human phenomena, the fact must be notorious, that the impression of fear not only increases the urinary secretion, but not unfrequently result in untimely evacuation from the bladder and the bowels such spectacles have we repeatedly witnessed in by [illegible] day under the uplifted Rod of the school master or the dog whip of the sportsman- These phenomena and always attended with more or less of a temporary chill, contraction, and consequent suppression of the exhalations from the skin, [illegible] the fluids are thrown, more abundantly on the kidneys- But when this same impression is [illegible] and carried to the highest pitch than [illegible] called to witness an inverted action of the lacteals and absorbents which are promptly followed by copious and rapid evacuations from the stomach and bowels But of this we shall speak more fully under the head- of [illegible]- We can receive of but Two general causes of diseases, that is febrile proper, and one a particular condition of the system the other a particular state of the atmosphere, and it is to the modifying influence of these causes separatly and jointly that we are to look for the [cross out] shades and grades of fever- Many are the volumes that have been already written on the subject of Malaria and the other predisposing causes of disease, yet still has this subtile element eluded our grasp; of its intrinsic essence we know but little; of its modus operandi, on the animal economy we are likewise in the dark. with its sources that is the felicitous circumstance for generating deleterious gasses, we have formed some acquaintance, with its effects on the human frame- have all had some more or less of 63 personal intimacy- It may be that to know, the prime sources of disease are to understand its effect is all that is neccesary and proper that we should know- he [illegible] we flatter ourselves the chemical and philosophical researches will not [illegible] made, untill all these mysteries, and [illegible] up to our view- One thing certain in that every breath we breathe, every step we take and every evolution of the [illegible] or less predisposing or exciting cause to either healthy or unhealthy action in the system Nor do we often know with absolute certainty whether they are to be for the better or the Worse- It is from the lessons of wisdom and experience alone, that we [c?u??] how best to deport ourselves- [illegible] whether of body or mind- (and is taken the two to make the whole man) are much more closely allied and more inseparably linked together than the mass of mankind have ever yet thought- Either or both under the guidance of reason, will find the greater share of health and of happiness in [illegible] a just medium in all things- He who shuts himself up in a house, from fear of the influence of the sun, the wind &c is at least as subject to disease as he who regularly and fearlessly face them all, or he that dose not take bodily exercise or live on two spare and meagre, a diet from a fear of wearing himself out, or under the vain hope of prolonging his existence, is about as likely to cut short the thread of life, as he who obeys the instructive impulses of his animal desires- (Stimulants.( 64 Sudorifics, tonics and stimulant are all centrifugal at in their effects all having a tendency to facilitate and sustain the circulation of the blood to excite airs to maintain the natural secretion and exhalations from the body; and not that alone but to counteract the enfeebled the irritated the irregular and the spasmodic actions attendant on fevers of sudorifics we have already spoken of tonics we shall speak more fully in our next chapter; But of stimulants we must have something to say before we close the present- The present state of [cross out] knowledge as conveyed in classification of remedies and the use of terms renders it necessary for us to explain what we mean by the expression stimulants proper- The words stimuli or stimulant has by most writers been indiscriminately applied to whatever would excite the living tissue- In this sense- emetics cathartics cantharides &c, are all stimulants- But we shall confine the use of the term to those articles only, which excite or exalt the system, in a manner only congenial to its own healthy laws; all other excitants we shall consider as irrtants- When we look to the origin, the history of stimulants proper, we find them springing only from those elements, that are capable of sustaining Animal life; and the quality of the stimulus always modified by the quality of elements from which it is obtained and the chemical aptitude and skill with which it is elaborated- The grades of nutriment, of permanency, of diffusibility of stimuli, is the result, of the formative powers of the processes of fermentation and distiliation and 65 the elements used- Thus we obtain Wine cider Malt liquors, rum brandy whiskey and their subdivisions- But the weakness of man in by his approximation to [illegible] ever kept kind vacillating from one extreme to another from the extreme of confidence to that of [dist??] [illegible] hope to unnecessary fear- [illegible] the [p??] of distillation, was first [illegible] put in use, some of the philosophers of that day verily believed, that they have discovered he secret of human immortality- So [pac???] indeed are its effects that it readily found favour in every land- too [se??] the distilled liquors have troubled the [illegible] been tasted tried used and [illegible] nations now while we write all [illegible] organized and public speakers [illegible] to proclaim to their fellow men, the dangerous and the deleterious and the deadly [illegible] of intoxicating drinks; the drinks [illegible] themselves calumniate [illegible] to public view as man [illegible] and are societies former ready and willing to expunge from the best [illegible] discoveries and important [illegible] baunties the name the laws of [dist??] Thus verifying the word of [illegible] Chem stilted vetant alia vetce [illegible] Contrarea- Whenever man shall acquire wisdom and venture rightly to see, and rightly to appreciate, his own ignorance, and his own folly, then, and not till then, will he cease to abuse. The munificence of Deity,, The very reasons for which the civilized world is now toiling to put down the use of stimulants to wit,, its excessive use, its abuse is to us the strongest possiable proof of its, salubrity of its efficacy; for if its elements its action on the living atoms, had 66 not been congenial to the laws of his nature Man would have never learned to have loved it so= But out opponents may say that all this is habit if so will they be so kind as to tell us why their patients and the world have not yet in like manner contracted a fondness for calomel, tartar emetic ipec- or any other [cross out] of the numerous drugs we call irritants? Malt liquors wine cider, contain in addition to their stimulant properties their alchoholic elements some nutritious matter; and even the alchohol itself we have reason to believe is consumed in the living action no portions of it having yet been [di??cked] in the excrements the sercetion or exhalations from the body By [illegible] of the lights of chemical [illegible] are we now enabled to solve the [illegible] that has been so frequently pronounced [illegible] slow poison- A thorough [illegible] of its modus operandi in the [illegible] economy, has enabled us to comprehend [illegible] way it operated beneficially in [illegible] [???ased] condition, When the vital forces [illegible] much enfeebled by disease, and a [illegible] of elementary matter necessary for the support of life and animal heat is much diminished, then the prudent use of stimuti operated beneficially, by allying irritation directing the vital forces to the capillaries thereby restoring the last equilibrium, while at the same time it either nourishes the system or at lease prevents that waste of the animal matter that would otherwise result for the necessary maintenance of animal heat- We hope that no one will infer from what we have said of the use or the modus operandi 67 of stimulants in the diseased conditions that we are advocates for it as a luxury far from it, we use it not ourselves Nor have we ever advocated its use in others= the result of our experience further more is, that however greatful and [h???] beneficial it may be to the [?nfabled] the diseased and the convolescent from fever that they invariably lose their appetite for it with the return of strength and of health We would have it consumption strictly confined to remedial purposes- We are [illegible] aware of the fact that many unfortunate individuals, have an ungovernable propensity for its use, even in their best health- This state of thing we can readily to two sets of prime causes; the the organization of the brain and others the circumstance of education; both of which could be easily remedied by the united efforts of philanthropy- and wisdom Chapter 8th The Autho's practice and general treatment, in the cure of fevers- Having stated in the preceeding chapter our objections to all the various systems doctrines and modes of practice, [illegible] have been heretofore pursued and dwelt at some length on some of the particular errors introduced, into practice by our predecessors such as the errors in blood letting- Puking Purging, &c in the varied degrees and modes in which these measure have been applied to the treatment of fevers 68 We will now endeavor to unfold to our reader a very different and as we honestly believe, a far better plan of treating fever of all types- from whatever causes: They may have the origin and under whatever forms they may appear, for to us since we have learned to view more as a unit all general diseases seem but a unit so consequently to us fever is a unit- Now let us look back for a moment to what we have already said of health and disease- Health is but the harmonious play of all the solid structure- The equable and harmonious play of all the fluid [illegible] the natural response of every [illegible] every organ to its natural [illegible] healthy and its appropriate stimuli [illegible] is disease, but and interruption of this play, in some way, in any way or every way as the case maybe What then is fever? We conceive it to be an effect of the conservative powers of nature inherent in all Animated Creatures to sustain its own integrity from the deleterious, operations of causes of whatever kind, by which it may be assailed In this sense we make fever in its essence a unit, while in its phenomena, its physiognomy, it is multiform, and that multiformity of character proportionate to the peculiarity of constitutions and circumstances of existence and the nature of the varied cause or ''gents, that are made to stamp a diseased impression on individual sensibility, or the sensibility of particular organs 69 Particular tissues of his complicated Machinery, which machinery should ever be considered, as a unit, one whole, although, composed of many parts. united by indissoluble laws of unity, the nervous chords, the [t???] medium of that much used, much abused, and illy comprehended [h??] called sympathy Now if the reader is capable of comprehending what has been already said and will hold the truths already unfolded to his view ever present in his mind, he will find no difficulty in understanding and giving his assent to this which is to follow- The phenomenon of fever you will [illegible] we have said is the result of [illegible] debility, attended with a loss of balance in the functions of supply and [w??] This state of things impresses on [illegible] individual sensibility of the individual sufferer the assemblage of phenomena called fever, such as lassitude, heat, thirst, pain, restlessness, with more or less perturbed and interupted performance of all the functions of [illegible] vegetative, animal and intellectual in a word, a diseased of abnormal manifestation of some or all the function of organic life, For centuries past have the industry and ingenuity of man been fruitlessly essayed to fid the shortest, the safest and surest, way to remedy this state of things Born and raised as we have here under this state of collision of thought, 78 80 and decieved by our calling, as collaborators in the cause of science and of truth, we now find ourselves compelled by the lights both of experience and research, to fall confirmed in the the propriety of discarding the thoughts of every predcessor. and with them their practices also- [illegible] our investigation of the Laws of organic life, we think that we [illegible] some modifying or [???al] agent capable of making [illegible] prompt, more specific, and more salutary impressions, on the diseased subject than any of the numerous [illegible] measures heretofore relied on for the accomplishment of the same and [illegible] agents are called the vegetable [ahal??ids])- To this family belong [illegible] such as the sulphate of Quinine cinchonine, morphia, a class of remedies occupying the middle ground between that of the depletive and the [illegible], stimulating remedies= [??pent] the timely and judicious use of this class of remedies, do we chiefly rely on the cure of all fevers, not [d??yeting] [???eves], however, the benifit of any or all other remedies) That sciences or experience may have pointed out as salutary and proper. Thus you see that we have admitted the propriety of blood letting in certain cases, and under certain restrictions; so also have we admitted, and recommended the use emetics and cathartics, under, particular circumstances and with suitable restrictions)" 81 But our main auxilliaries to the use of quinine and the vegetable and alkaline diaphoretics [illegible] of extreme prostration the [illegible] stimulants with the [illegible] In all cases of local [illegible] inflammation, we have [illegible] acid advocated, the propriety of topical bleeding by cups or by leeches [illegible] the use of sinapisms and blisters still, however, holding on to the regular use of tonics with such [illegible] as might be indicated in the [pa??] case of state of the patients. The Gold pills which the author has prepared for sale, for [illegible] past and distributed under [illegible] name of Ward's Gold [illegible] And has deservally acquired for efficacy in the cure of fevers disease far surpassing that of [illegible] article ever offered to the public [illegible] plan of treatment before adopted [illegible] simply, composed of one grain of quinine to each pill three fourths of a grain of aloes and one fourth of a grain of Rheubarb to which was added just so much of the oil of cloves, as would gave them an agreeable odor) The aloes and Rheubarb, were cheap and convenient articles of which to make the mass= they were not intended as articles of medicine at all, nor could they have had any very material, the whole virture of the pills consisted in the quinine alone the The medium dose directed in his prescription being uniformly one grain of quinine to an adult, and in that proportion for children 82 [illegible] unpleasant effects have ever within [illegible] resulted resulted from [illegible] being made in the use of the [illegible] they have been placed in [illegible] all descriptions and [illegible] and used in all stages and in every form of fever to be met with in the [illegible] united states- particularly [illegible] states lying in the great valley of the [illegible] Mississippi for the space of eight [illegible] years- [illegible] author has vended pills to a larger [illegible] realized some money by his [illegible] have also saved a great many [illegible] by using them,, been relieved of much [illegible] suffering, and very many lives no [illegible] been saved and prolonged,, The [illegible] himself driven to this [illegible] more from motives of benevolence [illegible] than those of self interest= [illegible] as he did, the prejudices that existed against the medicine he also new that had he [illegible] his opinions to the world in any [illegible] than as he had done, and is now [illegible] neither the public nor himself would [illegible] [??ted] much, if any by it [illegible] the manner, that has been adopted the full benefit is now given to the world [illegible] with a great deal of other useful [illegible] that could not well have formed to place in a newspaper or common hand bill The obsticles with our predecessors cotemporaries to the discovery and adoption of what we hold to be truths, that is the aptitude, of quinine to the cure of fever are two fold, namely, a belief in the inflammatory nature of fever, in the first place, and, secondly of [ag??imutaing] 83 or inflammatory properly in the value of quinine, The error of their motion in [illegible] we hope, has already been [illegible] proven to the understanding of every [illegible] reader and it now only remains from to show the fallacy of the other imaginary obstacles, and then the whole [m??] [illegible] may be considered as [despe???] We know of but two ways by which [illegible] settle, or put to the test our [illegible] or our understanding- the properties of bodies of material things,, The one is the [im??] to be drawn from there [sen??] [imp??] on living matter the other is the chemical manifestations displayed in relation to or in conjunction with the other thing and circumstances,, suppose now, we submit the article of quinine to the tribunals, and see what will be [illegible] our examinations,, Let us first [illegible] in a chemical point of view. What is quinine? it is the salt of the [illegible] of a tree, indigenous to the elevated lands of Peru,,, in South America, It is obtained by the process of [illegible] desiccation and crystalization- but is not then a produce of [illegible] fermentation or of distillation it is [illegible] volatile; it is a fixed salt, not [tia??] waste by evaporation From where [illegible] stimulants proper derived. They are at either directly or indirectly the offspring [cross out] of nature, through the vegetable process; and are elaborated purified and concentrated by human contrivances under the natural Laws of fermentation and of destillation Hence comes camphor, porter ale, 84 Cider, Wine, rum, brandy whiskey the essential Oils of all scented plants of which might be added aumonia, all stimulating [a??ts], and all Votatile and [illegible] less [illegible] by evaporation, [illegible] the [???cal] view of the subject, [illegible] infer, from the processes of [illegible] and from the fact of its [illegible] exemption from change [illegible] common atmospheric influences [illegible] that passess those qualities, common to the list of articles universally [illegible] as stimulants,, But there is still another way by which to arrive at truth, it is the testimony of the facts of human experience, or of [illegible] observation on human sensibility alias the phenomena in living human matter, where we consult the pages of history, from the period of the first [illegible] of the virture of the peruvian [illegible] 1560,, we find febrifrege properties ascribed to it from that period to the present, in the hands of different chemists and different practitioners, have its properties and its varied remedial uses, been differently presented still we find that the sum of the testimony- the sum of the experiments [illegible] researches, up to this day, have tended rather, to advance, than to detract, from its virtues nearly all writers admiting its antiseptic, and its Tonic properties while some in a limited sense were willing to ascribe to it febrifuge and atterative Vitues for which it has, as yet, obtained credit and even more,, In our hands for years past, in some form or other 85 has it succeeded in a far more eminent degree then any other article of the whole materia medica in contending successfully with fever,, of whatever type and in whatever stage it has come before us = it would be respassing both in the patient and the good sense of the [illegible] reader to attempt to lay before him any thing like a detailed account of our personal experience,, But for the satisfaction of those [i??] [illegible] with the reports of cases, we have thought fit to cite the following, when we [c??] were attending medical lectures in the city of Philadelphia during the winter of 1834, +5, there was a man in the hospital laboring under simple bilous fever, the part [sy??] not severe I thought, this patient had been there at least four weeks, had no other disease, this case had been treated all the time with the [illegible] remedies; that is with occasonal pukes and purges, and with what [illegible] call refrigerating mixtures such as a solution of salts of tartar [cross out] or cream of tartar,, with nauseating doses of emetic tartar or Ipac, and when the fever, would somewhat abate, they would give, small doses of the, bark, and but seldom repeated for fear of aggravating the fever I do not recollect distinctly, but think it probable that the lance had been occasonally used also the Bark and laudanum were gradually increased the disease continued but not sufficiently to make a sensible 86 Impression on the system to as to obtain an ascendancy over the disease as should always be done in the treatment, of this fever The Hospital Physician, Sir R S Hartshorn [illegible] and evening, to take tea with him- In the [illegible] of our conversation he [illegible] had been practising medicine for several years) He then mentioned to me the [illegible] uncertainly of the cure of ague [illegible] general and named this case, [illegible] [part??],, was much pleased when he [illegible] and with some reserve, stated [illegible] his patient in North Carolina [illegible] lived that I thought I could [illegible] in forty eight, hours at furthest, [illegible] at me with some degree of astonish [illegible] said he if it is not a secret, [illegible] the case: I advised the [illegible] and Wine shortly after the sweating [illegible] and to use as much of the [illegible] as the stomach could bear, untill a short [illegible] [??or] the chill was expected to return [illegible] to increase the dose of laudanum [??pium] at least two or three fold= The [illegible] made,, the experiment (as he called it.) patient had no return of either fever or [illegible] he was cured immediately,, It should be recollected, that at that time quinine was not known, some time during the summer of 1850 and one I was called to see a Lady in to Town of Columbus Kentucky whose life was said to be disporic) of,, I found her the subject of a Typhoid fever of ten or twelve days standing, She was much emaciated, and very feeble and suffering with great restlessness, with 87 occasonal fits of delirium [illegible] tongue dry skin hot and dry thirst great, I learned that there were [illegible] physicians in attendance; they have been and were they giving of [illegible] historally blue mass) I [he??] [illegible] lady that could not wait [illegible] in attendance in [con??] might say to them that I [d??] [illegible] course of treatment,, that [illegible] the use of mercury and put [illegible] the use of tonics and [diaph??] [illegible] thought fit they could adopt that [illegible] not and she thought fit to [ad?p??] [illegible] send her the medicine and [illegible] the might treat the case herself Furthermore, that I was of opinion [illegible] presisted, in the corse, they [illegible] lose her daughter; but that if she in execution my prescription [illegible] mending in a few days,,, That pass [illegible] the good old lady and the [de??] little importance to the reader [illegible] say, that I was promptly applied [illegible] and prescription)) I simply [??hr?] of Quinine to be given every two [illegible] and a solution of the alkaline may [illegible] of the supercarbonate of potash and [s??] such quanties as would allay the patient a few hours use of these remedies [?x??] genial perspiration, with a return of healthy to the tongue and faces I learned that by the next morning all signs of fevers was entirely gone or fled, the patient commenced and continued to convalesce untill her health was entirely restored.. She has continued to enjoy good health ever sence up to this period Here there any motive or any utility in it. We could go on to fill thousands of pages with 88 [illegible] to similar cases) We have [illegible] [illegible] belief that the salt of [illegible] take was the best tonic, The be [auto??] [illegible] alterative and [deobst??] [illegible] acquanited and that [illegible] conjuction with [illegible] [??ies] to meet particular [illegible] achieved more good [illegible] of fevers, that with any [illegible] article of the whole materia [illegible] expressed an opinion [illegible] belief of its possessing [???ating] properties, its efficacy [illegible] resides purely in its tonic [illegible] other words,, in its aptitude [illegible] of the brain and the [illegible] system,, which in truth is the [illegible] mobile of all vital phenomena,, [illegible] possible that it may neutralize [illegible] of fever.) [illegible] desire a more extended view [illegible] understanding, of the part of our [illegible] consult the lights of organic [illegible] the recent labors of [illegible] Leibic) Before we take leave [illegible] general view of the subject, it would [illegible] to [add??] still another argument support of the correctness of the general [??ples] contended for)- The argument is this, [illegible] followers of the strictly depletive doctrines the [?liushits] and looking, have done much good, succeeded well in the treatment of fevers, and if also their antipates, the Brunonians, the Thompsonians &c have achieved half the wonders that they claim occupying as we do the middle ground, the Lust Millieue, so it not reasonable to infer that we who accept the lights of Both 89 extreams and of all extreams, but who tenaciously hold on for the middle course might be intitled to a modicum of the laurels [illegible] to be placed at the feet of tonics and [im?ho??] in the temples of Esculapius)- We are not only satisfied as to the curation [pa??] [illegible] quinine, but we are disposed to [illegible] preventive, Vitrus also) To this [con??] [illegible] led not only from experiments [illegible] author's own family; but from fact occurring in his experience in [illegible] in different portions of the united states [illegible] all seasons of the year, I generally [illegible] early in the spring, and seldom [illegible] than June or July and sometimes [illegible] August, and not unfrequently [illegible] set out again in the heat [illegible] to the most sickly region of country" I also had agent out at the same [illegible] They were all instructed to use the [illegible] occasonally as a means of protecting [illegible] the influence of Malaria, [illegible] yet occured a single instance [illegible] one of them has contracted a [illegible] kind), From There facts we are [illegible] than if quinine was judiciously [illegible] sickly countries, and in sickly [illegible] that such a thing as fevers, if any [illegible] would rarely if ever occur except circumstances of the combind [op??l] of the many causes)). When quinine is used as a preventive, and adult should take a dose three or four times a day untill he takes twenty five or thirty grains)) This quantity, should be taken every two three or four week untill the sickly season is over or the epidemic has subsided) 90 [illegible] should take less in proportion to [???age) Chapter 5 [Th??] Author's views on the subject of the [illegible] of fevers) [illegible] expresses the opinion that fever [illegible] some general reasons for [illegible] But we shall, in this chapter [illegible] into the details of the argument [illegible] show that all fevers are of one [illegible] the mildest form of intermittens [illegible] fever, down to the lowest [illegible] most malignant type, of yellow [illegible] nervous, typhous or whatever nomenclature, you may please to adopt [illegible] fevers as one continued chain [illegible] phenomena and the varied symptoms [illegible] [???ions] as only so many different [illegible] [???uced] by some particular conditions [illegible] [???pher], or state of the system [illegible] of these modifing causes are [???lly] changing and from these changes [??ate] all the apparent dissimilarity [illegible] the feature of disease, while in its essential [illegible] it is ever the same and every variety [illegible] should he treated pretty much alike, that is with the same classes of remedies, varing them only to suit the peculiarities of cases, with the grades of diseased manifestations)) We speak, here, of diseased manifestation when left unbiassed, under the controling agencies of natural causes, very many of the worst features assumed in fever 91 are the result of med [prac???] or hyper medication,, for are such [illegible] we have over been of opinion that the [illegible] should have fared [mu??] better [illegible] [??arels] of dame nature the [illegible] under the officiauness of [illegible] and inter medillering Doctors,) [illegible] immortal [Brou??ais] of [illegible] said that there is one disease at [illegible] which any practice is better [illegible] (Asiatic cholera) [illegible] speak hereafter, its a kind of [illegible] in fever, and that the reader may [illegible] satisfy himself of that fact,, we [illegible] summary of the most common and [illegible] symptoms in all fevers which [illegible] sevely, that the symptoms of all [illegible] sand, differing only in degrees of [illegible] that they are in proportion to the [illegible] severity of the causes, and the [illegible] impressibilities of the constitution are manifested, There are generally days of indisposition previous to [illegible] all fevers,, This is calld the premonitory [illegible] This state is known by the loss of appetite lassitude, a general restlessness [illegible] and an unusual drowsiness, [mor??] disturbed sleep with a disinclination [illegible] action of any kind,, In the [all??] in the onset of fevers, it rarely happens but that there are more or less of [illegible] sensation, attended with flushes of red, Sometimes these chilly feelings run into ague or shakes, but with the advance of disease or as the fever rises the chilly sensations subside) In the commencement of all fevers it rarely happens, that there is not more or less of aching pains over 92 the whole body predominating, however in [??cular] portions such as the head best [illegible] sometimes this pain is exquisite [illegible] is apt to moderate as the [illegible] as in the Language [illegible] reaction becomes establish [illegible] all fevers, there is more or [illegible] sometimes it is intensely [illegible] [??ptom] also continues as an [illegible] all fevers, but it is apt [illegible] disease progress although [illegible] and even fauces or throat [illegible] in such cases, the desire of [illegible] [???ings] more from the unpleasant [illegible] of dryness, or suspended [illegible] the structure just named [illegible] the actual cravings of [illegible] stomach, since patients in this [illegible] take only a swallow or two [illegible] while in some other conditions [illegible] that could be retained by [illegible] would satisfy by desire, [illegible] onset of all fevers there is [illegible] less appetite for food sometimes [??ior] as food, amounting to, [illegible] sick stomach without vomiting [illegible] times with vomiting and [???nally] with both puking and [???ing] [ar?el] it is well known, that there is little or no appetite for food during that time or the progress of fever In the first and earlier stages of all fevers except in the lowest grade of cold plague, yellow, putrid or typhous, fever, and even sometime in these, the pulse is apt to be not only quicker than natural, but irritated and fretful 93 giving often times the [illegible] ounce of increased force to [illegible] the force is diminished [illegible] action in such cases [b???] [illegible] up in frequency [illegible] wants in force,, [illegible] advances the patient [illegible] the pulse becomes, [st??] [illegible] and smaller, making, [illegible] resistance to the [pres??] [illegible] and evincing clearly [illegible] In the first stage of all [illegible] becomes covered with a whitish [illegible] fur) This however is not [illegible] in onset of the disease, but [illegible] observable, in the cause of [illegible] if the fever, is not checked, [illegible] to run into another stage, than [illegible] is apt to assume, a yellow [illegible] appearance,, But should [illegible] lower grade, or more [illegible] particuly, should it partake of [illegible] form such as yellow fever [illegible] or the like- then the tongue is apt to assume a dark brown to black [illegible] The casting off these apparent [illegible] coat from the tongue should [illegible] considered a favourable [illegible] In the last stages of all fevers [illegible] tongue teeth and lips are apt to [illegible] exceedingly dry, and oftentimes [illegible] with a dark stickey gummy Matter,, In some, more rare cases, the tongue assumes, a different appearance, from any of that have been mentioned that is it assumes a smooth glossy and appearance),, 94 This is apt to take place after many days continuance of [f??] [illegible] last stages of the disease [illegible] when ever this state [illgible] have generally [fa??] [illegible] tedious and more dangerous [illegible] [???nes] there is a roaring Laund [illegible] this is most common in [illegible] fevers but it daze [illegible] occur in any form of [illegible] is a common and a very [illegible] symptom in all fevers, this [illegible] symptom is more the offspring [illegible] organization, than the nature [illegible] cause, some individuals [illegible] whole famelies being prone [illegible] under fever from whatever [illegible] under whatever type; while [illegible] individuals are capable of [illegible] through any form of fever [illegible] much or any very [illegible] [???able] derangment of the function [illegible] organs of thought, [illegible] first stage of all fevers there is to be a kind or grade of destrubance [illegible] not amounting to delirium, that [illegible] slumbering or dozing condition, that the patient is more concious of than [???dant],, This symptom indicating [illegible] a slight departure, from the normal [illegible] is of but little consequense [illegible] as the disease progress in its stage and grades of prostration, the delirium assumes, a different, and more distressing character observing attended now discover a considerable derangement, in the faculties of the brain 95 the patient himself [illegible] conscious) the frequently [illegible] extent in a state of sleep [illegible] hard of hearing so much [illegible] efficent to arouse [illegible] make yourself [cou??][illegible] indifferent, to the [ex?e??][illegible] you short response [illegible] slumbers again) [illegible] stages you find him [illegible] fingers, and at the best [illegible] entirely stripping himself [illegible] again we hear him [illegible] [??ores] and manifesting [illegible] and going about, when [illegible] able to stand on his feet,, [illegible] patients we are apt to witness [illegible] twitching of the muscles of [illegible] legs) What is call'd sub [illegible] by the Doctors) the voice [be???] and sometimes unnatural [illegible] wild vacant expression of [illegible] There is still another form of [illegible] which also occasionally attend the [illegible] of fevers and indicates, a more [illegible] condition, than the one just [ment??] This is attended with [cross out] [illegible] watching the patient sleep leaves [illegible] this hearing becomes even more [ac??] than natural he is startled at [ev?y] and has imaginary and for the most [illegible] distressing images continually passing before his eyes) In all other particular his condition is pretty much the [?arn??] as in the state just before mentioned) Now as the delirium and Muscular agitations or twiching increase in proportion to the duration of the disease and physical 96 [illegible] of the patients these [illegible] to the general [illegible] [???ast] debility [illegible] organizations and no [illegible] of the brain, the head [illegible] other part of the [illegible] of the medical [illegible] have you to believe, [illegible] we observe some [illegible] of heat in the stomach and [illegible] also an increased color [illegible] [???ly] secretion of urine, [illegible] of all powers we occasionally [illegible] discharges by stool and by [illegible] forms of fevers these are alike [illegible] symptoms though not necessary [illegible] individuals have recovered [illegible] discharges from all manner [illegible] on all fevers the salutary changes [illegible] usually announced [illegible] very much the same [illegible] that is nearly all the cases yeild [illegible] of the salutary action of [illegible] deparative functions [illegible] the skin, Although the [illegible] [???tion] of the blood has been long under [illegible] and the indications to be drawn from [illegible] of the pulse long studied, and [illegible] grave lengthy and learned discourses delivered from pulpit of the schools yet still are the discrepancies of opinion upon this subject, as great even of this day, as at any former period of time) Such too must necessarily be the case, for two important reasons- The first is that the faculty have not yet agreed, even in the abstract, as to what constitutes the, 97 propriety or impropriety of [illegible] Blood; the second [illegible] the mass of practitioners [illegible] influence of physical, and [illegible] the phenomena, of [cir???] [illegible] patients) For want of [illegible] of all these things [illegible] and observant practitioners [illegible] blunders) In the [exam??] [illegible] with a view to the [ind??] [illegible] should never fail to [tak??] [illegible] all the symtoms of the [illegible] circumstances of causation) [illegible] signs which lead us to a [illegible] condition of the sick, [th??] [illegible] uniformly important, than [illegible] tongue, and the skin, [illegible] should therefore be paid to [th??] [illegible] condition) As a proof that [illegible] know less about fever than [illegible] supased, and less even than [illegible] imagine, all hear them continually [illegible] about the names of fevers of [illegible] or a season such as typhoid, [illegible] and billious fever, just [illegible] were all distinct, diseases and to be [illegible] widely varied remedies) The truth [illegible] the similarity of symptoms in the [illegible] of all fevers is so strikingly great not a matter of astonishment that to often dispute about their [class???] Many practitioners prescribe more from the appellation which they shall give the assemblage of symptoms than from a knowledge of what taking place in the economy of their patients [?bey] as often or oftener form their opinions as to the name or nature of a fever from the season 98 [illegible] in which it occurs [illegible] the symptoms which attend it, [illegible] known the fever of [sm??] [illegible] of malignant fever [illegible] healed for bilious fever [illegible] matter of supprise to us [illegible] mistaking one shade of [illegible] for another, nor [illegible] mistakes be a matter of [illegible] provided they under [illegible] of the fever in the general, [illegible] accostomed to see fevers assume [illegible] bilious in warm seasons and [illegible] countries, while typhoid fevers are [illegible] in the colder seasons and in the [illegible] Countries) We have thought that fever [illegible] its protoype, never stationary [illegible] in a state of progression or of [illegible] after saying very much in its [illegible] never fundamentally changing [illegible] running regularly through the different [illegible] of the particular type it may assume [illegible] and running from one type to [illegible] from a higher to a lower, or from [illegible] to a higher that is from the simple [???ing] form to bilious or even typhus [illegible] [???time] while at another time from [illegible] bilious, and finally ending in [illegible] and fevers) Such things are not [illegible] request occurrences in cases of relapses [???standing] our conviction as to the truth [illegible] the position, that there is a natural chain of connexion which bind all fevers together, yet still do we find it convenient for the purpose of making ourselves the easier understood), by the reader, to adopt the common classification of fevers) Hence 99 the succeeding chapters we shall treat of the several [illegible] commencing with the [illegible] of what is called summer [illegible] fevers and ending with [illegible] of fevers, called cold [plagu??] [illegible] fevers) The objects in [illegible] of this chapter, have [illegible] show by a brief summary of [illegible] symptoms attendant as [illegible] unity of disease and in a [illegible] the identity of all fever proper [illegible] attempt we have either failed [illegible] are still living and important [illegible] and will speak for themselves Chapter 6, Chapter 6 Of Intermitting or Ague and [illegible] We believe it is now universally [ad???] [illegible] low marshy lands, and all [illegible] or situation where the surface of the [illegible] such as to retain, the water that [illegible] either by virture of its depression it, [illegible] of surface, or by the impervious nature [illegible] clay or where the waters of creeks and [illegible] stagnated, either by artificial [illegible] obstructions, are ever fruitful source of [illegible] condition of atmosphere which [illegible] in the human subject the types of [illegible] called intermitting and remitting [illegible] as we are engaged in writing solely with a view to practical utility, we would consider it an unnecessary wate of the readers time, here to enter into any investigation of the laws of Malaria the laws of Vegetable and Animal decomposition 100 [illegible] the theories of the agency of water and calorie in disolving elevating the [???ing] the ultimate elements of with [illegible] the [illegible] matter) [illegible] or ague and fever is [illegible] which is characterized [illegible] [???ct] intermissions or pain [illegible] febrile symptoms,, [illegible] able to discover any [illegible] [??gant] time as was [illegible] verbal displays, which has [illegible] nosologists to affix a name [illegible] a little to every symptom [illegible] otherwise that might [illegible] accompany this form of fever [illegible] ourlves, with the interduc- [illegible] that are the most common [illegible] natural periodicity; such as [illegible] tertian quartan and their [illegible] into double trible and [illegible] and this divison even so far [illegible] alment is concurnece, for consider [??plance], since in whatever form it [illegible] appear its nature is the same, and the [illegible] treatment, with but slight all difientirn [illegible] ever be the same also,) We consider [???ers] at intermittent in character, which [??ally] coal off between each paroxysm [illegible] preceded by chill or not or [cross out] [illegible] chill and fever rise together [??s] a paroxysm of fever of this time continues not more than are four or two returning after a [cross out] lapse of about twenty four or forty eight hours without an intermission, and again, sometimes run on for three or four days but whenever a paroxysm continues for two or three days and then goes off entirely it is not apt to return 101 the most [commen??]/[???tel] of intermittents [h???] [illegible] chill or shake every day [illegible] every other day, or every [illegible] and if allowed by [illegible] two to ten or twenty [illegible] A large portion of [illegible] united states, [par??] [illegible] the intermittent [char???] [illegible] in the southern and [illegible] Symptoms, The symptoms or ague and [illegible] similar; to than of other [illegible] in the onset of the diseases [illegible] generally several day [illegible] or premonitory indicating [illegible] the attact unless in case [illegible] the attact usually commences [illegible] of lassitude and weakness [illegible] and stutering: quickly followed [illegible] rigors, and trembling; then [co??] [illegible] and lividily of the extremities [illegible] respiration anxity nausea, [illegible] vomiting, pulse frequent small [illegible] though sometimes more 'staw, [illegible] the skin generally sensibly [con???] and of a more or less livid pale and scanty,) these symptom [illegible] the first or cold stage, which often [illegible] for a longer or shorter time, is [suc???] by a heat, or redness of the skin particularly of the face, the respiration becomes fuller and stronger, these still great, with more of less pain of the head back and the limbs, this stage is again succeeded by the third or sweating stage when a remission of all 102 the symptoms takes place untill a [m??] abaundant perspiration [illegible] with an increase [illegible] and objections from [illegible] intermittent is justly consider [illegible] fever, and when rightly [illegible] [???cement] or before [illegible] many days is usually the [illegible] form of fever that we [illegible] with but when neglected [illegible] run its course for a [illegible] of formidable diseases [illegible] follow; in its train [illegible] [???nients] and enlargements [illegible] pancreas and liver attended [illegible] indigestions, and not unfrequent [illegible] [???ay] watery effusions of dropsies [illegible] [??en] and of the whole body,, [illegible] intermittent form of fever occupies [illegible] wider range than the medical [illegible] the populace have as yet been [illegible] of) This type of disease do we [illegible] the many anomalous cases of [??ical] pains in various parts of the [illegible] attended with more or less of [crossed out] [illegible] symptoms such as sore pain [illegible] very nearing muscular and [neur???] affection, of the limbs and other [illegible] of the body) Treatment,, Bleeding,, This remedy has at no period in the history of medicine found many [crossed out] advocates in the treatment of intermittents yet it has occasonally found favour with particular individuals, Dr. Rush, for example reports favourably of its use, and we are not sure, but that there are even at this 103 Time some individual practitioners who are [illegible] of this remedy) The can [illegible] of but a very few cases or [situa???] [illegible] it would be admissable [illegible] cases are when the [illegible] send plethoric individual [illegible] subjects as have a [constit??] [illegible] to particular congesting every [illegible] such as disposition to [illegible] congestion, of the lungs [illegible] we have thought it would be a [illegible] practice to abstract [crossed out] just [illegible] and no more as to take off [illegible] [????tion] in vascular system [illegible] be certainaly done by one [illegible] bleedings and then proceed to [illegible] with the proper doses of Tonics (Emetics and Cathatics) For these classes of remedies [illegible] find but little use in the [illegible] intermittents) should spontaneous [illegible] occur then we cause no necessity [illegible] tion of emetic forth stomach [?mp??] and when there is no sick stomach nor [illegible] are still unable to see any good reason [illegible] such symptoms) But whenever paroxysm occurs on a stomach overloaded with [illegible] a puking ensues There from, then is is [a???] The organ to empty itself before we attempt [illegible] compase it,) Tried to the use of cathartics we are well aware that some of the banned profession of the schools have strongly advocated and placed great reliance on them under a belief, that the disease was caused by a congestion in the liver and that the use on 104 [???stice] cathartics constituted the [illegible] [???ing] that viscus) bid [illegible] [illegible] [??ady] succeeded in [illegible] [???der] of the falacy of [illegible] principal inducement [illegible] the use of an aperient [illegible] the patient of constipation [illegible] of things exist for we [illegible] the proper treatment the [illegible] should be left or kept [illegible] the normal or healthy condition [illegible] in cases of looseness of [illegible] use small cases of laudanum [illegible] six [cross out] eight or ten drops of [illegible] six or eight hours until [illegible] an equivalent of paregorie, but [illegible] sick stomach or vomiting then use [illegible] peppermints or some other cordial) [illegible] we conceive necessary to be done [illegible] question) simply to abate the four [illegible] [??tiny] remedies) during the [illegible] For this purpose we have found [illegible] quinine, every two hours both way [illegible] regularly administered through [illegible] and by this course, the author has [illegible] [???ed] to releive, his patients in the course [illegible] three days) We have aided its [illegible] the skin, during the hot stage [illegible] of warm diaphoretic teas such [illegible] Virginia snake root, to which [illegible] added a little red pepper, or [??tinus] the alkaline salts) So soon as general perspiration in excited or the fibrile symptoms, are caused to abate than discontinue the use of the sudorifics and continue that of the tonic alone) it's this form of fever the patient is more liable to relapse, than in any other 109 When once the disease [illegible] he warned do well to take two or three [illegible] of quinine, a day united his strength complexion is restored) We have been [illegible] than suprise) at the very liberal, not to [illegible] uses that some of our [illegible] and even made of the [illegible] He born from the medical [illegible] that the sulphate of quinine has [illegible] in from fifty to one hundred grain [illegible] with a view to remove [illegible] spleen &c, for the cure of [intermi?], We consider this a [illegible] [illegible] of [illegible] of the best remedial agents [illegible] profession, We are at a loss to [illegible] On what grounds such [illegible] justified in any kind of cases, It reminds us of the [c???mours] [illegible] mass, and of calomel, that [w??] administered in many cases, and in many [p???] there united states, during the [illegible] of the Asiatic cholera,, Dr [?brite] [illegible] of 4320 grains of Calomel being given twenty four hours to one patient and the recommended [illegible] to be [???p??] in the next twenty four hours of cholera, Eberle's practice [p???] In a letter from Lewis to [prop???] [illegible] of Philadelphia dated Paris, character following interesting statement is [illegible] At the hospital of De La Petie, I [ha??] the sulphate of quinine uses in a wholesale manner, for the treatment of [inter???] fevers, supposed to be caused and dependent on the enlargement of the spleen. The doctrine is held that the fever cannot exist without the enlargement and derangement 106 of this [???s]) His theory has many disciples [illegible]) To relieve this state of things [illegible] to one hundred [illegible] given, and with [illegible] I have often very satisfed [illegible] and marked it [illegible] the administration of the [illegible] doses and in twenty [illegible] administration I have seen this organ very perceivably reduced in its whole circumstance, and the [illegible] or pattiated in an [illegible] short line) [illegible] wisdom to be drawn from [illegible] practice, yet to establish there very [illegible] first, the safty and [illegible] quinine, secondly a deobstruent [illegible] that drug, thirdly, that such is the [illegible] happy construction of the animal [illegible] that life is not necessarily the [illegible] not practice,, The immunity [illegible] in such cases, we would [???pt] to account for, on the supposition [illegible] force of the drug could not [illegible] once be brought into action on the [illegible] structure and in this the most [illegible] view that we can take of the [illegible] would seem (to say the least of [illegible] of economy, in the use of the [illegible] Chapter 7 Of Common Billious or Billious Remittent Fever From what has been already said of the unity of fever in Chapter 4th 107 the readers mind must be [illegible] prepared to receive the [??pertion] now sustained by [illegible] [illegible] [illegible] med practitioners, that all fevers are more or less liable to [illegible] according to the influence of [ex???] causes and the [susceptibilities] and imprissebilities of individual [illegible] that that observation, has [illegible] the fact, that intermittents [illegible] inflamatory, billious, [ci??] typhus, and malignant yellow fever have all in many instances [illegible] each, so also have [m??] in the [illegible] locality, and at the same time, the [s???] season different [individuals] the subjects of all the [???sities] of [illegible] example, one patient has intermitted another remittent, a third [illegible] a fourth typhus, and so on with the endless subdivisions, which [illegible] generally, [compression] [illegible] [cross out] is through [cross out] [cross out] From these remarks it will be readly inferred that fevers are almost infinite in the varieties of [shades] [illegible] which they assume= It is through the instrumentality of these truths that the world has been kept so long in the dark, by the wonderful fascinations of [illegible] (the magic of words:) while fever has [ever] been a unit, one and the same phenomenon from the days of Hippocrates, or even of Adam, down to the present time; with, in truth, but slight appreciable changes or shades of difference, to correspond with the development of humanity, man has created for it as many names, tittles and dress, as would fill the wardrobe of a modern city dandy- The doctors and dandies have both been laboring, to the maximum of their wits, but with this marked difference in the moving 108 spirit of their toils the one has even beer laboring to discover the truth while the other is laboring to discover the best mode to conceal it Now, this state of things has originated from the limited and banded nature of the human mind, which has ever compelled him first to toil to develope and to propagate isolated elements of truth, as a step preparatory to the ultimate explanation of the whole; since the harmony of these elements can only be seen by him who comprehends each and every individual atom or element of truth,, We come now to the consideration of that part of our theme which we have thought fit, to call the second link in the general chain of fever, viz: summer or autumnal fever There has been about as many names given to this link, in the chain as there have been modes of practice prescribed for its cure- It has been called bilious, malignant bilious &c Of late years we have seen it crowned with a new title, the congestive fever, or the congestive bilious or congestive intermittent, as though it were a new disease- The term congestive, used as a discriminating symptom, as though it did not belong to all other fevers for we cannot conceive of any fever without more or less congestion somewhere; the only difference then that we can perceive is that this particular feature is more marked, more prominent, than usual, for the disease all the time is the same old acquanitance, we recollect often times have not with on the lowlands of Maryland and Virginia, in the days of our boyhood The doctors then called it malignant intermittent This form of fever is most prevalent in the marshy situations of warm countries, and in the warm summer and autumnal seasons of all countries,, Like other fevers it is usually preceeded by more or less of premonitory symptoms such as are common to other fevers, The attact is usual announced by chilly sensations 109 more or less distinct of a longer or shorter duration sometimes [???ding] to an ague; these symptoms are suceeded by the ordinary symptoms of hurried inspiration pulse fretful and quick for the most part full and soft: pain of the head back and limbs a general restlessness nausea and sometimes a vomitting of bilious matter: this is sometimes quite an obstinate and distressing symptom The skin now becomes hot and dry the their considerable the patient usually desiring drink more than the stomach can bear)) Those symptoms remit or abate [illegible] twenty four hours, sometimes twice, but never go entirely off before a fresh attact ensues, so that the patient, is now without some fever, the remissions usually occur during the latter part of the night, or the early part of the day,, In the unbiased or natural order of things, this form of fever usually runs its course in ten or fifteen days,, but as we have said, we never have yet been able to satisfy, ourselves of the [illegible] of critical days in fever proper and are forced to believe, that his projections has arision from observance of such a law in the exanthemata, of eruptive fever such as most small pox and the like,, since this form of fever is most common, and from the the extended theatre of its action interesting a larger portion of our population than then other forms- being common not only to country situation in all climes, but also to cities, and to Towns, assailing all ages and all sexes- but we have thought proper for these reasons, to dwell more upon this than any other link in the chain)) causes It is partly produced from [o??arsh] 110 Exhalations, or from breathing an atmosphere impregnated with the exhalations arising from the decaying remains of vegetable and animal substances, and partly from the debilitating influences of excessive fatigue of any kind, the relaxing and debilitating effects of a meager or unwholesome diet, and partly from the relaxing influence of continued heat on our systems, and partly also from the sudden transitions of temperature,, hence, it is that this fever is more common and more fatal as we approach hot climates and low situations, and most prevalent in the hottest season of all climates,, This remitting or continued form of fever as you may please to call it, though the most common, is the least dangerous- or in other words, the most manageable, form of all the fevers except that of ague and fever, there are occasional cases and even occasional, seasons in which it assumes a violent or malignant, character from the commencement or cases and seasons, in which under our best effect, the disease is apt, to run into a low and dangerous grade,,) But the cause of these things being for the most part comprehended and more or less under our Controle might be obviated in due time to save the lives of the sufferers- To explain, the fatal tendencies in the most cases arising from malpractice of remedial [illegible] neglect neglect an error in diet, crowding the sick too much together, or the sick and well together, neglect of proper cleanliness [illegible] the want of a free circulation of wholesome air, and a proper attention to the release of the patient, sleep being as necessary for the well being of the sick as his food or his physic, since fever of all kind and grades, have been known to take life and are always attended with more or less danger they should 111 ever be promptly attended to and if possible fully managed for many cases that should yield under two or three days judicious management in the [???tic] disease something becoming manageable after [illegible] of that [illegible] [???naw] the [illegible] We are well aware of the fact that the fever of different seasons from the peculiar [illegible] defying influences of the producing causes, assume different types and different [??endi??] that is, that in some seasons the congestion or engorgement of the varied organs [neces???] the offspring of the febrile action, are more apt to result, in local congestions [illegible] other seasons, they are more prone to degenerate, into vitiations [p???] [illegible] in the secretions and ultimately to [illegible] in gangrene, or mortification [illegible] witness! in some fatal causes fevers Blood letting The propriety of abstract [illegible] judges of from the type of [illegible] the age and constitution [illegible] and the symptoms [illegible] For example when cases occur in young [illegible] subjects and the symptoms indicate such local [illegible] with a full free and active circulation [illegible] expect to practice one or two moderate [illegible] advantage; say Take just blood enough to [illegible] excess of toutione from the pulse) This we [ha??] [illegible] can be achieve by the lass of about three [illegible] more, of blood at a bleeding and should be [illegible] practice in the course of the first Two or three days from the attack; The use of this remedy we have confined to particular types, and particular discriptions of cases, If the general bleeding have 112 have been neglected at their proper [illegible] as if after having been [illegible] put in practice some local pain continues still [?aslress] the patient we should then seek further relief by the use of cups or blisters applied to the parts most affected as the judgement of the operator or practitioner the [ca??ects]) (Emetics Next to consider) In the early stages, and more especially in the onset, or forming stages of the fever, have we occasonally succeeded in cutting short, the disease by the use as simple emetic of ipecacuanha, is tarter emetic, antimonial wine, [illegible] be any choice, in the case, followed by the prompt, and [f???] of suitable diluent and diaphoretic drink, such as flax seed sage chamomile, or black snake root, Tea) We ascribe the efficacy of emetics in such cases more to the concusion or revolutionizing effects on the system whereby the circulation of the blood, and consequent equilibrium of animal [illegible] of the secection of the skin, [illegible] is effected, than to the [illegible] evacuation of any matter that may take [illegible] In most cases, it is best [illegible] of the action of the emetic by such auxiliaries as will unlock the pores of the skin and thereby mitigate the violence of the fever such as above cited but in those cases where we learn that the patient is in a state of greater or less constipation of the bowel, then we should endeavor to make a gentle impression on the bowels, by the use of little epsom salts and gruel the senna tea; Taking care at all, times, to guard against so great or so hurried an action of these organs as to produce much sensible debility in the patient; In the use of emetics as in every other step in the treatment, we should always look well to all the circumstances of the case not use them where peculiarity or 113 Idiosyncracy would forbid or when the delicacy of the constitution or the already irritated condition of the stomach would oppose it Cathartics Next in order While we stand opposed to the practice of attempting the care of bilious fever by the exclusive use of cathartics all are still willing to admit the fact that such thing have been repeatedly done,, But we do contend for the practicability of accomplishing the same thing by a less distressing, less debilitating and [illegible] them equally safe and short route,, In the early stages of the disease, we approve the use of one or two mercurial cathartics; especially if the stomach be too irritable to bear the administration of more bulky cathartic drugs. In those cases we recommend eight or ten grains of calomel with a half grain opium, or its equivalent in laudanum or paregoric or an equivalent of blue mass, in lieu of the calomel should the patient prefer it [cross out] [cross out] [cross out] [cross out] Such doses should or should not be repeated according to the exigencies of the case [illegible] or doses fail to operate in due time [illegible] with a dose of some more common [illegible] such as epsom salts, castor oil, [illegible] as such like) So soon as we shall [illegible] in evacuating the stomach and [illegible] the patient in a situation to [illegible] on the use of another class of remedies, vis, the use of [illegible] and sudorifics= The fact, the either, [illegible] had much experience in the treatment of that [illegible] of fever case not hesitate, to commence the Treatment by the immediate use of quinine, aided by sensible diaphoretics, at any stage and without preparatory depletion 114 the extended safe and the salutary response from those who have use the authors, gold pills throughout the southern and western states of this union, in all form and small stages, go to the facts repeated] from his own experience) Now Tonics and diaphoretics, Our objectives to depending on the depletive practice for the [illegible] billous fevers by repeated [illegible] purgings are first because we consider such practices contrary to an inverting the order [illegible] secondly if experience has taught [illegible] purges, when used in health [illegible] the individual, and bring on the necessary [illegible] [illegible] disease [illegible] drink, should, then be [illegible] [illegible] that these effects to a [illegible] [illegible] ensue on the use of [illegible] in a diseased conditions [illegible] the [illegible] [illegible] already great from [illegible] condition, to be still increased by the [illegible] irritation of the mucous membrane of the [illegible] [illegible] a consequence of the [illegible] [illegible] of the fluid elements [illegible] with this view of the subject, the [??one] of cure would seem to us to be [illegible] [illegible] to the circulation, reinstate [illegible] support the enfeebled system [illegible] morbid irritation,, [illegible] accomplishment of these desirable [illegible] [illegible] found the judicious and united [???tonics] a new diaphoretic remedies aided [illegible] [illegible] and properly combined opiate [???ing] in efficacy all other means,, [??ing] already stated the time increase and circumstances, under which we conceive bleeding puking or purging or any one or more of these remedies necessary, at the 120 discretion of the practitioner or attendant we will now proceed to say before the reader in as plain and simple terms as possible and a special plan of treatment We proceed at [once] with the administration of one grain of quinine every two hours, regardless of fever [regularly] by day and by night, after however the ceases with some suitable diaphoretic such as the vegetable sweating teas the virginia snake root, balm sage, or the like the sweet spirit of nitre, the supper carbonate of potash or soda, or a animal the alkalies with [some] one of the vegetable teas) These drinks [may] be used either warm or cold, as the [patient] appetite may prefer, watching the effect, of the diaphoretics and so regulate the [illegible] their repetitions, as to proceed a slight but general action on the skin, [illegible] [illegible] maintain such motion without running to any excess, Hence as should suspend the use of sudorifics whenever there was any [illegible] of excessive, perspiration, while we continued that of the tonics,, This course of treatment should be continued untill [illegible] crisis on a marked [auidi??] [illegible] [illegible] But it not unfrequently happens, [illegible] some unpleasant symptoms, in [illegible] with the state of the stomach and [illegible] occurs to interrupt the progress [illegible] [illegible] as intended course of treatment [so??] continuance of or a return of sick [illegible] and vomiting- symptoms constituting what the learned writers have been pleased to call a gastric fever, in such cases we [illegible] endeavour in the first place to correct or allay such morbid irritation before we can expect to obtain the benefits of the strictly febrifuge remedies,, continuing however; 116 the use of the quinine whenever the stomach will retain it This will be most effectually done by one or the other of following [desst?], should the patient be troubled the [illegible] sense of heat in the stomach with the casting of bilious or acid matter there administer what is called a saline mixture or effervescing draught a fallacy,, Take of saleratus, bicarbonate potash, a common salt to tartar have an ordinary tea-spoonful-fresh lemon juice or vinegar a moderate size tablespoonful,, Put the lemon juice or vinegar into a wine glass and fill it with water, then add, that saleratus, or bicarbonate of potash made fine, to immediately [illegible] or dress in the state of effervescence or foaming,, This dose may be repeated as often as necessary, to compose the stomach,, Should we fail by the case- to obtain the desired relief, Than we might make use of any one of the following remedies, such as essence of pepermint the aromatic spirits of parts from the compound spirits of lavender a few drops of the spirits of turpentine, taken in a little cold water, or on a lump of sugar, or an opiate portion of Morphine opium Laudanum or paregoric,, of these remedies we have the opiates most uniformly [cross out] successful, In all cases of irritation of the stomach more or less benefit maybe expected from exturnal applications such warm applications either wet or dry mustard, plasters blisters, cupping or leaching In some instances the irritation of the stomach is kept up or rendered more abstinate from a torpid or inactive State of the bowels,, in such cases we should not fast to make some impression on the bowels either by the 117 use of suitable aperients or by repeated use of injections,, If on the other hand, we should have to continue with a wasting from excessive looseness of the bowels then we restrain such evacuations by the use of small doses of Dover's powders paregoric compound spirits of lavender, tincture of kino are infusion of the root of dewberry or of the common blackberry or some other suitable astringent combind or not with a few drops of laudanum as the present or absence of pain might, indicate, In all stages of disease and under all circumstance of cases the practitioner should never lose sight of the utility and even importance of any minor consideration of comfort or of case, to the patient such as occasionally bathing the feet, especially at night in warm water, the application of cold cloths or cloths satuated with cold water and vinegar to the head while there is much excess of heat, and pain or occasionally springing for the same purpose, But this mode of palliating distress should be practiced, with caution and with judgement, for cold application are made in any part of the body at or about the [illegible] of the decline of fever or when the patient is [illegible] feeble, these unpleasant weaknesses restless and sometimes chilly sensations are the immediate consequences,, We should at all Times allow a reasonable indulgence in light and easy to digest food; when called for by the natural-sensation of the stomach Never officiously press the patient that which he dose not desire or more or even quite as much as he may desire to should pay some regard to the accustomed habits of individuals about taking nourishment as to point of time 118 administering our medicines so as to interfere a little as possible with the acustomed period of eating and sleeping,,, In this the reader will not fail to observe an [illegible] of an practice over that if the irritating piece of using emetics and cathartics, which are not only irritating to the digestive organ, exausting to the patient but at the same cutting off supply of the continually, require new element of life another very important requisite to the sick is that they be not molested by unnecessary conversation or even the presents of unnecessary company= carefully remove all among and of either sight or sound,,, give to them all proper opportunity of receiving the refreshing benefits of sleep,, and case of a loss of sleep from disease, or morbid vigilance or the annoyance a pain do not hesitate to procure natural rest by the use of a few drops of laudanum particular at sight, say twenty or twenty five drops,, the strength of the patient, the condition of the tongue, skin and of the pulse will ever in our surest and best guides as to the indications in the administerations of the remedies,,, The Tongue usually covered with a white coat, in the commencement of fever, with the progress of symptoms be comes yellow then brown, and sometimes dark brown, [??d] dry it sometimes sheds a first coat and then becomes red black and glossy, and in extreme cases becomes dry, and crack from a deficiancy of its natural secretion,,, [illegible] then unfavorable symptoms continue to manifest, themselves on the tongue a corresponding want of healthy action exists on the surface of the whole body the skin continuing for most part hot and dry as in a later or tenser stage becoming covered 119 with a more or profuse sticky and clammy perspirable matter with extremities frequently to cool. the pulse during the time becoming weaker with the decline of strength While in pregnancy is apt to be increased, whenever in the progressive course of a fever the attendant observes that the patient is declinig that is that he is sinking to a still lower grade in spite of the use of the quinine and the ordinary diaphoretics whether delirium exists or not the author has found great benefit result from the use of from three to five grains of camphor in union with a quarter of a grain of opium or six or eight drops of laudanum to be taken once in every six or eight hours in lieu of the other diaphoretic remedies already recommended adhering, however still to the regular use of the quinine and giving a moderate portion of toddy milk toddy or wine[illegible] every two or three hours,, Delirium,,, under our general view of fevers, we have already given some account of this symptoms as an occasional attendent on fevers,, It now becomes necessary to speak of it in particular form of fever with a view to the most appropriate mode of combatting it,, We have already conveyed the idea that [illegible] which arrest, the fever, arrest its individual manifestations or symptoms,, But this symptom has been shown to be partly the affect of [illegible] fever proper, and partly the result of a patient's organization, or particular temperment when it occurs in the first stage it is to be relieved as already directed in the first stage of fever and on the same general principle When this symptom, occurs in the later stage of the fever then we have found relief from the use of blisters to the back of the neck and the use of opiates while in all other respects 120 we continue to treat the case as though no such symptom has occured,,,, Deliarium varid and aggravated in its manifestations, and one in which little or no conciousness exits not unfrequently occurs at a later or in the last stage of the fever,,, Here is the result of prostration and irritation then the indications will be to sustain the vital energies and to [illegible] its irritations,, these indications can be best fulfilled by the use of suitable nourishment tonics, opiates, blisters, and lastly stimulants or nourishment, in the form of stimulating drinks such as wine whey milk toddy panada malt liquors and the like,, There is still another symptom which not infrequently occurs in this form of fever, that is internal irritation with or without more or less of wasting discharges from the [illegible] When such irritation exists without evacuation that is, when the natural evacuations are retained, then we should procure the necessary and healthy evacuations by the use of laxatives, or in case of such weakness by injections, alone,, But if on the other hand the patient is wasting from too frequent or too plentiful discharges There we should endeavor to correct such a state of things, by the use of small and repeated doses of opiates and astringents, such as small doses of laudanum paregoric tincture of kino or any of the vegetable astringent teas [illegible] there [cross out] cases of local distress in the bowels, we find warm application or application of mustard so used as to stimulate without blistering valuable agent In proportion, to the exaustion or depression of the patient is the liability to witching of of the muscles a kind of feeble spasmodic action What the medical writers called 121 sub suttus tendinum,, This symptom is the mere consequence of extreme weakness and we here draw the attention of the reader to the fact, that he may the more fully see the importance of sustaining his patient in this situation by all of this means in his power,, While we steadily aim to sustain we should be careful not to [co??] not, [st??] although a very dangerous symptom is not necessarily a dangerous case We have occasionally witnessed cases in which the patient passed no urine for eight or ten days, and still suffered no pain or inconvenience from it, in such cases the secretions are suspended or the absorbent and exhalants, take on an unusual and increased action- Involuntary discharges by stool or urine occasionally occur in low and protracted cases of fever, and although it is a dangrous symptom or circumstance it dose not necessarily follow that the case must prove fatal- Let your patient then just so much of the varied, stimuli that sustain life, as the judgement of the practitioners or attendant the organization in it pregnant state can manage, or requires and no more and careful so to time the repetition of your doses as to meet the continually [illegible] wants of the system- In case of coldness of the extremities we should maintain the natural heat by warm applications or the stimulus of mustard so used as to heat without blistering These remarks, applicable to the last stages of disease will be found equally applicable to all stages- 121 Before closing the present chapter we deem it proper to make some general remarks as and additional guide to whoever may attempt to put in execution our views to wit- They should ever bear in mind the healthy [?g?] [illegible] the healthy needs of the system, and let the object of every step, the use of every agent be to assist either directly or indirectly in bringing back [???inde] every organ of life to the discharge of its healthy function [illegible] all cases, which the sick are able and competent to give us clear and satisfactory responses as to their want [d??es] and sensations, we should never fail patiently to collect such information and apply it to the benefits of the patient and in case of mental alienation or such torpor of mind as cuts off the aid of the sufferer in explaining himself, then exercise your ouwn judgment on all such other lights, as may be brought before you-,,, [illegible] more full and explicit in the detail of [illegible] their applications, to particular symptoms, [illegible] any other chapters for reason already [illegible] we have thought it proper, hare, to remark, that [illegible] [???tions] with application of remedies to [illegible] symptoms, contained in this chapter [illegible] [??tted] in other chapters may with [illegible] be applied to the treatment of like [illegible] of system occurring in other fevers [illegible] the doses and modes of administering all the remedies recommended in this chapter. The [illegible] see in the last chapter, in This Work,, viii/,, 122 The authors Treatment on Cholera Infantum, The Author considers cholera Infantum as a species of fever peculiar to children say from six Months too two or three years old,, This he infers from the fact that children this age are seldom the Subjects of either bilious or typhus fevers, but are subject to ague and fever, and from the additional fact that cholera Infantum is much more common in the summer and fall months, and in sickly seasons-- When grown persons, suffer most from bilious affections The reasons for the occurrence of cholera Infantum in lieu of bilious fever, would to be the peculiar irritability of the stomach, and bowels of children at this period of life, being at this age more liable to take on unhealthy action, under any circumstance than at any other period of [illegible] affection of stomach and bowels, which take care in the winter months being usually slight, & of short duration [??it] those of the hot seasons are more protracted [illegible] serious in their nature, proving sometimes fatal in a short period, while in other cases they are protracted for many weeks, and even months untill the little suffers are reduced to mere living skeletons The puking and purging in cholera Infantum [illegible] some analogy to the cholera morbus of adults, but is not often so violent, so rapid in its progress or so fatal in its tendencies, although for the diseases [illegible] from the same or similar causes,, [illegible] infantum something the vomiting continues without purging but most generally the purging continues without vomiting, and it is not uncommon both symptoms to subside for six eight or ten days with every appearance of a speedy recovery and then return or relapse again after the manner of an [cross out] intermittent fevers As in other fevers the violence and the danger of the attack is proportioned to the circumstances of causation and the constitutions of the subjects hence its greater prevalence and greater 123 [illegible] fatality in [cross out] cities Towns and in [warm] climates, than in county situations and in more [salub??] [illegible],, In cholera Infantum as in other fevers and as in other [cases] of irritation of the stomach and [illegible] the sense of thirst is distroying [q???] the patient at as [d??ining] more [dim??] from the stomach [??ak] digest,, In the early [illegible] the disease the fevers [sometimes] considerable, the skin is [illegible] [illegible] in other fevers, the continued watery [illegible] [illegible] seem to suppress the natural [illegible] and moisture of the skin.) Towards the close of the disease, and when the patient is much [illegible] [illegible] are apt to be cold,, the [illegible] apt to be covered with a white fur and [illegible] [illegible]) It sometimes becomes [illegible] [illegible] it assumes a dark or [illegible] [illegible] as is more apt to prove fatal, [illegible] [illegible] Treatment) [illegible] [illegible] an attact, we deem it [illegible] see or the spontaneous evacuations to present [illegible], untill the stomach and [illegible] [emptied] themselves of their common [illegible] [such] generally accomplished in [illegible] [???ers],, something in a shorter [illegible] should proceed to allay the [illegible] stomach and bowels by means of [illegible] applied over the stomach so [illegible] blistering and the internal [illegible] [illegible] of small doses of paregoric essence [illegible] [illegible] laudanum or any greatful [illegible] should with the vomiting or purging [illegible] [???ss] than weeks such discharges, by the [illegible] of some astringent, that is should an [illegible] [illegible] of the bowels require it,) [illegible] unfrequently since then, pale and water discharges a very obstinate symptom,) In such cases in addition to translating the irritation the skins [illegible] plasters we have found it necessary to use 124 [??f??ted] [illegible] [illegible] such [illegible] the [illegible] [illegible] [illegible] [illegible] This [illegible] as [illegible] it may [illegible] [tak??] in toddy [illegible] [illegible] in [la??] if the [illegible] [illegible] [illegible] [illegible] [illegible] of [admi?t] [ag??] [illegible] [?ase?] able [illegible] again [illegible] [illegible] seldom intances, [ag??] [illegible] [illegible] prohibits the administration [illegible] [illegible] [illegible] [illegible] and bowels and [illegible] [illegible] a little starch and [laud??] [illegible] The teething process being [illegible] [illegible] mutch to the increased [illegible] [illegible] and whenever any tooth or both [illegible] [illegible] so as to be masked success of [illegible] [illegible] of a pen knife should [illegible] [illegible] so as to divide the natural [illegible] [illegible] tooth). The coldness the [extre??] [illegible] an attendant, should be [illegible] [illegible] covering or occasional friction [illegible] [illegible] on the skin,) If the patient [illegible] recover after using, the [forc??] [illegible] a few days, but continues to be [illegible] [illegible] suffering from a feverish state, or [illegible] exhausted, then [ca???nce] [illegible] [illegible] or tonics, such as quine peruvian [illegible] suitable Tonic, and repeat at [illegible] [illegible] hours, untill there is solution [illegible] [illegible] action- a complete crises) [she??] [illegible] between doses two or doses [illegible] its use in this way untill the little [illegible] [illegible] reinstated in health and strength- During the contiunance of the warmer season- children are very liable to relapses,) This [illegible] effectually guarded against by seeing a [purerat??] attention to cleanliness diet and exercise) 125 [illegible] [illegible] [??tion] [illegible] and [illegible] [illegible] [illegible] [illegible] and [illegible] [illegible] [???a] the [illegible] [illegible][illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [dis???] [illegible] [illegible] [illegible] [??a?i??] [illegible] [illegible] [???ag?]) [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] in the on [illegible] [illegible] [??ed] and [illegible] [illegible] teeth was natural [illegible] [illegible] growth of bones [illegible] [illegible] are produce) [illegible] [illegible] processes, if so [wh??] [illegible] [illegible] disease) [illegible] [illegible] would seem to us to be [illegible] [illegible] [??is], the other [illegible] [illegible] the [illegible] the makes its exit [illegible] [illegible] lasts but a few days, while [illegible] [illegible] liable to continue during the [illegible] [illegible] the opposition will say [illegible] [illegible] [??ies] too,) To this we reply [illegible] [illegible], dose not commence the [th?] winter season, or [?ven] run into the winter, months [illegible] [illegible] teething process is still going on, [illegible] [illegible] changes of, the seasons moreover [illegible] [illegible] children who get their teeth without [illegible] [illegible] [???laint] or indisposition of any [illegible] [??ular] those who pass through the [illegible] process while very young) again we hear [illegible] [??laint] about the stomach and bowels [??lant] in the sheding of teeth when there is not [illegible] a need growth, in process but the additional [illegible] of casting off the Hot ones) He readily admit the greater liability of children to disease and to [illegible] during the first two years of existence 126 than at an [illegible] [illegible] of time for the [illegible] [illegible] [??hi?] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [P???] as to the [illegible] [illegible] frequently to exist [illegible] [illegible] a [H???] [illegible] [illegible] sound and rigorous [illegible] [illegible] the [illegible] origin or [mad??] [illegible] [illegible] of [illegible], it is a matter [illegible] [illegible] The weight of [fest??] in [illegible] [illegible] favor of the idea [of??] [illegible] [illegible] in the human intesting, [illegible] [illegible] of life most, [illegible] such [illegible] would seem to be [??u??], [illegible] [illegible] more especially the use [o???] [illegible] indigestible food, [illegible] [illegible] that may tend to derang the [illegible] [illegible] digestion or of [asimil??] [th?] [illegible] view of the subject we are [illegible] that the existence of [illegible] [illegible] a result, than a cause disease) [illegible] when they have been generated [illegible] [illegible] when they exist, in great [munk??] that they then became an additional cause of [illegible] and ciation and of febrile disease [illegible] [illegible] not only so promptly, expelled [illegible] [illegible] suitable vermifuges, but that [illegible] [illegible] should afterwards be placed on the [illegible] of such remedies, as would most [illegible] prevent their return, as generational The symptoms ascribed to, and that [illegible] be attendant on worms in children, are almost as numerous and very much resembling the symptom of many their diseases to which they are subject; 127 [illegible] [illegible] [illegible] [chse??] [illegible] [illegible] from the symptoms [illegible] [illegible] [???ust] be left [illegible] [illegible] [???dant], and [illegible] [illegible] proof of it [illegible] [illegible] the presence of [illegible] [illegible] by variableness of [illegible] [illegible] [???ness] and [illegible] [illegible] the sleep picking of the [illegible] [illegible] of the upper lip, more or less of [illegible] [illegible] disturbance of bowell [illegible] [illegible] about the navel,, febrile [illegible] [illegible] of worms) When [illegible] [illegible] point to the presences [illegible] [illegible] administer, vemifuges [illegible] [illegible] of spigelia or Carolina [illegible] [illegible] two or more grains of Calomel [illegible] [illegible] the patient, Should be [illegible] [illegible] second morning for two doses [illegible] [illegible]; two or three times per day [illegible] [illegible] succession or a few drops of spirits [illegible] [illegible] a little sugar, and water two [illegible] [illegible] per day) Should there exist a costive [illegible] [illegible] while using, the warm Medicine [illegible] [illegible] purges gently with a little senna [illegible] [illegible] or a dose of calomel, provided [illegible] has not been used) in every case of worms [illegible] suceeding in expelling them the patient [illegible] [??ed] on the use of some better tonic [illegible] [illegible] to good health and to good digestion [illegible] suppose we know of nothing perferable [illegible] of suitable doses of quinine, in [illegible] we have reason to believe that it [itself] is itself a good vemifuge vither from its better principles or its tonic effects on the system The Some preparations of iron are also well suited to such cases.) The particulars as to remedies and their doses, the reader will see chap 16 128 Chapter ninth On yellow fever, description, [illegible] classification of fevers, this is the [illegible] and most malignant type of [illegible] disease it is to common [illegible] fever [illegible] plague or [illegible] fever is to typhus [illegible] fever, and much will [illegible] be called the typhoid bilious fever of cities [illegible] since it never appears in [illegible] in hot seasons and in crowded illy ventilated and filthy places, and even [illegible] tropical regions its ranges are checked by the coming on of the cold season of the year it is more violent in its attacks more rapid in its progress and more putressent and fatal in its [illegible] than any other form of bilious fevers Causes The concentrated virus of [illegible] with the exhalations from human [illegible] civic life that is to say, the debilitating [illegible] effects resulting from a violation of organic laws [illegible] by the continued and relaxing influence of [illegible] other words the external causes [illegible] influence of heat, with a peculiar vitiation [illegible] while the internal causes are violations of organic laws) The united effects of these are [illegible] modifying causes are to debilitate, to [illegible] and derange, the functional actions of [illegible] in brain nerves, muscles and all the glandular tissues) Hence, we see such rapid [illegible] secretions to vitiations and [illegible] in the solids, particularly in the stomach and [illegible] is a rapid running into gangrene, and [illegible] as is evinced by the black and putrid matters [illegible] from them, and the speedy triumphs of death and decomposition that we are occasionally called to witness) We are aware that a prejudice exists not only the minds of the populace but of the profession 129 [illegible] [illegible] of the [S???] [illegible] [illegible] [illegible] [illegible] [illegible] quantity [illegible] [illegible] [???ally] [dist??] [illegible] [illegible] [illegible] it [illegible] [illegible] [illegible] or [?iten] [illegible] [illegible] such [rapi?] [illegible] [illegible] jaundice evident [illegible] [illegible] yellow fever which [illegible] [illegible] all seasons is so [illegible] [illegible] or occurs in [illegible] [illegible] it [rea??y] produces [illegible] [illegible] freely [diffus??] [illegible] [illegible] system, the patient in [illegible] [illegible] [??ly] concious of being [illegible] [illegible] color of the skin, Symptoms, The [illegible] [illegible] most particulars like that [illegible] [illegible] ushered in by sensations of [illegible] [illegible] stiffiness or soreness of the [illegible] [illegible] head, back and limbs, generally [illegible] [illegible] degree of chilliness, these [illegible] [illegible] succeded increased pain of the [illegible] [illegible] sinuses, giddiness or dizziness [illegible] [illegible] face, a sense of fulness in the eye [illegible] [illegible] expression of distress in the countinence [illegible] [illegible] suffused, with tears a general [illegible] [illegible] with thirst, either great restlessness [illegible] delirium or a tendency to lethargy [illegible] [illegible] scanty and turbid perspiration [illegible] interrupted and diminished pulse irregular [illegible] [??izs] or too slow full fretful and [illegible] often giving a delusive feeling of [i??ased] force seldom strictly tense,, tongue covered [illegible] a whitish mucous coat great irritability of stomach, with nausea and vomiting of bilious matter usually found, epigastrium Tender 130 [??prepure]) [illegible] [illegible] [illegible] as [illegible] [illegible] first [para???] [illegible] [illegible] [???p] [illegible] [illegible] [illegible] [illegible] yellow [wh??] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??ter] [illegible] [illegible] [illegible] [??ll] the [dis?a??] [illegible] [illegible] [illegible] [??ih] generally [illegible] [illegible] [illegibe] hours, when an [illegible] [illegible] [illegible] times, which such [illegible] [illegible] [illegible] induce the patient [illegible] [illegible] [illegible] of danger. But [illegible] [illegible] [illegible] with an aggravation of symptoms [illegible] [illegible] [illegible] of this error) As the [disea??] [illegible] [illegible] more and more indicative [illegible] [illegible] [illegible] manifest themselves, the patients [illegible] [illegible] to decline, the Skin becomes [illegible] [illegible] and hue,, patches of livid spots [illegible] [illegible] different parts, of the body [de???] [illegible] [illegible] secreations begin to [illegible] [illegible] the tongue becomes dark and [illegible] [illegible] incrusted, with a dark [illegible] [illegible] hickups ensue haemorrages [illegible] [illegible] forth from the mouth, nostrils [illegible] [illegible] foetid and involuntary, discharge [illegible] [illegible] from the bowels, the pulse sinks [illegible] [illegible] closes the scene.) Such are the ordinary [illegible] [illegible] in those cases which [termi??] [illegible] [illegible] In this fever as in all fevers proper [illegible] [illegible] marked critical days the duration of [di???] terminating favorably or otherwise [illegible] [illegible] proportion to the violence of the causes and [illegible] constitutions of the subjects of disease) Being [illegible] malignant, disease it usually runs it [ca??] from two to five or seven days,, recovering from [illegible] protracted beyond this period are for the most part tardy and imperfect the patients suffering [m??] 131 from indgistion the necessary result of injuries [s???] [illegible] [illegible] [illegible] of the [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??pular] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] those who [illegible] [illegible] [??in] [sub??] [illegible] [illegible] of distinguished [illegible] [illegible] [??its] of illustrious [illegible] [illegible] unbiassed love of [illegible] [illegible] we have been forced [illegible] [illegible] a course ( [illegible] [illegible] is the exclusive property [illegible] [illegible] of thought either in [illegible] [illegible] [???ent] of human researcher [illegible] [illegible] [??hed], and that when reached [illegible] [illegible] forced to rest in simple [illegible] [illegible] [illegible] have ventured to raise [illegible] [illegible] [??ition] certanily in accordance [illegible] [illegible] [??ions] predecessors) We shall [illegible] [illegible] plain and simple view in [illegible] [illegible] disease, than any heretofore [illegible] [illegible] too, which we conceive to be [illegible] calculated cauintuact the virus [illegible] [illegible] in accordance with the [illegible] [illegible] life if In consulting the pages of [illegible] [illegible] we find the weight of authority [illegible] [illegible] favour of the depletive practice at least [illegible] of the [cross out] (immortal Rush,) [illegible] [???tal], because to him we are indebted [illegible] measure for the demonstration of its [illegible] origin, to him are we indebted for [illegible] [illegible] clearest lights, on the subject of contagin [illegible] the earliest the freest and the fullest [???ents] in the depletive practice. (When the [illegible] made its appearance in Philadelphia [illegible] Dr Rush seems to have been much at a less [illegible] that course of treatment, he should 132 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] give [illegible] [illegible] [illegible] distressed [illegible] [illegible] in the [???ment] of [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] happened, [illegible] [illegible] [illegible] advice and [illegible] [illegible] [illegible] disease as his [illegible] [illegible] [illegible] Indies, would [n???] [illegible] [illegible] me that he had [illegible] [illegible] [illegible] of all kinds, [illegible] [illegible] found to be hurtful, and that [illegible] [illegible] readily to bark, [illegible] and above [illegible] cold bath (He [ad??ed] the bark to [illegible] large quantities, by way of [illegible] [illegible] usual ways and he informed [illegible] [illegible] the cold bath should be used [illegible] [illegible] benefit from it (The made of [illegible] [illegible] appeared to be reasonable [illegible] [illegible] manner he had recommended it, [illegible] [illegible] sporadic yellow fever, with [illegible] [illegible] I had moreover the authority of [illegible] [illegible] of reputation in its favor) Dr [illegible] [illegible] sometimes gave the bark, when the [illegible] [illegible] vicious humors, these humor,, he says, [illegible] by the fault of the circulation,) The [illegible] [illegible] solids enables them to throw off [illegible] [illegible] excrementitious, fluids by their [illegible] [illegible] I began the use of Dr Strong, remedies [illegible] after my interview with him with [illegible] of their success,, I prescribed back in [fa??] [illegible] one case ordered it to be injected into the [illegible] four hours. (I directed buckets full of cold [illegible] to be thrown frequently upon my patients, ( The [illegible] was offensive to the stomach or rejected by it in every case in which I prescribed it, (The cold bath was greatful and produced relief in several cases 133 [illegible] [illegible] [??l] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??ment] [??und?] [illegible] [illegible] him in the course [illegible] [illegible] opposite extreme,, [illegible] [illegible] [??ely] of free and [illegible] [illegible] are, (One dose was [illegible] [illegible] bowels, but from [illegible] [illegible] [illegible] for that purpose,, [illegible] [illegible] were frequently rejected [illegible] [illegible] and inconvenience from [illegible] [illegible] [??lass] (It was always without [illegible] [illegible] and it served to discharge [illegible] [illegible] the stomach,, (Nor did I rest the [illegible] [illegible] the bowels on the issue of the one [illegible] [illegible] (There is in all bilious fevers, a [illegible] [illegible] life, as fast as it is discharged [illegible] [illegible] every day, while the fever continued [illegible] [illegible] from tartar and rhubarb, [illegible] [illegible] purges, had preformed their office [illegible] [illegible] of my patients, in all these cases [illegible] [illegible] easily moved,, when this was not the case [illegible] [illegible] dose of Calomel and jalap every day [illegible] [illegible] maybe supposed to be it was often [illegible] [illegible] especially after the 20th of September, [illegible] become neon obstinatly constipated of [illegible] place of the jalap I now added gamboge [illegible] [illegible] two grains and a half of each made into pills [illegible] to an adult, every six hours, until they [illegible] four or five stools) on the 133 page ( [illegible] doctor, we have said on abandoning the Tonic [illegible] of treatment, suggested by Dr Stevens, [???ty], [???pon] the opposite extream, (he now not 134 [illegible] practices [illegible] and [illegible] purgings [illegible] [illegible] [illegible] use of the lancet [illegible] [illegible] sage [illegible] in the [illegible] [illegible] thrown was [illegible] [illegible] temperature [illegible] [illegible] [??nd] one [illegible] [illegible] [??due] the [f???] [illegible] [illegible] the diminution [illegible] [illegible] fever put on [illegible] [illegible] diathesis more frequent [illegible] [illegible] I bled many patients [illegible] [illegible] a day,, (I prefered, [illegible] [illegible] bleedings, in the [illegible] [illegible] the hight and class of [illegible] [illegible] -nce, from the loss of a [illegible] [illegible] of blood at a time ([illegible] [illegible] seventy and eighty ounce [illegible] [illegible] a few much larger quantitys, [illegible] [illegible] in front street, last by ten bleeding [illegible] [illegible] blood Mr George a carter, in [illegible] [illegible] same quantity, in five bleedings, [illegible] [illegible] one hundred and fourteen [illegible] [illegible] in the last of the above named [illegible] taken it as determined by weight, ( [illegible] near Dock street, was eight times [illegible] seven days, the quantity taken [fro??] [illegible] hundred ounces.) The blood in all [illegible] and in the last, very sizy, (They [illegible] the month of October, and chiefly [illegible] [illegible] Mr Fisher,, and they were all year, [illegible] [illegible] and healthy instance, of the efficacy [illegible] [illegible] bloodleting, and of the intrepidity, and [illegible] this young Physician (Again [illegible] Vol 2, P.147, Now that we have patientaly [illegible] Doctor through, some of his Transitions of opinon [illegible] witnessed the processes by which he has been [illegible] erarers, we will next call the attention of the reader [illegible] 135 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??set] the [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] stage [illegible] [illegible] [illegible] [ons?untly] [illegible] [illegible] in her stomach [illegible] [illegible] were prescribed [illegible] [illegible] [???ing] of the next [illegible] [illegible] discovered, to me at [illegible] [illegible] which Dr Faulke [illegible] [illegible] which had been [illegible] [illegible] the adjoining Hoch on [illegible] [illegible] with Mr Le Margre's [illegible] [illegible] [???fied], there to the great [illegible] [illegible] [???hood, (After this [illegible] [illegible] trace all the cases of fever [illegible] [illegible] to this cause of diseases ( [illegible] [illegible] a conviction, that the disease [illegible] [illegible] exhalations, from the damage [illegible] [illegible] American daily, advertiser to August [illegible] [illegible] citizens of Philadelphia with a [illegible] [illegible] attention to the spot where the [illegible] [illegible] checking the progress of the [illegible] [illegible] continued by the original caused [illegible] [illegible] when received into the body, were [illegible] [illegible] into action in a few days-(Im with [se??] cases, in which they acted so as to produce a fever [illegible] some day in which they were received into the [illegible] [illegible] I heard of two cases, in which they [illegible] [???ss], fainting and fever with in one hour, [illegible] [???ns] were exposed, (I met with no instant [illegible] [illegible] there was a longer, interval than sixteen [illegible] between their being received into the body, and [??tion] of the disease. This poison acted [illegible] different constitutions according to [illegible] the degree predisposing 136 [illegible] [ar?] the quanity [illegible] [???tin] of [cross out] [illegible] [illegible] [illegible] [illegible] [illegible] that in [illegible] the [pois??] [s??] the [??tmosphere] the [illegible] [??as] excited to [illegible] the [illegible] [illegible] upon the [dys???] [illegible] [illegible] [illegible] [illegible] [illegible] (first great [lat??] [illegible] [illegible] [illegible] [??din] walking [?idiny], [illegible] [illegible] [illegible] Second, ([illegible] from [illegible] [illegible] [illegible] heat of the sun; [illegible] [illegible] [illegible] of the [dis??] Third [int???] in [illegible] [illegible] [T???ion] (Tear ([illegible] [illegible] sudden [par??] of [illegible] [illegible] [illegible] seventh sleep right [illegible] [illegible] all these [illegible] [illegible] [illegible] debilitate, the body [a??] [illegible] [illegible] [illegible] purges, repeated [illegible] [illegible] [illegible] call it by what [nam??] [illegible] [illegible] putrifying, [vegat??], [a??] [illegible] [illegible] damaged [illegible] [illegible] [illegible] be the real cause and [p??] [ha??] [illegible] [illegible] than it most rational to [???t] [illegible] [illegible] infected, with such [p??] [illegible] [illegible] bleeding, and purging to [illegible] [illegible] such poison) But the [oppo??ion] [illegible] [illegible] are the attacks, so rapid the [pr??] [illegible] [illegible] to words a fatal [ex??e], that [les?] efficient [illegible] [illegible] remedies would be of [illegible] [illegible] [illegible] become the subjects of disease [fr??] [illegible] [illegible] exposure, to the infected almosphere, [illegible] [illegible] and frequently become its [vi?ting] in [illegible] [illegible] from the period of the attack, ([illegible] [illegible] The effects of poisons of many kinds and [inter????] upon the animal economy,) We here seen individuals suddenaly into fevers with vomiting into cramps [cons??] syncope or fainting, from breathing for a time [n?p??h] gases, of different kinds, such as whit the [illegible] call damps or damp airs, we have seen individuals [ferati?] 137 divested of all the ordinary signs of life, yet we have never relied in bleeding and purging for the restoration of such [p???] (We have been calld to witness the effects of animal poisons such as the life of spiders and venemous serpents (We have witnessed the rapid [tu??] faction, The sudden inflammended of you [illegible] the [exp??sint] the spasms (heard the oft repeated, cries of pain observed the tears of [illegible], yet still we have not relied on bleeding purging for the relief of such cases, and then vegetable animal, [???al] poisons have [illegible] [illegible] allowed, we have not relied on [illegible] or [???in], remedies, than the case of such [antidet??] known to neutralize or [illegible] [illegible] of the particular poisons taken [illegible] [illegible] chief reliance, upon these measures [illegible] [illegible] (Doctor Rush in the first [illegible] [illegible] [???enc?] of 1793, treated them with the [illegible] [illegible] swelling and purging with calomel [illegible] [illegible] Rush's Works page 41, Vol. 2 [illegible] [illegible] dose not say, but we find him [illegible] [illegible] [???ing], with ipecacuanha bark wine [illegible] [???ally], blankits dipped in warm vinegar [illegible] rubed on the right sides) his works [illegible] [illegible] him asking counsel of Dr Steven's [illegible] [illegible] St Orix, The recommended the [illegible] [cold bath],(This made of treating, The [illegible] [illegible] [???able], to the Dr,, he has use bark in the [illegible] [illegible] several cases of sporadic yellow fever [illegible] years, (In fact the Dr was so will pleased [illegible] [illegible] Stevens, that he proceeded to put his [illegible] [illegible] the very next days (Now to you it may [illegible] [illegible] Rush Should so soon change his opinion [illegible] Dr Stevens, so far as we know and to believe [illegible] (It may be that there is as much in the skill judgement, with which scientific, labors are [??ed], as in the power of intersect in which the truth of [illegible] conceived (In his first experiments with the [ten?] 138 [illegible] stimulating [illegible] [illegible] 123 vol [illegible] [illegible][illegible] seemed [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [???g] [illegible] [illegible] [illegible] [s?pp??] [illegible] [illegible] [illegible] [illegible] the reason [illegible] [illegible] [illegible] he did, [illegible] [illegible] [illegible] [??st?] experiments [illegible] [illegible] without judgement, ([illegible] [illegible] infer, that he [ex??] [illegible] [illegible] second experiments, [illegible] [illegible] [illegible] Dr,,Stevens he failed [illegible] [illegible] [illegible] the clear inference of his [illegible] [illegible] [illegible] paid no attention to the state [illegible] [illegible] [illegible] the consequences (The [?ark] [illegible] [illegible] [illegible] or rejected by it in every case [illegible] [illegible] [illegible] We have been taught to [beli??] [illegible] [illegible] [illegible] understand or not to read at all ([illegible] [illegible] [illegible] patent agent either for good [illegible] [illegible] [illegible] too carelessly, directed, (His [illegible] [illegible] cold water to be thrown frequently [illegible] [illegible] good could any one expect from [illegible] [illegible] [illegible] at most under such vague [instr???] [illegible] [illegible] baffled, in every atempt, to step the [?a??] [illegible] [illegible] took himself to intense study ([illegible] [illegible] [illegible] pored every book,, that treated of [illegible] [illegible] [illegible] overhauled, a manuscript, that had been [illegible] [illegible] by Dr Franklin, a short time before his [illegible] [illegible] [illegible] the aid of Dr Mitchell resulting in leading him [illegible] [illegible] [illegible] to the depletive, particularly the purgative [illegible] [illegible] [illegible] see him enraptured, with the virtues of [cal??][illegible] [illegible] [illegible] of ten and ten, are now, distributed in a wholesale [illegible] [illegible] the city, indeed so great in his confidence in the [illegible] [illegible] that he directed his patients, to be purged every day [illegible] [illegible] His next remedy in the lancet, he bled may patients [t??] [illegible] three times a day, he prefered frequent, and small to large [illegible] [illegible] in the month of September, but towards the height and [illegible] [illegible] 139 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [???tant] with [illegible] [illegible] [illegible] [???b??d] [illegible] [illegible] [??ssition], that, [illegible] [illegible] [illegible] basinss of they [illegible] [illegible] [??eto], to remove [illegible] [illegible] as the circumstances [illegible] [illegible] a assist nature, when [illegible] [illegible] [??ets], but never too officious [illegible] [illegible] nights, (But the Dr,, says [illegible] [illegible] hands, (Took in [illegible] [illegible] expressions like these to [illegible] [illegible] [??ltraism], such individuals [illegible] [illegible] natural law to maintain or [illegible] [illegible] (We have been induced to twice [illegible] [illegible] of yellow fever for the reason [illegible] [illegible] of the [??sudar] prejudices, that have [illegible] [illegible] stand opposed to us, but the names of [illegible] [illegible] in office, individually, whose named [illegible] [illegible] have been received as [illegible] [??tors] in the stage of usefulness [illegible] [illegible] (Dr James Johnson of London, who [illegible] [illegible] [???anc] of the soundest medical Philosopher [illegible] [illegible] [??ssicat] and talented author of Tropical [illegible] Change of Air, and some other works of [illegible] [illegible] as inn the tropical climates, Vol.2 [illegible] [illegible] signature of Archibald. Robertson [illegible] [illegible] Medica (society of Edinburgh as [illegible] [illegible] the [??al] treatment of the epidemic fever I [illegible] [illegible] [???ake,]regarding this disease to be all practical [illegible] [???oses], inflammatory and the affection of the head [illegible] and essential, which is evenced, by headach [??bir] lueis, and red eyes, is how generally an index state of the Brain in the same manner as the tongue is of 140 stomach, I have [illegible] [illegible] [illegible] [???ins] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [s???] [?nd] large [illegible] [illegible] [???a] ([illegible] [illegible] [illegible] the patients [illegible] [illegible] of the [illegible], I have generally [illegible] [illegible] [illegible] [illegible] can be [illegible] [illegible] [illegible] be [tak??] ought [illegible] [illegible] [illegible] [illegible] order to [illegible] [illegible] and induce a [sp??] [illegible] [illegible] that it is not only, by [illegible] [illegible] [s??] I cannot [exp??] it in [philoso??] [illegible] [illegible] to the whole system nervous [illegible] [illegible] letting efforts, the magical, [illegible] [illegible] [illegible] it is also cheifly, by the in [exp??] [illegible] [illegible] word shock, (That cold effusions [illegible] [illegible] from in tropical climaty, where the [illegible] [illegible] is generally from 80.to 82, its [s???ig??] [illegible] [illegible] much abated (The state of the [illegible] [illegible] than the urgency of the other [illegible] [illegible] imperiously, around renewed [de???] [illegible] [illegible] former is thready spreading, or [illegible] [illegible] demand must be complied with, [illegible] [illegible] An a disease like this, where the danger [illegible] [illegible] in twelve, or fifteen hours, it is often [illegible] [illegible] apparent character may be altered [illegible] [illegible] again he says (Is is a [hucul??] [illegible] [illegible] that almost omnimpotent, remedy, the [illegible] [illegible] said to in counter A remedy for all other [illegible] [illegible] second of force, (It requires all the [illegible] [illegible] [illegible] [illegible] will gain ground on uswith rapid strides, [illegible] [illegible] to bleed again and again this is the mainstay [illegible] [illegible] anchor of hope, (Without it many very [ma??] [illegible] infallibly be lost. (Would I could say [illegible] [illegible] The same writer further remakes. Page 341. [illegible] [illegible] [??urging] I have not hitherto, mentioned, the [illegible] [illegible] much a matter of course (A stimulus ought to be [illegible] [14?] [illegible] [illegible] than [illegible] [illegible] [illegible] [illegible] [illegible] [????tion] of fevers [illegible] [illegible] [illegible] [co???ted] [illegible] [illegible] [illegible] [a???] [illegible] [illegible] [illegible] [illegible] [illegible] [???ment] [ar???] [illegible] [illegible] that it is the [illegible] [illegible] [illegible] [???er] to result [illegible] [illegible] [illegible] [illegible] [confi?t??] [illegible] [illegible] [???illy] [sustained] [illegible] [illegible] make appeals, ( [illegible] [illegible] say [illegible] 335. Vol 2. Tropical [illegible] [illegible] he says, elsewhere is [illegible] [illegible] continues.) I found the vessels [illegible] [illegible] [???ous], than natural and filled [illegible] [illegible] an distinct traces of [illegible] [illegible] and other viscera of the thorax [illegible] [illegible] appearance of inflammation whatever [illegible] [illegible] ready be accounted for [illegible] [illegible] brain [illegible] membranes, I found [illegible] [illegible] action save in its basilar portion [illegible] [illegible] and adhered pretty firmly to the [illegible] [illegible] of coagulable lymph were [illegible] [illegible] living together, the inferior, convolution [illegible] [illegible] with dark colored, and appearently [illegible] [illegible] the other cerebral nerves from the [illegible] [illegible] the sustance of cerebrum pons and [illegible] [illegible] exit by the cranial foramina,(- [illegible] [illegible] has found in each one of the lateral [illegible] [illegible] was in the cerebellum, and medulla [illegible] [illegible] chief morbid appearances were directed [illegible] [illegible] a degree of vascularity, indicative of [illegible] [???irly] it was covered with a plexus of [illegible] [illegible] and the later together, with the pons varolii [illegible] medulla oblongata, was enveloped by tenacious [illegible] of fibres, which could scarcely be removed with [illegible] [illegible] substances, underneath,(about [illegible] spoonfuls of serum also were found effused in the fourth 142 [illegible] [illegible] [illegible] medulla [illegible] [???g] [illegible] [illegible] [illegible] [???tions] [illegible] [illegible] [illegible] of [illegible] [???p] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] less to know [illegible] [illegible] strictly [???able], to the [illegible] [illegible] [???pe?is] or [illegible] [illegible] [illegible] [???duced] by the [illegible] [illegible] we do know that [illegible] [illegible] [illegible] the laws of [illegible] [illegible] will die, in spite of [illegible] [illegible] [illegible] could be adopted; [illegible] [illegible] [illegible] of treatment might be [pur???] [illegible] [illegible] by him, (For if the danger of [illegible] [illegible] tendency to inflammation, and [illegible] [illegible] [illegible] and purged nearly to death, to [illegible] [illegible] the inference, seems at [illegible] [illegible] [illegible] is not the same, and [pre??] not [illegible] [illegible] it, (Dr. Rush we shown [illegible] [illegible] [illegible] and liberal depletion) and has [illegible] [illegible] several dissections made by Dr [illegible] [illegible] to sustain the doctrines-( [illegible] [illegible] [illegible] great importance, of the disease [illegible] [illegible] in the investigation of diseases, we [illegible] [illegible] [illegible] that some of these dead, of the present [illegible] [illegible] fevers should be examined, and [illegible] [illegible] observations, it appears at present [suff??] [illegible] [illegible] following facts, (Fast that the brain, in [illegible] [illegible] found in a natural condition, ([illegible] [illegible] viscera of the thorax are perfectly sound [illegible] [illegible] in the heart and veins, is fluid, similar [illegible] [illegible] of the blood of persons who have been [hang??] [illegible] [illegible] by electricity, (That the stomach, and [begin??] [illegible] [illegible] duodenum arc the parts that appear most [dis??] [illegible] in Two persons that have dies, of the disease on the [illegible] the villous membrane of the stomach especially [a???] 143 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [d???] [illegible] [illegible] [illegible] [sim??] [illegible] [illegible] [illegible] by [illegible] [illegible] [illegible] in a [f???] distroyed by it ([illegible] [illegible] of its [illegible] [illegible] [illegible] died [illegible] [illegible] [???ation] [illegible] [d???] [illegible] [illegible] [???arly] about [illegible] [illegible] [illegible] [???tion] of which [h???] [illegible] [illegible] [illegible] beginning of the [illegible] [illegible] [illegible] this part is as [illegible] [illegible] [illegible] at a more advanced [illegible] [illegible] inflammation disappeared [illegible] [illegible] [illegible] intestines, a black liquor, which [illegible] [illegible] [illegible] death, (This black liquor [illegible] [illegible] altered secretion from the liver [illegible] [illegible] [illegible] quality was found in the [illegible] [illegible] [illegible] [???s] acrid that it produced [illegible] [illegible] and swelling, on the operator's hand [illegible] [illegible] [illegible] (The villous membrane of the [illegible] [illegible] [???dis], was found inflamed in sever [illegible] [illegible] [illegible] its natural appearance, erupting [illegible] [illegible] the surface of which a very [illegible] [illegible] [illegible] seen all the other abdominal [illegible] [illegible] appearance, (The external surface of [illegible] [illegible] of the intestines, was quite free from [illegible] veins being distended with blood which [illegible] through, the transparent peritoneum gave [illegible] [illegible] (The stomach of those who died early in [illegible] [illegible] always contracted, but in those who died [illegible] [illegible] period of it, where extravasation appear [illegible] [illegible] with, air (Rush's works Page 92, Vol 2 [illegible] [illegible] Physick and P. Cathrall [illegible] [illegible] interduce, these reports of post mortem [illegible] [illegible] for purposes already mentioned, but further [illegible] [illegible] reports-(First that the disease in question has 144 fixed [illegible] [illegible] [illegible] [illegible] [illegible] [??ated], [illegible] [illegible] [illegible] be [illegible] [illegible] stomach and duodenum [illegible] [illegible] [illegible] organs, ( [illegible] that [illegible] strong indication of [putrese??] [illegible] decomposition and [illegible] [illegible] [illegible] sometimes procedes [illegible] [illegible] Healthy inflammation [illegible] [illegible] and the term inflammation [illegible] [illegible] be nightly used or the [illegible] [illegible] changes of structure [illegible] [illegible] we are well aware of [illegible] [illegible] the very many imposing [illegible] [illegible] addition to those already [cel???] [illegible] [illegible] still another of which standing [illegible] [illegible] [illegible] Surgeon Lawson (Pork, in [illegible] [illegible] [illegible] perpared under the [der???],of Surgeon General 2 OL) [illegible] [illegible] [illegible] appearance late in the season [illegible] [illegible] [illegible] character, but is in [illegible] [illegible] disease of highly arterial ([illegible] [illegible] at lease one more and [illegible] [illegible] medicine for four of five days [illegible] [illegible] Calomel is the cathartic [conn???] [illegible] [illegible] decidedly the most efficient [illegible] [illegible] of from sixteen to twenty ounces of [illegible] [illegible] the extent of twenty or twenty five [illegible] [illegible] for several days, the doss is repeated, [illegible] [illegible] oil and enemata according to [circu???] [illegible] [illegible] After the first day the calmel in [addi???] special administration as a purgative [illegible] [illegible] in doses of five grains every three hours [illegible] [illegible] irritating the salivary glands and this [illegible] [illegible] from more vital organs, (Those is no [dang??] [illegible] [illegible] the patient by excessive purgation, as it is very [di???] excite the intestinal cannal into action and 145 [illegible] [illegible] [illegible] [par??] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [d???] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] day [illegible] [illegible] [illegible] [stop???] [illegible] [illegible] [illegible] must [res??] [illegible] [illegible] [illegible] [???darble] our [illegible] [illegible] the lowest [illegible] [illegible] to employed with [illegible] [illegible] which is frequently [illegible] [illegible] symptom, to require [illegible] [illegible] [???sion] cerebral excitement [illegible] [illegible] [??ailed] in connection with [illegible] [illegible] constition; the main and [illegible] [illegible] in this fever, ( [illegible] [illegible] not necessary none but the [illegible] [illegible] infusion can be administered [illegible] [illegible] such as the sulphatic of quinine [illegible] [illegible] ( This disease runds its course [illegible] [illegible] fatal, in few days by a [illegible] [illegible] organ or being itself [illegible] [illegible] seventh day, having once [illegible] [illegible] the conflict, (The surgeon's [illegible] [illegible] use of quinine, stand in direct [illegible] [illegible] even Thinks quinine is inadmissible in [illegible] [illegible] the fever, while we use it in every stage [illegible] [illegible] inflammation or aggravating [illegible] [illegible] gives to it opposite effects( We [illegible] [illegible] [??fuige] antiseptic and touic vertues [illegible] [illegible] reliance, upon the [super??tion] of [??tydis?] [illegible] [illegible] witness, ( 147 148 148 149 150 153 157 158 159 160 161 162 163 164 188 Polish For Furniture In 1 quart Boil Lint seed oil 1 pt Alcohol One lb Gum Shelac 2/3 [illegible] Mix it as below When mixing this polish it must be warm, that is the oil And put in the other articles And the polish is ready to put on 187 A fine tonic for [illegible] Persons caused by chills and fever or otherwise R. hyposulfate of Soda 2 oz Elixer viteral 2oz Sulphate quinine 90 gr pure Aqua 1 [illegible] let it stand one hour and it is ready for use. Dose for an adult a table spoonfull 3 times a day Children in proportion- Fine Cement R 4 Tablespoonfulls of Salt; water 1 pt gum Shelac 1/2 lb let it boil Slow until all is melted and where it is about a consistency of Shoemakers wax draw it in long Strips and break it into six inch Sticks it is now ready to mend with by heating the stick and applying it to the glass as dish and pressing the parts together and then let stand 12 or 24 hours and the vessel is ready for use [1??] [illegible] [illegible] [illegible] [illegible] Tinc [comp??] [illegible] [illegible] [illegible] to be [app??] [illegible] per day, [illegible] be taken internalle in [illegible] 3 or 4 times [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] Acit 3X [illegible] [illegible] [illegible] 3ii Tinc Lavender [illegible] 3 [illegible] Aqua [illegible] 3XXi Muc gum [illegible] 3 [illegible] i Dose to [illegible] [illegible] Tonic [Al???] [illegible] [illegible] Rx Rad sarsaparilla [illegible] [illegible] xii sassafras cont-[g???] Rad Gb Mezeron Cont Dulcamara [Eupa??] [illegible] 3vi aqua congt to [illegible] [illegible] then boil half an [illegible] [illegible] mix with simple sys, [iilegible] [illegible] Anodyme, and 1/2 dz [illegible] [illegible] Cong-Dose 1 tablespoon [illegible] [illegible] a day- Rheamatic [m??] D. Tinct semini [Colc?ici] each 3Xvi tinc opii Tinc lavender Compound [illegible] Aqua cinnamon 365- spoonful every 4 [hou??] cases, a teaspoofull every [illegible] not so urgent 195 [Ha??] [W???] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [?his] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] Pills [illegible] [?il] [??t???th] [Comp] ℥i [illegible] [illegible] [illegible] Grs 20 [sub??] [illegible] grs 15 [illegible] [illegible] [illegible] gr i [illegible] [illegible] [illegible] gr3 [illegible] [illegible] [illegible] gr, 6 [illegible] [illegible] [illegible] pills [illegible] [illegible] [illegible] bed Time [8??] [illegible] the [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] 197 [illegible] [illegible] [illegible] 9 1/4 [y???] [illegible] [illegible] [illegible] 35 [illegible] [illegible] [illegible] 34 [illegible] [illegible] [illegible] 33 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] 37 [illegible] [illegible] [illegible] 36 [illegible] [illegible] [illegible] 41 [illegible] [illegible] 87 [illegible] [illegible] 20 [illegible] [illegible] 6,, 08 [illegible] [illegible] [illegible] '' "" 60 [illegible] [illegible] [illegible] Ru 80 [illegible] [illegible] [illegible] " 25 [illegible] [illegible] [illegible] " 60 [illegible] [illegible] [illegible] " 30 [illegible] [illegible] 16 2/3 1 00 [illegible] [illegible] 6 1/4 85 [illegible] [illegible] 61 21 [illegible] [illegible] [illegible] " 75 [illegible] [illegible] -2,25- 1" 13 [illegible] [???hs]-" 85 [illegible] [???e] 1 50 [illegible] [illegible] paper 2" 00 [illegible] [illegible] " 40 [illegible] 10 20 [illegible] [illegible] 12 1/2 " 25 [illegible] [???s] 18 3/4 " 37 [illegible] [illegible] 35 " 70 [illegible] [illegible] 50 c " 37 1/2 [illegible] [illegible] " 05 [illegible] [illegible] [???a], 25, " 25 [illegible] [illegible] 6, " 54 [illegible] [illegible] " 30 [illegible] [illegible] Buttons 3 " 45 [illegible] [illegible] 15 " 15 [illegible] [illegible] cutter 25 " 35 185/ 198 [illegible] [illegible] [illegible] [illegible] [illegible] 43 [illegible] [illegible] 25 [illegible] [illegible] 40 [illegible] [illegible] 25 [illegible] [illegible] 20 [illegible] [illegible] 30 [illegible] [illegible] 36 [illegible] [illegible] 85 [illegible] [illegible] [illegible] [illegible] [???d] [illegible] 60 1 [Bla???] [illegible] 0 1 [alue] [illegible] 6 [illegible] Red 48 15 1/ do Cofee- [illegible] 33 1 Whisky [o???] [illegible] [illegible] 2 do3 Butter 1 Powder Can 1 Load-haling Tb R. Guthbertseu [illegible] For Harrison [Hamil??] [illegible] 197 [pu???] [illegible] [illegible] [illegible] [B????] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [4??] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [5??] [illegible] [illegible] [illegible] [3??] [illegible] [illegible] [illegible] [4??] [illegible] [illegible] [illegible] [?1] [illegible] [illegible] [illegible] 12/ 400 [illegible] [illegible] [illegible] 1 369 [illegible] [illegible] II 308 [illegible] [illegible] 25 750 [illegible] [illegible] 20, 315 [illegible] [illegible] 10, 352 [?oe] Cure For, (?) Take [??rid] of [j??k] [illegible] [illegible] [illegible] Sanguinary [?earsa?ll??]) [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [Sli?k] [???her] Work it [illegible] [illegible] And [sp??d] it [illegible] a [p?ace] of strong [c??t] [?a???] [illegible] to easer the [(illegible)] [illegible] it remain [illegible] and [illegible] remove the plaster, [illegible] [illegible] (6) is dead, [???nce] [p??ing] and it will matter [cross out] and come out in a few days Paltice with flax [illegible] [illegible] day, and slippery [illegible] [illegible] the next day, and so an [illegible] [illegible] out then keep pathing untill it heals up [??ellard] 201 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [a???] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] glove, [illegible] [illegible] ratio of its [illegible] [illegible] rejected and [illegible] [illegible] [??ick], [illegible] [illegible] [??ghly] rubbed [illegible] [illegible] drops of water [illegible] [illegible] [??encis] more, [illegible] [illegible] [??ar], two teaspoonfuls [illegible] [illegible] adult, a child are [illegible] [illegible] [???ers.] and should the [illegible] [illegible] which is rarely ever the [illegible] [illegible] compound powder [illegible] [illegible] of the herb or fox glove [illegible] [illegible] given as above directed [illegible] [illegible] and soon as the pustules [illegible] [illegible] and clean off [illegible] [???pply] the liquid and your [illegible] [illegible] did put on as good a [illegible] [illegible] made of gun cotton and [20?] [illegible] [illegible] [per??] [illegible] [illegible] [illegible] you [?et] up in [illegible] [illegible] to what [illegible] to [d??] [illegible] must be [illegible] the break of [??ery] & [sin??] [illegible] [illegible] [illegible] straight [illegible] can to [illegible] [illegible] best to try [illegible] [illegible] [illegible] [d?y] [illegible] say exting [c???] you will [?ak?] [illegible] [illegible] a half of the [?ord] of the [c?d???] of the north east side of the [illegible] [illegible] take hold of the [li?t] [illegible] [illegible] [illegible] and in a [pi???] manner it would be well to have a place [illegible] [illegible] three feet square cleaned off the [illegible] side of the bush to throw your twig down, when [illegible] [illegible] step up to the [illegible] taking [illegible] [??g] say cedar brush have come [illegible] you through [illegible] to try to cure a blister [illegible] the [illegible] of WG. left hand, [illegible] [illegible] [illegible] Father the son and [illegible] [illegible] [illegible] the last word you [?ill] [p??] [illegible] [illegible] it down where you cleaned [illegible] [illegible] raunel to your right [han??] [illegible] [illegible] to act, as near as you [c??] [illegible] [illegible] started from,, it is of [illegible] [illegible] [illegible] or cloudy raining [illegible] [illegible] [illegible] warm it will do very well [illegible] [illegible] time, between the middle of [illegible] [illegible] if the day be very worm and [illegible] the same words in trying [illegible] [illegible] that you may try for, [illegible] [illegible] you try and find out the [illegible] [illegible] if you can. [20?] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] patient can [illegible] [illegible] [illegible] in the water, untill [illegible] [illegible] [??pply] [illegible] [illegible] [illegible] 4 [illegible] [illegible] [illegible] [illegible] [illegible] the [illegible] [illegible] [illegible] diet [illegible] [illegible] [illegible] of [illegible] [illegible] 2 or 3 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] and use [illegible] [illegible] [??nty] of loaf [illegible] [illegible] burnt allum [illegible] [illegible] [illegible] about 1 inch in [illegible] [illegible] [illegible] altogether and then [illegible] [illegible] [illegible] [???tion] and than [illegible] [illegible] [illegible] the juice, which [illegible] [illegible] 2 drops to each eye 3 times [illegible] [illegible] [illegible] [illegible] [illegible] Remedy [illegible] [illegible] quaciam [illegible] [illegible] and [illegible] [illegible], all put into [illegible] [illegible] whisky and take one [illegible] [illegible] [illegible] per day it is a very [illegible] [illegible] [illegible] GW Ward MD [??4] Hooping Cough Tincture Digitalis 2 dram Lobelia 2, do ℥ij opium- 1,gr ℥i syrup 1 oz ℥ss water 4, do ℥rv [illegible] [illegible] [illegible] [sp???] [illegible] [illegible] [C???] [illegible] [illegible] oil [p???] [illegible] [illegible] [camph???] [illegible] [illegible] Teething [illegible] [illegible] [illegible] [Cuast??t] [illegible] [illegible] [illegible] Aple Vinegar [illegible] [illegible] [illegible] Spts serpentine [illegible] [illegible] Again Creasote 1, 8 Suepleuric either 1 clo Laudnum 1 1/3 chloriform 1/2 spt niter 1, do Recept for [pr???] 20 prd, red 1 1/2 gallay [illegible] 1/2/[illegible] 1 pint oilum- hagus 11 handful Ban gelling- Mullin Leaves And Eldor, Cerid [illegible] [illegible] Black Salve take 3 quarts of Olive Oil Common Rasin 3 oz Beeswax 3 do Red precepitate 1/4 lb And Raise all to a boiling heat and then put 1/2 oz gum camphor into id Red just before the mixture get, Cold, put in the Red precipitate llued its then ready for use Caryophyllus Sweet Gum Bark 4 oz Red oak 40, d Caynrim Peper 1/4 S.S Laudnum 4 oz Cuminum 4,, Cloves 4, Brandy-from 1/2 to 1 pt Brandy Cough syrup squills paragoric Spt, neter equal parts, Tricopherous Alcohol 7 Pts Water 1 do Caster Oil 8 oz Tincture of Canthardies 3 oz Perfumery Tasting 3    Medical Manscript 1852 10 10 11 100 10 1000 111 GlW18 Medical Manuscript 12 11 11 10 100 4)  [Be???] fort Bauguht for girls 3lb 6oz Butter at 12 1/2 et 4 doz eggs do 6 Sold for cash Whisky do do- 2 1/4 Butter 124 12 3/4 Lard 10 Sold for cash why [illegible] Sold for cash 1 pare shoes for 1 do do fine 1 do do cone 1 do do do 2 Ladies-fine 1. do--fine 1 pare fine 13 yd donut 4/ 3/4 yds Rum [illegible] May 11th 1851 [illegible] Benten Pill County Sc [?ast], [J???] B, Polk BEV Dedication Citizens of the united states-But more particularly that portion, with whom I have had personal acquaintance, and from whom I have always received a hearty welcome, and [illegible] [illegible] and also to all that portion of the medical profession who can so far divest themselves of [??gihst] education as to give to the following presentation [illegible] and impartial perusal, and it this [i????] by its author- [Pry??] At the present age of the [illegible] [prop???] a [illegible] illumination is advancing of the world , just so it the [illegible] [illegible] [p???] that that individual who [illegible] [illegible] the human family is intitled to the highest [illegible] Ancient History informs us that [illegible] [illegible] Philosophers hand ever [illegible] [illegible] for the highest distinctions [illegible] [illegible] although the sumit might [illegible] [illegible] by all, still this considiration [illegible] of mankind from doing whatever [illegible] [illegible] to ameliorate the suffering, [illegible] [illegible] human race. As it [illegible] [illegible] of human investigation, which [illegible] [illegible] and the cure of all those ills that [illegible] [illegible] frailties and imperfections inherent in the physical organization, [cross out] [repe??] [illegible] Now he who advances the just knowledge of his physical once a knowledge of the modifying powers of [illegible] it physical agents that act on his varied sensibility quit impressibilities, we consider as achieving and important step in the science of human happiness- The Author of This work has not vanity enough to believe, nor [illegible] it to be understood, that he consider as having claims above all others upon the great of mankind of anything that he has done, [illegible] yet he cannot resist the impression [??calic] which he now presents to the public [illegible] upon a fair trial to contain the most certain speedy, and effectual plan, for the cure of fevers, that has hitherto been offered to the public as this treatis is designed more for the benefit of the public [illegible] then the [cross out], profession, the author has [sh??] [???ly] [??diave] to avoid technicalities, and to present [illegible] the most simple and plain language the he could possibly employ, so that every reader may [illegible] and fully understand and comprehend his way on every subjet that he may treat- This work will be found to differ somewhat from the theories and [illegible] the [illegible] [illegible] indeed from all that have preceded it [illegible] [illegible] [illegible]. For whilst almost every physician is of [illegible] that the different forms of fever, are dissimilar in there [illegible] [illegible], and that notwithstanding this dissimilarity [illegible] [illegible], that they all have more or less inflammatory tendency, the [illegible] this work between them to depend upon a uniform law nature; which [illegible] only of disease, in accordance with the unity [illegible] [illegible] that they have there origin and progress in debility. [illegible] [illegible] of Physicians consider depletion either [illegible] [illegible] purging or by the use of nauseating medicines [illegible] [illegible] the means combind, as indispensably [illegible] for the cure of fevers, the author has limited their use very [illegible] [illegible] [disa?????] their use entirely in the last stage and relies abreast exclusively on Tonics and their auxiliaries [illegible] the same desirable object [illegible] [illegible] that all pukes and purgatves are irritant [illegible] stimulants, and that fever proper is a disease of irritation; and that it never was into active inflammation He likewise thinks that the peruvian bark or quine, is a tonic, and not a stimulant; as has generally been supposed._ Although he was himself taught that theory practice of medicine as was [cou??] [illegible], schools, in the day of his pupilage [illegible] imbibed them, but the result of his [illegible] experience in an extensive practice for [illegible] only years has fully satisfied him of the first [???pe??] this practice polar, that of either the depleting [illegible] stimulant so while this plan of treatment [illegible] speedy and more certain care without [pro??] systems that are based upon opposite [????e] prolong the disease and suffering of the patient And if a cure be effected at all, [illegible] [illegible] such treatment, and not unfrequently [illegible][illegible] The constitution, that the unfair treatment [illegible] in invalid throughout the bottom [illegible] The author is well aware of the responsibility assumed in daring to [illegible] [illegible] of this kind, differing as it [illegible] opinions on the theory and [illegible] [illegible] is likewise aware, of the [un??] [illegible] probably excite among the [illegible] [illegible] [A??] While he [cou???] [illegible] [illegible] Medicine he was after [illegible] [illegible] because he dared to differ [illegible] [illegible] practice that has been [empa??] [illegible] [illegible] the minds of the community [illegible] too; on justification of his practice [illegible] main supported the same physiologie, [illegible] that they themselves did, and [illegible] do, as [illegible] in the body of this Work. He thinks, [illegible] might say, on without doing them any [injust??] whatever, For without having any [illegible] for them as men, that they are very [illegible] them, who, no matter what a man's acquiantance sucess in practice might be, if he dared to differ from them, or their, favourite leaders in the [s??] whould either treat him with cold, silent contempt or attempt slily to defame his character This seems to be the effect of deep feelings, probably based on natural organization and, I suppose, being regarded as the result [illegible] fixed prime causes and the circumstances, Education, ought therefore to be excused But the Author, knowing the success of his theory from his own experience and observation, contrasted with [illegible] fully justifies himself, in the opinion, that ha hazards nothing as a man, or as a physician [ass?ding] that it is the safest [cross out] most speedy with successful practice extant for the care of fever, His opinion is further confirmed by [illegible] [illegible] [??xampled], success of his practice [illegible] in the north and south for the last ten years the [illegible] considers himself called upon to [illegible] [illegible] and practice to the public [illegible] [illegible] has [add?ssled] which will [illegible] [illegible] and fair opportunity of [illegible] [illegible] And also, a [illegible] of [illegible] [illegible] [Hix?can] was and his [illegible] [illegible] [?atasenie], & a [illegible] [illegible] the public he is willing [illegible] a fall- Authors Preface Chapter Fist On Fever, XX Theory and Practice of fevers Chapter first The opinion has been long since [cetert??] and by some eminent medical Philosophers [expr?fsor] that a theory founded upon nature, a theory that should bind together these scattered facts eg, medical knowledge and converge into one point of [?ie??] the [illegible] the [illegible] organic life, would they on many accounts [illegible] to the interest of society- It [al???] [illegible] of [illegible] men of moderate ability to practice the art of healing with real advantage to the public; [illegible] [illegible] literary acquirement to distinguish, the [illegible] [illegible] effrontery or of wiley address; and [illegible] [illegible] important, situations the [h???] [illegible] [illegible] Form of Practice does have being [illegible] [illegible] theory and practice in which [illegible] [illegible] are now, engaged in waiting again the it [illegible] proper that I should give my [illegible] [illegible] I commenced the study of medicine [illegible] That cook, cold and [illegible] [illegible] greatly at the head of their [re??] [illegible] and promulgating to the World their [illegible] Bloodletting and the modes of [illegible] by the follow, of the depletion or [ant??] Theories I was instructed in those [illegible] after having practised with my preceptor for about years, who was a scientific and experienced, and inclined to the Brownonian and [illegible] Tonics and stimulants earlier and more [g??] than was common, I entered one the duties of my profession on my own book and was at least as sucessful as those around me. But not being satisfied with the result of my own practice [c???] less so with that of others, which was chiefly that of bleeding and acting on the stomach and bowels, with emetics and cathartics, as we thought the patient could bear them; [illegible] [illegible] the case principally,with what we called [illegible] [illegible] phlogistic medicines which indeed was of little or no use, untill the patients died or recovered by the mere sanative operation of the constitution. After having practised medicine several years and having undergone a considerable change in my view, and opinions relative to the nature and [illegible] of some diseases, and some remedies attended [illegible] by medical lectures in the university at Philadelphia, where became confirmed in the opinion states was reasonably acquainted with the different [illegible] [illegible] had of the day, but which only [illegible] [illegible] of their error, in very many [p???] [illegible] [illegible] serious evil in society and [illegible] [illegible] that the ruling or [illegible] [illegible] medicine like that of bigots [illegible] [illegible] alway willing to edge and exterminate & [illegible] [illegible] any theory or practice that [illegible] [illegible] from their views of proprity! [illegible] [illegible] the principles upon which it is [illegible] [illegible] the result of the practice in [illegible] any way whatever. being aware of this [illegible] believing that I had made a valuable discovery [illegible] or thats had more fully developed the [illegible] and article of the materia medica that [illegible] been in use, but was still very imperfectly [??tard], I was an witting that it should be last to [??ly]. I therefore prepared and sent forth to the public large quanties of my magnetic, Gold Pills, and at the same time concealing their composition that they might acquire a reputation upon their own intrusie worth- Now that the virtue of these pills to the amount of at least ten thousand Boxes been tested by the people of the united states [illegible] of mexico, and up to this state have [???tained] an improving reputation; thereby [???turing] the correctness of my theory for the [??petery] is not now in the drug than the use I [illegible] made of it I presume that the public will begin to how strongly and unjustly the medical properties of the peruvian bark and its preparations have been perverted, and that instead of its being injurious when taken in the hot stage found all been frequently said of it it is not only entirely soft but it is the fibrefuge tonic and antiseptic human The truth of my position is still further [ma??] by the fact, that since the distribution of my magnetic Gold Pills (not (firm years [illegible] [illegible] announcing that their virtues reside [illegible] [illegible] tonic properties and that they did not contain any arsenic, many apothecaries [illegible] [illegible] not [illegible] have endeavoured to imitate them [illegible] vended the same or some similar [illegible] [illegible] used in all stages of fever- Now when I had established the fact that tonics [illegible] softy and with efficacy be used in all [illegible] [illegible] difficult task for practitioners to [illegible] [illegible] particular drying heat [cate??] [illegible] indications, hence all of them [illegible] [illegible] had more or less of quine in their costum I am led to these remarks from an [opp???] that so soon as these pages shall be [illegible] to the public eye, that the practitioners of medicine the venders of fever nostrums may not after [f??] to harass, the public mind be refusing to [illegible] the fact, that quine or some other vegetable constituted the basis of their specifics far from not toug after I commenced the practice of medicine, An old physician fell in company work one, an [illegible] Road from Wilmington leading to Elizabeth, he informed me that the practice in that Country did not see 4 The carious diseases of the Country and the reason was that they the physicians [illegible] not sure tonics soon [erough] enough, that are depletory practise intirely to much, [a??] his lecture with best of my recollection was as follows: A sect of religious people known by the name of jesuits, in their intercourse with the inhabitants of of South America, in passing through the state of Peru, were compelled to drink and use for cooking the waters of certain Ponds on their way,, The water in some of these ponds, was strongly impregnated with the properties of the bark of certain trees that grew around them,,, Other ponds in these waters which have none of those trees in or about [illegible] [illegible] resorted to for water,,, those persons who happened to fall sick at the latter [illegible] [illegible] remained there untill the tardy [illegible] [illegible] constitution enable them [illegible] their illness as to continue their [illegible] [illegible] of those persons who became [illegible] [illegible] where the trees grew [illegible] [illegible] for all purposes the [illegible] [illegible] rarely detained more than a few [illegible] they were cured, and enabled to pursue [illegible] these facts became so notorious, the cases of cure so numerous that it caused much enquiry and investigation; When it was ascertained [Soli??] that these cures were effected by the waters in consequence of its being impregnated with the medicial properties of the Bark of these trees Hence the first knowledge that we have of these trees or the Bark,, is under the name of jesuits or peruvian bark x Many of these unfortunate wore stricken down, at various Times, by fevers and in that hot climate it is reasonable to suppose that many were of the lowest grade and most malignant character & it is said, there was a time when the Peruvian barks (Acot the sulphate of quine) sold for its own weight in gold which is proof of it [illegible] esteemed value since my knowledge of medicine, the best quality of gold from five to ten dollars per pound,, But for the last fifteen years, it has varied from one dollar to fifty cents per pound,, From these facts all all might [illegible] that the use of it has been very much [illegible] In that short space of Time, and that [illegible] all other poisions and prostrating medicines had been substituted in its stead), all my times, have i set by the bed side of my patient for days together giving it & anxiously [illegible] to see the affect it would have upon [illegible] At the same time amousing their minds and the minds of their attendants rarely by giving some persons placebo that I new to be harmless and useless found no more used heat [illegible] arterial actions, nor any [illegible] that I could asscribe to the bark [illegible] contrary, in a few hours [illegible] most the skin would become [illegible] prehaps a free and generous [illegible] would ensue, the thirst whole [illegible] irritated condition by the pulse [illegible] and the feverish heat and restless anixety (alway more or less attendant on fevers Subsides, in much less time than [illegible] course of treatment, I had one [illegible] patients recover their health [illegible] with less prostration or debility- I have took the bark myself (in good health for a mere experiment,) in ounce doses which is equal to [illegible] or twelve grains of quinine, and although it produced some dizzyness or swimming, in the head, there was no increased heat in the skin or increased action in the pulse- I presume that it acts more directly on The brain, And the nervous system, but it produce no such effects, as an over portion of intoxication 6 liquors, on the preparation of opium [illegible] dose languor, or prostration follow as a [illegible] natural consequence as is the case [illegible] use of stimulant proper,, We think it [illegible] them probable that the back would [nev??] have last the reputation it posins too obtain at the, time of it first interduction, if we had then known wt we now do, how to separate its active medical properties from its cortical and [???t] matter_ The irritating and supposed stimulating effects, ascribed to it by the older practitioner, may in our opinions be more justly assignable to its bulk, and the presence of the cortical matter with which it was incumbered, them, to its salt, in which modern chemistry has shown its [illegible] to reside- Before the improved condition and highly concentrated preparation of the [illegible] the form of quinine, was known,I was in many occasions, much inconvenienced and sometimes defeated in getting as much [illegible] - Partly owing to the prejudices [illegible] them to fear that it would escape their fevers, and partly to the fact that in some instances the stomach would not retain it- or that it woul'd pass off on the bowels as a purgative- in either event any object was more or less defeated- The names of Pellitier and Caventou, who first seporated the pure alkaline salt called quina from the bulky and inert, mass in which nature had placed it deserves to be remembered by [cross out] with gratitude by all mankind- since that fortunate day in medicine I have been enabled to administer the bark at any stage, and in any quantities that I might think advisable as without fear of injury to my patients or exciting any fear in their minds- This discovery has not only afforded me- heart-felt for gratification- 1 for the reason that it enabled me to give more prompt and certain relief to the sick- but it has been instrumental in giving to me a character and standing in my profession all calculated to excite the envy of the Physicians around me- But this I desired not for I did not conceal from them, in our consultations, my views, on either the Theory or practice which gave me such superior success- It seemed [illegible] the most melancholy experience was not sufficient to convince them of their errors, and they still from the mere force of education, considered my practice as empirical- Far be it from us to censure any one for tenacious adhering to the prejudices may be; let the jew be jew still,- let the Bushite be Bushite: for we deem it a wise provison in the economy of [illegible] We only seek to apologize for the course we have as individual laborers in the cause of humanity have pursued- Every philosophic mind [illegible] that all innovations have to work their way to popular favour all their own intestine [illegible] The discovery of truth is a like open to [illegible] it is the exclusive property of [illegible] part of eternal bounty of nature, [au??] from beginning designed for all- Then let all and let no one be debarred the privilage of pas claiming whatever he may have found- We are well aware of the necessity and the importance of well-endowed-[illegible] establishments, for the purpose of mental [illegible] and manual discipline, in every deport of human thought, and of human actions- We know: also that one of the marked characteristics, are of the [cross out] advantage of civilization. consists in the division of labor- Such division tends unquestionably, to the perfection of science, and to the perfection of slice in the [illegible] manipulations of the arts Hence, in the earlier period of the World, as we see from the records of Egiyptian of Babylonion Grecian Roman and other historians,- resulted the establishment under state Authorities the laws of Castes, of trades, of professons and of privileged orders in society. Now such (was, such regulations such usages may have been rendered) necessary at those epoch, of time from the nature of the [??ment] of humanity than under progress of development But is is easy to trace in the downfall all of those states the deleterious influence of Castes and of chartered privileges, and protection upon [illegible] various branches of human occupancy- In proposition as trades and professions are [fa?tered] by law, in the same proportions do their [vota???] become indolent, and the wholesome [illegible] [illegible] dies away- The check thus [illegible] to the freedom of thought, causes the [illegible] [illegible] of law, divinity, [illegible] [illegible] arts to dwindle to lapse its [illegible] and the minds of men to become fixed [illegible] stereotyped into settled formularies [illegible] have been [illegible] into the preceeding train of [illegible] from the manifestation given by many of the states of this union, in their legislation enactments, chartering either directly or indirectly, sectarian colleges calculated to faster partisan religionist- [E??] those entitled acts to regulate the practice of medicine; many of these contrary to the spirit of this government, and calculated to promote the interest of a particular class, to the detriment of others- the effect of the one is to fetter to stagnate the advancement of the study of the spiritual nature and the spiritual happiness of man; While that of the other retards the progressive 9 knowledge of the Laws of his physical nature, [illegible] the true mode of improving his condition [illegible] happiness as based in his physical nature [illegible] influence by physical causes- What better evidence could be desired of the [illegible] and selfishness of all these petitions & petitioners for protection, than the universal fact that they spring from the professions, care not from the people whose welfare they hypocritically profess to guard and serve- Tis strange! Tis passing strange! at this enlightened day, at this half rational era of the world in This free, this new sepereated republic; that the people, the true the only legitimate sovereign of the earth, should not know what they needed what they wanted, what they desired, what was best for them, as well as the safely led- guardians of their bodies and their [illegible]- We do not wish to be understood [illegible] with or objecting to, any thing that [illegible] has transpired- Oh the past and [illegible] [illegible] has not controle, Whatever has [illegible] [illegible] it is; and whether right or wrong [illegible] it- Let us, then, gather [illegible] [illegible] from a knowledge of the past and the present; by which to direct our own future [illegilbe] [illegible] which alone an indulgent providence or has willed to man a modifying influence- Chapter 2,- Containing A Brief outline of the Animal- Economy- That those who may peruse this work may perfectually understand, the authors meaning- and have some idea of the offices of some of the most important organs the human systems 10 And that members of the profession may conceive more readily of the manner in which I suppose [illegible] are contracted, and the most natural and speedy way by which they may be cured, I deem it proper that I should give a short account of the functions of those ongoing, which are supposed to be mostly involved in fevers, as dull as most other diseases- It is the office of the stomach to receive all the ingesta both solid and fluid, designed for the nurishment and growth of the whole body It is by the very peculiar action of this organ and its secretions, that the first process, and important part of digestion, is performed- So soon as the stomach shall have performed its office on the varied aliment, and drink taken in, then the whole of the residual mass passes on the first portion of the intestinal canal called the duodenum, where the ingesta in its present state of preparation comes [illegible] with the peculiar fluids secreted by the liver and the pancreas, called bile and pancreatic juice- Through the agency of these secretions of the nutritious matter called chyle supposed to be elaborated from the food; and [illegible] lacteal and absorbents, situated in this [illegible] portion of the canal, stimulated by its [illegible] [illegible] take it up to carry it into the general circulation for the nourishment and the support of the whole- The digestion being thus principally performed by the stomach and duodenum, the food continues its passage downward through the remaining small and large intestines to make it exit from the bowels by stool, being no longer fit for the purpose of the economy; however affording more or less matter for the absorbents throughout its whole extent 11 The Lacteal and absorbents above mentioned, having carried the nutritious portion [illegible] which was taken into the stomach the chyle, into the receptacle of the chyle, where [??aming] a white or milky appearance, it is carried through this duct to be emptied into the left subclavian vein- at or near its junction with the internal jugular, and there mixing with the venous blood carried into the great descending vein called vena cava from thence into the two cavities of the heart, (the right auricle, and the right ventricle) from which latter it is propelled into the pulmonary arteries and carried by the various ramifications of the same strength the lungs, in which it is properly prepared for the action of the air for the [illegible] uses of the system- Being thus assimilated it is carried back by the pulmonary veins to the left auricle from thence the [illegible] and from thence, it is propelled into the artery on the spine called aorta. [illegible] thence [cross out] is distributed through its numerous branches to every part of the body- Having passed through this routine of elaboration and circulation and attained its highest state of vitality it reaches its final distination in the capillary Tissues. The fine net-work to be found in the parenchymae of all the glands- as well as all the surfaces- both internal and external called surfaces of relation, the most considerable of which is the external cuteaneous surface. Now the object to be accomplished in the [cross out] animal economy by the circulation of the blood, which has been justly called the vital fluid, or manifold: but for our present purposes it will only be necessary to dwell 12 On two of them- The one is the disposition of atomic molecules.- in other words nutrition the other is the preformance of the offices of depuration, or the elimination of useless or redundant matter from the system- In this latter capacity the skin and it auxiliary, the lungs, by their respective process of sensible and insensible perspiration, and Inhaleting or exhallations leave duties assigned them more extended, and equally important and imperious as any of the functions of the whole animal economy, that portion of the blood not expended or eliminated in the capillaries is returned to the heart and Lungs for further preparation, or retain and preserved in the circulation for the future [al??] of economy and not returned to the stomach and bowels, where it was first received where it was first elaborated [illegible] [illegible] since demonstrated by many [illegible] [illegible] What there is more [recumion??ious] [illegible] through the pores of the skin, and by its auxiliary, the lungs (for these surfaces in print or desperation, perform very analogous offices) than by stool by urine and by all other out lets of the human body united- this fact should never be lost [cross out] sight of for on it acts an important stept toward the knowledge and treatment of diseases,, There are many persons, individuals who enjoy good health,- usually of good digestion too,,- The exhalations from whose bodies, partake of the [illegible] of the excrementitious matter of the Bowels There are others, again whose perspiration has a desided urinous odor,, in such person, perspirat is usually abundant, while their healthy habits, act, to urinate but little and to defecate but seldom- it should be recollected, that every organ of the body- the liver the lungs 13 the kidney, the stomach, the bowels- the brain, the nerves, the muscles et cetera, [illegible] receive their support by and through [illegible] before mentioned process of digestion circulation an assimilation, and that of all these organs- perform their respective offices promptly and harmoniously when under the influence of their [cross out] appropriate stimuli, and when not obstructed or deranged by some offending cause or causes, but these causes; are numorous, in kind, character and quality as also variable in degree- We come now; to the investigation of that part of the body or animal structure [illegible] the encephalon or brain, and its appendages or elongations the nerves- Here we find both structural and functional phenomena [illegible] peculiar but in many respects- widely [illegible] from that of all other organs yet [illegible] portions, of organic matter inseparably connected with and depending or other organs other structures for its support- particularly that of the vascular and muscular systems the one peculiarity of the brain consists in its [ex??] from cellular reticular tissues and the deposits of adipose matter) Brain, though not affording adipose matter) in its common sense, furnished with (peculiar fatty acids containing phosphorus) the intermittent character of its functions and the function of the nervous system generally all is evinced by the emperian necessity of sleep While other functions of Animal life are in full force- such as circulation respiration digestion et cetera, Another peculiarity consists in its susceptibility of being acted on. and that in a very eminent degree by the instrumentality] of moral, and intellectual stimuli as well as physical 14 stimuli, which alone, make an impression on all other organs- it is to this latter peculiarity that we wish to draw the attention of medical men; its uses and its influence we think much more extensive and important than is generally supposed, by the members of the profession- We do not mean to enter into any enquire upon the spiritual or mental immaterial agencies in human phenomena; but shall consider the brain in a strictly natural and philosophic light, as the seat of all the sensations passion and emotions, and as the mutual organ of thought- it is by the instrumentality of this organ, through the medium of its nerves or that all sense of pleasure [cross out] or pain is felt that averson or desire is produced that every organ is made alive to as appropriate stimulis and every muscle [illegible] that body would be deprived of motion or sensation without its benign influence it [illegible] therefore, an all prevading power both in sickness and in health the animal machine is not governed by the laws of mechanics; no by these of hydraulics; nor those chemistry: nor by a union of them all; but by laws by forces peculiar to vegetable and animal existences called laws of vitality, and which are more or less modified by the influence of the before named laws or powers as we shall endeavour to explain- The machanic laws are recognized, and most aptly exemplified in the boney and muscular structure, in their aptitudes to the purpose for which they were designed and in the amenability of the whole both solids and fluids; to the powers of gravitation- The hydraulic laws are observable to a limited extent, in the valvular structure so common throughout the vascular and lymphatic systems and the influence of both must be admitted from the comfort and advantages of 15 position more especially the advantages of the recumbent position during sleep, thereby giving [illegible] to the solids while it facilitates the passage of the fluid elements through the whole body- As to chemical laws we conceive them to play still a much more important part in vital machinery- Physiologists and chemists have both long since concurred in the general belief that the oxygen of the atmosphere and the functions of respiration had a decided agency in the production of Animal heat, however widely they may have differed in their particular views as to the modus operandi, in producing the effect Whoever desires to keep pace with the progressive development of organic chemistry will be [illegible] with the recent experiments of professor [illegible] Europe, contained in his reports on organic chemistry applied to Physiology and Pathology_ The learned professor has gone into a careful [illegible] of every portion of the human body,then into the analysis of every description of [illegible] both fluid and solid, on which he [illegible] he might discover all those elements [illegible] food best suited to the products [illegible] necessary for the body- The results to which he has arrived are truly interesting some of which we will introduce He says:- that every notion every manifestation of force is the result of the transformation of the structures [??of at] substance_ every conception every mental affection is followed by changes in the [illegible] of the substances of the brain, it is to supply the [illegible]? Thus produced that food is necessary- Again vitality in the ruling agent by which the [ale??ical] powers are made, to subserves its purposes, but the acting forces are chemical The professor further observes: That the neutral action between the element of food and the 16 oxygen of the air in the source of animal heat- All living creatures whose existence depend on the [cross out] absorption of oxygen possess within themselves a source of heat independent of the medium, in which they exist I therefore believe that the oxygen is in its nature one of those properties which sustane Animal life This heat in professor Leibigs opinion is wholly due to the combustion of the Carbon and hydrogen contained in the food which they consume- To this last result of the professor, we are not entirely ready to give our assent, unless intends to include the galvanic and electric agency in the development of caloric, as coming under his veins of the union of Oxygen and carbon or oxygen and hydrogen and in this way account for the sudden developments of heat which we frequently witness under impressions of moral laws; such as the sudden flash of modesty on the virgins cheek, which we think to be too instantaneous to be achieved through the heart and the circulation- Another remarkable and useful result to which, the professor experiments- have led- is connection between the food on which we live- and the physiological result to the economy- From all the articles of diet which man, is accustomed to consume he has been enabled to point those that abounds most in the elements for the formation of bone of muscle of fat of cerebral mass or even the matter of heat, or in other words, the diet to give, strengths of bone of muscle of passion and of thought on which abounds in the elements of heat So important a part dose the phenomenon of clinic animal heat perform in the 17 Animal economy, That some deluded minds have been simple enough to contend, that heat is life that the want of it is death- they mistake a symptom a single penonenon for the [u???um] taken Perfect life perfect Health, consists not in the high degree of elevation of temperature but in [cross out] ability to maintain a proper degree under different circumstances and that degree is different in different orders of animated nature- What should we say of all those numerous families of insects, of reptiles, yea, of the whole round of cold-blooded creatures, that for the most part remain torpid, cold, and, even in many instances froz Through the whole winter, but yet revive again with the return of the genial heat of Spring! Shall we pronounce them dead or in a state of suspended animation merely? That the general reader may he better comprehend our Theme, and that our own particular views may be more fully carried home to their understanding all propose in the next place, to give a concise and as clear an account of the theories of medicines [cross out] that have at various periods of the world found favour in human estimation as the nature of the subject and the nature this work will permit- Engaged as we are in effort to cast what light we can on a particular class of diseases only, we do not feel ourselves under any obligation to a critical examination of the history of medicine or even to sew up in regular order a Classification of the varied chains of thought that have at different times occupied in the minds of distinguished professor, and writers; but to introduce and dwell on such only 18 as have gained or obtained the greatest notariety, and such as may best suit us our present purposes- What, then, should we understand by the science, of medicine; It is that science which treats of diseases and their remedies- The term medicine from the verb medios to heal, has given to the professor- the tittle of the healing art, with the greeks it was mostly confined to surgery and to the use of external remedies- let was for Hippocrates, to lay the foundation on which [cross out] succeeding ages and nations have built, He first separated it from Philsophy_ gave it the form of a destinct science and personally observed the progress of diseases as well as the effects of remedies on this account he is styled the inventor of the medicina clinica But we are endeavouring to lift the veil of mystery from the feature in the physiognomy of man called fever- Now, the theory of fever is inseparable from the theory of medicine, which comprises the doctrine of the nature of man the nature of his diseases and their remedies used this involves the doctrines of Vitality the laws of human life,-and these again the will of God as made manifest in man, in the lords the theology of humanity now man since his first introduction on the theatre has been ever subjected to great and perpetual changes, every condition of his existence stamps, its peculiar character on his physiognomy and with it corresponding moral and mental manifestations, he is the subject of continued change he is modified by climate by soil, by food, and even by the face of the country, in which he lives- To use the Language of Dunglingson, man changes 19 much near changes often, yet he changes not radically- On these facts is bassed the usefulness of history, whether it be of law medicine or divinity- The absolute truths, of humanity ever the sour in proposition as they became disengaged from the masses of error, with they are by nature encumbered are distined to flow from generation to generation- from nation to nation, in one continued stream of light in ceaseless and rapid augmentation to the end of Time; or to the terminus of all human truths. the full unfolding of man, to man, the complete development of the philosophy of humanity- The proceeding route of inquiry has been crowded with l'etaries, now more than two thousand years and though, the labor of no one individual have been entirely, crowned, with success, the world is still much indebted to every one for his particular toil for while in the distance of time- and the darkness of ignorance that overshadowed the earth any light was better than no light and the many lights enabled the latest Laborers to compound light and thereby obtain- a cleaner and a brighter view than feel to the lot of any of his individual predecessers- To what particular in this department in this position or department of philosophy is increased- and complicated circuit of ideas we may have reached will be for posterity to decide- That the terminous has not yet been reached is certained from the fact that none has stood the test of Time, and of criticism, not one has carried conviction to the mind of all, however lauded however popular many for season may have been_ 20 It seems that we ever have been, and still are, in a state of progresson [illegible] progression its self implies a position short of maturity- All absolute disembodied disencumbered spiritualized truths are pure elements of philosophy, from whatever source they may spring Law, medicine, religion fashions are the subjects of continued, because they partake of the changeableness of man, while the pure elements of truth which belong to them are the same to-day, yesterday and forever- Let us return to Hippocrates the coan sage: He was a philosopher, who turned his attention to medicine as one of its branches- Not all the portion of him which has withstood the test of time belongs to the philosophie element of which he was composed, or containg the particular truths of the science of medicine disencumbered by himself as we shall presently show- philosophy, was interior to medicine it is coeval with man with theology- Theology now, and philosophy when rightly understood are one and the same thing- It was it is it ever will be, a prime, a constant a universal want, a universal desire of humanity, while medicine, while medicine and Law are only secondary and accidental wants- Medicine as science: commenced with the coan sage. Anteriorly, all thing were under the dommion of theocracy, and the state But in proportion as time roled on population increased, wants multiplied, and the minds of men agitated in the cradle of civilization the ancient dynasty, gave way then from the elements of humanity sprang the profession commonly called the learned 21 profession of law medicine and divinity These assuming the guardianship of the people and the state branched off each in separate trackes to pursue it destine course; all professing, and with more or less sincerity too:- to be laborers in the cause of human good- each still standing apart has continued its assigned route up to this our time, our place. But springing originally from the elements of humanity they are doomed sooner or later necessarily to meet again, in her element, springing from special wants special necessities and from peculiar frailties common to her nature they can but in the general the universal wants, the philosophic element of humanity But it is time to leave the walks of general philosophy to enter on the examination of those that are peculiar to the task assign viz: the philosophy the theory the truth - of fever It was by the coan sage, we think the the first elementary and the first [cross out] [cross out] imperishable truths were spoken, when he affirmed that fever was an effort of nature to expel some offending cause, or humor, from the body- Now this sentiment, so far as it goes, we hold in the abstract to be true, but the has faild, in his explanation of its modus operandi- he was compelled to fail to fall short of the full clearing up of the subject for such a thing would have been without the pale of the circumsatances of his existence, going a head of the minutiae of the science. The knowledge of which minutae is indisposable with the full, the clear the transparent 22 View of theme- His notions of the four elements of blood, of phlegm, of yellow, and black, bile, modern reaches compel us to lay aside: while his leading his, elementary his philosophie element will stand- His views upon diet, exercise, and the influence of Malaria in producing diseases, are for the most part, based upon sound experience Here he errs again when he dips into the minutiae of explanation- From this doctrine of the four elementary humors have emanated the doctrines of Galen, and with varied modifications of all the humorists down to this day, receiving continually the lights of the minutiae of science, as the sciences progressed- But it would be trespassing on the time the patience, and the good sense of the reader to go into a detailed account of the varied grades and shades of light that belong to the different champions of the humoralistss, schools: suffice to say that disease was laid at the feet of the elements of fire, by others of water, of phlegm, of acid of Bile, and of flatus, &c. From the idea of flatus with the greeks, probably originated, those numerous conjecture phantoms, ideas, which at different times differ places, have assumed the various names of spiritus. Anima, Neuma, Soul, Spirit, Vita Motis, Phanus, Eros, Cronus, Ulomis, chusarus, Aura, Aroma Vis, Medicatrix, Naturae et cetera Now, under any or all of these titles do we recognize an element of truth but that element has not yet been fully evolved- At this time, at this every hour while we write, is this phantom, this phenomenon in one of its protean forms, held up in wonder to the admiring gaze of the populace by the followers of mesmer, but we have not time to expatiate on this feature in the phenomana of the neumena of humanity.- 23 that more properly belongs to our next series- For the sake of brevity we have thought fit to link together some of the [illegible] Rival chains of thought- Let us then hold up to view the Rushites the depletives, with the Brunonians in modern nomenclature, the Thompsonians, the steamers standing at the distance that we do, and beholding, the movements of these rival captains, and their well armed followers, on the battle-field, recalls to our mind a passage from a poet of Rome one of the favourites with us in the days of our boyhood (demr stali vetanl alia vitia current, in contraria) of planiea, as follows- While the one is running depletion to excess, the other is running on the opposite extreme- As though none could not perish, as well by suffocation as by exhaustion alias, as well by fire as by the sword_ Veritary [illegible] inter extremas explained) to wit- Truth lies in the middle- As to the [illegible], and the solidists, we see but little choice between, them; to us both parties seem to have taken results, in the depurative efforts of nature for their causes- The one locates fever in the liver, and attempts to prove it by a very fanciful flurish about the portal circle, in the circulation of the blood, while the other locates, it in the mucous membrane of the stomach and intestines, and rests its proof on the numerous autopses- As to the result of their different modes of practice again we see no choice- From our personal observations on the theatre of life we are led to believe that the one as many souls has purged away as the others bodies saved- But, a record to the enlightened founder of solidism- When the ancoatal, Broussais 24 of Paris has reviewed the history of medicine, and with great skill, and with great judgement enlisted the labors and the thearies of every predecessor, and upon them ruins based his localized views of fever he then went on to demonstrate its truth by his numerous autopses; he thought no doubt that he had reached the terminus of thought the handling he christened (as par excellence) the physiological doctrine, and the world has accepted it under that specious tittle- But to us only serves to recall to our mind a passage from the inspired author of our text- The wisdom of man is folly for he taught the wise in their own craftiness- The rigid mental discipline common in schools of medicine throughout continental Europe, while they tend to perfection in the manifestations of art, either in surgery or medicine, are well calculated to circumscribe [illegible] the native spontaneity of thought in general expanses of mind so indispensably necessary for philosophic generalization and progression in science- Thus we are enabled clearly to see the influences of the force of circumstances which compelled Broussais to blunder- His [crossed out] physiology is based on anatomy; his pathology on his Physiology, and his autoposes served only to confirm him in error he had not learned so to abstract himself from the purely physical man as to see and to comprehend the Laws of his neumana alias his vitality, or in other words-again, he could not compass the [cross out] whole man in connection with the whole series of causes and their consequence; therefore he took a result of fever for its cause 25 What then is fever; We conceive it to be an effort of nature inherent in all animated, creatures, to sustain its own integrity from the deleterious opererotions of causes, of whatever kind, by which it may be assailed; in this sense we make fever in its essence a unit, while in its phenomena, its physiognomy it is multiform and that multiformity of character proportioned to the peculiarity of constitutions send circumstances of existence and the nature of the varied causes or agents that are made to stamp diseased impressions on individual sensibility or the sensibility of particular organs, particular, [illegible] of his completed machinery, which machinery should ever be considered as a unit one whole- although composed of many parts while by indisoluble laws of unity; its nervous chords the true the only medium of that much used much abused and illy comprehended term called sympathy- The- difficulties we should not lay errors in the labors, of all who have preceeded me [illegible] consisted we conceive in two reasons: the one is, that the element of man, of medicine, and of nature, were not sufficiently evolved; the other in the want of development of mind, the ability the liberty, The expanse of thought to enable them at a single coup de ceil, to compass the whole man, to comprehend the harmony of contrariety, to be hold the unity of variety, that delved within him, or in other words they have been like unto certain eastern reviewers, of certain philosophic thoughts on certain earthly phenomena, called Cholera, asiatica whose intitled, being too 26 limited too local, to comprehend a phenomonan [crossed out] which encompassed the whole Earth very shrewedly suspected, that in the same category should be included the whole of the ballance of us= Now since the reviewers have failed to comprehend are thoughts on a feature in the physiognomy of humanity, we have concluded again to try them with some thoughts on a single phenomenon in the physiognomy of men; or using the wards of the inspired author of our text meats have we offered them, but find that to milk they must return,"- St. Pauls Epist to the Corinthains 3, Chap. 2, Verse- But it is time to leave the follies of the learned,, and look to nature as the fount of light- Too long now has man the World beguiled by promises of art, too few have looked, to natures watches, to see, to have the modest dame; the still, the secrect and the silent ways, the sure, the lasting operations of her laws- Through spectacles of books the world has looked from times begining down, it is time to lay aside the mask; let nature speak to nature now, unmasked,- But man, frail now, will say it is wrong to strip the damsel of her gown- We write for men; their voices we must obey- Then let the maiden stand not bare but covered with a veil- But to the labors of our task let us return once more, for on us the duties fall to make our footing sure,- We have thought [ap??] man into one complete, one perfect, wholesome living mass of organized machinery- Now in as much as His treaties, is intended for general, reading and extended usefulness to go to the families and friendes of the community the great body politice more than the learned World all conceive it to be our duty in the illustrations of our theme, in the applications of our theory to 27 practice, the result of which is the only proper test of truth, to dip as little at possible into the mysteries, of minutiae- that is into the play of atomic phonomena, atomic affinities- as such a cause would serve only to embarrass the tender mind, and be productive of no real utillity- What, then, is health, but the harmonious play of all the solid structure the equable and harmonious play of all the fluid matters, the healthy response of every surface, of every organ to its natural its healthy, and its appropriate stimuli? What, then, is disease, but an interruption of this play, in some in any way, in every way as the [c??] may be? Diseased action- that is a departure from the healthy action may result from many causes- and in very many ways- We shall in the first place, enumerate the avenues of offending causes, and than proceed to mention some of them merely for the purpose of illustration for it would be going intirely beyond the spirit, and intent of this treaties to attempt a full and complete narration of Causes or of their modes of operating as such a View would require the compass of many volumes- We shall therefore content[illegible] with citing such only as are best Calculated to give him a clearer view of the nature of disease[illegible] he may the better see, the indications of one, and be enabled, to vary his steps in the use of remedial agents, so as to bring about, a return to healthy action, in the safest way and the shortest space of time- and with the last possible detriment to the constitution of his patients- The prime causes of all febrile diseases no concern to operate on or to pass not the system through the following avenues, viz) 1st, through the nostril, the larynx, and the lungs- 2d The whole extent of the cutaneous surface that is, of the skin, in the light of a reflected membrane, so altered in structed as to perform an additional duty 38 to wit the medium of generating heat- 4th The senses- commonly called the five senses,- That is to say the sense of seeing, of smelling, of tasting, of hearing, and lastly, of touch- In the first place, let us take under consideration the liability to deranged action through the medium of the lungs, the breathing organs. Diseased action may be produced in the breathing organs themselves, from the mere extremes of temperature, or, What is more common from the sudden transitions of temperature; or it may again result from the presence of gases positively deleterious to the organization or from the absence of natural stimuli those elements that consitute pure atmospheric air, so indispensably neccessary to life and health, when fevers result from any of the above-named causes they are likely under proper treatment, to be of short duration but here is still another way in which fever ( commonly called essential fever) is produced [illegible] near those classes of fever produced by the absorption of Malaria- That is, the imbibing the mephitic gases; that emanate from the debris of vegetable and Animal matter or both combind- These fruitful sources of diseases insinuate themselves into the Animal organization to make a marked impression, on the whole man without leaving any demonstrable traces in the particular structure through which they pass or by which they are imbibed, viz. the skin and the lungs- Now the system may be changed, with the seed of disease that is Malaria, for weeks yea, for even months, and still never be ripened into action; because it generally requires the operation of some exciting or proximate cause or, causes acting on the predisposed organization, to develop the disease; that is to produce a departure from the natural, the regular, the healthy and 29 sympathetic, play of all the structure The prime impressions, then is made on the brain_ The centre, the fountain of the sentient the phenomena, Indeed, but for cerebral and nervous sensibility; we should not be the subject of disease at all- It has been asserted by Dr. Rush, that during the prevalence of epidemic, bilious and yellow fever, in the city of Philadelphia, that persons who were strongly Changed or predisposed to fever could readily, discover it in the odor of their hand, by merely rubing them together We have frequently experienced the same thing ourselves_ But we should not overlook the disturbances of the [dep??] process or functions of the lungs as a [illegible] of fever_ The deleterious effects of [illegible] transitions_ of temperature_ may so modify the timing of the internal aflicted membrane of the lungs as to impair its ability for receiving oxygen, of the atmosphere the same time, of transmitting the elements that should be thrown out through this worst way- Again, imperfect digestion disturbs the assimulations of the blood in the lungs and in this way may prove a source of disease to the lungs, and consequently give rise to few of this we shall speak more fully when we have under consideration the functions of the stomach and intestines at is we believe principally through the medium of the Lungs or breathing organs, that all these febrile disease called contagious diseases, are propagated such as measles, small pox mumps-whooping cough and the like_ We come [cross out] next to take under consideration the liability of the system to take on febrile diseases, through the medium of the cutaneous surface 30 What is the skin- The skin is well known through its own inter extent to be an absorbing surface under certain exigencies of the animal economy- For example when the comunication to the stomach through the gullet, or oesophagus, is obstructed and The individual is suffering much from thirst then that want can be measurably supplied by sponging the surface, of the body with water of suitable temperature, or by bathing- It is by verture of this law that we are enabled, to reconcile the fact that poultry sheep, hogs and even cattle can live for some time and even fatten too. When cutt off from their regular supplies of Water to drink They then take is from the atmosphere from it four going examples or facts, we are led to the belief that malaria may in like manner, be imbibed by the skin, and this enter the Circulation when the such malaria be held in solution or in a state of suspension, merely, in water or in atmospheric air,- But the most frequent, the most common, and the most demonstrable way, in which febrile action is induced through the interrupted function of the skin, is the sudden transitions of temperature, particulary the impression of cold and humid atmospheres; these causes operate by putting a stop to both sensible and insensible perspiration, which we have already shown to be the most extensive, and as essential an outlet or was way for the redundant or useless matters of the system, as any excretory organ of the whole animal economy,, But happily for man, skin possesses within itself, the power a most eminent degree, of adopting itself to the surrounding circumstances in which it is placed- There are however constitutional, peculiarities in the textures and faculties of the Cutaneous surface of different races of men, hence the stronger the odor of the exhalation from their bodies even under the same clime and the same mode of living, 31 The African race for example have more highly reticulated surface than the Caucasian or other races of men- Hence in all probability their comparative immunity from the deleterious impressions of malaria; the depurative offices of their skin being more actively performed- We come to the consideration of the mouth, the stomach, and the intestines, as natural inlets of disease, particularly the seeds of febrile diseases this we shall trace through the medium of of the food- By this term we mean to now, to include all the necessary ingesta to sustain life both solid and liquid and aeroform fluids- Food although it be continually required to meet the exigencies of the system, maybe and frequently in instrumental in the production of disease in one or many of the following ways, ([to??] first by too long fasting or the scantiness of nutritious matter in the food taken or its indigestible form or nature; or again the want of the particular, elements most needed at the time by the particular individual the first impressions of long fasting is the sense of hunger, then in the stomach. Then of fullness and pain in the forehead, with a general sense of langor or debility next comes- the fever- c vas This fever is the result of simple irritation of the brain from not having received its accustomed stimuli; the same results we have frequently witnessed from the stomach not having received its accustomed kind of food- for example milk in the place of coffee for breakfast What now is best to be done? The Doctor comes bleed puke, purge, and sweat or administers a mess of meats soup tea or coffee as the accustomed habits say- The food the ingesta, the alimentaria may be production 32 of disease from mere quantity whither it be in a solid or liquid form. The over-distention simply may paralyze the action of the stomach- Again when ingesta is too much for the gastric secretion to same from the play of chemic laws; that is of natural decomposition in other words, of indigestion, then the food becomes a source of disease; now, this result may take place in the stomach, or it may not be felt until the food reaches the intestines, then you may look out for colics and for bowels complaints and lastly for fevers. such fevers would be strictly symptomatic; but of this we can say no more as our business is to explain idiopathic or essential fevers- The uses of the saliva and the objects be accomplished, by mastication, we think have been but imperfectly understood untill now The recent experiments of the professor Deniglinger of Philadelphia, have thrown much valuable new light on this subject- The learned professor asserts that the viscid nature of saliva is intended in the economy of nature to envelope globules of atmospheric air, and thus by masticating our food, we introduce qualities of oxygen [illegible] stomach, to pass from thence into the circulation to maintain the slow combustion so necessary for the production of animal heat the professor further states that one main object in ruminating Animals is to unite an additional quantity of oxygen with their food- Now if this be the fact and we do not question it, the reader can readily conceive how it is that malaria which is inseparably united with the atmosphere, finds its way, with the food into the circulation- Who ever has witnessed the ravages of what is called milk sickness on cattle, horses, hogs, dogs, men, and Vultures of the air also can readily conceive that poison may enter by the mouth and stomach into the whole organic, mass- We have witnessed it effects repeatedly, and on 33 a pretty liberal scale, but of this we may speak hereafter= It would be going beyond [cross out] the intended limits of this treaties to attempt to show the many elements, and the many ways in which diseases or even febrile diseases may be induced through the medium of the extended catalogue of drinks and aliments; yet we will make one other remake, before we have this division of the subject, it is that a mere deficiency in the liquid elements in the system, may prove a source of disease as we have repeatedly witnessed when water was scarce, or was of such quality, that it only taken when pressed by very imperious calls of nature to allay thirst- Water is known to be continually, required to maintain a proper fluidity in the blood- In warm weather particularly and to laboring men, it is constantly expended by the exhalations from the skin and lungs It is a fact well known to the profession, that when the serum, the fluid element of the blood been wasted through the stomach, the bowels and the skin during the reign of the recent epidemic Asiatic cholera, that many individuals who had this run into collapse, were again resuscitated restored to life, and to health, by merely injecting simple water, or salt and water into their veins I promised to explain the five senses in this chapter) as avenues of disease- This investigation involves all mental emotions and phenomena, or to speak now properly, all encephalic, which is the brain movements and perturbations and the laws of sympathy these unto belonging- First, then let us commence with the olfactories the nose and the lining membrane through- while none but the natural sound and healthy generations, from fruits from flowers, from men, and animals floating in the atmosphere impinge on the organ of scent, all is well 34 Indeed who is it that has not a pleasurable exaltation of brain, of thought, and through it of the whole organism from in holding the odors of nature's laboratory, at the opening of the spring or on a ramble over the spice islands of the South and east- Now should we but change the scene, and let the olfactories, meet on every hill and every plain, in street alley and the main, nought but mephitic gases of the dead, of men, of animals and plants of whatever kind, of whatever hue, then the perturbation of the brain delirium, first and fever next succeeds also creations wild and horned fill the whole machine, and onwards onwards moves to death, from whence he came- Taste comes next The [illegible] direct and sympathetic associations of taste are either or both very frequent causes of mental perturbations, and even of physical convulsions, as we have frequently witnessed, and occasionally experienced ourselves. Who is there that has never lost a meal from having swallowed, or even having imagined themselves to have swallowed, with their meats, milk, or other drinks a fly or some more loathsome object? I recollect once in the days of my boyhood, to have taken a few grains of Calomel and jalope in a piece of preserved fruit pears, and how this seemed while I labored under inflamation of the stomach more than fifteen years have elapsed and to this day my stomach would reject a preseved pear, and if the calomel were added probably a gastritis would ensue. we have heard a story of a learned medical professor, whose native modesty in the juvenile period of his life once compelled him while at the festive board of a friend, to take down a chick from the egg, that have been cooked through mistake 35 (and what is still more strange as the story goes) it stuck- But we question much if that stomach has ever has a fondness for eggs in any way sense- Hearing next in course- The sense of hearing comes next in order, which is the last to die- That is to leave us- This sense play an important part, in the drama of life_ The deaf man is always serious- for the most part melancholy; will the blind man plays the fiddle whistles, sings, dances and is talkative and gay- The immortal Homer, the blind poet of Greece, sang his Iliad and ossian Odyssey too long after he had lost his sight, Milton wrote his paradise Lost after he had become blinds- The ear, then, as a medium of intelligence is not less important than the eye- Through this channel [illegible] The passions, the emotions, the neutral perturbations yea- all the manned of physical and moral action either for good or for evil,- be produced- The tones of the orchestra falling on the ears of the auditory are made to elevate or depress at the will of the performers- Just so the power of speech The narrator or orator, now inspiries with hope now gladens with joy, anon, he fills with dispair or maddens into rage: Then comes the fever of combat, or the fever of disease- Touch So still another sense which claims our especial regard, we mean the sense of Touch or the impressibility of man by the surrounding circumstances of factitious Causes- Men in a state of nature and of nudity is a very different animal, from man dressed up and put in houses- The well-dressed light headed, civilian hears of or beholds with astonishment, the debaucheries and excesses of the naked aboriginal or debased African the brutal. [illegible] or the inhabitant of remote Polynesia_ But not so with the philosopher: he comprehends, the reasons for all these things, and wisely concludes, that whatever is, is right," that it is of necessity: and then your [illegible] civilian, would be astonished to find with a change or circumstances- how soon you would learn to drink brandy, eat fish blubber and horse beef and appreciate the dilacacies of train oil- But it is time to come a little nearer home to every day experience- There are varied grades and shades of susceptibility and impressibility among ourselves for example; the stings of venomous insects or the handling of posionous plants do not affect us all alike, for one man is proof against spiders wasps and bees while another is laid up with a [illegible] by black gnats and mosquitoes_ some handle the posionous oak (rus toxacadendron) with impunity while other one laid up with eruptive fever by it, but none entirely resist the posion of the rattle-snake the cotton mouth or the [illegible] mad dog- now this is all a mystery yet no mystery too- That which is to [?oma] mystery is still mystery is to you- Again we observe very different susceptibility and impressibility in different individuals, and indeed in whole families to contagious, and infectious diseases, some taking on diseased action from the slightes contact while other resist entirely- These facts we have known exemplified in an eminent degree in syphilis- But to offer explanations of these things would be going beyond the limits of this work Chapter 3 An this chapter we shall endeavor to explain the authors Views and opinions in regard to the common theories and 37 practices heretofore adopted in the treatment of fevers; [illegible] endeavor to demonstrate the folly and irrationality of the varied modes of practice pursued under the influence of these theories- We shall commence with same [com??] in the depletion remedies- First. The use and abuse of the lancet. Second. The use and abuse of emetics. Third. The use and abuse of cathartics. Fourth. The use and abuse of diaphoretics- and conclude this chapter with some comments, or moral and intellectual views on the use of stimulants- Having in the preceeding chapter given a brief summary of the animal economy and death somewhat on the offices of those organs [illegible] in the phenomena of fever all shall now attempt to [illegible] to the satisfaction of every imprejudice mind, the error [illegible] impropriety of attempting to cure fever, by depletion that is by bleeding, puking, purging, sweating, nauseating medicines and the like- It will not be denied by the followers of the anti-phlogistic, schools, that they [illegible] that fevers are almost all, more or less of an inflammation character; or that febrile existence in their estimation implies a state of exaltation of one or more of the [illegible] life: and that they consequently infer, from this view of the subject, that relief is to be sought for and obtained by and through the agency of remedies more or less [dep??] in their opperations, that is to say, bleeding, puking, purging, sweating, nauseating remedies and so on! Now while we are free to admit of a state of irritation, a state of perturbation and even more a state of exaltation for the time being in one or more tissues, we shall endeavour to show that it is not best to depend on depletive measures to restore the system to its last salutary balance and healthy tonic action- For while we admit a perturbed, and even accelerated arterial action to exist in some of the organs, some of the tissues, during the paroxysms of fever we contend that this accelerated local or local and general arterial, both combined, in the result of a loss of balance of the whole system accompanied by a more or less [su?fecbled] tone and debilitated action of a 38 parts or of the whole economy- While we believe the use of remedies and give our assent to the salutary influence of remedial agents of the varied kinds that have been heretofore brought into use- we [we??d] [?igh] never to misunderstand or to run counter to the indication the calls, the laws of nature, as enfolded in every individual case= We already comprehend from our knowledge of the laws of supply and water, in what way the followers of the depletive, the antiphlogistic schools have [illegible] achieved the restoration of the lost balance (the cessation of febrile diseases) but we contend that the depletive cause alone, is not the safest the best The surest and the shortest way to esestablish the normal action so also we stand opposed to all those enthusiasts in the healing [illegible] who have been so rash as to think and even to [illegible] we should take the case out of natures hand [illegible] own, and treat it according to the rules of [illegible] when the indications of cure are not strictly [illegible] to the understanding, we then hold it safest [illegible] to adopt the maxim of an aged medical friend, that the error of omission is less [illegible] than that, of commission- Then let us [illegible] and carefully observe until nature speaks out her wants- The depletists continue that their treatment is necessary, and proper if not to subdue inflammation to guard against it; hence they take blood- to febrile heat and hurried action still continuing they admister pukes, they say to expell the morbific matter, and thereby subdue the disease- The heat to the skin and perturbed actions still continuing they administer purgatives- still to redue the fever and to rid the system of morbific matters- The fever still runs on. They repeat their bleeding emetics, cathartics, still to redue or to elimanate morbific matters from the stomach bowels, or gall-bladder; under the little vitiated bile- Well what next! Now comes either a cause of nauseating and sweating drugs, or else alterative 79 cases of blue mass or calomel- By this time the race is nearly run; the patient either begins to mend in spite of the doctors, or retreats from their custody- But cause there is evidently a hot and dry skin, thirst, often heat and burning sensation in the stomach and bowels a quick, fretful, and irritated condition of the pulse with more or less of pain, they contend that there is more or less of an inflammatory diathesis,- As plausible as this argument may appear it proves but little in support in the position taken, even in a theoretical point of view, as we shall attempt to show- In the first place, we hold that no fever proper, is strictly of an active inflammatory character- Our proof is as follows= All real and acknowledged inflammatory [affections] in the natural and unbiassed order of such phenomenon- run their course come to a crisis niether more nor less than eight or ten days- this law is so precise and notorious that the ancients from their experience settled [down]; on the nineth day as the fixed period to [arrive] at a crisis- But when the old practitioner attempt to apply this law, to fever proper they erred- Hence at this period of time the idea of critical days has nearly run out of use- Now we [did] contend contend that this law hold good in acute pleurisies fractures, and in all cases of fever from mechanic violence- The same laws is manifested in the [exanthemata] (eruptive diseases) Such as small-pox measles, &c These diseases are known to all medical men to have a prescribed course to cure, and the intelligent practitioner aims to conduct them to a solutory crisis- But not so with fever proper- Yellow fever- plague, cold plague, Typhoid fevers, and other forms of putrid fever such as camp, jail hospital and ship fever and the like (to which might 40 be added (cholera morbus) are all the natural and legitimate offspring of human folly. often kill their subject in a day, or two, while again they run ten, fifteen or twenty days, or more before the attending physician can say whether the patient will recover or not- Milder grades of disease such as common bilious, and mild typhus fevers through they sometimes terminate life in a few days not unfrequently run a month or six weeks before any one can say, that they have even reached a crisis- Fevers then bear some analogy to ill-conditioned sores and ulcers having no fixed period for coming to a crisis- Fevers however are always of a general character, while these [illegible] and ulcers may be either of a general or local nature, or both combined- But their continuence most probably depends on a [??lilated] and abnormal, or irregular action in [illegible] depurative, process of the system that is, the play of the secretory and absorbent vessels, the vital force being enfeebled or the vital fluid (the blood,) not containing the proper elements or its elements not being in their natural and healthy ratio, the consequence will be inaction, that is effective vital secretion hence in such cases we rarely see a due proportion of animal heat, soreness or inflammation in those parts; never the proper quantity and quaility of well digested pus (matter) well formed granulations untill some favourable change is produced either by nature or by art and this change is much more certainly and speedly made by such agents as will equalize the excitement and purify the secretions without debilitating the general system than by bleeding puking purging and nauseating medicines-- When the sores and an ulcers are of a local character general 41 treatment may not be necessary- But the application should be alterative one deobstruent astringent tonics, or medicines more or less stimulant should be applied- But it will be asked, if fever is not inflammatory what it its character? We would say that fever is a disease of irritation; or if you prefer it, and and allow the expression, we would go so far as to admit that it may be a disease of subacute inflammation- But fever never runs up into active inflammation Secondly although there is a hot, dry skin, thirst after heat and burning sensations in the stomach and bowels, a quick fretful irritated condition of the pulse, with more or less pain, still [illegible] there is not a general preternatural excitement [illegible] system- On the contrary, that there is a [ge??] diminished action, and a general [a??] of tone- When the organs of supply that is the absorbent vessels, act with abnormal energy is an energy too great for the organic [illegible] that is the organs of elimination and of [illegible] viz: the skin kindneys, and lungs; then the phenomenon of fever takes place that is the circulation is perturbed and the skin becomes hot and dry, in other words, the equilibrium disturbed, the healthy balance lost- Now [illegible] this state of things occurs from the cause that produce fever proper we contend, that while the vital action is in excess in the one class of vessels it is in a proportionate, torpor in the other class and vice versa so these oscillations continue to take place- constituting the [re??ssious] of fever of diseased phenomena: untill, by the [??adiden] conservative, powers of nature or through the wisely constructed agencies of art, the whole economy settles down to the natural equilibrium, the healthy balance again- or else terminates in death- Now this vessels, that is the vessels of 41 supply and waste, are in one sense antegenistical in their action so that when the stomach and bowels are acted on by pukes and purges, the exhalants of the skin, lungs and kidneys too are proportionally inactive or Torpid- suppressions of their accustomed functions takes place for want of the matter to eliminate, they have been thus directed to another channel, indeed the prime elements are released by this process- that is the regular supply for the time being cut off- But it is further [illegible] that thirst is again a sign of inflammation- It were probably the existence of this symptom in the epidemic asiatic cholera which [illegible] Braussais to administer cold drinks, to [illegible] even ice, to his patients- To disprove this [??tion], it will only be necessary to cite a few common occurrences, familiar to the experience of almost every man, any one of which facts is worth more, than a thousand Theories- Whoever has suffered long in hot [crossed out] weather [illegible] want of water, as many travellers and soldiers have done have found their skins hot dry, and the sense of thirst inffusably great, so also, whoever has witnessed the war- worn soldier or the citizen [??ttering] in his own blood, and dying for want of it could not fail to observe the animal heat departing from his skin, with the failing of his pulse while at the same time his cries for water ice water becomes greater and greater to the last- Now could any one be so stupid as the think or to say, in either of these situations because the skin was hot and dry so the thirst great, or both or, thirst with neither with neither of the other conditions that the subject or sufferer [crossed out] the subject of inflammation of any kind or in any tissue The thirst on 43 either of these situations is demonstrably the consequence of a deficiency of the fluid elements of the Blood- Some as hot and dry skins as we ever felt, were in low protracted cases of fever, where there was evident debility, and much prostration in every part of the body- Every man familiar with fevers must have witness the same thing- The hot and burning sensation occasionally experienced in the stomach [illegible] bowels are often more distressing in the last than in the first stages of [illegible] when there is evidently general debility- It rarely happens in fevers that the pulse is any other than a fretful and irritated increased in frequency to be sure a quicker pulse in frequently, indicative of a general debility- the circulation have to make up in speed what is relents in volume and in it may be full and soft but is rarely [illegible] increased in force_ The pain ever attendant on fever is much more frequently the [congog??] of too little than of too much action in the general system- Witness the long train of painful nervous affections acknowledged to be the offspring of the irritable condition of the nervous system, attended with more or less debility of the muscular fibres- The neuralgia for example, such as chronic rheumatisms nervous colics, nervous sick headach, periodical headach or sun pain (tic doulaureux) et cetera all of which are of this class of disease constituting a very considerable proportion of the pain that we suffer, From what has been heretofore said useful a confident assurance that the attentive reader will concur with less in saying that to attempt to cure fever proper, exclusively, or mainly by 44 by bleeding, puking and purging in [in??] unphilosophical, and at variance with acknowledged principles of human physiology_ Now review it is admitted by all enlightened physilologists, what the skin kidneys, and the lungs, are the three greatest ways for the redundant matters of the system. Though there be several others of minor importance in point of amount or weight of matter, eliminated such as animal secretions and the matter of thought, the passions & that is the imponderable fluids expended in thought and the encephalic (of the brain) phenomena, we think that with these facts, these lase constantly in view [illegible] not be a difficult task to demonstrate the [illegible] heretofore commited by medical men in to treatment of fevers when they have relied mainly on bleeding puking or purging or a [illegible] of them all to cure fevers- While we admit the efficacy of all these classes of remedies, in certain cases, we wish to show the errors of all those to have depended on them as remedies exclusively Blood letting Let us commence with the use of the lancet; whoever will real in mind the Physiological View of supply and wast,, can readily preceive, that since the blood is both in the medium of supply and wast, it should be abstracted with great caution, and that as should never loose sight of the necessity of supply [cross out] it with new elements; that is we should look the proper supply of food and of drink and the necessary performance of the function of digestion in due time Or meet the demand of the economy that is to supply its waste- The proper use of the lancet in all fevers proper, we conceive to be restricted to plethoric subjects; we mean persons of vascular plethora- and young subjects, whose recuperative powers will the 45 better justify it;- in such subjects when the victims of fever, our practice has been- and our sitter convictions still are, that it is best to take off so much blood only as may be necessary to relieve the circulating system of abnormal tension; that is to give to the circulatory fluids their nature and accustomed free and easy play, and no more; and this should be done at as early a stage of the disease as the its necessities may be pointed out This opinion is the natural result of a combind experience for nearly twenty three years that is to say, fifteen for the one and eight for the other-- Emetics. The medications for the rise of emetics we hold [illegible] two and two only viz- First the evacuations [illegible] contents of the stomach, either on account [illegible] excessive fullness, or on account of the [illegible] nature of its contents; secondly, with [illegible] [cross out] revolutionizing and relaxing affects, [illegible] the waste way of the system are unlocked first time, and the general economy is thus [aff??] an opportunity of resuming the healthy last [illegible] Now, when fever is symptomatic or even when [illegible] in its proper character and the cause both [illegible] and proximate, have been slight or the [cross out] constitutional stamina in the individual is very good we have frequently found the diseased action cut short by the simple operation of a single emetic- when such results follow it the use of An emetic the patients needs no more But when an irration fails of the accomplishment of so disirable an end- We are opposed to its repetition, because it has achieved of all the good that we had a right to expect from it, and the system is now prepared for the use of other remedies more natural and for more efficient, or our abundantly testified we now mean the class of remedies called tonics and sodorifics- Whoever will hear 46 in mind the operations of the natural law, that the waste ways of morbific or redundant matters is through the lungs, the kidneys and the skin, and the skin in the most considerable and important of the three cannot fail to comprehend the propriety of these remarks for so long as you irritate the stomach by emetics and nauseating drugs just so long as you suspend the action of the natural law of depuration; and so long too do you cut off the neccessary supply of new element any matters which can only enter through the digestive process- In other words he who repeats improperly, prodigatlely sports with vital organization; and when this course is persisted in as we to our motification have been compelled Occasionally to witness; under the direction of our intermeddling brethern until the organic [cross out] tissues were so much exhausted and the stock of vital elements, one hand had become so much reduced for the recuperative powers of life to reinstate itself death becomes the inevitable consequence. If any one should feel disposed to question the comparative utility of the two systems of practice, we have only repeat to him the following question and at his own experience answer it, Have you ever witnessed a genial and general perspiration coming over your patient whether from spontaneous or from the interference of art and continunig for five or six hours without a sensible mitigation of the symptoms- that too, without half the distress and the prostration that would have ensued, from the same a reduction of fever. (Could it be achieved) by the use of nauseating and puking agents? We are well aware of the fact. That the 47 suppression of the healthy depurations through their natural waste say in fevers not unfrequently indeed very commonly became a cause of local irritation to the stomach and bowels; the morbific or redundant matters seeking an exit through this cannel rather than through their natural outlet In this way we can readily perceive how it that that which- The commencement of disease is merely irritation [???n] after a short continuance inflammation consisting what Broussais and his followers call gastritis, or [cross out] enteritis or gastroenteritis the case may be; which occurrences they gravely lay down in their writing as the cause of fever- But we contend that the fever exists before it inflames and that is always coexistent with the power of irritation If these views be correct then how absurd must it not appear to increase the local irritation of the stomach and bowels by the repetition of emetics? It is [cross out] not uncommon to see an attack of Autumnal fever of any kind commence with a spontaneous, and distressing vomiting Now, could any one acquanited with the laws of healthy actions, and at the same time with the laws of revulsion of the repurative functions under such circumstances as have been just cited think of administrating tarter emetic or active emetics of any kind? Would not common sense and reason instruct them to throw or cast off the redundant matters from the stomach by the mere use of [cross out] diluents and then imediately set about the quest at morbid irritation and throw the force of circulation to the 48 surface of the body as soon as possible and there by save the suffering organ from the danger of inflammation! By gently moving the bowels, in any Day, under such circumstances, you might diffuse the irritation over so extended a surface of the alimentary canal as to relieve any particular points or portions of it from the danger of great local distress- This course which in many cases is necessary, and even the best step to be taken in at all Times preferable to relying on the repetition of emetics or even nauseating drugs- There is still another idea in febrile diseas which has long haunted the minds of practitioners and the people, that is the quantity and quality of the bile- Having but some vague notions of diseased secretion of the liver,- which have been expressed by the terms [??liated], and redundant bile,- They imagine that the patient should be puked or purged So long as the liver continued its morbid secretions, or that some had consequence most inevitablly follow- The thought seems to have occurred to them, that the secretions are partly [cross out] up by the use of their medicine as [cross out] as of the continuance of the disease and that there are other means of relieving the patient besides those of puking and purging- But of this we shall speak, more fully under the next head- We might be charged with having too little regard for public opinion, if While on this point, of our subject, we should pass unnoticed the practice of the steamers- The Thompsonians- The followers of Thompson placed great reliance on the virtues of the lobelia inflata- With this article of materia medica we have long since, had some acquaintance 49 acquaintance more or less of personal intimacy- Besides its emetic properties it possesses more or less the properties of a Dialogue- In its effects, and its operation, it bears a striking analogy to tobacco- We think from what have witness, of its effects, that it is much better adopted to the treatment of cramp, and catarrhal affections than to febrile disease- As an emetic in fevers we should give a preference to Ipecacuanha- Cathartics Purgatives in all ages and in all countries have been justly enrolled in the list of important remedial agents and in the hands of different practioners, the different articles of this class of [re???] have obtained a varied celebrity- [illegible] Some have preferred individual articles in their simple, uncombined state- either [t??] exerted their ingenuity to find the best and make the best possible combinations of Them- Hence has resulted the long catalogues of patent purgatives and anti-bilious pills. Whose miraculous Virtues have filled our papers with certificates of their infallible cures; from the celebrated Lee's antibilious, Down to Cooh's R.A.C. We find one sect of docters deriding the use of the mineral cathartics while another sect are extolling them as the sampsons of the materia medica: some contending exclusively for the offspring of the [cross out] vegetable Kingdom are asserting that all things else are poisonous to the animal economy (such are the Botanic, doctors- One would think that 50 Such men had not exactly kept peace with progress of organic chemistry;- some there are again who give a decided preference in the saline cathartics- So we find one class of practioners( The Hamiltonians and the Cookites for example) promising the greater possible good in the treatment of fevers, from the use of purgatives alone; while many of the French medical writers [illegible], admit their efficacy at all- In this labyrinth of doubt, Who shall dare assert, I am the light I am the way." In a word mankind have projected almost as many ways to health as to heaven, while in truth there is but the one way to [illegible] If we were permitted to give our opinion on the use of cathartics in fibrile diseases, we would dwell less upon the particular article than upon its dose and its repetition- As most any article of the class may by suitable combinations made to set easy on the stomach, and operate gently on the bowels; yet any individual stomach especially if it has often been under the care of docters has its aversions (We could not say its partialities) and these circumstances we think alway worthy of attention- In our choice, then, we should be in a great measure guided by the antipathies of the patient, and the circumstances and symptoms at the time being sometimes the mercurials should be preferred sometimes the vegetable, at others saline and not unfrequently a combination would be preferable, according to the particular modified action desired to be produced in the case-. With our settled physiological and pathological 51 views, we have but little use for carthartics at all- and when used we would desire to have them operate efficiently, but as mildly (that is giving as little local irritation) as possible. To us the indications fur their use would seem to be first, where there was constipation of the bowels, or fulness of the alimentary canal than evacuate, secondly, when the irritation of fire was spending its force mainly on the brain, then we should use cathartics, with a view not merely to evacuate and to diffuse the irritation over a larger surface of the systems, but to produce revulsions from the brain to the alimentary canal, and then prepare the patient for the better operations [cross out] other remedies- We are not ignorant of the fact that fevers have been repeatedly cured by the mere repetition of cathartics, [illegible] we have had the same thing occure occasionly under our own experience; we know that with good constitutions, the work of depuration and the ultimate restoration of the equilibrium, may be achieved through the medium of the stomach bowels & liver- But to accomplish this much time must be consumed great suffering endured considerable emaciation, and consequent prostration of physical tone produced and the constitutional, stamina of individual is defective= death is not unfrequently the result of such a circutous rout to health- But the depletists especially the purging sectarians, contend that there is great acrimony, vitiation and redundancy of bilious matter, in the system, that can only be eliminated by purging- We will not deny that the secretions in fever are generally abnormal; but we do contend that the departure from the healthy action as 52 frequently consists in a defective as in a redundant secretion- We are even writting to admit that the bile formed under the febrile action is not often strictly healthy in is properties but the admission of this fact those not lead us to infer, with many who have expressed their opinions, that the acrid bile is the cause of fever are conceive that to be a clearly a consequense as is the inflammation of the mucus membrane of the stomach and bowels, so much relied on as a [illegible] of the soundness of their doctrines, by the layers of the autopsic mode of setting the laws of phenomena,- Much has been said of the necessity of discharging morbific matters and the liver has been much more censured for the part it plays in febrile diseases than it really deserves- the mass of mankind have been all most urged to the belief, that the existence of bile was inimical to health- and if to it should be added the qualifying expression vitiated, from the likes of the grave medical philosophers, then it becomes truly alarming now while we admit that the liver in the discharges of its functional duties frequently departs during fevers from it, healthy labors, and that sick stomach, head-ach and vomiting are sometimes occasioned from this cause yet we know that a regular and plentiful supply of bile is as necesary to the process of digestion and a healthy existence as any other names secretion for its distine office nor is it more liable to vitiation or decay than other secretions it is known in its natural envelope, the gallbladder, or in an inspissated, state, under favourable circumstances, to be preserved for any length of time; indeed it has long since been in use as a vulgar and popular remedy for colics, disspepsias 53 and fever and we have such faith in the efficacy of sound healthy bile as to believe that it will [illegible] long, find [jo??] even with the learned, The [illegible] of high-colored urine, and the yellow tinge of the skin so common in bilious fever, jaundice, and yellow fever should not be ascribed so much to the suspension of the secretions of the liver as to the invention or retrograde action of the absorbents,, The bile in these cases we conceive to pass directly from the liver and the gall bladder back into the circulation, instead of first entering the alimentary canal and then passing through the absorbents and lacteals, whose mouths are spread out on the surfaces of the stomach and intestines, the unpleasant symptoms attendant, in the conditions of the [???al] we are disposed to ascribe more to the loss of balance in the great function of organic life, and the enfeebled [illegible] of the brain and nervous system than to the mere presence of missplaced secretions- for bile misplaces in [illegilbe] than any other secretion or element,- and the only reason why it has attracted so much attention, we conceive to be because of its color it being the only one of the numerous secretions which in becoming misplaced in rendered visible to the eye. Every body is familiar with the retrograde action of the lacteals, and absorbents in cholera morbus and more especially in Asiatic cholera where the lacteals and absorbents were not only employed emptying their own contents but through them blood vessels themselves were 54 exhausted of their serum then fluid elements to be thrown off by the stomach and the bowels- Now having witnessed these facts and comprehending as we do the operation of the natural laws of health, we object to treating fevers mainly by cathartics and emetics, our reasons are, first, because such a course would be inventing natures, laws, and secondly because, we have found a much better and [illegible] way to arrive at the same desired result,, namely the use of tonics and sudorific, But that sect of partisans known to the public under the imposing tittle of mercurial doctors, will contend that they have and [illegible] more good by the judicious and of mercurials than any one can do with Tonics and sudorifics such more often deceive themselves and the public too, from vague notions connected with the color and consistency of the stools. Those who have observed them closely in the routine of their professional toils, have found them administering calomel for almost all purposes; for example, if, the operations are thin, they give calomel if otherwise they give calomel sill; if white calomel if black calomel if green calomel; if yellow calomel sill; in a word they seem to have the same blind attachment, to calomel that certain topers have for whisky it is their toy for joy, their remedy for grief, Many Valuable lives we have no doubt have been sacrificed to the erroneous ideas attached to dark discharges such appearances being as much the effect of Calomel as of the nature of the disease To us the color and consistence of the evacuations serves to throw some light 65 not only on the condition of the organs themselves involved but on the state of perturbation of the general system likewise. The olor of the evacuations is more or less modified by the operations of three causes, to wit the food we eat, the nature of the secretions, for the time being and the chemical charater of the drugs taken,, will cause pale on even white [illegible] changes, others brown or blacking [illegible] and some a yellowish cast [illegible] may still be equally healthy, while we admit the virtue of calomel and Blue mass, we would wish to [illegible] the abuse of them- The calomel Docters who has made the [illegible] the focus of all fevers and calomel the panacea while they condem The [illegible] alicon in medicine, still continue to [illegible] Mercury, in some shape or other, in some [illegible] or other every stage and every [illegible] it is their carthartic, their alterative, their salivant, their solvent, and even their tonic There is one disease and one only which we have not been able to treat satisfactorily without it we mean lues venerea of French [illegible] This disease it seems to exercise some specific Virtues; but even in this disease we have been accustomed to use it very [cross out] guardedly- The great facility with which doctors are fabricate in this our day and the innumerable swarms that are turned out every day or annually from the many factories more scatered over the whole surface of the globe, or the civilized world in one of the many reasons that have induced us to place in the hands of the people the results of our research and experiances that they may be the better 56 enabled to understand the laws of self preservation and may the better appreciate the comparative value of the labors of their medical advisers-But have not yet taken our leave of the mercurialists- The extent to which calomel and blue mass have been administered during the last twenty five or thirty years is so great, and the ratio that has been mal-administered so enormous that it is high Time for humanity to raise her voice either to disarm her heroes of the weapons of death, or to withdraw her subjects from the field- In what part of the vast continents can any man cast his eyes and not behold the grave of some victim of its pestilential powers. where can a social club convene that dose not contain some living monument [illegible] it is indeed the most insidious of all known poisons- the poison tree [illegible] the serpent the arsenic are the [illegible] acid either gives timely [hlor???] of their present or distory their [illegible] or since- But not so with there [???y] or [lus?ingtis], those who [cross out] [cross out] listen with credulity to their wispers of fancy or powers with alacrity their phantoms of hope are doomed sooner or later to awaken in the realities of despare; for when once the victim of their remorseless grasp, neither prayers tears, time, nor antidotes will ever remove the spell, for every rain that falls every wind that blows will ever tell through their aching bones_ So such of our readers, as have dived deep into that department of the arcana of nature called laws of propagation we may 69 [cross out] safely assert that mercurial diseases is not solely confined to the individual sufferers but its effects are in a greater or less degree revived in their offsprings- Every body knows that [illegible] like yet all do not know that this law holds good even to the particular [illegible] of body or mind (we had like to have [illegible] brain) at the particular moment of vivification- But these things we must leave to posterity to settle- Diaphoretics We come next to treat of that class [illegible] whose action on the animal economy is [illegible] union with natures laws- In [illegible] in our minds the great ruling and controlling powers of organic life, we discover two very important movements in vital phenomena the one we shall call the centripetal the other the centrifugal; the one a concentration of the energies of the vital forces to the internal surfaces of relation; the other the [illegible] of the same forces to the external surface or what might be more strictly speaking to the periphery of vital action) there to eliminate or to bid adieu to all those [illegible] which having served the purposes of life are no longer needed and whose continuance indeed would be oppressive to the system In the right knowledge, and the right exercise of a controlling power over these phenomena of vital action, consist all the secrets of health and disease- sudorifics, and diaphoretics are those medicines which being taken internally increase the sensible and insensible exhalation [cross out] 59 from the skin- This effect may be produced in any one of many ways or more certainly by a combination of means to exemplify external heat alone may produce the effect; the use of diluents the use of stimulants proper (we mean not irritants see chapter on medicine) The use of the vegetable, mineral, and alkaline diaphoretics proper and the many combinations that may be made of them, of this numerous class of remedial agents the discoveries now in progress in organic chemistry will lead us [cross out] to make the most judicious choice- Our past experience has led us to give a decided prejudice to the vegetable and alkaline as a union [illegible]- This class of remedies when rightly [illegible] comprise two others- classes of [???rmmae] [illegible] [illegible] of expectorants, [crossed out], diuretics, for collectively those agents are used for the same purposes namely to unlock and to maintain the [illegible] action of the three great waste ways the [illegible] the kidneys and the skin, that is to say in the natural, order they are but different members of the same family, hence under one set of circumstances diaphoretics are made to act diuretically and vice versa- under another set of circumstances diuretics act as diaphortics- To explain more fully: Squill, digitalis, the alkaline salts of Potash Soda and ammonia, Any one or a combination of these articles- in conjunction with warm diluents such as flaxseeds, or others simple herb-teas with warm atmosphere a warmly clad skin- But use the same articles and change the circumstance to a cold skin, cold extremities- a passive condition or passive exercise, such as a ride of a cold day,- and substitue malt liquor- Give cider or even the free use of weak wines- and you may expect an increased diuresis- Again if you place a 59 patient in a medium situation as [reg??] the protection and temperture of the body and use the same articles in such combinations as will cause the [???ating] drug to make a sensible impression again [illegible] expect to have the greater [illegible] then of the office of depuration- Thrown upon the lungs that is you will have the expectorant effect In certain healthy conditions and natural exigencies of the body simple cold water in the most prompt and salutary sudorific [illegible] for example: In hot weather, [illegible] of great labor and fatigue, [illegible] from regular suplies of water untill the skin becomes hot feverish and dry and the sense of suffering from thirst excessively great a pint of more of good cold water, promply alays all sense of distress, and it administation is promptly followed by a general flow of perspirable matter from every pore of the skin or of the whole surface of the body [illegible] case just cited, the experience of the [illegible] goes to prove that the remedy is not only prompt but pleasurable; just so should be [illegible] the remedial agents in the treatment of fevers under the guidance of wisdom- But the folly of man. And the madness of medicine, have ever caused him to be too local to [circum??] too bounded and too much inflated with a partial discovery of isolated truth to see the harmony of all the truth which belongs even to a single series in the phenomena of nature- Hence when Brown [cross out] had discovered an element of truth, in the use of stimulants he ran his theory, this element of truth to excess and fortunately for the world, he fell an early victim to his own partial discovery from the ashes of a Brown have arisen the Theories 60 of w [???ing] and a Thompson and other members of the same family, To play a more rational part, and to approch some nearer to the temple of truth, in a modified and an extended scale- Hence the application of stimulants both externally and internally by drugs and by fire; and these too, aided by their distressing and depressing yet efficient ally, the far famed lobelia- The [illegible] of the steamers to us seem to consist first [illegible] not being able to discover the particular [cases] to which their routine was best adapted and their indiscriminated application of their remedies to all manner of class; secondly in the excess to which their remedies have been used When in their faint glimpses of the laws of life they had learned how to make an impression on the skin, and observed the salutary result which occasonally, followed there from they immediately prescribed too much; and were [illegible] to take up erroneous idea that by forcing the living actions through the instrumentality of pepper brandy Myrrh, and external heat to achieve whatever they desired by the mere [illegible] Like unto some simple men in every country to be found) relying on the [illegible] and strength of their purses to make [illegible] [??ise] men of their fans, or gentlemen by the mere power of wealth-As though the God of Nature, could be bribed to [illegible] his eternal laws [cross out] [cross out] to please the geathers of gold- Now [??ile] we admit the essential differences that belong to [cross out] stimulants, tonics, and diaphoretics, we at the same Time contend that they all act in union with natures Laws and that under proper restriction and right circumstances they constitute our chief reliance for 61 restoring to last balance to the [illegible] used the play of healthy action are the function of organic life- Where rightly used they all tend to excite sustain the healthy coneglated [illegible] of action in the whole system and to direct the energies of the [illegible] the surface of the body that to [illegible] the action of the natural and beautiful depurations which being rightly maintend will in due time acheive through [illegible] deranged irritated febrile [illegible]- From an attentive view of the [illegible] explanations in connection with what [illegible] have already said in our chapters are the laws of the general [illegible] as we are led to believe that the- intelliget reader cannot fail to [illegible] and the comparative value of the several modes that have been resorted to for the cure of febrile diseases- All these who have relied on bleeding puking or purging by using [rep??] any one of them or resorting to the whole of those means, conjointly have [pr??] an unnecessary waste of the element of life, and not that alone: but by the improper repetition of emetics or cathartics they have reverted the natural action of the system; thus producing a retrograde action of the lacteals and absorbents which inverted action in connection with local irritation made on he mucous membranes of the stomach and bowels by their use we conceive to be the real causes of the congestion and inflammations so commonly to be found on post mortem examination Before we take leave of this subject, it would be well to make some remakes for the controlling 62 powers of the moral agencies on the secretions- is all who have been attentive observers of human phenomena, the fact must be notorious, that the impression of fear not only increases the urinary secretion, but not unfrequently result in untimely evacuation from the bladder and the bowels such spectacles have we repeatedly witnessed in by [illegible] day under the uplifted Rod of the school master or the dog whip of the sportsman- These phenomena and always attended with more or less of a temporary chill, contraction, and consequent suppression of the exhalations from the skin, [illegible] the fluids are thrown, more abundantly on the kidneys- But when this same impression is [illegible] and carried to the highest pitch than [illegible] called to witness an inverted action of the lacteals and absorbents which are promptly followed by copious and rapid evacuations from the stomach and bowels But of this we shall speak more fully under the head- of [illegible]- We can receive of but Two general causes of diseases, that is febrile proper, and one a particular condition of the system the other a particular state of the atmosphere, and it is to the modifying influence of these causes separatly and jointly that we are to look for the [cross out] shades and grades of fever- Many are the volumes that have been already written on the subject of Malaria and the other predisposing causes of disease, yet still has this subtile element eluded our grasp; of its intrinsic essence we know but little; of its modus operandi, on the animal economy we are likewise in the dark. with its sources that is the felicitous circumstance for generating deleterious gasses, we have formed some acquaintance, with its effects on the human frame- have all had some more or less of 63 personal intimacy- It may be that to know, the prime sources of disease are to understand its effect is all that is neccesary and proper that we should know- he [illegible] we flatter ourselves the chemical and philosophical researches will not [illegible] made, untill all these mysteries, and [illegible] up to our view- One thing certain in that every breath we breathe, every step we take and every evolution of the [illegible] or less predisposing or exciting cause to either healthy or unhealthy action in the system Nor do we often know with absolute certainty whether they are to be for the better or the Worse- It is from the lessons of wisdom and experience alone, that we [c?u??] how best to deport ourselves- [illegible] whether of body or mind- (and is taken the two to make the whole man) are much more closely allied and more inseparably linked together than the mass of mankind have ever yet thought- Either or both under the guidance of reason, will find the greater share of health and of happiness in [illegible] a just medium in all things- He who shuts himself up in a house, from fear of the influence of the sun, the wind &c is at least as subject to disease as he who regularly and fearlessly face them all, or he that dose not take bodily exercise or live on two spare and meagre, a diet from a fear of wearing himself out, or under the vain hope of prolonging his existence, is about as likely to cut short the thread of life, as he who obeys the instructive impulses of his animal desires- (Stimulants.( 64 Sudorifics, tonics and stimulant are all centrifugal at in their effects all having a tendency to facilitate and sustain the circulation of the blood to excite airs to maintain the natural secretion and exhalations from the body; and not that alone but to counteract the enfeebled the irritated the irregular and the spasmodic actions attendant on fevers of sudorifics we have already spoken of tonics we shall speak more fully in our next chapter; But of stimulants we must have something to say before we close the present- The present state of [cross out] knowledge as conveyed in classification of remedies and the use of terms renders it necessary for us to explain what we mean by the expression stimulants proper- The words stimuli or stimulant has by most writers been indiscriminately applied to whatever would excite the living tissue- In this sense- emetics cathartics cantharides &c, are all stimulants- But we shall confine the use of the term to those articles only, which excite or exalt the system, in a manner only congenial to its own healthy laws; all other excitants we shall consider as irrtants- When we look to the origin, the history of stimulants proper, we find them springing only from those elements, that are capable of sustaining Animal life; and the quality of the stimulus always modified by the quality of elements from which it is obtained and the chemical aptitude and skill with which it is elaborated- The grades of nutriment, of permanency, of diffusibility of stimuli, is the result, of the formative powers of the processes of fermentation and distiliation and 65 the elements used- Thus we obtain Wine cider Malt liquors, rum brandy whiskey and their subdivisions- But the weakness of man in by his approximation to [illegible] ever kept kind vacillating from one extreme to another from the extreme of confidence to that of [dist??] [illegible] hope to unnecessary fear- [illegible] the [p??] of distillation, was first [illegible] put in use, some of the philosophers of that day verily believed, that they have discovered he secret of human immortality- So [pac???] indeed are its effects that it readily found favour in every land- too [se??] the distilled liquors have troubled the [illegible] been tasted tried used and [illegible] nations now while we write all [illegible] organized and public speakers [illegible] to proclaim to their fellow men, the dangerous and the deleterious and the deadly [illegible] of intoxicating drinks; the drinks [illegible] themselves calumniate [illegible] to public view as man [illegible] and are societies former ready and willing to expunge from the best [illegible] discoveries and important [illegible] baunties the name the laws of [dist??] Thus verifying the word of [illegible] Chem stilted vetant alia vetce [illegible] Contrarea- Whenever man shall acquire wisdom and venture rightly to see, and rightly to appreciate, his own ignorance, and his own folly, then, and not till then, will he cease to abuse. The munificence of Deity,, The very reasons for which the civilized world is now toiling to put down the use of stimulants to wit,, its excessive use, its abuse is to us the strongest possiable proof of its, salubrity of its efficacy; for if its elements its action on the living atoms, had 66 not been congenial to the laws of his nature Man would have never learned to have loved it so= But out opponents may say that all this is habit if so will they be so kind as to tell us why their patients and the world have not yet in like manner contracted a fondness for calomel, tartar emetic ipec- or any other [cross out] of the numerous drugs we call irritants? Malt liquors wine cider, contain in addition to their stimulant properties their alchoholic elements some nutritious matter; and even the alchohol itself we have reason to believe is consumed in the living action no portions of it having yet been [di??cked] in the excrements the sercetion or exhalations from the body By [illegible] of the lights of chemical [illegible] are we now enabled to solve the [illegible] that has been so frequently pronounced [illegible] slow poison- A thorough [illegible] of its modus operandi in the [illegible] economy, has enabled us to comprehend [illegible] way it operated beneficially in [illegible] [???ased] condition, When the vital forces [illegible] much enfeebled by disease, and a [illegible] of elementary matter necessary for the support of life and animal heat is much diminished, then the prudent use of stimuti operated beneficially, by allying irritation directing the vital forces to the capillaries thereby restoring the last equilibrium, while at the same time it either nourishes the system or at lease prevents that waste of the animal matter that would otherwise result for the necessary maintenance of animal heat- We hope that no one will infer from what we have said of the use or the modus operandi 67 of stimulants in the diseased conditions that we are advocates for it as a luxury far from it, we use it not ourselves Nor have we ever advocated its use in others= the result of our experience further more is, that however greatful and [h???] beneficial it may be to the [?nfabled] the diseased and the convolescent from fever that they invariably lose their appetite for it with the return of strength and of health We would have it consumption strictly confined to remedial purposes- We are [illegible] aware of the fact that many unfortunate individuals, have an ungovernable propensity for its use, even in their best health- This state of thing we can readily to two sets of prime causes; the the organization of the brain and others the circumstance of education; both of which could be easily remedied by the united efforts of philanthropy- and wisdom Chapter 8th The Autho's practice and general treatment, in the cure of fevers- Having stated in the preceeding chapter our objections to all the various systems doctrines and modes of practice, [illegible] have been heretofore pursued and dwelt at some length on some of the particular errors introduced, into practice by our predecessors such as the errors in blood letting- Puking Purging, &c in the varied degrees and modes in which these measure have been applied to the treatment of fevers 68 We will now endeavor to unfold to our reader a very different and as we honestly believe, a far better plan of treating fever of all types- from whatever causes: They may have the origin and under whatever forms they may appear, for to us since we have learned to view more as a unit all general diseases seem but a unit so consequently to us fever is a unit- Now let us look back for a moment to what we have already said of health and disease- Health is but the harmonious play of all the solid structure- The equable and harmonious play of all the fluid [illegible] the natural response of every [illegible] every organ to its natural [illegible] healthy and its appropriate stimuli [illegible] is disease, but and interruption of this play, in some way, in any way or every way as the case maybe What then is fever? We conceive it to be an effect of the conservative powers of nature inherent in all Animated Creatures to sustain its own integrity from the deleterious, operations of causes of whatever kind, by which it may be assailed In this sense we make fever in its essence a unit, while in its phenomena, its physiognomy, it is multiform, and that multiformity of character proportionate to the peculiarity of constitutions and circumstances of existence and the nature of the varied cause or ''gents, that are made to stamp a diseased impression on individual sensibility, or the sensibility of particular organs 69 Particular tissues of his complicated Machinery, which machinery should ever be considered, as a unit, one whole, although, composed of many parts. united by indissoluble laws of unity, the nervous chords, the [t???] medium of that much used, much abused, and illy comprehended [h??] called sympathy Now if the reader is capable of comprehending what has been already said and will hold the truths already unfolded to his view ever present in his mind, he will find no difficulty in understanding and giving his assent to this which is to follow- The phenomenon of fever you will [illegible] we have said is the result of [illegible] debility, attended with a loss of balance in the functions of supply and [w??] This state of things impresses on [illegible] individual sensibility of the individual sufferer the assemblage of phenomena called fever, such as lassitude, heat, thirst, pain, restlessness, with more or less perturbed and interupted performance of all the functions of [illegible] vegetative, animal and intellectual in a word, a diseased of abnormal manifestation of some or all the function of organic life, For centuries past have the industry and ingenuity of man been fruitlessly essayed to fid the shortest, the safest and surest, way to remedy this state of things Born and raised as we have here under this state of collision of thought, 78 80 and decieved by our calling, as collaborators in the cause of science and of truth, we now find ourselves compelled by the lights both of experience and research, to fall confirmed in the the propriety of discarding the thoughts of every predcessor. and with them their practices also- [illegible] our investigation of the Laws of organic life, we think that we [illegible] some modifying or [???al] agent capable of making [illegible] prompt, more specific, and more salutary impressions, on the diseased subject than any of the numerous [illegible] measures heretofore relied on for the accomplishment of the same and [illegible] agents are called the vegetable [ahal??ids])- To this family belong [illegible] such as the sulphate of Quinine cinchonine, morphia, a class of remedies occupying the middle ground between that of the depletive and the [illegible], stimulating remedies= [??pent] the timely and judicious use of this class of remedies, do we chiefly rely on the cure of all fevers, not [d??yeting] [???eves], however, the benifit of any or all other remedies) That sciences or experience may have pointed out as salutary and proper. Thus you see that we have admitted the propriety of blood letting in certain cases, and under certain restrictions; so also have we admitted, and recommended the use emetics and cathartics, under, particular circumstances and with suitable restrictions)" 81 But our main auxilliaries to the use of quinine and the vegetable and alkaline diaphoretics [illegible] of extreme prostration the [illegible] stimulants with the [illegible] In all cases of local [illegible] inflammation, we have [illegible] acid advocated, the propriety of topical bleeding by cups or by leeches [illegible] the use of sinapisms and blisters still, however, holding on to the regular use of tonics with such [illegible] as might be indicated in the [pa??] case of state of the patients. The Gold pills which the author has prepared for sale, for [illegible] past and distributed under [illegible] name of Ward's Gold [illegible] And has deservally acquired for efficacy in the cure of fevers disease far surpassing that of [illegible] article ever offered to the public [illegible] plan of treatment before adopted [illegible] simply, composed of one grain of quinine to each pill three fourths of a grain of aloes and one fourth of a grain of Rheubarb to which was added just so much of the oil of cloves, as would gave them an agreeable odor) The aloes and Rheubarb, were cheap and convenient articles of which to make the mass= they were not intended as articles of medicine at all, nor could they have had any very material, the whole virture of the pills consisted in the quinine alone the The medium dose directed in his prescription being uniformly one grain of quinine to an adult, and in that proportion for children 82 [illegible] unpleasant effects have ever within [illegible] resulted resulted from [illegible] being made in the use of the [illegible] they have been placed in [illegible] all descriptions and [illegible] and used in all stages and in every form of fever to be met with in the [illegible] united states- particularly [illegible] states lying in the great valley of the [illegible] Mississippi for the space of eight [illegible] years- [illegible] author has vended pills to a larger [illegible] realized some money by his [illegible] have also saved a great many [illegible] by using them,, been relieved of much [illegible] suffering, and very many lives no [illegible] been saved and prolonged,, The [illegible] himself driven to this [illegible] more from motives of benevolence [illegible] than those of self interest= [illegible] as he did, the prejudices that existed against the medicine he also new that had he [illegible] his opinions to the world in any [illegible] than as he had done, and is now [illegible] neither the public nor himself would [illegible] [??ted] much, if any by it [illegible] the manner, that has been adopted the full benefit is now given to the world [illegible] with a great deal of other useful [illegible] that could not well have formed to place in a newspaper or common hand bill The obsticles with our predecessors cotemporaries to the discovery and adoption of what we hold to be truths, that is the aptitude, of quinine to the cure of fever are two fold, namely, a belief in the inflammatory nature of fever, in the first place, and, secondly of [ag??imutaing] 83 or inflammatory properly in the value of quinine, The error of their motion in [illegible] we hope, has already been [illegible] proven to the understanding of every [illegible] reader and it now only remains from to show the fallacy of the other imaginary obstacles, and then the whole [m??] [illegible] may be considered as [despe???] We know of but two ways by which [illegible] settle, or put to the test our [illegible] or our understanding- the properties of bodies of material things,, The one is the [im??] to be drawn from there [sen??] [imp??] on living matter the other is the chemical manifestations displayed in relation to or in conjunction with the other thing and circumstances,, suppose now, we submit the article of quinine to the tribunals, and see what will be [illegible] our examinations,, Let us first [illegible] in a chemical point of view. What is quinine? it is the salt of the [illegible] of a tree, indigenous to the elevated lands of Peru,,, in South America, It is obtained by the process of [illegible] desiccation and crystalization- but is not then a produce of [illegible] fermentation or of distillation it is [illegible] volatile; it is a fixed salt, not [tia??] waste by evaporation From where [illegible] stimulants proper derived. They are at either directly or indirectly the offspring [cross out] of nature, through the vegetable process; and are elaborated purified and concentrated by human contrivances under the natural Laws of fermentation and of destillation Hence comes camphor, porter ale, 84 Cider, Wine, rum, brandy whiskey the essential Oils of all scented plants of which might be added aumonia, all stimulating [a??ts], and all Votatile and [illegible] less [illegible] by evaporation, [illegible] the [???cal] view of the subject, [illegible] infer, from the processes of [illegible] and from the fact of its [illegible] exemption from change [illegible] common atmospheric influences [illegible] that passess those qualities, common to the list of articles universally [illegible] as stimulants,, But there is still another way by which to arrive at truth, it is the testimony of the facts of human experience, or of [illegible] observation on human sensibility alias the phenomena in living human matter, where we consult the pages of history, from the period of the first [illegible] of the virture of the peruvian [illegible] 1560,, we find febrifrege properties ascribed to it from that period to the present, in the hands of different chemists and different practitioners, have its properties and its varied remedial uses, been differently presented still we find that the sum of the testimony- the sum of the experiments [illegible] researches, up to this day, have tended rather, to advance, than to detract, from its virtues nearly all writers admiting its antiseptic, and its Tonic properties while some in a limited sense were willing to ascribe to it febrifuge and atterative Vitues for which it has, as yet, obtained credit and even more,, In our hands for years past, in some form or other 85 has it succeeded in a far more eminent degree then any other article of the whole materia medica in contending successfully with fever,, of whatever type and in whatever stage it has come before us = it would be respassing both in the patient and the good sense of the [illegible] reader to attempt to lay before him any thing like a detailed account of our personal experience,, But for the satisfaction of those [i??] [illegible] with the reports of cases, we have thought fit to cite the following, when we [c??] were attending medical lectures in the city of Philadelphia during the winter of 1834, +5, there was a man in the hospital laboring under simple bilous fever, the part [sy??] not severe I thought, this patient had been there at least four weeks, had no other disease, this case had been treated all the time with the [illegible] remedies; that is with occasonal pukes and purges, and with what [illegible] call refrigerating mixtures such as a solution of salts of tartar [cross out] or cream of tartar,, with nauseating doses of emetic tartar or Ipac, and when the fever, would somewhat abate, they would give, small doses of the, bark, and but seldom repeated for fear of aggravating the fever I do not recollect distinctly, but think it probable that the lance had been occasonally used also the Bark and laudanum were gradually increased the disease continued but not sufficiently to make a sensible 86 Impression on the system to as to obtain an ascendancy over the disease as should always be done in the treatment, of this fever The Hospital Physician, Sir R S Hartshorn [illegible] and evening, to take tea with him- In the [illegible] of our conversation he [illegible] had been practising medicine for several years) He then mentioned to me the [illegible] uncertainly of the cure of ague [illegible] general and named this case, [illegible] [part??],, was much pleased when he [illegible] and with some reserve, stated [illegible] his patient in North Carolina [illegible] lived that I thought I could [illegible] in forty eight, hours at furthest, [illegible] at me with some degree of astonish [illegible] said he if it is not a secret, [illegible] the case: I advised the [illegible] and Wine shortly after the sweating [illegible] and to use as much of the [illegible] as the stomach could bear, untill a short [illegible] [??or] the chill was expected to return [illegible] to increase the dose of laudanum [??pium] at least two or three fold= The [illegible] made,, the experiment (as he called it.) patient had no return of either fever or [illegible] he was cured immediately,, It should be recollected, that at that time quinine was not known, some time during the summer of 1850 and one I was called to see a Lady in to Town of Columbus Kentucky whose life was said to be disporic) of,, I found her the subject of a Typhoid fever of ten or twelve days standing, She was much emaciated, and very feeble and suffering with great restlessness, with 87 occasonal fits of delirium [illegible] tongue dry skin hot and dry thirst great, I learned that there were [illegible] physicians in attendance; they have been and were they giving of [illegible] historally blue mass) I [he??] [illegible] lady that could not wait [illegible] in attendance in [con??] might say to them that I [d??] [illegible] course of treatment,, that [illegible] the use of mercury and put [illegible] the use of tonics and [diaph??] [illegible] thought fit they could adopt that [illegible] not and she thought fit to [ad?p??] [illegible] send her the medicine and [illegible] the might treat the case herself Furthermore, that I was of opinion [illegible] presisted, in the corse, they [illegible] lose her daughter; but that if she in execution my prescription [illegible] mending in a few days,,, That pass [illegible] the good old lady and the [de??] little importance to the reader [illegible] say, that I was promptly applied [illegible] and prescription)) I simply [??hr?] of Quinine to be given every two [illegible] and a solution of the alkaline may [illegible] of the supercarbonate of potash and [s??] such quanties as would allay the patient a few hours use of these remedies [?x??] genial perspiration, with a return of healthy to the tongue and faces I learned that by the next morning all signs of fevers was entirely gone or fled, the patient commenced and continued to convalesce untill her health was entirely restored.. She has continued to enjoy good health ever sence up to this period Here there any motive or any utility in it. We could go on to fill thousands of pages with 88 [illegible] to similar cases) We have [illegible] [illegible] belief that the salt of [illegible] take was the best tonic, The be [auto??] [illegible] alterative and [deobst??] [illegible] acquanited and that [illegible] conjuction with [illegible] [??ies] to meet particular [illegible] achieved more good [illegible] of fevers, that with any [illegible] article of the whole materia [illegible] expressed an opinion [illegible] belief of its possessing [???ating] properties, its efficacy [illegible] resides purely in its tonic [illegible] other words,, in its aptitude [illegible] of the brain and the [illegible] system,, which in truth is the [illegible] mobile of all vital phenomena,, [illegible] possible that it may neutralize [illegible] of fever.) [illegible] desire a more extended view [illegible] understanding, of the part of our [illegible] consult the lights of organic [illegible] the recent labors of [illegible] Leibic) Before we take leave [illegible] general view of the subject, it would [illegible] to [add??] still another argument support of the correctness of the general [??ples] contended for)- The argument is this, [illegible] followers of the strictly depletive doctrines the [?liushits] and looking, have done much good, succeeded well in the treatment of fevers, and if also their antipates, the Brunonians, the Thompsonians &c have achieved half the wonders that they claim occupying as we do the middle ground, the Lust Millieue, so it not reasonable to infer that we who accept the lights of Both 89 extreams and of all extreams, but who tenaciously hold on for the middle course might be intitled to a modicum of the laurels [illegible] to be placed at the feet of tonics and [im?ho??] in the temples of Esculapius)- We are not only satisfied as to the curation [pa??] [illegible] quinine, but we are disposed to [illegible] preventive, Vitrus also) To this [con??] [illegible] led not only from experiments [illegible] author's own family; but from fact occurring in his experience in [illegible] in different portions of the united states [illegible] all seasons of the year, I generally [illegible] early in the spring, and seldom [illegible] than June or July and sometimes [illegible] August, and not unfrequently [illegible] set out again in the heat [illegible] to the most sickly region of country" I also had agent out at the same [illegible] They were all instructed to use the [illegible] occasonally as a means of protecting [illegible] the influence of Malaria, [illegible] yet occured a single instance [illegible] one of them has contracted a [illegible] kind), From There facts we are [illegible] than if quinine was judiciously [illegible] sickly countries, and in sickly [illegible] that such a thing as fevers, if any [illegible] would rarely if ever occur except circumstances of the combind [op??l] of the many causes)). When quinine is used as a preventive, and adult should take a dose three or four times a day untill he takes twenty five or thirty grains)) This quantity, should be taken every two three or four week untill the sickly season is over or the epidemic has subsided) 90 [illegible] should take less in proportion to [???age) Chapter 5 [Th??] Author's views on the subject of the [illegible] of fevers) [illegible] expresses the opinion that fever [illegible] some general reasons for [illegible] But we shall, in this chapter [illegible] into the details of the argument [illegible] show that all fevers are of one [illegible] the mildest form of intermittens [illegible] fever, down to the lowest [illegible] most malignant type, of yellow [illegible] nervous, typhous or whatever nomenclature, you may please to adopt [illegible] fevers as one continued chain [illegible] phenomena and the varied symptoms [illegible] [???ions] as only so many different [illegible] [???uced] by some particular conditions [illegible] [???pher], or state of the system [illegible] of these modifing causes are [???lly] changing and from these changes [??ate] all the apparent dissimilarity [illegible] the feature of disease, while in its essential [illegible] it is ever the same and every variety [illegible] should he treated pretty much alike, that is with the same classes of remedies, varing them only to suit the peculiarities of cases, with the grades of diseased manifestations)) We speak, here, of diseased manifestation when left unbiassed, under the controling agencies of natural causes, very many of the worst features assumed in fever 91 are the result of med [prac???] or hyper medication,, for are such [illegible] we have over been of opinion that the [illegible] should have fared [mu??] better [illegible] [??arels] of dame nature the [illegible] under the officiauness of [illegible] and inter medillering Doctors,) [illegible] immortal [Brou??ais] of [illegible] said that there is one disease at [illegible] which any practice is better [illegible] (Asiatic cholera) [illegible] speak hereafter, its a kind of [illegible] in fever, and that the reader may [illegible] satisfy himself of that fact,, we [illegible] summary of the most common and [illegible] symptoms in all fevers which [illegible] sevely, that the symptoms of all [illegible] sand, differing only in degrees of [illegible] that they are in proportion to the [illegible] severity of the causes, and the [illegible] impressibilities of the constitution are manifested, There are generally days of indisposition previous to [illegible] all fevers,, This is calld the premonitory [illegible] This state is known by the loss of appetite lassitude, a general restlessness [illegible] and an unusual drowsiness, [mor??] disturbed sleep with a disinclination [illegible] action of any kind,, In the [all??] in the onset of fevers, it rarely happens but that there are more or less of [illegible] sensation, attended with flushes of red, Sometimes these chilly feelings run into ague or shakes, but with the advance of disease or as the fever rises the chilly sensations subside) In the commencement of all fevers it rarely happens, that there is not more or less of aching pains over 92 the whole body predominating, however in [??cular] portions such as the head best [illegible] sometimes this pain is exquisite [illegible] is apt to moderate as the [illegible] as in the Language [illegible] reaction becomes establish [illegible] all fevers, there is more or [illegible] sometimes it is intensely [illegible] [??ptom] also continues as an [illegible] all fevers, but it is apt [illegible] disease progress although [illegible] and even fauces or throat [illegible] in such cases, the desire of [illegible] [???ings] more from the unpleasant [illegible] of dryness, or suspended [illegible] the structure just named [illegible] the actual cravings of [illegible] stomach, since patients in this [illegible] take only a swallow or two [illegible] while in some other conditions [illegible] that could be retained by [illegible] would satisfy by desire, [illegible] onset of all fevers there is [illegible] less appetite for food sometimes [??ior] as food, amounting to, [illegible] sick stomach without vomiting [illegible] times with vomiting and [???nally] with both puking and [???ing] [ar?el] it is well known, that there is little or no appetite for food during that time or the progress of fever In the first and earlier stages of all fevers except in the lowest grade of cold plague, yellow, putrid or typhous, fever, and even sometime in these, the pulse is apt to be not only quicker than natural, but irritated and fretful 93 giving often times the [illegible] ounce of increased force to [illegible] the force is diminished [illegible] action in such cases [b???] [illegible] up in frequency [illegible] wants in force,, [illegible] advances the patient [illegible] the pulse becomes, [st??] [illegible] and smaller, making, [illegible] resistance to the [pres??] [illegible] and evincing clearly [illegible] In the first stage of all [illegible] becomes covered with a whitish [illegible] fur) This however is not [illegible] in onset of the disease, but [illegible] observable, in the cause of [illegible] if the fever, is not checked, [illegible] to run into another stage, than [illegible] is apt to assume, a yellow [illegible] appearance,, But should [illegible] lower grade, or more [illegible] particuly, should it partake of [illegible] form such as yellow fever [illegible] or the like- then the tongue is apt to assume a dark brown to black [illegible] The casting off these apparent [illegible] coat from the tongue should [illegible] considered a favourable [illegible] In the last stages of all fevers [illegible] tongue teeth and lips are apt to [illegible] exceedingly dry, and oftentimes [illegible] with a dark stickey gummy Matter,, In some, more rare cases, the tongue assumes, a different appearance, from any of that have been mentioned that is it assumes a smooth glossy and appearance),, 94 This is apt to take place after many days continuance of [f??] [illegible] last stages of the disease [illegible] when ever this state [illgible] have generally [fa??] [illegible] tedious and more dangerous [illegible] [???nes] there is a roaring Laund [illegible] this is most common in [illegible] fevers but it daze [illegible] occur in any form of [illegible] is a common and a very [illegible] symptom in all fevers, this [illegible] symptom is more the offspring [illegible] organization, than the nature [illegible] cause, some individuals [illegible] whole famelies being prone [illegible] under fever from whatever [illegible] under whatever type; while [illegible] individuals are capable of [illegible] through any form of fever [illegible] much or any very [illegible] [???able] derangment of the function [illegible] organs of thought, [illegible] first stage of all fevers there is to be a kind or grade of destrubance [illegible] not amounting to delirium, that [illegible] slumbering or dozing condition, that the patient is more concious of than [???dant],, This symptom indicating [illegible] a slight departure, from the normal [illegible] is of but little consequense [illegible] as the disease progress in its stage and grades of prostration, the delirium assumes, a different, and more distressing character observing attended now discover a considerable derangement, in the faculties of the brain 95 the patient himself [illegible] conscious) the frequently [illegible] extent in a state of sleep [illegible] hard of hearing so much [illegible] efficent to arouse [illegible] make yourself [cou??][illegible] indifferent, to the [ex?e??][illegible] you short response [illegible] slumbers again) [illegible] stages you find him [illegible] fingers, and at the best [illegible] entirely stripping himself [illegible] again we hear him [illegible] [??ores] and manifesting [illegible] and going about, when [illegible] able to stand on his feet,, [illegible] patients we are apt to witness [illegible] twitching of the muscles of [illegible] legs) What is call'd sub [illegible] by the Doctors) the voice [be???] and sometimes unnatural [illegible] wild vacant expression of [illegible] There is still another form of [illegible] which also occasionally attend the [illegible] of fevers and indicates, a more [illegible] condition, than the one just [ment??] This is attended with [cross out] [illegible] watching the patient sleep leaves [illegible] this hearing becomes even more [ac??] than natural he is startled at [ev?y] and has imaginary and for the most [illegible] distressing images continually passing before his eyes) In all other particular his condition is pretty much the [?arn??] as in the state just before mentioned) Now as the delirium and Muscular agitations or twiching increase in proportion to the duration of the disease and physical 96 [illegible] of the patients these [illegible] to the general [illegible] [???ast] debility [illegible] organizations and no [illegible] of the brain, the head [illegible] other part of the [illegible] of the medical [illegible] have you to believe, [illegible] we observe some [illegible] of heat in the stomach and [illegible] also an increased color [illegible] [???ly] secretion of urine, [illegible] of all powers we occasionally [illegible] discharges by stool and by [illegible] forms of fevers these are alike [illegible] symptoms though not necessary [illegible] individuals have recovered [illegible] discharges from all manner [illegible] on all fevers the salutary changes [illegible] usually announced [illegible] very much the same [illegible] that is nearly all the cases yeild [illegible] of the salutary action of [illegible] deparative functions [illegible] the skin, Although the [illegible] [???tion] of the blood has been long under [illegible] and the indications to be drawn from [illegible] of the pulse long studied, and [illegible] grave lengthy and learned discourses delivered from pulpit of the schools yet still are the discrepancies of opinion upon this subject, as great even of this day, as at any former period of time) Such too must necessarily be the case, for two important reasons- The first is that the faculty have not yet agreed, even in the abstract, as to what constitutes the, 97 propriety or impropriety of [illegible] Blood; the second [illegible] the mass of practitioners [illegible] influence of physical, and [illegible] the phenomena, of [cir???] [illegible] patients) For want of [illegible] of all these things [illegible] and observant practitioners [illegible] blunders) In the [exam??] [illegible] with a view to the [ind??] [illegible] should never fail to [tak??] [illegible] all the symtoms of the [illegible] circumstances of causation) [illegible] signs which lead us to a [illegible] condition of the sick, [th??] [illegible] uniformly important, than [illegible] tongue, and the skin, [illegible] should therefore be paid to [th??] [illegible] condition) As a proof that [illegible] know less about fever than [illegible] supased, and less even than [illegible] imagine, all hear them continually [illegible] about the names of fevers of [illegible] or a season such as typhoid, [illegible] and billious fever, just [illegible] were all distinct, diseases and to be [illegible] widely varied remedies) The truth [illegible] the similarity of symptoms in the [illegible] of all fevers is so strikingly great not a matter of astonishment that to often dispute about their [class???] Many practitioners prescribe more from the appellation which they shall give the assemblage of symptoms than from a knowledge of what taking place in the economy of their patients [?bey] as often or oftener form their opinions as to the name or nature of a fever from the season 98 [illegible] in which it occurs [illegible] the symptoms which attend it, [illegible] known the fever of [sm??] [illegible] of malignant fever [illegible] healed for bilious fever [illegible] matter of supprise to us [illegible] mistaking one shade of [illegible] for another, nor [illegible] mistakes be a matter of [illegible] provided they under [illegible] of the fever in the general, [illegible] accostomed to see fevers assume [illegible] bilious in warm seasons and [illegible] countries, while typhoid fevers are [illegible] in the colder seasons and in the [illegible] Countries) We have thought that fever [illegible] its protoype, never stationary [illegible] in a state of progression or of [illegible] after saying very much in its [illegible] never fundamentally changing [illegible] running regularly through the different [illegible] of the particular type it may assume [illegible] and running from one type to [illegible] from a higher to a lower, or from [illegible] to a higher that is from the simple [???ing] form to bilious or even typhus [illegible] [???time] while at another time from [illegible] bilious, and finally ending in [illegible] and fevers) Such things are not [illegible] request occurrences in cases of relapses [???standing] our conviction as to the truth [illegible] the position, that there is a natural chain of connexion which bind all fevers together, yet still do we find it convenient for the purpose of making ourselves the easier understood), by the reader, to adopt the common classification of fevers) Hence 99 the succeeding chapters we shall treat of the several [illegible] commencing with the [illegible] of what is called summer [illegible] fevers and ending with [illegible] of fevers, called cold [plagu??] [illegible] fevers) The objects in [illegible] of this chapter, have [illegible] show by a brief summary of [illegible] symptoms attendant as [illegible] unity of disease and in a [illegible] the identity of all fever proper [illegible] attempt we have either failed [illegible] are still living and important [illegible] and will speak for themselves Chapter 6, Chapter 6 Of Intermitting or Ague and [illegible] We believe it is now universally [ad???] [illegible] low marshy lands, and all [illegible] or situation where the surface of the [illegible] such as to retain, the water that [illegible] either by virture of its depression it, [illegible] of surface, or by the impervious nature [illegible] clay or where the waters of creeks and [illegible] stagnated, either by artificial [illegible] obstructions, are ever fruitful source of [illegible] condition of atmosphere which [illegible] in the human subject the types of [illegible] called intermitting and remitting [illegible] as we are engaged in writing solely with a view to practical utility, we would consider it an unnecessary wate of the readers time, here to enter into any investigation of the laws of Malaria the laws of Vegetable and Animal decomposition 100 [illegible] the theories of the agency of water and calorie in disolving elevating the [???ing] the ultimate elements of with [illegible] the [illegible] matter) [illegible] or ague and fever is [illegible] which is characterized [illegible] [???ct] intermissions or pain [illegible] febrile symptoms,, [illegible] able to discover any [illegible] [??gant] time as was [illegible] verbal displays, which has [illegible] nosologists to affix a name [illegible] a little to every symptom [illegible] otherwise that might [illegible] accompany this form of fever [illegible] ourlves, with the interduc- [illegible] that are the most common [illegible] natural periodicity; such as [illegible] tertian quartan and their [illegible] into double trible and [illegible] and this divison even so far [illegible] alment is concurnece, for consider [??plance], since in whatever form it [illegible] appear its nature is the same, and the [illegible] treatment, with but slight all difientirn [illegible] ever be the same also,) We consider [???ers] at intermittent in character, which [??ally] coal off between each paroxysm [illegible] preceded by chill or not or [cross out] [illegible] chill and fever rise together [??s] a paroxysm of fever of this time continues not more than are four or two returning after a [cross out] lapse of about twenty four or forty eight hours without an intermission, and again, sometimes run on for three or four days but whenever a paroxysm continues for two or three days and then goes off entirely it is not apt to return 101 the most [commen??]/[???tel] of intermittents [h???] [illegible] chill or shake every day [illegible] every other day, or every [illegible] and if allowed by [illegible] two to ten or twenty [illegible] A large portion of [illegible] united states, [par??] [illegible] the intermittent [char???] [illegible] in the southern and [illegible] Symptoms, The symptoms or ague and [illegible] similar; to than of other [illegible] in the onset of the diseases [illegible] generally several day [illegible] or premonitory indicating [illegible] the attact unless in case [illegible] the attact usually commences [illegible] of lassitude and weakness [illegible] and stutering: quickly followed [illegible] rigors, and trembling; then [co??] [illegible] and lividily of the extremities [illegible] respiration anxity nausea, [illegible] vomiting, pulse frequent small [illegible] though sometimes more 'staw, [illegible] the skin generally sensibly [con???] and of a more or less livid pale and scanty,) these symptom [illegible] the first or cold stage, which often [illegible] for a longer or shorter time, is [suc???] by a heat, or redness of the skin particularly of the face, the respiration becomes fuller and stronger, these still great, with more of less pain of the head back and the limbs, this stage is again succeeded by the third or sweating stage when a remission of all 102 the symptoms takes place untill a [m??] abaundant perspiration [illegible] with an increase [illegible] and objections from [illegible] intermittent is justly consider [illegible] fever, and when rightly [illegible] [???cement] or before [illegible] many days is usually the [illegible] form of fever that we [illegible] with but when neglected [illegible] run its course for a [illegible] of formidable diseases [illegible] follow; in its train [illegible] [???nients] and enlargements [illegible] pancreas and liver attended [illegible] indigestions, and not unfrequent [illegible] [???ay] watery effusions of dropsies [illegible] [??en] and of the whole body,, [illegible] intermittent form of fever occupies [illegible] wider range than the medical [illegible] the populace have as yet been [illegible] of) This type of disease do we [illegible] the many anomalous cases of [??ical] pains in various parts of the [illegible] attended with more or less of [crossed out] [illegible] symptoms such as sore pain [illegible] very nearing muscular and [neur???] affection, of the limbs and other [illegible] of the body) Treatment,, Bleeding,, This remedy has at no period in the history of medicine found many [crossed out] advocates in the treatment of intermittents yet it has occasonally found favour with particular individuals, Dr. Rush, for example reports favourably of its use, and we are not sure, but that there are even at this 103 Time some individual practitioners who are [illegible] of this remedy) The can [illegible] of but a very few cases or [situa???] [illegible] it would be admissable [illegible] cases are when the [illegible] send plethoric individual [illegible] subjects as have a [constit??] [illegible] to particular congesting every [illegible] such as disposition to [illegible] congestion, of the lungs [illegible] we have thought it would be a [illegible] practice to abstract [crossed out] just [illegible] and no more as to take off [illegible] [????tion] in vascular system [illegible] be certainaly done by one [illegible] bleedings and then proceed to [illegible] with the proper doses of Tonics (Emetics and Cathatics) For these classes of remedies [illegible] find but little use in the [illegible] intermittents) should spontaneous [illegible] occur then we cause no necessity [illegible] tion of emetic forth stomach [?mp??] and when there is no sick stomach nor [illegible] are still unable to see any good reason [illegible] such symptoms) But whenever paroxysm occurs on a stomach overloaded with [illegible] a puking ensues There from, then is is [a???] The organ to empty itself before we attempt [illegible] compase it,) Tried to the use of cathartics we are well aware that some of the banned profession of the schools have strongly advocated and placed great reliance on them under a belief, that the disease was caused by a congestion in the liver and that the use on 104 [???stice] cathartics constituted the [illegible] [???ing] that viscus) bid [illegible] [illegible] [??ady] succeeded in [illegible] [???der] of the falacy of [illegible] principal inducement [illegible] the use of an aperient [illegible] the patient of constipation [illegible] of things exist for we [illegible] the proper treatment the [illegible] should be left or kept [illegible] the normal or healthy condition [illegible] in cases of looseness of [illegible] use small cases of laudanum [illegible] six [cross out] eight or ten drops of [illegible] six or eight hours until [illegible] an equivalent of paregorie, but [illegible] sick stomach or vomiting then use [illegible] peppermints or some other cordial) [illegible] we conceive necessary to be done [illegible] question) simply to abate the four [illegible] [??tiny] remedies) during the [illegible] For this purpose we have found [illegible] quinine, every two hours both way [illegible] regularly administered through [illegible] and by this course, the author has [illegible] [???ed] to releive, his patients in the course [illegible] three days) We have aided its [illegible] the skin, during the hot stage [illegible] of warm diaphoretic teas such [illegible] Virginia snake root, to which [illegible] added a little red pepper, or [??tinus] the alkaline salts) So soon as general perspiration in excited or the fibrile symptoms, are caused to abate than discontinue the use of the sudorifics and continue that of the tonic alone) it's this form of fever the patient is more liable to relapse, than in any other 109 When once the disease [illegible] he warned do well to take two or three [illegible] of quinine, a day united his strength complexion is restored) We have been [illegible] than suprise) at the very liberal, not to [illegible] uses that some of our [illegible] and even made of the [illegible] He born from the medical [illegible] that the sulphate of quinine has [illegible] in from fifty to one hundred grain [illegible] with a view to remove [illegible] spleen &c, for the cure of [intermi?], We consider this a [illegible] [illegible] of [illegible] of the best remedial agents [illegible] profession, We are at a loss to [illegible] On what grounds such [illegible] justified in any kind of cases, It reminds us of the [c???mours] [illegible] mass, and of calomel, that [w??] administered in many cases, and in many [p???] there united states, during the [illegible] of the Asiatic cholera,, Dr [?brite] [illegible] of 4320 grains of Calomel being given twenty four hours to one patient and the recommended [illegible] to be [???p??] in the next twenty four hours of cholera, Eberle's practice [p???] In a letter from Lewis to [prop???] [illegible] of Philadelphia dated Paris, character following interesting statement is [illegible] At the hospital of De La Petie, I [ha??] the sulphate of quinine uses in a wholesale manner, for the treatment of [inter???] fevers, supposed to be caused and dependent on the enlargement of the spleen. The doctrine is held that the fever cannot exist without the enlargement and derangement 106 of this [???s]) His theory has many disciples [illegible]) To relieve this state of things [illegible] to one hundred [illegible] given, and with [illegible] I have often very satisfed [illegible] and marked it [illegible] the administration of the [illegible] doses and in twenty [illegible] administration I have seen this organ very perceivably reduced in its whole circumstance, and the [illegible] or pattiated in an [illegible] short line) [illegible] wisdom to be drawn from [illegible] practice, yet to establish there very [illegible] first, the safty and [illegible] quinine, secondly a deobstruent [illegible] that drug, thirdly, that such is the [illegible] happy construction of the animal [illegible] that life is not necessarily the [illegible] not practice,, The immunity [illegible] in such cases, we would [???pt] to account for, on the supposition [illegible] force of the drug could not [illegible] once be brought into action on the [illegible] structure and in this the most [illegible] view that we can take of the [illegible] would seem (to say the least of [illegible] of economy, in the use of the [illegible] Chapter 7 Of Common Billious or Billious Remittent Fever From what has been already said of the unity of fever in Chapter 4th 107 the readers mind must be [illegible] prepared to receive the [??pertion] now sustained by [illegible] [illegible] [illegible] med practitioners, that all fevers are more or less liable to [illegible] according to the influence of [ex???] causes and the [susceptibilities] and imprissebilities of individual [illegible] that that observation, has [illegible] the fact, that intermittents [illegible] inflamatory, billious, [ci??] typhus, and malignant yellow fever have all in many instances [illegible] each, so also have [m??] in the [illegible] locality, and at the same time, the [s???] season different [individuals] the subjects of all the [???sities] of [illegible] example, one patient has intermitted another remittent, a third [illegible] a fourth typhus, and so on with the endless subdivisions, which [illegible] generally, [compression] [illegible] [cross out] is through [cross out] [cross out] From these remarks it will be readly inferred that fevers are almost infinite in the varieties of [shades] [illegible] which they assume= It is through the instrumentality of these truths that the world has been kept so long in the dark, by the wonderful fascinations of [illegible] (the magic of words:) while fever has [ever] been a unit, one and the same phenomenon from the days of Hippocrates, or even of Adam, down to the present time; with, in truth, but slight appreciable changes or shades of difference, to correspond with the development of humanity, man has created for it as many names, tittles and dress, as would fill the wardrobe of a modern city dandy- The doctors and dandies have both been laboring, to the maximum of their wits, but with this marked difference in the moving 108 spirit of their toils the one has even beer laboring to discover the truth while the other is laboring to discover the best mode to conceal it Now, this state of things has originated from the limited and banded nature of the human mind, which has ever compelled him first to toil to develope and to propagate isolated elements of truth, as a step preparatory to the ultimate explanation of the whole; since the harmony of these elements can only be seen by him who comprehends each and every individual atom or element of truth,, We come now to the consideration of that part of our theme which we have thought fit, to call the second link in the general chain of fever, viz: summer or autumnal fever There has been about as many names given to this link, in the chain as there have been modes of practice prescribed for its cure- It has been called bilious, malignant bilious &c Of late years we have seen it crowned with a new title, the congestive fever, or the congestive bilious or congestive intermittent, as though it were a new disease- The term congestive, used as a discriminating symptom, as though it did not belong to all other fevers for we cannot conceive of any fever without more or less congestion somewhere; the only difference then that we can perceive is that this particular feature is more marked, more prominent, than usual, for the disease all the time is the same old acquanitance, we recollect often times have not with on the lowlands of Maryland and Virginia, in the days of our boyhood The doctors then called it malignant intermittent This form of fever is most prevalent in the marshy situations of warm countries, and in the warm summer and autumnal seasons of all countries,, Like other fevers it is usually preceeded by more or less of premonitory symptoms such as are common to other fevers, The attact is usual announced by chilly sensations 109 more or less distinct of a longer or shorter duration sometimes [???ding] to an ague; these symptoms are suceeded by the ordinary symptoms of hurried inspiration pulse fretful and quick for the most part full and soft: pain of the head back and limbs a general restlessness nausea and sometimes a vomitting of bilious matter: this is sometimes quite an obstinate and distressing symptom The skin now becomes hot and dry the their considerable the patient usually desiring drink more than the stomach can bear)) Those symptoms remit or abate [illegible] twenty four hours, sometimes twice, but never go entirely off before a fresh attact ensues, so that the patient, is now without some fever, the remissions usually occur during the latter part of the night, or the early part of the day,, In the unbiased or natural order of things, this form of fever usually runs its course in ten or fifteen days,, but as we have said, we never have yet been able to satisfy, ourselves of the [illegible] of critical days in fever proper and are forced to believe, that his projections has arision from observance of such a law in the exanthemata, of eruptive fever such as most small pox and the like,, since this form of fever is most common, and from the the extended theatre of its action interesting a larger portion of our population than then other forms- being common not only to country situation in all climes, but also to cities, and to Towns, assailing all ages and all sexes- but we have thought proper for these reasons, to dwell more upon this than any other link in the chain)) causes It is partly produced from [o??arsh] 110 Exhalations, or from breathing an atmosphere impregnated with the exhalations arising from the decaying remains of vegetable and animal substances, and partly from the debilitating influences of excessive fatigue of any kind, the relaxing and debilitating effects of a meager or unwholesome diet, and partly from the relaxing influence of continued heat on our systems, and partly also from the sudden transitions of temperature,, hence, it is that this fever is more common and more fatal as we approach hot climates and low situations, and most prevalent in the hottest season of all climates,, This remitting or continued form of fever as you may please to call it, though the most common, is the least dangerous- or in other words, the most manageable, form of all the fevers except that of ague and fever, there are occasional cases and even occasional, seasons in which it assumes a violent or malignant, character from the commencement or cases and seasons, in which under our best effect, the disease is apt, to run into a low and dangerous grade,,) But the cause of these things being for the most part comprehended and more or less under our Controle might be obviated in due time to save the lives of the sufferers- To explain, the fatal tendencies in the most cases arising from malpractice of remedial [illegible] neglect neglect an error in diet, crowding the sick too much together, or the sick and well together, neglect of proper cleanliness [illegible] the want of a free circulation of wholesome air, and a proper attention to the release of the patient, sleep being as necessary for the well being of the sick as his food or his physic, since fever of all kind and grades, have been known to take life and are always attended with more or less danger they should 111 ever be promptly attended to and if possible fully managed for many cases that should yield under two or three days judicious management in the [???tic] disease something becoming manageable after [illegible] of that [illegible] [???naw] the [illegible] We are well aware of the fact that the fever of different seasons from the peculiar [illegible] defying influences of the producing causes, assume different types and different [??endi??] that is, that in some seasons the congestion or engorgement of the varied organs [neces???] the offspring of the febrile action, are more apt to result, in local congestions [illegible] other seasons, they are more prone to degenerate, into vitiations [p???] [illegible] in the secretions and ultimately to [illegible] in gangrene, or mortification [illegible] witness! in some fatal causes fevers Blood letting The propriety of abstract [illegible] judges of from the type of [illegible] the age and constitution [illegible] and the symptoms [illegible] For example when cases occur in young [illegible] subjects and the symptoms indicate such local [illegible] with a full free and active circulation [illegible] expect to practice one or two moderate [illegible] advantage; say Take just blood enough to [illegible] excess of toutione from the pulse) This we [ha??] [illegible] can be achieve by the lass of about three [illegible] more, of blood at a bleeding and should be [illegible] practice in the course of the first Two or three days from the attack; The use of this remedy we have confined to particular types, and particular discriptions of cases, If the general bleeding have 112 have been neglected at their proper [illegible] as if after having been [illegible] put in practice some local pain continues still [?aslress] the patient we should then seek further relief by the use of cups or blisters applied to the parts most affected as the judgement of the operator or practitioner the [ca??ects]) (Emetics Next to consider) In the early stages, and more especially in the onset, or forming stages of the fever, have we occasonally succeeded in cutting short, the disease by the use as simple emetic of ipecacuanha, is tarter emetic, antimonial wine, [illegible] be any choice, in the case, followed by the prompt, and [f???] of suitable diluent and diaphoretic drink, such as flax seed sage chamomile, or black snake root, Tea) We ascribe the efficacy of emetics in such cases more to the concusion or revolutionizing effects on the system whereby the circulation of the blood, and consequent equilibrium of animal [illegible] of the secection of the skin, [illegible] is effected, than to the [illegible] evacuation of any matter that may take [illegible] In most cases, it is best [illegible] of the action of the emetic by such auxiliaries as will unlock the pores of the skin and thereby mitigate the violence of the fever such as above cited but in those cases where we learn that the patient is in a state of greater or less constipation of the bowel, then we should endeavor to make a gentle impression on the bowels, by the use of little epsom salts and gruel the senna tea; Taking care at all, times, to guard against so great or so hurried an action of these organs as to produce much sensible debility in the patient; In the use of emetics as in every other step in the treatment, we should always look well to all the circumstances of the case not use them where peculiarity or 113 Idiosyncracy would forbid or when the delicacy of the constitution or the already irritated condition of the stomach would oppose it Cathartics Next in order While we stand opposed to the practice of attempting the care of bilious fever by the exclusive use of cathartics all are still willing to admit the fact that such thing have been repeatedly done,, But we do contend for the practicability of accomplishing the same thing by a less distressing, less debilitating and [illegible] them equally safe and short route,, In the early stages of the disease, we approve the use of one or two mercurial cathartics; especially if the stomach be too irritable to bear the administration of more bulky cathartic drugs. In those cases we recommend eight or ten grains of calomel with a half grain opium, or its equivalent in laudanum or paregoric or an equivalent of blue mass, in lieu of the calomel should the patient prefer it [cross out] [cross out] [cross out] [cross out] Such doses should or should not be repeated according to the exigencies of the case [illegible] or doses fail to operate in due time [illegible] with a dose of some more common [illegible] such as epsom salts, castor oil, [illegible] as such like) So soon as we shall [illegible] in evacuating the stomach and [illegible] the patient in a situation to [illegible] on the use of another class of remedies, vis, the use of [illegible] and sudorifics= The fact, the either, [illegible] had much experience in the treatment of that [illegible] of fever case not hesitate, to commence the Treatment by the immediate use of quinine, aided by sensible diaphoretics, at any stage and without preparatory depletion 114 the extended safe and the salutary response from those who have use the authors, gold pills throughout the southern and western states of this union, in all form and small stages, go to the facts repeated] from his own experience) Now Tonics and diaphoretics, Our objectives to depending on the depletive practice for the [illegible] billous fevers by repeated [illegible] purgings are first because we consider such practices contrary to an inverting the order [illegible] secondly if experience has taught [illegible] purges, when used in health [illegible] the individual, and bring on the necessary [illegible] [illegible] disease [illegible] drink, should, then be [illegible] [illegible] that these effects to a [illegible] [illegible] ensue on the use of [illegible] in a diseased conditions [illegible] the [illegible] [illegible] already great from [illegible] condition, to be still increased by the [illegible] irritation of the mucous membrane of the [illegible] [illegible] a consequence of the [illegible] [illegible] of the fluid elements [illegible] with this view of the subject, the [??one] of cure would seem to us to be [illegible] [illegible] to the circulation, reinstate [illegible] support the enfeebled system [illegible] morbid irritation,, [illegible] accomplishment of these desirable [illegible] [illegible] found the judicious and united [???tonics] a new diaphoretic remedies aided [illegible] [illegible] and properly combined opiate [???ing] in efficacy all other means,, [??ing] already stated the time increase and circumstances, under which we conceive bleeding puking or purging or any one or more of these remedies necessary, at the 120 discretion of the practitioner or attendant we will now proceed to say before the reader in as plain and simple terms as possible and a special plan of treatment We proceed at [once] with the administration of one grain of quinine every two hours, regardless of fever [regularly] by day and by night, after however the ceases with some suitable diaphoretic such as the vegetable sweating teas the virginia snake root, balm sage, or the like the sweet spirit of nitre, the supper carbonate of potash or soda, or a animal the alkalies with [some] one of the vegetable teas) These drinks [may] be used either warm or cold, as the [patient] appetite may prefer, watching the effect, of the diaphoretics and so regulate the [illegible] their repetitions, as to proceed a slight but general action on the skin, [illegible] [illegible] maintain such motion without running to any excess, Hence as should suspend the use of sudorifics whenever there was any [illegible] of excessive, perspiration, while we continued that of the tonics,, This course of treatment should be continued untill [illegible] crisis on a marked [auidi??] [illegible] [illegible] But it not unfrequently happens, [illegible] some unpleasant symptoms, in [illegible] with the state of the stomach and [illegible] occurs to interrupt the progress [illegible] [illegible] as intended course of treatment [so??] continuance of or a return of sick [illegible] and vomiting- symptoms constituting what the learned writers have been pleased to call a gastric fever, in such cases we [illegible] endeavour in the first place to correct or allay such morbid irritation before we can expect to obtain the benefits of the strictly febrifuge remedies,, continuing however; 116 the use of the quinine whenever the stomach will retain it This will be most effectually done by one or the other of following [desst?], should the patient be troubled the [illegible] sense of heat in the stomach with the casting of bilious or acid matter there administer what is called a saline mixture or effervescing draught a fallacy,, Take of saleratus, bicarbonate potash, a common salt to tartar have an ordinary tea-spoonful-fresh lemon juice or vinegar a moderate size tablespoonful,, Put the lemon juice or vinegar into a wine glass and fill it with water, then add, that saleratus, or bicarbonate of potash made fine, to immediately [illegible] or dress in the state of effervescence or foaming,, This dose may be repeated as often as necessary, to compose the stomach,, Should we fail by the case- to obtain the desired relief, Than we might make use of any one of the following remedies, such as essence of pepermint the aromatic spirits of parts from the compound spirits of lavender a few drops of the spirits of turpentine, taken in a little cold water, or on a lump of sugar, or an opiate portion of Morphine opium Laudanum or paregoric,, of these remedies we have the opiates most uniformly [cross out] successful, In all cases of irritation of the stomach more or less benefit maybe expected from exturnal applications such warm applications either wet or dry mustard, plasters blisters, cupping or leaching In some instances the irritation of the stomach is kept up or rendered more abstinate from a torpid or inactive State of the bowels,, in such cases we should not fast to make some impression on the bowels either by the 117 use of suitable aperients or by repeated use of injections,, If on the other hand, we should have to continue with a wasting from excessive looseness of the bowels then we restrain such evacuations by the use of small doses of Dover's powders paregoric compound spirits of lavender, tincture of kino are infusion of the root of dewberry or of the common blackberry or some other suitable astringent combind or not with a few drops of laudanum as the present or absence of pain might, indicate, In all stages of disease and under all circumstance of cases the practitioner should never lose sight of the utility and even importance of any minor consideration of comfort or of case, to the patient such as occasionally bathing the feet, especially at night in warm water, the application of cold cloths or cloths satuated with cold water and vinegar to the head while there is much excess of heat, and pain or occasionally springing for the same purpose, But this mode of palliating distress should be practiced, with caution and with judgement, for cold application are made in any part of the body at or about the [illegible] of the decline of fever or when the patient is [illegible] feeble, these unpleasant weaknesses restless and sometimes chilly sensations are the immediate consequences,, We should at all Times allow a reasonable indulgence in light and easy to digest food; when called for by the natural-sensation of the stomach Never officiously press the patient that which he dose not desire or more or even quite as much as he may desire to should pay some regard to the accustomed habits of individuals about taking nourishment as to point of time 118 administering our medicines so as to interfere a little as possible with the acustomed period of eating and sleeping,,, In this the reader will not fail to observe an [illegible] of an practice over that if the irritating piece of using emetics and cathartics, which are not only irritating to the digestive organ, exausting to the patient but at the same cutting off supply of the continually, require new element of life another very important requisite to the sick is that they be not molested by unnecessary conversation or even the presents of unnecessary company= carefully remove all among and of either sight or sound,,, give to them all proper opportunity of receiving the refreshing benefits of sleep,, and case of a loss of sleep from disease, or morbid vigilance or the annoyance a pain do not hesitate to procure natural rest by the use of a few drops of laudanum particular at sight, say twenty or twenty five drops,, the strength of the patient, the condition of the tongue, skin and of the pulse will ever in our surest and best guides as to the indications in the administerations of the remedies,,, The Tongue usually covered with a white coat, in the commencement of fever, with the progress of symptoms be comes yellow then brown, and sometimes dark brown, [??d] dry it sometimes sheds a first coat and then becomes red black and glossy, and in extreme cases becomes dry, and crack from a deficiancy of its natural secretion,,, [illegible] then unfavorable symptoms continue to manifest, themselves on the tongue a corresponding want of healthy action exists on the surface of the whole body the skin continuing for most part hot and dry as in a later or tenser stage becoming covered 119 with a more or profuse sticky and clammy perspirable matter with extremities frequently to cool. the pulse during the time becoming weaker with the decline of strength While in pregnancy is apt to be increased, whenever in the progressive course of a fever the attendant observes that the patient is declinig that is that he is sinking to a still lower grade in spite of the use of the quinine and the ordinary diaphoretics whether delirium exists or not the author has found great benefit result from the use of from three to five grains of camphor in union with a quarter of a grain of opium or six or eight drops of laudanum to be taken once in every six or eight hours in lieu of the other diaphoretic remedies already recommended adhering, however still to the regular use of the quinine and giving a moderate portion of toddy milk toddy or wine[illegible] every two or three hours,, Delirium,,, under our general view of fevers, we have already given some account of this symptoms as an occasional attendent on fevers,, It now becomes necessary to speak of it in particular form of fever with a view to the most appropriate mode of combatting it,, We have already conveyed the idea that [illegible] which arrest, the fever, arrest its individual manifestations or symptoms,, But this symptom has been shown to be partly the affect of [illegible] fever proper, and partly the result of a patient's organization, or particular temperment when it occurs in the first stage it is to be relieved as already directed in the first stage of fever and on the same general principle When this symptom, occurs in the later stage of the fever then we have found relief from the use of blisters to the back of the neck and the use of opiates while in all other respects 120 we continue to treat the case as though no such symptom has occured,,,, Deliarium varid and aggravated in its manifestations, and one in which little or no conciousness exits not unfrequently occurs at a later or in the last stage of the fever,,, Here is the result of prostration and irritation then the indications will be to sustain the vital energies and to [illegible] its irritations,, these indications can be best fulfilled by the use of suitable nourishment tonics, opiates, blisters, and lastly stimulants or nourishment, in the form of stimulating drinks such as wine whey milk toddy panada malt liquors and the like,, There is still another symptom which not infrequently occurs in this form of fever, that is internal irritation with or without more or less of wasting discharges from the [illegible] When such irritation exists without evacuation that is, when the natural evacuations are retained, then we should procure the necessary and healthy evacuations by the use of laxatives, or in case of such weakness by injections, alone,, But if on the other hand the patient is wasting from too frequent or too plentiful discharges There we should endeavor to correct such a state of things, by the use of small and repeated doses of opiates and astringents, such as small doses of laudanum paregoric tincture of kino or any of the vegetable astringent teas [illegible] there [cross out] cases of local distress in the bowels, we find warm application or application of mustard so used as to stimulate without blistering valuable agent In proportion, to the exaustion or depression of the patient is the liability to witching of of the muscles a kind of feeble spasmodic action What the medical writers called 121 sub suttus tendinum,, This symptom is the mere consequence of extreme weakness and we here draw the attention of the reader to the fact, that he may the more fully see the importance of sustaining his patient in this situation by all of this means in his power,, While we steadily aim to sustain we should be careful not to [co??] not, [st??] although a very dangerous symptom is not necessarily a dangerous case We have occasionally witnessed cases in which the patient passed no urine for eight or ten days, and still suffered no pain or inconvenience from it, in such cases the secretions are suspended or the absorbent and exhalants, take on an unusual and increased action- Involuntary discharges by stool or urine occasionally occur in low and protracted cases of fever, and although it is a dangrous symptom or circumstance it dose not necessarily follow that the case must prove fatal- Let your patient then just so much of the varied, stimuli that sustain life, as the judgement of the practitioners or attendant the organization in it pregnant state can manage, or requires and no more and careful so to time the repetition of your doses as to meet the continually [illegible] wants of the system- In case of coldness of the extremities we should maintain the natural heat by warm applications or the stimulus of mustard so used as to heat without blistering These remarks, applicable to the last stages of disease will be found equally applicable to all stages- 121 Before closing the present chapter we deem it proper to make some general remarks as and additional guide to whoever may attempt to put in execution our views to wit- They should ever bear in mind the healthy [?g?] [illegible] the healthy needs of the system, and let the object of every step, the use of every agent be to assist either directly or indirectly in bringing back [???inde] every organ of life to the discharge of its healthy function [illegible] all cases, which the sick are able and competent to give us clear and satisfactory responses as to their want [d??es] and sensations, we should never fail patiently to collect such information and apply it to the benefits of the patient and in case of mental alienation or such torpor of mind as cuts off the aid of the sufferer in explaining himself, then exercise your ouwn judgment on all such other lights, as may be brought before you-,,, [illegible] more full and explicit in the detail of [illegible] their applications, to particular symptoms, [illegible] any other chapters for reason already [illegible] we have thought it proper, hare, to remark, that [illegible] [???tions] with application of remedies to [illegible] symptoms, contained in this chapter [illegible] [??tted] in other chapters may with [illegible] be applied to the treatment of like [illegible] of system occurring in other fevers [illegible] the doses and modes of administering all the remedies recommended in this chapter. The [illegible] see in the last chapter, in This Work,, viii/,, 122 The authors Treatment on Cholera Infantum, The Author considers cholera Infantum as a species of fever peculiar to children say from six Months too two or three years old,, This he infers from the fact that children this age are seldom the Subjects of either bilious or typhus fevers, but are subject to ague and fever, and from the additional fact that cholera Infantum is much more common in the summer and fall months, and in sickly seasons-- When grown persons, suffer most from bilious affections The reasons for the occurrence of cholera Infantum in lieu of bilious fever, would to be the peculiar irritability of the stomach, and bowels of children at this period of life, being at this age more liable to take on unhealthy action, under any circumstance than at any other period of [illegible] affection of stomach and bowels, which take care in the winter months being usually slight, & of short duration [??it] those of the hot seasons are more protracted [illegible] serious in their nature, proving sometimes fatal in a short period, while in other cases they are protracted for many weeks, and even months untill the little suffers are reduced to mere living skeletons The puking and purging in cholera Infantum [illegible] some analogy to the cholera morbus of adults, but is not often so violent, so rapid in its progress or so fatal in its tendencies, although for the diseases [illegible] from the same or similar causes,, [illegible] infantum something the vomiting continues without purging but most generally the purging continues without vomiting, and it is not uncommon both symptoms to subside for six eight or ten days with every appearance of a speedy recovery and then return or relapse again after the manner of an [cross out] intermittent fevers As in other fevers the violence and the danger of the attack is proportioned to the circumstances of causation and the constitutions of the subjects hence its greater prevalence and greater 123 [illegible] fatality in [cross out] cities Towns and in [warm] climates, than in county situations and in more [salub??] [illegible],, In cholera Infantum as in other fevers and as in other [cases] of irritation of the stomach and [illegible] the sense of thirst is distroying [q???] the patient at as [d??ining] more [dim??] from the stomach [??ak] digest,, In the early [illegible] the disease the fevers [sometimes] considerable, the skin is [illegible] [illegible] in other fevers, the continued watery [illegible] [illegible] seem to suppress the natural [illegible] and moisture of the skin.) Towards the close of the disease, and when the patient is much [illegible] [illegible] are apt to be cold,, the [illegible] apt to be covered with a white fur and [illegible] [illegible]) It sometimes becomes [illegible] [illegible] it assumes a dark or [illegible] [illegible] as is more apt to prove fatal, [illegible] [illegible] Treatment) [illegible] [illegible] an attact, we deem it [illegible] see or the spontaneous evacuations to present [illegible], untill the stomach and [illegible] [emptied] themselves of their common [illegible] [such] generally accomplished in [illegible] [???ers],, something in a shorter [illegible] should proceed to allay the [illegible] stomach and bowels by means of [illegible] applied over the stomach so [illegible] blistering and the internal [illegible] [illegible] of small doses of paregoric essence [illegible] [illegible] laudanum or any greatful [illegible] should with the vomiting or purging [illegible] [???ss] than weeks such discharges, by the [illegible] of some astringent, that is should an [illegible] [illegible] of the bowels require it,) [illegible] unfrequently since then, pale and water discharges a very obstinate symptom,) In such cases in addition to translating the irritation the skins [illegible] plasters we have found it necessary to use 124 [??f??ted] [illegible] [illegible] such [illegible] the [illegible] [illegible] [illegible] [illegible] This [illegible] as [illegible] it may [illegible] [tak??] in toddy [illegible] [illegible] in [la??] if the [illegible] [illegible] [illegible] [illegible] [illegible] of [admi?t] [ag??] [illegible] [?ase?] able [illegible] again [illegible] [illegible] seldom intances, [ag??] [illegible] [illegible] prohibits the administration [illegible] [illegible] [illegible] [illegible] and bowels and [illegible] [illegible] a little starch and [laud??] [illegible] The teething process being [illegible] [illegible] mutch to the increased [illegible] [illegible] and whenever any tooth or both [illegible] [illegible] so as to be masked success of [illegible] [illegible] of a pen knife should [illegible] [illegible] so as to divide the natural [illegible] [illegible] tooth). The coldness the [extre??] [illegible] an attendant, should be [illegible] [illegible] covering or occasional friction [illegible] [illegible] on the skin,) If the patient [illegible] recover after using, the [forc??] [illegible] a few days, but continues to be [illegible] [illegible] suffering from a feverish state, or [illegible] exhausted, then [ca???nce] [illegible] [illegible] or tonics, such as quine peruvian [illegible] suitable Tonic, and repeat at [illegible] [illegible] hours, untill there is solution [illegible] [illegible] action- a complete crises) [she??] [illegible] between doses two or doses [illegible] its use in this way untill the little [illegible] [illegible] reinstated in health and strength- During the contiunance of the warmer season- children are very liable to relapses,) This [illegible] effectually guarded against by seeing a [purerat??] attention to cleanliness diet and exercise) 125 [illegible] [illegible] [??tion] [illegible] and [illegible] [illegible] [illegible] [illegible] and [illegible] [illegible] [???a] the [illegible] [illegible][illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [dis???] [illegible] [illegible] [illegible] [??a?i??] [illegible] [illegible] [???ag?]) [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] in the on [illegible] [illegible] [??ed] and [illegible] [illegible] teeth was natural [illegible] [illegible] growth of bones [illegible] [illegible] are produce) [illegible] [illegible] processes, if so [wh??] [illegible] [illegible] disease) [illegible] [illegible] would seem to us to be [illegible] [illegible] [??is], the other [illegible] [illegible] the [illegible] the makes its exit [illegible] [illegible] lasts but a few days, while [illegible] [illegible] liable to continue during the [illegible] [illegible] the opposition will say [illegible] [illegible] [??ies] too,) To this we reply [illegible] [illegible], dose not commence the [th?] winter season, or [?ven] run into the winter, months [illegible] [illegible] teething process is still going on, [illegible] [illegible] changes of, the seasons moreover [illegible] [illegible] children who get their teeth without [illegible] [illegible] [???laint] or indisposition of any [illegible] [??ular] those who pass through the [illegible] process while very young) again we hear [illegible] [??laint] about the stomach and bowels [??lant] in the sheding of teeth when there is not [illegible] a need growth, in process but the additional [illegible] of casting off the Hot ones) He readily admit the greater liability of children to disease and to [illegible] during the first two years of existence 126 than at an [illegible] [illegible] of time for the [illegible] [illegible] [??hi?] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [P???] as to the [illegible] [illegible] frequently to exist [illegible] [illegible] a [H???] [illegible] [illegible] sound and rigorous [illegible] [illegible] the [illegible] origin or [mad??] [illegible] [illegible] of [illegible], it is a matter [illegible] [illegible] The weight of [fest??] in [illegible] [illegible] favor of the idea [of??] [illegible] [illegible] in the human intesting, [illegible] [illegible] of life most, [illegible] such [illegible] would seem to be [??u??], [illegible] [illegible] more especially the use [o???] [illegible] indigestible food, [illegible] [illegible] that may tend to derang the [illegible] [illegible] digestion or of [asimil??] [th?] [illegible] view of the subject we are [illegible] that the existence of [illegible] [illegible] a result, than a cause disease) [illegible] when they have been generated [illegible] [illegible] when they exist, in great [munk??] that they then became an additional cause of [illegible] and ciation and of febrile disease [illegible] [illegible] not only so promptly, expelled [illegible] [illegible] suitable vermifuges, but that [illegible] [illegible] should afterwards be placed on the [illegible] of such remedies, as would most [illegible] prevent their return, as generational The symptoms ascribed to, and that [illegible] be attendant on worms in children, are almost as numerous and very much resembling the symptom of many their diseases to which they are subject; 127 [illegible] [illegible] [illegible] [chse??] [illegible] [illegible] from the symptoms [illegible] [illegible] [???ust] be left [illegible] [illegible] [???dant], and [illegible] [illegible] proof of it [illegible] [illegible] the presence of [illegible] [illegible] by variableness of [illegible] [illegible] [???ness] and [illegible] [illegible] the sleep picking of the [illegible] [illegible] of the upper lip, more or less of [illegible] [illegible] disturbance of bowell [illegible] [illegible] about the navel,, febrile [illegible] [illegible] of worms) When [illegible] [illegible] point to the presences [illegible] [illegible] administer, vemifuges [illegible] [illegible] of spigelia or Carolina [illegible] [illegible] two or more grains of Calomel [illegible] [illegible] the patient, Should be [illegible] [illegible] second morning for two doses [illegible] [illegible]; two or three times per day [illegible] [illegible] succession or a few drops of spirits [illegible] [illegible] a little sugar, and water two [illegible] [illegible] per day) Should there exist a costive [illegible] [illegible] while using, the warm Medicine [illegible] [illegible] purges gently with a little senna [illegible] [illegible] or a dose of calomel, provided [illegible] has not been used) in every case of worms [illegible] suceeding in expelling them the patient [illegible] [??ed] on the use of some better tonic [illegible] [illegible] to good health and to good digestion [illegible] suppose we know of nothing perferable [illegible] of suitable doses of quinine, in [illegible] we have reason to believe that it [itself] is itself a good vemifuge vither from its better principles or its tonic effects on the system The Some preparations of iron are also well suited to such cases.) The particulars as to remedies and their doses, the reader will see chap 16 128 Chapter ninth On yellow fever, description, [illegible] classification of fevers, this is the [illegible] and most malignant type of [illegible] disease it is to common [illegible] fever [illegible] plague or [illegible] fever is to typhus [illegible] fever, and much will [illegible] be called the typhoid bilious fever of cities [illegible] since it never appears in [illegible] in hot seasons and in crowded illy ventilated and filthy places, and even [illegible] tropical regions its ranges are checked by the coming on of the cold season of the year it is more violent in its attacks more rapid in its progress and more putressent and fatal in its [illegible] than any other form of bilious fevers Causes The concentrated virus of [illegible] with the exhalations from human [illegible] civic life that is to say, the debilitating [illegible] effects resulting from a violation of organic laws [illegible] by the continued and relaxing influence of [illegible] other words the external causes [illegible] influence of heat, with a peculiar vitiation [illegible] while the internal causes are violations of organic laws) The united effects of these are [illegible] modifying causes are to debilitate, to [illegible] and derange, the functional actions of [illegible] in brain nerves, muscles and all the glandular tissues) Hence, we see such rapid [illegible] secretions to vitiations and [illegible] in the solids, particularly in the stomach and [illegible] is a rapid running into gangrene, and [illegible] as is evinced by the black and putrid matters [illegible] from them, and the speedy triumphs of death and decomposition that we are occasionally called to witness) We are aware that a prejudice exists not only the minds of the populace but of the profession 129 [illegible] [illegible] of the [S???] [illegible] [illegible] [illegible] [illegible] [illegible] quantity [illegible] [illegible] [???ally] [dist??] [illegible] [illegible] [illegible] it [illegible] [illegible] [illegible] or [?iten] [illegible] [illegible] such [rapi?] [illegible] [illegible] jaundice evident [illegible] [illegible] yellow fever which [illegible] [illegible] all seasons is so [illegible] [illegible] or occurs in [illegible] [illegible] it [rea??y] produces [illegible] [illegible] freely [diffus??] [illegible] [illegible] system, the patient in [illegible] [illegible] [??ly] concious of being [illegible] [illegible] color of the skin, Symptoms, The [illegible] [illegible] most particulars like that [illegible] [illegible] ushered in by sensations of [illegible] [illegible] stiffiness or soreness of the [illegible] [illegible] head, back and limbs, generally [illegible] [illegible] degree of chilliness, these [illegible] [illegible] succeded increased pain of the [illegible] [illegible] sinuses, giddiness or dizziness [illegible] [illegible] face, a sense of fulness in the eye [illegible] [illegible] expression of distress in the countinence [illegible] [illegible] suffused, with tears a general [illegible] [illegible] with thirst, either great restlessness [illegible] delirium or a tendency to lethargy [illegible] [illegible] scanty and turbid perspiration [illegible] interrupted and diminished pulse irregular [illegible] [??izs] or too slow full fretful and [illegible] often giving a delusive feeling of [i??ased] force seldom strictly tense,, tongue covered [illegible] a whitish mucous coat great irritability of stomach, with nausea and vomiting of bilious matter usually found, epigastrium Tender 130 [??prepure]) [illegible] [illegible] [illegible] as [illegible] [illegible] first [para???] [illegible] [illegible] [???p] [illegible] [illegible] [illegible] [illegible] yellow [wh??] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??ter] [illegible] [illegible] [illegible] [??ll] the [dis?a??] [illegible] [illegible] [illegible] [??ih] generally [illegible] [illegible] [illegibe] hours, when an [illegible] [illegible] [illegible] times, which such [illegible] [illegible] [illegible] induce the patient [illegible] [illegible] [illegible] of danger. But [illegible] [illegible] [illegible] with an aggravation of symptoms [illegible] [illegible] [illegible] of this error) As the [disea??] [illegible] [illegible] more and more indicative [illegible] [illegible] [illegible] manifest themselves, the patients [illegible] [illegible] to decline, the Skin becomes [illegible] [illegible] and hue,, patches of livid spots [illegible] [illegible] different parts, of the body [de???] [illegible] [illegible] secreations begin to [illegible] [illegible] the tongue becomes dark and [illegible] [illegible] incrusted, with a dark [illegible] [illegible] hickups ensue haemorrages [illegible] [illegible] forth from the mouth, nostrils [illegible] [illegible] foetid and involuntary, discharge [illegible] [illegible] from the bowels, the pulse sinks [illegible] [illegible] closes the scene.) Such are the ordinary [illegible] [illegible] in those cases which [termi??] [illegible] [illegible] In this fever as in all fevers proper [illegible] [illegible] marked critical days the duration of [di???] terminating favorably or otherwise [illegible] [illegible] proportion to the violence of the causes and [illegible] constitutions of the subjects of disease) Being [illegible] malignant, disease it usually runs it [ca??] from two to five or seven days,, recovering from [illegible] protracted beyond this period are for the most part tardy and imperfect the patients suffering [m??] 131 from indgistion the necessary result of injuries [s???] [illegible] [illegible] [illegible] of the [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??pular] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] those who [illegible] [illegible] [??in] [sub??] [illegible] [illegible] of distinguished [illegible] [illegible] [??its] of illustrious [illegible] [illegible] unbiassed love of [illegible] [illegible] we have been forced [illegible] [illegible] a course ( [illegible] [illegible] is the exclusive property [illegible] [illegible] of thought either in [illegible] [illegible] [???ent] of human researcher [illegible] [illegible] [??hed], and that when reached [illegible] [illegible] forced to rest in simple [illegible] [illegible] [illegible] have ventured to raise [illegible] [illegible] [??ition] certanily in accordance [illegible] [illegible] [??ions] predecessors) We shall [illegible] [illegible] plain and simple view in [illegible] [illegible] disease, than any heretofore [illegible] [illegible] too, which we conceive to be [illegible] calculated cauintuact the virus [illegible] [illegible] in accordance with the [illegible] [illegible] life if In consulting the pages of [illegible] [illegible] we find the weight of authority [illegible] [illegible] favour of the depletive practice at least [illegible] of the [cross out] (immortal Rush,) [illegible] [???tal], because to him we are indebted [illegible] measure for the demonstration of its [illegible] origin, to him are we indebted for [illegible] [illegible] clearest lights, on the subject of contagin [illegible] the earliest the freest and the fullest [???ents] in the depletive practice. (When the [illegible] made its appearance in Philadelphia [illegible] Dr Rush seems to have been much at a less [illegible] that course of treatment, he should 132 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] give [illegible] [illegible] [illegible] distressed [illegible] [illegible] in the [???ment] of [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] happened, [illegible] [illegible] [illegible] advice and [illegible] [illegible] [illegible] disease as his [illegible] [illegible] [illegible] Indies, would [n???] [illegible] [illegible] me that he had [illegible] [illegible] [illegible] of all kinds, [illegible] [illegible] found to be hurtful, and that [illegible] [illegible] readily to bark, [illegible] and above [illegible] cold bath (He [ad??ed] the bark to [illegible] large quantities, by way of [illegible] [illegible] usual ways and he informed [illegible] [illegible] the cold bath should be used [illegible] [illegible] benefit from it (The made of [illegible] [illegible] appeared to be reasonable [illegible] [illegible] manner he had recommended it, [illegible] [illegible] sporadic yellow fever, with [illegible] [illegible] I had moreover the authority of [illegible] [illegible] of reputation in its favor) Dr [illegible] [illegible] sometimes gave the bark, when the [illegible] [illegible] vicious humors, these humor,, he says, [illegible] by the fault of the circulation,) The [illegible] [illegible] solids enables them to throw off [illegible] [illegible] excrementitious, fluids by their [illegible] [illegible] I began the use of Dr Strong, remedies [illegible] after my interview with him with [illegible] of their success,, I prescribed back in [fa??] [illegible] one case ordered it to be injected into the [illegible] four hours. (I directed buckets full of cold [illegible] to be thrown frequently upon my patients, ( The [illegible] was offensive to the stomach or rejected by it in every case in which I prescribed it, (The cold bath was greatful and produced relief in several cases 133 [illegible] [illegible] [??l] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??ment] [??und?] [illegible] [illegible] him in the course [illegible] [illegible] opposite extreme,, [illegible] [illegible] [??ely] of free and [illegible] [illegible] are, (One dose was [illegible] [illegible] bowels, but from [illegible] [illegible] [illegible] for that purpose,, [illegible] [illegible] were frequently rejected [illegible] [illegible] and inconvenience from [illegible] [illegible] [??lass] (It was always without [illegible] [illegible] and it served to discharge [illegible] [illegible] the stomach,, (Nor did I rest the [illegible] [illegible] the bowels on the issue of the one [illegible] [illegible] (There is in all bilious fevers, a [illegible] [illegible] life, as fast as it is discharged [illegible] [illegible] every day, while the fever continued [illegible] [illegible] from tartar and rhubarb, [illegible] [illegible] purges, had preformed their office [illegible] [illegible] of my patients, in all these cases [illegible] [illegible] easily moved,, when this was not the case [illegible] [illegible] dose of Calomel and jalap every day [illegible] [illegible] maybe supposed to be it was often [illegible] [illegible] especially after the 20th of September, [illegible] become neon obstinatly constipated of [illegible] place of the jalap I now added gamboge [illegible] [illegible] two grains and a half of each made into pills [illegible] to an adult, every six hours, until they [illegible] four or five stools) on the 133 page ( [illegible] doctor, we have said on abandoning the Tonic [illegible] of treatment, suggested by Dr Stevens, [???ty], [???pon] the opposite extream, (he now not 134 [illegible] practices [illegible] and [illegible] purgings [illegible] [illegible] [illegible] use of the lancet [illegible] [illegible] sage [illegible] in the [illegible] [illegible] thrown was [illegible] [illegible] temperature [illegible] [illegible] [??nd] one [illegible] [illegible] [??due] the [f???] [illegible] [illegible] the diminution [illegible] [illegible] fever put on [illegible] [illegible] diathesis more frequent [illegible] [illegible] I bled many patients [illegible] [illegible] a day,, (I prefered, [illegible] [illegible] bleedings, in the [illegible] [illegible] the hight and class of [illegible] [illegible] -nce, from the loss of a [illegible] [illegible] of blood at a time ([illegible] [illegible] seventy and eighty ounce [illegible] [illegible] a few much larger quantitys, [illegible] [illegible] in front street, last by ten bleeding [illegible] [illegible] blood Mr George a carter, in [illegible] [illegible] same quantity, in five bleedings, [illegible] [illegible] one hundred and fourteen [illegible] [illegible] in the last of the above named [illegible] taken it as determined by weight, ( [illegible] near Dock street, was eight times [illegible] seven days, the quantity taken [fro??] [illegible] hundred ounces.) The blood in all [illegible] and in the last, very sizy, (They [illegible] the month of October, and chiefly [illegible] [illegible] Mr Fisher,, and they were all year, [illegible] [illegible] and healthy instance, of the efficacy [illegible] [illegible] bloodleting, and of the intrepidity, and [illegible] this young Physician (Again [illegible] Vol 2, P.147, Now that we have patientaly [illegible] Doctor through, some of his Transitions of opinon [illegible] witnessed the processes by which he has been [illegible] erarers, we will next call the attention of the reader [illegible] 135 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??set] the [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] stage [illegible] [illegible] [illegible] [ons?untly] [illegible] [illegible] in her stomach [illegible] [illegible] were prescribed [illegible] [illegible] [???ing] of the next [illegible] [illegible] discovered, to me at [illegible] [illegible] which Dr Faulke [illegible] [illegible] which had been [illegible] [illegible] the adjoining Hoch on [illegible] [illegible] with Mr Le Margre's [illegible] [illegible] [???fied], there to the great [illegible] [illegible] [???hood, (After this [illegible] [illegible] trace all the cases of fever [illegible] [illegible] to this cause of diseases ( [illegible] [illegible] a conviction, that the disease [illegible] [illegible] exhalations, from the damage [illegible] [illegible] American daily, advertiser to August [illegible] [illegible] citizens of Philadelphia with a [illegible] [illegible] attention to the spot where the [illegible] [illegible] checking the progress of the [illegible] [illegible] continued by the original caused [illegible] [illegible] when received into the body, were [illegible] [illegible] into action in a few days-(Im with [se??] cases, in which they acted so as to produce a fever [illegible] some day in which they were received into the [illegible] [illegible] I heard of two cases, in which they [illegible] [???ss], fainting and fever with in one hour, [illegible] [???ns] were exposed, (I met with no instant [illegible] [illegible] there was a longer, interval than sixteen [illegible] between their being received into the body, and [??tion] of the disease. This poison acted [illegible] different constitutions according to [illegible] the degree predisposing 136 [illegible] [ar?] the quanity [illegible] [???tin] of [cross out] [illegible] [illegible] [illegible] [illegible] [illegible] that in [illegible] the [pois??] [s??] the [??tmosphere] the [illegible] [??as] excited to [illegible] the [illegible] [illegible] upon the [dys???] [illegible] [illegible] [illegible] [illegible] [illegible] (first great [lat??] [illegible] [illegible] [illegible] [??din] walking [?idiny], [illegible] [illegible] [illegible] Second, ([illegible] from [illegible] [illegible] [illegible] heat of the sun; [illegible] [illegible] [illegible] of the [dis??] Third [int???] in [illegible] [illegible] [T???ion] (Tear ([illegible] [illegible] sudden [par??] of [illegible] [illegible] [illegible] seventh sleep right [illegible] [illegible] all these [illegible] [illegible] [illegible] debilitate, the body [a??] [illegible] [illegible] [illegible] purges, repeated [illegible] [illegible] [illegible] call it by what [nam??] [illegible] [illegible] putrifying, [vegat??], [a??] [illegible] [illegible] damaged [illegible] [illegible] [illegible] be the real cause and [p??] [ha??] [illegible] [illegible] than it most rational to [???t] [illegible] [illegible] infected, with such [p??] [illegible] [illegible] bleeding, and purging to [illegible] [illegible] such poison) But the [oppo??ion] [illegible] [illegible] are the attacks, so rapid the [pr??] [illegible] [illegible] to words a fatal [ex??e], that [les?] efficient [illegible] [illegible] remedies would be of [illegible] [illegible] [illegible] become the subjects of disease [fr??] [illegible] [illegible] exposure, to the infected almosphere, [illegible] [illegible] and frequently become its [vi?ting] in [illegible] [illegible] from the period of the attack, ([illegible] [illegible] The effects of poisons of many kinds and [inter????] upon the animal economy,) We here seen individuals suddenaly into fevers with vomiting into cramps [cons??] syncope or fainting, from breathing for a time [n?p??h] gases, of different kinds, such as whit the [illegible] call damps or damp airs, we have seen individuals [ferati?] 137 divested of all the ordinary signs of life, yet we have never relied in bleeding and purging for the restoration of such [p???] (We have been calld to witness the effects of animal poisons such as the life of spiders and venemous serpents (We have witnessed the rapid [tu??] faction, The sudden inflammended of you [illegible] the [exp??sint] the spasms (heard the oft repeated, cries of pain observed the tears of [illegible], yet still we have not relied on bleeding purging for the relief of such cases, and then vegetable animal, [???al] poisons have [illegible] [illegible] allowed, we have not relied on [illegible] or [???in], remedies, than the case of such [antidet??] known to neutralize or [illegible] [illegible] of the particular poisons taken [illegible] [illegible] chief reliance, upon these measures [illegible] [illegible] (Doctor Rush in the first [illegible] [illegible] [???enc?] of 1793, treated them with the [illegible] [illegible] swelling and purging with calomel [illegible] [illegible] Rush's Works page 41, Vol. 2 [illegible] [illegible] dose not say, but we find him [illegible] [illegible] [???ing], with ipecacuanha bark wine [illegible] [???ally], blankits dipped in warm vinegar [illegible] rubed on the right sides) his works [illegible] [illegible] him asking counsel of Dr Steven's [illegible] [illegible] St Orix, The recommended the [illegible] [cold bath],(This made of treating, The [illegible] [illegible] [???able], to the Dr,, he has use bark in the [illegible] [illegible] several cases of sporadic yellow fever [illegible] years, (In fact the Dr was so will pleased [illegible] [illegible] Stevens, that he proceeded to put his [illegible] [illegible] the very next days (Now to you it may [illegible] [illegible] Rush Should so soon change his opinion [illegible] Dr Stevens, so far as we know and to believe [illegible] (It may be that there is as much in the skill judgement, with which scientific, labors are [??ed], as in the power of intersect in which the truth of [illegible] conceived (In his first experiments with the [ten?] 138 [illegible] stimulating [illegible] [illegible] 123 vol [illegible] [illegible][illegible] seemed [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [???g] [illegible] [illegible] [illegible] [s?pp??] [illegible] [illegible] [illegible] [illegible] the reason [illegible] [illegible] [illegible] he did, [illegible] [illegible] [illegible] [??st?] experiments [illegible] [illegible] without judgement, ([illegible] [illegible] infer, that he [ex??] [illegible] [illegible] second experiments, [illegible] [illegible] [illegible] Dr,,Stevens he failed [illegible] [illegible] [illegible] the clear inference of his [illegible] [illegible] [illegible] paid no attention to the state [illegible] [illegible] [illegible] the consequences (The [?ark] [illegible] [illegible] [illegible] or rejected by it in every case [illegible] [illegible] [illegible] We have been taught to [beli??] [illegible] [illegible] [illegible] understand or not to read at all ([illegible] [illegible] [illegible] patent agent either for good [illegible] [illegible] [illegible] too carelessly, directed, (His [illegible] [illegible] cold water to be thrown frequently [illegible] [illegible] good could any one expect from [illegible] [illegible] [illegible] at most under such vague [instr???] [illegible] [illegible] baffled, in every atempt, to step the [?a??] [illegible] [illegible] took himself to intense study ([illegible] [illegible] [illegible] pored every book,, that treated of [illegible] [illegible] [illegible] overhauled, a manuscript, that had been [illegible] [illegible] by Dr Franklin, a short time before his [illegible] [illegible] [illegible] the aid of Dr Mitchell resulting in leading him [illegible] [illegible] [illegible] to the depletive, particularly the purgative [illegible] [illegible] [illegible] see him enraptured, with the virtues of [cal??][illegible] [illegible] [illegible] of ten and ten, are now, distributed in a wholesale [illegible] [illegible] the city, indeed so great in his confidence in the [illegible] [illegible] that he directed his patients, to be purged every day [illegible] [illegible] His next remedy in the lancet, he bled may patients [t??] [illegible] three times a day, he prefered frequent, and small to large [illegible] [illegible] in the month of September, but towards the height and [illegible] [illegible] 139 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [???tant] with [illegible] [illegible] [illegible] [???b??d] [illegible] [illegible] [??ssition], that, [illegible] [illegible] [illegible] basinss of they [illegible] [illegible] [??eto], to remove [illegible] [illegible] as the circumstances [illegible] [illegible] a assist nature, when [illegible] [illegible] [??ets], but never too officious [illegible] [illegible] nights, (But the Dr,, says [illegible] [illegible] hands, (Took in [illegible] [illegible] expressions like these to [illegible] [illegible] [??ltraism], such individuals [illegible] [illegible] natural law to maintain or [illegible] [illegible] (We have been induced to twice [illegible] [illegible] of yellow fever for the reason [illegible] [illegible] of the [??sudar] prejudices, that have [illegible] [illegible] stand opposed to us, but the names of [illegible] [illegible] in office, individually, whose named [illegible] [illegible] have been received as [illegible] [??tors] in the stage of usefulness [illegible] [illegible] (Dr James Johnson of London, who [illegible] [illegible] [???anc] of the soundest medical Philosopher [illegible] [illegible] [??ssicat] and talented author of Tropical [illegible] Change of Air, and some other works of [illegible] [illegible] as inn the tropical climates, Vol.2 [illegible] [illegible] signature of Archibald. Robertson [illegible] [illegible] Medica (society of Edinburgh as [illegible] [illegible] the [??al] treatment of the epidemic fever I [illegible] [illegible] [???ake,]regarding this disease to be all practical [illegible] [???oses], inflammatory and the affection of the head [illegible] and essential, which is evenced, by headach [??bir] lueis, and red eyes, is how generally an index state of the Brain in the same manner as the tongue is of 140 stomach, I have [illegible] [illegible] [illegible] [???ins] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [s???] [?nd] large [illegible] [illegible] [???a] ([illegible] [illegible] [illegible] the patients [illegible] [illegible] of the [illegible], I have generally [illegible] [illegible] [illegible] [illegible] can be [illegible] [illegible] [illegible] be [tak??] ought [illegible] [illegible] [illegible] [illegible] order to [illegible] [illegible] and induce a [sp??] [illegible] [illegible] that it is not only, by [illegible] [illegible] [s??] I cannot [exp??] it in [philoso??] [illegible] [illegible] to the whole system nervous [illegible] [illegible] letting efforts, the magical, [illegible] [illegible] [illegible] it is also cheifly, by the in [exp??] [illegible] [illegible] word shock, (That cold effusions [illegible] [illegible] from in tropical climaty, where the [illegible] [illegible] is generally from 80.to 82, its [s???ig??] [illegible] [illegible] much abated (The state of the [illegible] [illegible] than the urgency of the other [illegible] [illegible] imperiously, around renewed [de???] [illegible] [illegible] former is thready spreading, or [illegible] [illegible] demand must be complied with, [illegible] [illegible] An a disease like this, where the danger [illegible] [illegible] in twelve, or fifteen hours, it is often [illegible] [illegible] apparent character may be altered [illegible] [illegible] again he says (Is is a [hucul??] [illegible] [illegible] that almost omnimpotent, remedy, the [illegible] [illegible] said to in counter A remedy for all other [illegible] [illegible] second of force, (It requires all the [illegible] [illegible] [illegible] [illegible] will gain ground on uswith rapid strides, [illegible] [illegible] to bleed again and again this is the mainstay [illegible] [illegible] anchor of hope, (Without it many very [ma??] [illegible] infallibly be lost. (Would I could say [illegible] [illegible] The same writer further remakes. Page 341. [illegible] [illegible] [??urging] I have not hitherto, mentioned, the [illegible] [illegible] much a matter of course (A stimulus ought to be [illegible] [14?] [illegible] [illegible] than [illegible] [illegible] [illegible] [illegible] [illegible] [????tion] of fevers [illegible] [illegible] [illegible] [co???ted] [illegible] [illegible] [illegible] [a???] [illegible] [illegible] [illegible] [illegible] [illegible] [???ment] [ar???] [illegible] [illegible] that it is the [illegible] [illegible] [illegible] [???er] to result [illegible] [illegible] [illegible] [illegible] [confi?t??] [illegible] [illegible] [???illy] [sustained] [illegible] [illegible] make appeals, ( [illegible] [illegible] say [illegible] 335. Vol 2. Tropical [illegible] [illegible] he says, elsewhere is [illegible] [illegible] continues.) I found the vessels [illegible] [illegible] [???ous], than natural and filled [illegible] [illegible] an distinct traces of [illegible] [illegible] and other viscera of the thorax [illegible] [illegible] appearance of inflammation whatever [illegible] [illegible] ready be accounted for [illegible] [illegible] brain [illegible] membranes, I found [illegible] [illegible] action save in its basilar portion [illegible] [illegible] and adhered pretty firmly to the [illegible] [illegible] of coagulable lymph were [illegible] [illegible] living together, the inferior, convolution [illegible] [illegible] with dark colored, and appearently [illegible] [illegible] the other cerebral nerves from the [illegible] [illegible] the sustance of cerebrum pons and [illegible] [illegible] exit by the cranial foramina,(- [illegible] [illegible] has found in each one of the lateral [illegible] [illegible] was in the cerebellum, and medulla [illegible] [illegible] chief morbid appearances were directed [illegible] [illegible] a degree of vascularity, indicative of [illegible] [???irly] it was covered with a plexus of [illegible] [illegible] and the later together, with the pons varolii [illegible] medulla oblongata, was enveloped by tenacious [illegible] of fibres, which could scarcely be removed with [illegible] [illegible] substances, underneath,(about [illegible] spoonfuls of serum also were found effused in the fourth 142 [illegible] [illegible] [illegible] medulla [illegible] [???g] [illegible] [illegible] [illegible] [???tions] [illegible] [illegible] [illegible] of [illegible] [???p] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] less to know [illegible] [illegible] strictly [???able], to the [illegible] [illegible] [???pe?is] or [illegible] [illegible] [illegible] [???duced] by the [illegible] [illegible] we do know that [illegible] [illegible] [illegible] the laws of [illegible] [illegible] will die, in spite of [illegible] [illegible] [illegible] could be adopted; [illegible] [illegible] [illegible] of treatment might be [pur???] [illegible] [illegible] by him, (For if the danger of [illegible] [illegible] tendency to inflammation, and [illegible] [illegible] [illegible] and purged nearly to death, to [illegible] [illegible] the inference, seems at [illegible] [illegible] [illegible] is not the same, and [pre??] not [illegible] [illegible] it, (Dr. Rush we shown [illegible] [illegible] [illegible] and liberal depletion) and has [illegible] [illegible] several dissections made by Dr [illegible] [illegible] to sustain the doctrines-( [illegible] [illegible] [illegible] great importance, of the disease [illegible] [illegible] in the investigation of diseases, we [illegible] [illegible] [illegible] that some of these dead, of the present [illegible] [illegible] fevers should be examined, and [illegible] [illegible] observations, it appears at present [suff??] [illegible] [illegible] following facts, (Fast that the brain, in [illegible] [illegible] found in a natural condition, ([illegible] [illegible] viscera of the thorax are perfectly sound [illegible] [illegible] in the heart and veins, is fluid, similar [illegible] [illegible] of the blood of persons who have been [hang??] [illegible] [illegible] by electricity, (That the stomach, and [begin??] [illegible] [illegible] duodenum arc the parts that appear most [dis??] [illegible] in Two persons that have dies, of the disease on the [illegible] the villous membrane of the stomach especially [a???] 143 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [d???] [illegible] [illegible] [illegible] [sim??] [illegible] [illegible] [illegible] by [illegible] [illegible] [illegible] in a [f???] distroyed by it ([illegible] [illegible] of its [illegible] [illegible] [illegible] died [illegible] [illegible] [???ation] [illegible] [d???] [illegible] [illegible] [???arly] about [illegible] [illegible] [illegible] [???tion] of which [h???] [illegible] [illegible] [illegible] beginning of the [illegible] [illegible] [illegible] this part is as [illegible] [illegible] [illegible] at a more advanced [illegible] [illegible] inflammation disappeared [illegible] [illegible] [illegible] intestines, a black liquor, which [illegible] [illegible] [illegible] death, (This black liquor [illegible] [illegible] altered secretion from the liver [illegible] [illegible] [illegible] quality was found in the [illegible] [illegible] [illegible] [???s] acrid that it produced [illegible] [illegible] and swelling, on the operator's hand [illegible] [illegible] [illegible] (The villous membrane of the [illegible] [illegible] [???dis], was found inflamed in sever [illegible] [illegible] [illegible] its natural appearance, erupting [illegible] [illegible] the surface of which a very [illegible] [illegible] [illegible] seen all the other abdominal [illegible] [illegible] appearance, (The external surface of [illegible] [illegible] of the intestines, was quite free from [illegible] veins being distended with blood which [illegible] through, the transparent peritoneum gave [illegible] [illegible] (The stomach of those who died early in [illegible] [illegible] always contracted, but in those who died [illegible] [illegible] period of it, where extravasation appear [illegible] [illegible] with, air (Rush's works Page 92, Vol 2 [illegible] [illegible] Physick and P. Cathrall [illegible] [illegible] interduce, these reports of post mortem [illegible] [illegible] for purposes already mentioned, but further [illegible] [illegible] reports-(First that the disease in question has 144 fixed [illegible] [illegible] [illegible] [illegible] [illegible] [??ated], [illegible] [illegible] [illegible] be [illegible] [illegible] stomach and duodenum [illegible] [illegible] [illegible] organs, ( [illegible] that [illegible] strong indication of [putrese??] [illegible] decomposition and [illegible] [illegible] [illegible] sometimes procedes [illegible] [illegible] Healthy inflammation [illegible] [illegible] and the term inflammation [illegible] [illegible] be nightly used or the [illegible] [illegible] changes of structure [illegible] [illegible] we are well aware of [illegible] [illegible] the very many imposing [illegible] [illegible] addition to those already [cel???] [illegible] [illegible] still another of which standing [illegible] [illegible] [illegible] Surgeon Lawson (Pork, in [illegible] [illegible] [illegible] perpared under the [der???],of Surgeon General 2 OL) [illegible] [illegible] [illegible] appearance late in the season [illegible] [illegible] [illegible] character, but is in [illegible] [illegible] disease of highly arterial ([illegible] [illegible] at lease one more and [illegible] [illegible] medicine for four of five days [illegible] [illegible] Calomel is the cathartic [conn???] [illegible] [illegible] decidedly the most efficient [illegible] [illegible] of from sixteen to twenty ounces of [illegible] [illegible] the extent of twenty or twenty five [illegible] [illegible] for several days, the doss is repeated, [illegible] [illegible] oil and enemata according to [circu???] [illegible] [illegible] After the first day the calmel in [addi???] special administration as a purgative [illegible] [illegible] in doses of five grains every three hours [illegible] [illegible] irritating the salivary glands and this [illegible] [illegible] from more vital organs, (Those is no [dang??] [illegible] [illegible] the patient by excessive purgation, as it is very [di???] excite the intestinal cannal into action and 145 [illegible] [illegible] [illegible] [par??] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [d???] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] day [illegible] [illegible] [illegible] [stop???] [illegible] [illegible] [illegible] must [res??] [illegible] [illegible] [illegible] [???darble] our [illegible] [illegible] the lowest [illegible] [illegible] to employed with [illegible] [illegible] which is frequently [illegible] [illegible] symptom, to require [illegible] [illegible] [???sion] cerebral excitement [illegible] [illegible] [??ailed] in connection with [illegible] [illegible] constition; the main and [illegible] [illegible] in this fever, ( [illegible] [illegible] not necessary none but the [illegible] [illegible] infusion can be administered [illegible] [illegible] such as the sulphatic of quinine [illegible] [illegible] ( This disease runds its course [illegible] [illegible] fatal, in few days by a [illegible] [illegible] organ or being itself [illegible] [illegible] seventh day, having once [illegible] [illegible] the conflict, (The surgeon's [illegible] [illegible] use of quinine, stand in direct [illegible] [illegible] even Thinks quinine is inadmissible in [illegible] [illegible] the fever, while we use it in every stage [illegible] [illegible] inflammation or aggravating [illegible] [illegible] gives to it opposite effects( We [illegible] [illegible] [??fuige] antiseptic and touic vertues [illegible] [illegible] reliance, upon the [super??tion] of [??tydis?] [illegible] [illegible] witness, ( 147 148 148 149 150 153 157 158 159 160 161 162 163 164 188 Polish For Furniture In 1 quart Boil Lint seed oil 1 pt Alcohol One lb Gum Shelac 2/3 [illegible] Mix it as below When mixing this polish it must be warm, that is the oil And put in the other articles And the polish is ready to put on 187 A fine tonic for [illegible] Persons caused by chills and fever or otherwise R. hyposulfate of Soda 2 oz Elixer viteral 2oz Sulphate quinine 90 gr pure Aqua 1 [illegible] let it stand one hour and it is ready for use. Dose for an adult a table spoonfull 3 times a day Children in proportion- Fine Cement R 4 Tablespoonfulls of Salt; water 1 pt gum Shelac 1/2 lb let it boil Slow until all is melted and where it is about a consistency of Shoemakers wax draw it in long Strips and break it into six inch Sticks it is now ready to mend with by heating the stick and applying it to the glass as dish and pressing the parts together and then let stand 12 or 24 hours and the vessel is ready for use [1??] [illegible] [illegible] [illegible] [illegible] Tinc [comp??] [illegible] [illegible] [illegible] to be [app??] [illegible] per day, [illegible] be taken internalle in [illegible] 3 or 4 times [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] Acit 3X [illegible] [illegible] [illegible] 3ii Tinc Lavender [illegible] 3 [illegible] Aqua [illegible] 3XXi Muc gum [illegible] 3 [illegible] i Dose to [illegible] [illegible] Tonic [Al???] [illegible] [illegible] Rx Rad sarsaparilla [illegible] [illegible] xii sassafras cont-[g???] Rad Gb Mezeron Cont Dulcamara [Eupa??] [illegible] 3vi aqua congt to [illegible] [illegible] then boil half an [illegible] [illegible] mix with simple sys, [iilegible] [illegible] Anodyme, and 1/2 dz [illegible] [illegible] Cong-Dose 1 tablespoon [illegible] [illegible] a day- Rheamatic [m??] D. Tinct semini [Colc?ici] each 3Xvi tinc opii Tinc lavender Compound [illegible] Aqua cinnamon 365- spoonful every 4 [hou??] cases, a teaspoofull every [illegible] not so urgent 195 [Ha??] [W???] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [?his] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] Pills [illegible] [?il] [??t???th] [Comp] ℥i [illegible] [illegible] [illegible] Grs 20 [sub??] [illegible] grs 15 [illegible] [illegible] [illegible] gr i [illegible] [illegible] [illegible] gr3 [illegible] [illegible] [illegible] gr, 6 [illegible] [illegible] [illegible] pills [illegible] [illegible] [illegible] bed Time [8??] [illegible] the [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] 197 [illegible] [illegible] [illegible] 9 1/4 [y???] [illegible] [illegible] [illegible] 35 [illegible] [illegible] [illegible] 34 [illegible] [illegible] [illegible] 33 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] 37 [illegible] [illegible] [illegible] 36 [illegible] [illegible] [illegible] 41 [illegible] [illegible] 87 [illegible] [illegible] 20 [illegible] [illegible] 6,, 08 [illegible] [illegible] [illegible] '' "" 60 [illegible] [illegible] [illegible] Ru 80 [illegible] [illegible] [illegible] " 25 [illegible] [illegible] [illegible] " 60 [illegible] [illegible] [illegible] " 30 [illegible] [illegible] 16 2/3 1 00 [illegible] [illegible] 6 1/4 85 [illegible] [illegible] 61 21 [illegible] [illegible] [illegible] " 75 [illegible] [illegible] -2,25- 1" 13 [illegible] [???hs]-" 85 [illegible] [???e] 1 50 [illegible] [illegible] paper 2" 00 [illegible] [illegible] " 40 [illegible] 10 20 [illegible] [illegible] 12 1/2 " 25 [illegible] [???s] 18 3/4 " 37 [illegible] [illegible] 35 " 70 [illegible] [illegible] 50 c " 37 1/2 [illegible] [illegible] " 05 [illegible] [illegible] [???a], 25, " 25 [illegible] [illegible] 6, " 54 [illegible] [illegible] " 30 [illegible] [illegible] Buttons 3 " 45 [illegible] [illegible] 15 " 15 [illegible] [illegible] cutter 25 " 35 185/ 198 [illegible] [illegible] [illegible] [illegible] [illegible] 43 [illegible] [illegible] 25 [illegible] [illegible] 40 [illegible] [illegible] 25 [illegible] [illegible] 20 [illegible] [illegible] 30 [illegible] [illegible] 36 [illegible] [illegible] 85 [illegible] [illegible] [illegible] [illegible] [???d] [illegible] 60 1 [Bla???] [illegible] 0 1 [alue] [illegible] 6 [illegible] Red 48 15 1/ do Cofee- [illegible] 33 1 Whisky [o???] [illegible] [illegible] 2 do3 Butter 1 Powder Can 1 Load-haling Tb R. Guthbertseu [illegible] For Harrison [Hamil??] [illegible] 197 [pu???] [illegible] [illegible] [illegible] [B????] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [4??] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [5??] [illegible] [illegible] [illegible] [3??] [illegible] [illegible] [illegible] [4??] [illegible] [illegible] [illegible] [?1] [illegible] [illegible] [illegible] 12/ 400 [illegible] [illegible] [illegible] 1 369 [illegible] [illegible] II 308 [illegible] [illegible] 25 750 [illegible] [illegible] 20, 315 [illegible] [illegible] 10, 352 [?oe] Cure For, (?) Take [??rid] of [j??k] [illegible] [illegible] [illegible] Sanguinary [?earsa?ll??]) [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [Sli?k] [???her] Work it [illegible] [illegible] And [sp??d] it [illegible] a [p?ace] of strong [c??t] [?a???] [illegible] to easer the [(illegible)] [illegible] it remain [illegible] and [illegible] remove the plaster, [illegible] [illegible] (6) is dead, [???nce] [p??ing] and it will matter [cross out] and come out in a few days Paltice with flax [illegible] [illegible] day, and slippery [illegible] [illegible] the next day, and so an [illegible] [illegible] out then keep pathing untill it heals up [??ellard] 201 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [a???] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] glove, [illegible] [illegible] ratio of its [illegible] [illegible] rejected and [illegible] [illegible] [??ick], [illegible] [illegible] [??ghly] rubbed [illegible] [illegible] drops of water [illegible] [illegible] [??encis] more, [illegible] [illegible] [??ar], two teaspoonfuls [illegible] [illegible] adult, a child are [illegible] [illegible] [???ers.] and should the [illegible] [illegible] which is rarely ever the [illegible] [illegible] compound powder [illegible] [illegible] of the herb or fox glove [illegible] [illegible] given as above directed [illegible] [illegible] and soon as the pustules [illegible] [illegible] and clean off [illegible] [???pply] the liquid and your [illegible] [illegible] did put on as good a [illegible] [illegible] made of gun cotton and [20?] [illegible] [illegible] [per??] [illegible] [illegible] [illegible] you [?et] up in [illegible] [illegible] to what [illegible] to [d??] [illegible] must be [illegible] the break of [??ery] & [sin??] [illegible] [illegible] [illegible] straight [illegible] can to [illegible] [illegible] best to try [illegible] [illegible] [illegible] [d?y] [illegible] say exting [c???] you will [?ak?] [illegible] [illegible] a half of the [?ord] of the [c?d???] of the north east side of the [illegible] [illegible] take hold of the [li?t] [illegible] [illegible] [illegible] and in a [pi???] manner it would be well to have a place [illegible] [illegible] three feet square cleaned off the [illegible] side of the bush to throw your twig down, when [illegible] [illegible] step up to the [illegible] taking [illegible] [??g] say cedar brush have come [illegible] you through [illegible] to try to cure a blister [illegible] the [illegible] of WG. left hand, [illegible] [illegible] [illegible] Father the son and [illegible] [illegible] [illegible] the last word you [?ill] [p??] [illegible] [illegible] it down where you cleaned [illegible] [illegible] raunel to your right [han??] [illegible] [illegible] to act, as near as you [c??] [illegible] [illegible] started from,, it is of [illegible] [illegible] [illegible] or cloudy raining [illegible] [illegible] [illegible] warm it will do very well [illegible] [illegible] time, between the middle of [illegible] [illegible] if the day be very worm and [illegible] the same words in trying [illegible] [illegible] that you may try for, [illegible] [illegible] you try and find out the [illegible] [illegible] if you can. [20?] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] patient can [illegible] [illegible] [illegible] in the water, untill [illegible] [illegible] [??pply] [illegible] [illegible] [illegible] 4 [illegible] [illegible] [illegible] [illegible] [illegible] the [illegible] [illegible] [illegible] diet [illegible] [illegible] [illegible] of [illegible] [illegible] 2 or 3 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] and use [illegible] [illegible] [??nty] of loaf [illegible] [illegible] burnt allum [illegible] [illegible] [illegible] about 1 inch in [illegible] [illegible] [illegible] altogether and then [illegible] [illegible] [illegible] [???tion] and than [illegible] [illegible] [illegible] the juice, which [illegible] [illegible] 2 drops to each eye 3 times [illegible] [illegible] [illegible] [illegible] [illegible] Remedy [illegible] [illegible] quaciam [illegible] [illegible] and [illegible] [illegible], all put into [illegible] [illegible] whisky and take one [illegible] [illegible] [illegible] per day it is a very [illegible] [illegible] [illegible] GW Ward MD [??4] Hooping Cough Tincture Digitalis 2 dram Lobelia 2, do ℥ij opium- 1,gr ℥i syrup 1 oz ℥ss water 4, do ℥rv [illegible] [illegible] [illegible] [sp???] [illegible] [illegible] [C???] [illegible] [illegible] oil [p???] [illegible] [illegible] [camph???] [illegible] [illegible] Teething [illegible] [illegible] [illegible] [Cuast??t] [illegible] [illegible] [illegible] Aple Vinegar [illegible] [illegible] [illegible] Spts serpentine [illegible] [illegible] Again Creasote 1, 8 Suepleuric either 1 clo Laudnum 1 1/3 chloriform 1/2 spt niter 1, do Recept for [pr???] 20 prd, red 1 1/2 gallay [illegible] 1/2/[illegible] 1 pint oilum- hagus 11 handful Ban gelling- Mullin Leaves And Eldor, Cerid [illegible] [illegible] Black Salve take 3 quarts of Olive Oil Common Rasin 3 oz Beeswax 3 do Red precepitate 1/4 lb And Raise all to a boiling heat and then put 1/2 oz gum camphor into id Red just before the mixture get, Cold, put in the Red precipitate llued its then ready for use Caryophyllus Sweet Gum Bark 4 oz Red oak 40, d Caynrim Peper 1/4 S.S Laudnum 4 oz Cuminum 4,, Cloves 4, Brandy-from 1/2 to 1 pt Brandy Cough syrup squills paragoric Spt, neter equal parts, Tricopherous Alcohol 7 Pts Water 1 do Caster Oil 8 oz Tincture of Canthardies 3 oz Perfumery Tasting 3    Medical Manscript 1852 10 10 11 100 10 1000 111 GlW18 Medical Manuscript 12 11 11 10 100 4)  [Be???] fort Bauguht for girls 3lb 6oz Butter at 12 1/2 et 4 doz eggs do 6 Sold for cash Whisky do do- 2 1/4 Butter 124 12 3/4 Lard 10 Sold for cash why [illegible] Sold for cash 1 pare shoes for 1 do do fine 1 do do cone 1 do do do 2 Ladies-fine 1. do--fine 1 pare fine 13 yd donut 4/ 3/4 yds Rum [illegible] May 11th 1851 [illegible] Benten Pill County Sc [?ast], [J???] B, Polk BEV Dedication Citizens of the united states-But more particularly that portion, with whom I have had personal acquaintance, and from whom I have always received a hearty welcome, and [illegible] [illegible] and also to all that portion of the medical profession who can so far divest themselves of [??gihst] education as to give to the following presentation [illegible] and impartial perusal, and it this [i????] by its author- [Pry??] At the present age of the [illegible] [prop???] a [illegible] illumination is advancing of the world , just so it the [illegible] [illegible] [p???] that that individual who [illegible] [illegible] the human family is intitled to the highest [illegible] Ancient History informs us that [illegible] [illegible] Philosophers hand ever [illegible] [illegible] for the highest distinctions [illegible] [illegible] although the sumit might [illegible] [illegible] by all, still this considiration [illegible] of mankind from doing whatever [illegible] [illegible] to ameliorate the suffering, [illegible] [illegible] human race. As it [illegible] [illegible] of human investigation, which [illegible] [illegible] and the cure of all those ills that [illegible] [illegible] frailties and imperfections inherent in the physical organization, [cross out] [repe??] [illegible] Now he who advances the just knowledge of his physical once a knowledge of the modifying powers of [illegible] it physical agents that act on his varied sensibility quit impressibilities, we consider as achieving and important step in the science of human happiness- The Author of This work has not vanity enough to believe, nor [illegible] it to be understood, that he consider as having claims above all others upon the great of mankind of anything that he has done, [illegible] yet he cannot resist the impression [??calic] which he now presents to the public [illegible] upon a fair trial to contain the most certain speedy, and effectual plan, for the cure of fevers, that has hitherto been offered to the public as this treatis is designed more for the benefit of the public [illegible] then the [cross out], profession, the author has [sh??] [???ly] [??diave] to avoid technicalities, and to present [illegible] the most simple and plain language the he could possibly employ, so that every reader may [illegible] and fully understand and comprehend his way on every subjet that he may treat- This work will be found to differ somewhat from the theories and [illegible] the [illegible] [illegible] indeed from all that have preceded it [illegible] [illegible] [illegible]. For whilst almost every physician is of [illegible] that the different forms of fever, are dissimilar in there [illegible] [illegible], and that notwithstanding this dissimilarity [illegible] [illegible], that they all have more or less inflammatory tendency, the [illegible] this work between them to depend upon a uniform law nature; which [illegible] only of disease, in accordance with the unity [illegible] [illegible] that they have there origin and progress in debility. [illegible] [illegible] of Physicians consider depletion either [illegible] [illegible] purging or by the use of nauseating medicines [illegible] [illegible] the means combind, as indispensably [illegible] for the cure of fevers, the author has limited their use very [illegible] [illegible] [disa?????] their use entirely in the last stage and relies abreast exclusively on Tonics and their auxiliaries [illegible] the same desirable object [illegible] [illegible] that all pukes and purgatves are irritant [illegible] stimulants, and that fever proper is a disease of irritation; and that it never was into active inflammation He likewise thinks that the peruvian bark or quine, is a tonic, and not a stimulant; as has generally been supposed._ Although he was himself taught that theory practice of medicine as was [cou??] [illegible], schools, in the day of his pupilage [illegible] imbibed them, but the result of his [illegible] experience in an extensive practice for [illegible] only years has fully satisfied him of the first [???pe??] this practice polar, that of either the depleting [illegible] stimulant so while this plan of treatment [illegible] speedy and more certain care without [pro??] systems that are based upon opposite [????e] prolong the disease and suffering of the patient And if a cure be effected at all, [illegible] [illegible] such treatment, and not unfrequently [illegible][illegible] The constitution, that the unfair treatment [illegible] in invalid throughout the bottom [illegible] The author is well aware of the responsibility assumed in daring to [illegible] [illegible] of this kind, differing as it [illegible] opinions on the theory and [illegible] [illegible] is likewise aware, of the [un??] [illegible] probably excite among the [illegible] [illegible] [A??] While he [cou???] [illegible] [illegible] Medicine he was after [illegible] [illegible] because he dared to differ [illegible] [illegible] practice that has been [empa??] [illegible] [illegible] the minds of the community [illegible] too; on justification of his practice [illegible] main supported the same physiologie, [illegible] that they themselves did, and [illegible] do, as [illegible] in the body of this Work. He thinks, [illegible] might say, on without doing them any [injust??] whatever, For without having any [illegible] for them as men, that they are very [illegible] them, who, no matter what a man's acquiantance sucess in practice might be, if he dared to differ from them, or their, favourite leaders in the [s??] whould either treat him with cold, silent contempt or attempt slily to defame his character This seems to be the effect of deep feelings, probably based on natural organization and, I suppose, being regarded as the result [illegible] fixed prime causes and the circumstances, Education, ought therefore to be excused But the Author, knowing the success of his theory from his own experience and observation, contrasted with [illegible] fully justifies himself, in the opinion, that ha hazards nothing as a man, or as a physician [ass?ding] that it is the safest [cross out] most speedy with successful practice extant for the care of fever, His opinion is further confirmed by [illegible] [illegible] [??xampled], success of his practice [illegible] in the north and south for the last ten years the [illegible] considers himself called upon to [illegible] [illegible] and practice to the public [illegible] [illegible] has [add?ssled] which will [illegible] [illegible] and fair opportunity of [illegible] [illegible] And also, a [illegible] of [illegible] [illegible] [Hix?can] was and his [illegible] [illegible] [?atasenie], & a [illegible] [illegible] the public he is willing [illegible] a fall- Authors Preface Chapter Fist On Fever, XX Theory and Practice of fevers Chapter first The opinion has been long since [cetert??] and by some eminent medical Philosophers [expr?fsor] that a theory founded upon nature, a theory that should bind together these scattered facts eg, medical knowledge and converge into one point of [?ie??] the [illegible] the [illegible] organic life, would they on many accounts [illegible] to the interest of society- It [al???] [illegible] of [illegible] men of moderate ability to practice the art of healing with real advantage to the public; [illegible] [illegible] literary acquirement to distinguish, the [illegible] [illegible] effrontery or of wiley address; and [illegible] [illegible] important, situations the [h???] [illegible] [illegible] Form of Practice does have being [illegible] [illegible] theory and practice in which [illegible] [illegible] are now, engaged in waiting again the it [illegible] proper that I should give my [illegible] [illegible] I commenced the study of medicine [illegible] That cook, cold and [illegible] [illegible] greatly at the head of their [re??] [illegible] and promulgating to the World their [illegible] Bloodletting and the modes of [illegible] by the follow, of the depletion or [ant??] Theories I was instructed in those [illegible] after having practised with my preceptor for about years, who was a scientific and experienced, and inclined to the Brownonian and [illegible] Tonics and stimulants earlier and more [g??] than was common, I entered one the duties of my profession on my own book and was at least as sucessful as those around me. But not being satisfied with the result of my own practice [c???] less so with that of others, which was chiefly that of bleeding and acting on the stomach and bowels, with emetics and cathartics, as we thought the patient could bear them; [illegible] [illegible] the case principally,with what we called [illegible] [illegible] phlogistic medicines which indeed was of little or no use, untill the patients died or recovered by the mere sanative operation of the constitution. After having practised medicine several years and having undergone a considerable change in my view, and opinions relative to the nature and [illegible] of some diseases, and some remedies attended [illegible] by medical lectures in the university at Philadelphia, where became confirmed in the opinion states was reasonably acquainted with the different [illegible] [illegible] had of the day, but which only [illegible] [illegible] of their error, in very many [p???] [illegible] [illegible] serious evil in society and [illegible] [illegible] that the ruling or [illegible] [illegible] medicine like that of bigots [illegible] [illegible] alway willing to edge and exterminate & [illegible] [illegible] any theory or practice that [illegible] [illegible] from their views of proprity! [illegible] [illegible] the principles upon which it is [illegible] [illegible] the result of the practice in [illegible] any way whatever. being aware of this [illegible] believing that I had made a valuable discovery [illegible] or thats had more fully developed the [illegible] and article of the materia medica that [illegible] been in use, but was still very imperfectly [??tard], I was an witting that it should be last to [??ly]. I therefore prepared and sent forth to the public large quanties of my magnetic, Gold Pills, and at the same time concealing their composition that they might acquire a reputation upon their own intrusie worth- Now that the virtue of these pills to the amount of at least ten thousand Boxes been tested by the people of the united states [illegible] of mexico, and up to this state have [???tained] an improving reputation; thereby [???turing] the correctness of my theory for the [??petery] is not now in the drug than the use I [illegible] made of it I presume that the public will begin to how strongly and unjustly the medical properties of the peruvian bark and its preparations have been perverted, and that instead of its being injurious when taken in the hot stage found all been frequently said of it it is not only entirely soft but it is the fibrefuge tonic and antiseptic human The truth of my position is still further [ma??] by the fact, that since the distribution of my magnetic Gold Pills (not (firm years [illegible] [illegible] announcing that their virtues reside [illegible] [illegible] tonic properties and that they did not contain any arsenic, many apothecaries [illegible] [illegible] not [illegible] have endeavoured to imitate them [illegible] vended the same or some similar [illegible] [illegible] used in all stages of fever- Now when I had established the fact that tonics [illegible] softy and with efficacy be used in all [illegible] [illegible] difficult task for practitioners to [illegible] [illegible] particular drying heat [cate??] [illegible] indications, hence all of them [illegible] [illegible] had more or less of quine in their costum I am led to these remarks from an [opp???] that so soon as these pages shall be [illegible] to the public eye, that the practitioners of medicine the venders of fever nostrums may not after [f??] to harass, the public mind be refusing to [illegible] the fact, that quine or some other vegetable constituted the basis of their specifics far from not toug after I commenced the practice of medicine, An old physician fell in company work one, an [illegible] Road from Wilmington leading to Elizabeth, he informed me that the practice in that Country did not see 4 The carious diseases of the Country and the reason was that they the physicians [illegible] not sure tonics soon [erough] enough, that are depletory practise intirely to much, [a??] his lecture with best of my recollection was as follows: A sect of religious people known by the name of jesuits, in their intercourse with the inhabitants of of South America, in passing through the state of Peru, were compelled to drink and use for cooking the waters of certain Ponds on their way,, The water in some of these ponds, was strongly impregnated with the properties of the bark of certain trees that grew around them,,, Other ponds in these waters which have none of those trees in or about [illegible] [illegible] resorted to for water,,, those persons who happened to fall sick at the latter [illegible] [illegible] remained there untill the tardy [illegible] [illegible] constitution enable them [illegible] their illness as to continue their [illegible] [illegible] of those persons who became [illegible] [illegible] where the trees grew [illegible] [illegible] for all purposes the [illegible] [illegible] rarely detained more than a few [illegible] they were cured, and enabled to pursue [illegible] these facts became so notorious, the cases of cure so numerous that it caused much enquiry and investigation; When it was ascertained [Soli??] that these cures were effected by the waters in consequence of its being impregnated with the medicial properties of the Bark of these trees Hence the first knowledge that we have of these trees or the Bark,, is under the name of jesuits or peruvian bark x Many of these unfortunate wore stricken down, at various Times, by fevers and in that hot climate it is reasonable to suppose that many were of the lowest grade and most malignant character & it is said, there was a time when the Peruvian barks (Acot the sulphate of quine) sold for its own weight in gold which is proof of it [illegible] esteemed value since my knowledge of medicine, the best quality of gold from five to ten dollars per pound,, But for the last fifteen years, it has varied from one dollar to fifty cents per pound,, From these facts all all might [illegible] that the use of it has been very much [illegible] In that short space of Time, and that [illegible] all other poisions and prostrating medicines had been substituted in its stead), all my times, have i set by the bed side of my patient for days together giving it & anxiously [illegible] to see the affect it would have upon [illegible] At the same time amousing their minds and the minds of their attendants rarely by giving some persons placebo that I new to be harmless and useless found no more used heat [illegible] arterial actions, nor any [illegible] that I could asscribe to the bark [illegible] contrary, in a few hours [illegible] most the skin would become [illegible] prehaps a free and generous [illegible] would ensue, the thirst whole [illegible] irritated condition by the pulse [illegible] and the feverish heat and restless anixety (alway more or less attendant on fevers Subsides, in much less time than [illegible] course of treatment, I had one [illegible] patients recover their health [illegible] with less prostration or debility- I have took the bark myself (in good health for a mere experiment,) in ounce doses which is equal to [illegible] or twelve grains of quinine, and although it produced some dizzyness or swimming, in the head, there was no increased heat in the skin or increased action in the pulse- I presume that it acts more directly on The brain, And the nervous system, but it produce no such effects, as an over portion of intoxication 6 liquors, on the preparation of opium [illegible] dose languor, or prostration follow as a [illegible] natural consequence as is the case [illegible] use of stimulant proper,, We think it [illegible] them probable that the back would [nev??] have last the reputation it posins too obtain at the, time of it first interduction, if we had then known wt we now do, how to separate its active medical properties from its cortical and [???t] matter_ The irritating and supposed stimulating effects, ascribed to it by the older practitioner, may in our opinions be more justly assignable to its bulk, and the presence of the cortical matter with which it was incumbered, them, to its salt, in which modern chemistry has shown its [illegible] to reside- Before the improved condition and highly concentrated preparation of the [illegible] the form of quinine, was known,I was in many occasions, much inconvenienced and sometimes defeated in getting as much [illegible] - Partly owing to the prejudices [illegible] them to fear that it would escape their fevers, and partly to the fact that in some instances the stomach would not retain it- or that it woul'd pass off on the bowels as a purgative- in either event any object was more or less defeated- The names of Pellitier and Caventou, who first seporated the pure alkaline salt called quina from the bulky and inert, mass in which nature had placed it deserves to be remembered by [cross out] with gratitude by all mankind- since that fortunate day in medicine I have been enabled to administer the bark at any stage, and in any quantities that I might think advisable as without fear of injury to my patients or exciting any fear in their minds- This discovery has not only afforded me- heart-felt for gratification- 1 for the reason that it enabled me to give more prompt and certain relief to the sick- but it has been instrumental in giving to me a character and standing in my profession all calculated to excite the envy of the Physicians around me- But this I desired not for I did not conceal from them, in our consultations, my views, on either the Theory or practice which gave me such superior success- It seemed [illegible] the most melancholy experience was not sufficient to convince them of their errors, and they still from the mere force of education, considered my practice as empirical- Far be it from us to censure any one for tenacious adhering to the prejudices may be; let the jew be jew still,- let the Bushite be Bushite: for we deem it a wise provison in the economy of [illegible] We only seek to apologize for the course we have as individual laborers in the cause of humanity have pursued- Every philosophic mind [illegible] that all innovations have to work their way to popular favour all their own intestine [illegible] The discovery of truth is a like open to [illegible] it is the exclusive property of [illegible] part of eternal bounty of nature, [au??] from beginning designed for all- Then let all and let no one be debarred the privilage of pas claiming whatever he may have found- We are well aware of the necessity and the importance of well-endowed-[illegible] establishments, for the purpose of mental [illegible] and manual discipline, in every deport of human thought, and of human actions- We know: also that one of the marked characteristics, are of the [cross out] advantage of civilization. consists in the division of labor- Such division tends unquestionably, to the perfection of science, and to the perfection of slice in the [illegible] manipulations of the arts Hence, in the earlier period of the World, as we see from the records of Egiyptian of Babylonion Grecian Roman and other historians,- resulted the establishment under state Authorities the laws of Castes, of trades, of professons and of privileged orders in society. Now such (was, such regulations such usages may have been rendered) necessary at those epoch, of time from the nature of the [??ment] of humanity than under progress of development But is is easy to trace in the downfall all of those states the deleterious influence of Castes and of chartered privileges, and protection upon [illegible] various branches of human occupancy- In proposition as trades and professions are [fa?tered] by law, in the same proportions do their [vota???] become indolent, and the wholesome [illegible] [illegible] dies away- The check thus [illegible] to the freedom of thought, causes the [illegible] [illegible] of law, divinity, [illegible] [illegible] arts to dwindle to lapse its [illegible] and the minds of men to become fixed [illegible] stereotyped into settled formularies [illegible] have been [illegible] into the preceeding train of [illegible] from the manifestation given by many of the states of this union, in their legislation enactments, chartering either directly or indirectly, sectarian colleges calculated to faster partisan religionist- [E??] those entitled acts to regulate the practice of medicine; many of these contrary to the spirit of this government, and calculated to promote the interest of a particular class, to the detriment of others- the effect of the one is to fetter to stagnate the advancement of the study of the spiritual nature and the spiritual happiness of man; While that of the other retards the progressive 9 knowledge of the Laws of his physical nature, [illegible] the true mode of improving his condition [illegible] happiness as based in his physical nature [illegible] influence by physical causes- What better evidence could be desired of the [illegible] and selfishness of all these petitions & petitioners for protection, than the universal fact that they spring from the professions, care not from the people whose welfare they hypocritically profess to guard and serve- Tis strange! Tis passing strange! at this enlightened day, at this half rational era of the world in This free, this new sepereated republic; that the people, the true the only legitimate sovereign of the earth, should not know what they needed what they wanted, what they desired, what was best for them, as well as the safely led- guardians of their bodies and their [illegible]- We do not wish to be understood [illegible] with or objecting to, any thing that [illegible] has transpired- Oh the past and [illegible] [illegible] has not controle, Whatever has [illegible] [illegible] it is; and whether right or wrong [illegible] it- Let us, then, gather [illegible] [illegible] from a knowledge of the past and the present; by which to direct our own future [illegilbe] [illegible] which alone an indulgent providence or has willed to man a modifying influence- Chapter 2,- Containing A Brief outline of the Animal- Economy- That those who may peruse this work may perfectually understand, the authors meaning- and have some idea of the offices of some of the most important organs the human systems 10 And that members of the profession may conceive more readily of the manner in which I suppose [illegible] are contracted, and the most natural and speedy way by which they may be cured, I deem it proper that I should give a short account of the functions of those ongoing, which are supposed to be mostly involved in fevers, as dull as most other diseases- It is the office of the stomach to receive all the ingesta both solid and fluid, designed for the nurishment and growth of the whole body It is by the very peculiar action of this organ and its secretions, that the first process, and important part of digestion, is performed- So soon as the stomach shall have performed its office on the varied aliment, and drink taken in, then the whole of the residual mass passes on the first portion of the intestinal canal called the duodenum, where the ingesta in its present state of preparation comes [illegible] with the peculiar fluids secreted by the liver and the pancreas, called bile and pancreatic juice- Through the agency of these secretions of the nutritious matter called chyle supposed to be elaborated from the food; and [illegible] lacteal and absorbents, situated in this [illegible] portion of the canal, stimulated by its [illegible] [illegible] take it up to carry it into the general circulation for the nourishment and the support of the whole- The digestion being thus principally performed by the stomach and duodenum, the food continues its passage downward through the remaining small and large intestines to make it exit from the bowels by stool, being no longer fit for the purpose of the economy; however affording more or less matter for the absorbents throughout its whole extent 11 The Lacteal and absorbents above mentioned, having carried the nutritious portion [illegible] which was taken into the stomach the chyle, into the receptacle of the chyle, where [??aming] a white or milky appearance, it is carried through this duct to be emptied into the left subclavian vein- at or near its junction with the internal jugular, and there mixing with the venous blood carried into the great descending vein called vena cava from thence into the two cavities of the heart, (the right auricle, and the right ventricle) from which latter it is propelled into the pulmonary arteries and carried by the various ramifications of the same strength the lungs, in which it is properly prepared for the action of the air for the [illegible] uses of the system- Being thus assimilated it is carried back by the pulmonary veins to the left auricle from thence the [illegible] and from thence, it is propelled into the artery on the spine called aorta. [illegible] thence [cross out] is distributed through its numerous branches to every part of the body- Having passed through this routine of elaboration and circulation and attained its highest state of vitality it reaches its final distination in the capillary Tissues. The fine net-work to be found in the parenchymae of all the glands- as well as all the surfaces- both internal and external called surfaces of relation, the most considerable of which is the external cuteaneous surface. Now the object to be accomplished in the [cross out] animal economy by the circulation of the blood, which has been justly called the vital fluid, or manifold: but for our present purposes it will only be necessary to dwell 12 On two of them- The one is the disposition of atomic molecules.- in other words nutrition the other is the preformance of the offices of depuration, or the elimination of useless or redundant matter from the system- In this latter capacity the skin and it auxiliary, the lungs, by their respective process of sensible and insensible perspiration, and Inhaleting or exhallations leave duties assigned them more extended, and equally important and imperious as any of the functions of the whole animal economy, that portion of the blood not expended or eliminated in the capillaries is returned to the heart and Lungs for further preparation, or retain and preserved in the circulation for the future [al??] of economy and not returned to the stomach and bowels, where it was first received where it was first elaborated [illegible] [illegible] since demonstrated by many [illegible] [illegible] What there is more [recumion??ious] [illegible] through the pores of the skin, and by its auxiliary, the lungs (for these surfaces in print or desperation, perform very analogous offices) than by stool by urine and by all other out lets of the human body united- this fact should never be lost [cross out] sight of for on it acts an important stept toward the knowledge and treatment of diseases,, There are many persons, individuals who enjoy good health,- usually of good digestion too,,- The exhalations from whose bodies, partake of the [illegible] of the excrementitious matter of the Bowels There are others, again whose perspiration has a desided urinous odor,, in such person, perspirat is usually abundant, while their healthy habits, act, to urinate but little and to defecate but seldom- it should be recollected, that every organ of the body- the liver the lungs 13 the kidney, the stomach, the bowels- the brain, the nerves, the muscles et cetera, [illegible] receive their support by and through [illegible] before mentioned process of digestion circulation an assimilation, and that of all these organs- perform their respective offices promptly and harmoniously when under the influence of their [cross out] appropriate stimuli, and when not obstructed or deranged by some offending cause or causes, but these causes; are numorous, in kind, character and quality as also variable in degree- We come now; to the investigation of that part of the body or animal structure [illegible] the encephalon or brain, and its appendages or elongations the nerves- Here we find both structural and functional phenomena [illegible] peculiar but in many respects- widely [illegible] from that of all other organs yet [illegible] portions, of organic matter inseparably connected with and depending or other organs other structures for its support- particularly that of the vascular and muscular systems the one peculiarity of the brain consists in its [ex??] from cellular reticular tissues and the deposits of adipose matter) Brain, though not affording adipose matter) in its common sense, furnished with (peculiar fatty acids containing phosphorus) the intermittent character of its functions and the function of the nervous system generally all is evinced by the emperian necessity of sleep While other functions of Animal life are in full force- such as circulation respiration digestion et cetera, Another peculiarity consists in its susceptibility of being acted on. and that in a very eminent degree by the instrumentality] of moral, and intellectual stimuli as well as physical 14 stimuli, which alone, make an impression on all other organs- it is to this latter peculiarity that we wish to draw the attention of medical men; its uses and its influence we think much more extensive and important than is generally supposed, by the members of the profession- We do not mean to enter into any enquire upon the spiritual or mental immaterial agencies in human phenomena; but shall consider the brain in a strictly natural and philosophic light, as the seat of all the sensations passion and emotions, and as the mutual organ of thought- it is by the instrumentality of this organ, through the medium of its nerves or that all sense of pleasure [cross out] or pain is felt that averson or desire is produced that every organ is made alive to as appropriate stimulis and every muscle [illegible] that body would be deprived of motion or sensation without its benign influence it [illegible] therefore, an all prevading power both in sickness and in health the animal machine is not governed by the laws of mechanics; no by these of hydraulics; nor those chemistry: nor by a union of them all; but by laws by forces peculiar to vegetable and animal existences called laws of vitality, and which are more or less modified by the influence of the before named laws or powers as we shall endeavour to explain- The machanic laws are recognized, and most aptly exemplified in the boney and muscular structure, in their aptitudes to the purpose for which they were designed and in the amenability of the whole both solids and fluids; to the powers of gravitation- The hydraulic laws are observable to a limited extent, in the valvular structure so common throughout the vascular and lymphatic systems and the influence of both must be admitted from the comfort and advantages of 15 position more especially the advantages of the recumbent position during sleep, thereby giving [illegible] to the solids while it facilitates the passage of the fluid elements through the whole body- As to chemical laws we conceive them to play still a much more important part in vital machinery- Physiologists and chemists have both long since concurred in the general belief that the oxygen of the atmosphere and the functions of respiration had a decided agency in the production of Animal heat, however widely they may have differed in their particular views as to the modus operandi, in producing the effect Whoever desires to keep pace with the progressive development of organic chemistry will be [illegible] with the recent experiments of professor [illegible] Europe, contained in his reports on organic chemistry applied to Physiology and Pathology_ The learned professor has gone into a careful [illegible] of every portion of the human body,then into the analysis of every description of [illegible] both fluid and solid, on which he [illegible] he might discover all those elements [illegible] food best suited to the products [illegible] necessary for the body- The results to which he has arrived are truly interesting some of which we will introduce He says:- that every notion every manifestation of force is the result of the transformation of the structures [??of at] substance_ every conception every mental affection is followed by changes in the [illegible] of the substances of the brain, it is to supply the [illegible]? Thus produced that food is necessary- Again vitality in the ruling agent by which the [ale??ical] powers are made, to subserves its purposes, but the acting forces are chemical The professor further observes: That the neutral action between the element of food and the 16 oxygen of the air in the source of animal heat- All living creatures whose existence depend on the [cross out] absorption of oxygen possess within themselves a source of heat independent of the medium, in which they exist I therefore believe that the oxygen is in its nature one of those properties which sustane Animal life This heat in professor Leibigs opinion is wholly due to the combustion of the Carbon and hydrogen contained in the food which they consume- To this last result of the professor, we are not entirely ready to give our assent, unless intends to include the galvanic and electric agency in the development of caloric, as coming under his veins of the union of Oxygen and carbon or oxygen and hydrogen and in this way account for the sudden developments of heat which we frequently witness under impressions of moral laws; such as the sudden flash of modesty on the virgins cheek, which we think to be too instantaneous to be achieved through the heart and the circulation- Another remarkable and useful result to which, the professor experiments- have led- is connection between the food on which we live- and the physiological result to the economy- From all the articles of diet which man, is accustomed to consume he has been enabled to point those that abounds most in the elements for the formation of bone of muscle of fat of cerebral mass or even the matter of heat, or in other words, the diet to give, strengths of bone of muscle of passion and of thought on which abounds in the elements of heat So important a part dose the phenomenon of clinic animal heat perform in the 17 Animal economy, That some deluded minds have been simple enough to contend, that heat is life that the want of it is death- they mistake a symptom a single penonenon for the [u???um] taken Perfect life perfect Health, consists not in the high degree of elevation of temperature but in [cross out] ability to maintain a proper degree under different circumstances and that degree is different in different orders of animated nature- What should we say of all those numerous families of insects, of reptiles, yea, of the whole round of cold-blooded creatures, that for the most part remain torpid, cold, and, even in many instances froz Through the whole winter, but yet revive again with the return of the genial heat of Spring! Shall we pronounce them dead or in a state of suspended animation merely? That the general reader may he better comprehend our Theme, and that our own particular views may be more fully carried home to their understanding all propose in the next place, to give a concise and as clear an account of the theories of medicines [cross out] that have at various periods of the world found favour in human estimation as the nature of the subject and the nature this work will permit- Engaged as we are in effort to cast what light we can on a particular class of diseases only, we do not feel ourselves under any obligation to a critical examination of the history of medicine or even to sew up in regular order a Classification of the varied chains of thought that have at different times occupied in the minds of distinguished professor, and writers; but to introduce and dwell on such only 18 as have gained or obtained the greatest notariety, and such as may best suit us our present purposes- What, then, should we understand by the science, of medicine; It is that science which treats of diseases and their remedies- The term medicine from the verb medios to heal, has given to the professor- the tittle of the healing art, with the greeks it was mostly confined to surgery and to the use of external remedies- let was for Hippocrates, to lay the foundation on which [cross out] succeeding ages and nations have built, He first separated it from Philsophy_ gave it the form of a destinct science and personally observed the progress of diseases as well as the effects of remedies on this account he is styled the inventor of the medicina clinica But we are endeavouring to lift the veil of mystery from the feature in the physiognomy of man called fever- Now, the theory of fever is inseparable from the theory of medicine, which comprises the doctrine of the nature of man the nature of his diseases and their remedies used this involves the doctrines of Vitality the laws of human life,-and these again the will of God as made manifest in man, in the lords the theology of humanity now man since his first introduction on the theatre has been ever subjected to great and perpetual changes, every condition of his existence stamps, its peculiar character on his physiognomy and with it corresponding moral and mental manifestations, he is the subject of continued change he is modified by climate by soil, by food, and even by the face of the country, in which he lives- To use the Language of Dunglingson, man changes 19 much near changes often, yet he changes not radically- On these facts is bassed the usefulness of history, whether it be of law medicine or divinity- The absolute truths, of humanity ever the sour in proposition as they became disengaged from the masses of error, with they are by nature encumbered are distined to flow from generation to generation- from nation to nation, in one continued stream of light in ceaseless and rapid augmentation to the end of Time; or to the terminus of all human truths. the full unfolding of man, to man, the complete development of the philosophy of humanity- The proceeding route of inquiry has been crowded with l'etaries, now more than two thousand years and though, the labor of no one individual have been entirely, crowned, with success, the world is still much indebted to every one for his particular toil for while in the distance of time- and the darkness of ignorance that overshadowed the earth any light was better than no light and the many lights enabled the latest Laborers to compound light and thereby obtain- a cleaner and a brighter view than feel to the lot of any of his individual predecessers- To what particular in this department in this position or department of philosophy is increased- and complicated circuit of ideas we may have reached will be for posterity to decide- That the terminous has not yet been reached is certained from the fact that none has stood the test of Time, and of criticism, not one has carried conviction to the mind of all, however lauded however popular many for season may have been_ 20 It seems that we ever have been, and still are, in a state of progresson [illegible] progression its self implies a position short of maturity- All absolute disembodied disencumbered spiritualized truths are pure elements of philosophy, from whatever source they may spring Law, medicine, religion fashions are the subjects of continued, because they partake of the changeableness of man, while the pure elements of truth which belong to them are the same to-day, yesterday and forever- Let us return to Hippocrates the coan sage: He was a philosopher, who turned his attention to medicine as one of its branches- Not all the portion of him which has withstood the test of time belongs to the philosophie element of which he was composed, or containg the particular truths of the science of medicine disencumbered by himself as we shall presently show- philosophy, was interior to medicine it is coeval with man with theology- Theology now, and philosophy when rightly understood are one and the same thing- It was it is it ever will be, a prime, a constant a universal want, a universal desire of humanity, while medicine, while medicine and Law are only secondary and accidental wants- Medicine as science: commenced with the coan sage. Anteriorly, all thing were under the dommion of theocracy, and the state But in proportion as time roled on population increased, wants multiplied, and the minds of men agitated in the cradle of civilization the ancient dynasty, gave way then from the elements of humanity sprang the profession commonly called the learned 21 profession of law medicine and divinity These assuming the guardianship of the people and the state branched off each in separate trackes to pursue it destine course; all professing, and with more or less sincerity too:- to be laborers in the cause of human good- each still standing apart has continued its assigned route up to this our time, our place. But springing originally from the elements of humanity they are doomed sooner or later necessarily to meet again, in her element, springing from special wants special necessities and from peculiar frailties common to her nature they can but in the general the universal wants, the philosophic element of humanity But it is time to leave the walks of general philosophy to enter on the examination of those that are peculiar to the task assign viz: the philosophy the theory the truth - of fever It was by the coan sage, we think the the first elementary and the first [cross out] [cross out] imperishable truths were spoken, when he affirmed that fever was an effort of nature to expel some offending cause, or humor, from the body- Now this sentiment, so far as it goes, we hold in the abstract to be true, but the has faild, in his explanation of its modus operandi- he was compelled to fail to fall short of the full clearing up of the subject for such a thing would have been without the pale of the circumsatances of his existence, going a head of the minutiae of the science. The knowledge of which minutae is indisposable with the full, the clear the transparent 22 View of theme- His notions of the four elements of blood, of phlegm, of yellow, and black, bile, modern reaches compel us to lay aside: while his leading his, elementary his philosophie element will stand- His views upon diet, exercise, and the influence of Malaria in producing diseases, are for the most part, based upon sound experience Here he errs again when he dips into the minutiae of explanation- From this doctrine of the four elementary humors have emanated the doctrines of Galen, and with varied modifications of all the humorists down to this day, receiving continually the lights of the minutiae of science, as the sciences progressed- But it would be trespassing on the time the patience, and the good sense of the reader to go into a detailed account of the varied grades and shades of light that belong to the different champions of the humoralistss, schools: suffice to say that disease was laid at the feet of the elements of fire, by others of water, of phlegm, of acid of Bile, and of flatus, &c. From the idea of flatus with the greeks, probably originated, those numerous conjecture phantoms, ideas, which at different times differ places, have assumed the various names of spiritus. Anima, Neuma, Soul, Spirit, Vita Motis, Phanus, Eros, Cronus, Ulomis, chusarus, Aura, Aroma Vis, Medicatrix, Naturae et cetera Now, under any or all of these titles do we recognize an element of truth but that element has not yet been fully evolved- At this time, at this every hour while we write, is this phantom, this phenomenon in one of its protean forms, held up in wonder to the admiring gaze of the populace by the followers of mesmer, but we have not time to expatiate on this feature in the phenomana of the neumena of humanity.- 23 that more properly belongs to our next series- For the sake of brevity we have thought fit to link together some of the [illegible] Rival chains of thought- Let us then hold up to view the Rushites the depletives, with the Brunonians in modern nomenclature, the Thompsonians, the steamers standing at the distance that we do, and beholding, the movements of these rival captains, and their well armed followers, on the battle-field, recalls to our mind a passage from a poet of Rome one of the favourites with us in the days of our boyhood (demr stali vetanl alia vitia current, in contraria) of planiea, as follows- While the one is running depletion to excess, the other is running on the opposite extreme- As though none could not perish, as well by suffocation as by exhaustion alias, as well by fire as by the sword_ Veritary [illegible] inter extremas explained) to wit- Truth lies in the middle- As to the [illegible], and the solidists, we see but little choice between, them; to us both parties seem to have taken results, in the depurative efforts of nature for their causes- The one locates fever in the liver, and attempts to prove it by a very fanciful flurish about the portal circle, in the circulation of the blood, while the other locates, it in the mucous membrane of the stomach and intestines, and rests its proof on the numerous autopses- As to the result of their different modes of practice again we see no choice- From our personal observations on the theatre of life we are led to believe that the one as many souls has purged away as the others bodies saved- But, a record to the enlightened founder of solidism- When the ancoatal, Broussais 24 of Paris has reviewed the history of medicine, and with great skill, and with great judgement enlisted the labors and the thearies of every predecessor, and upon them ruins based his localized views of fever he then went on to demonstrate its truth by his numerous autopses; he thought no doubt that he had reached the terminus of thought the handling he christened (as par excellence) the physiological doctrine, and the world has accepted it under that specious tittle- But to us only serves to recall to our mind a passage from the inspired author of our text- The wisdom of man is folly for he taught the wise in their own craftiness- The rigid mental discipline common in schools of medicine throughout continental Europe, while they tend to perfection in the manifestations of art, either in surgery or medicine, are well calculated to circumscribe [illegible] the native spontaneity of thought in general expanses of mind so indispensably necessary for philosophic generalization and progression in science- Thus we are enabled clearly to see the influences of the force of circumstances which compelled Broussais to blunder- His [crossed out] physiology is based on anatomy; his pathology on his Physiology, and his autoposes served only to confirm him in error he had not learned so to abstract himself from the purely physical man as to see and to comprehend the Laws of his neumana alias his vitality, or in other words-again, he could not compass the [cross out] whole man in connection with the whole series of causes and their consequence; therefore he took a result of fever for its cause 25 What then is fever; We conceive it to be an effort of nature inherent in all animated, creatures, to sustain its own integrity from the deleterious opererotions of causes, of whatever kind, by which it may be assailed; in this sense we make fever in its essence a unit, while in its phenomena, its physiognomy it is multiform and that multiformity of character proportioned to the peculiarity of constitutions send circumstances of existence and the nature of the varied causes or agents that are made to stamp diseased impressions on individual sensibility or the sensibility of particular organs, particular, [illegible] of his completed machinery, which machinery should ever be considered as a unit one whole- although composed of many parts while by indisoluble laws of unity; its nervous chords the true the only medium of that much used much abused and illy comprehended term called sympathy- The- difficulties we should not lay errors in the labors, of all who have preceeded me [illegible] consisted we conceive in two reasons: the one is, that the element of man, of medicine, and of nature, were not sufficiently evolved; the other in the want of development of mind, the ability the liberty, The expanse of thought to enable them at a single coup de ceil, to compass the whole man, to comprehend the harmony of contrariety, to be hold the unity of variety, that delved within him, or in other words they have been like unto certain eastern reviewers, of certain philosophic thoughts on certain earthly phenomena, called Cholera, asiatica whose intitled, being too 26 limited too local, to comprehend a phenomonan [crossed out] which encompassed the whole Earth very shrewedly suspected, that in the same category should be included the whole of the ballance of us= Now since the reviewers have failed to comprehend are thoughts on a feature in the physiognomy of humanity, we have concluded again to try them with some thoughts on a single phenomenon in the physiognomy of men; or using the wards of the inspired author of our text meats have we offered them, but find that to milk they must return,"- St. Pauls Epist to the Corinthains 3, Chap. 2, Verse- But it is time to leave the follies of the learned,, and look to nature as the fount of light- Too long now has man the World beguiled by promises of art, too few have looked, to natures watches, to see, to have the modest dame; the still, the secrect and the silent ways, the sure, the lasting operations of her laws- Through spectacles of books the world has looked from times begining down, it is time to lay aside the mask; let nature speak to nature now, unmasked,- But man, frail now, will say it is wrong to strip the damsel of her gown- We write for men; their voices we must obey- Then let the maiden stand not bare but covered with a veil- But to the labors of our task let us return once more, for on us the duties fall to make our footing sure,- We have thought [ap??] man into one complete, one perfect, wholesome living mass of organized machinery- Now in as much as His treaties, is intended for general, reading and extended usefulness to go to the families and friendes of the community the great body politice more than the learned World all conceive it to be our duty in the illustrations of our theme, in the applications of our theory to 27 practice, the result of which is the only proper test of truth, to dip as little at possible into the mysteries, of minutiae- that is into the play of atomic phonomena, atomic affinities- as such a cause would serve only to embarrass the tender mind, and be productive of no real utillity- What, then, is health, but the harmonious play of all the solid structure the equable and harmonious play of all the fluid matters, the healthy response of every surface, of every organ to its natural its healthy, and its appropriate stimuli? What, then, is disease, but an interruption of this play, in some in any way, in every way as the [c??] may be? Diseased action- that is a departure from the healthy action may result from many causes- and in very many ways- We shall in the first place, enumerate the avenues of offending causes, and than proceed to mention some of them merely for the purpose of illustration for it would be going intirely beyond the spirit, and intent of this treaties to attempt a full and complete narration of Causes or of their modes of operating as such a View would require the compass of many volumes- We shall therefore content[illegible] with citing such only as are best Calculated to give him a clearer view of the nature of disease[illegible] he may the better see, the indications of one, and be enabled, to vary his steps in the use of remedial agents, so as to bring about, a return to healthy action, in the safest way and the shortest space of time- and with the last possible detriment to the constitution of his patients- The prime causes of all febrile diseases no concern to operate on or to pass not the system through the following avenues, viz) 1st, through the nostril, the larynx, and the lungs- 2d The whole extent of the cutaneous surface that is, of the skin, in the light of a reflected membrane, so altered in structed as to perform an additional duty 38 to wit the medium of generating heat- 4th The senses- commonly called the five senses,- That is to say the sense of seeing, of smelling, of tasting, of hearing, and lastly, of touch- In the first place, let us take under consideration the liability to deranged action through the medium of the lungs, the breathing organs. Diseased action may be produced in the breathing organs themselves, from the mere extremes of temperature, or, What is more common from the sudden transitions of temperature; or it may again result from the presence of gases positively deleterious to the organization or from the absence of natural stimuli those elements that consitute pure atmospheric air, so indispensably neccessary to life and health, when fevers result from any of the above-named causes they are likely under proper treatment, to be of short duration but here is still another way in which fever ( commonly called essential fever) is produced [illegible] near those classes of fever produced by the absorption of Malaria- That is, the imbibing the mephitic gases; that emanate from the debris of vegetable and Animal matter or both combind- These fruitful sources of diseases insinuate themselves into the Animal organization to make a marked impression, on the whole man without leaving any demonstrable traces in the particular structure through which they pass or by which they are imbibed, viz. the skin and the lungs- Now the system may be changed, with the seed of disease that is Malaria, for weeks yea, for even months, and still never be ripened into action; because it generally requires the operation of some exciting or proximate cause or, causes acting on the predisposed organization, to develop the disease; that is to produce a departure from the natural, the regular, the healthy and 29 sympathetic, play of all the structure The prime impressions, then is made on the brain_ The centre, the fountain of the sentient the phenomena, Indeed, but for cerebral and nervous sensibility; we should not be the subject of disease at all- It has been asserted by Dr. Rush, that during the prevalence of epidemic, bilious and yellow fever, in the city of Philadelphia, that persons who were strongly Changed or predisposed to fever could readily, discover it in the odor of their hand, by merely rubing them together We have frequently experienced the same thing ourselves_ But we should not overlook the disturbances of the [dep??] process or functions of the lungs as a [illegible] of fever_ The deleterious effects of [illegible] transitions_ of temperature_ may so modify the timing of the internal aflicted membrane of the lungs as to impair its ability for receiving oxygen, of the atmosphere the same time, of transmitting the elements that should be thrown out through this worst way- Again, imperfect digestion disturbs the assimulations of the blood in the lungs and in this way may prove a source of disease to the lungs, and consequently give rise to few of this we shall speak more fully when we have under consideration the functions of the stomach and intestines at is we believe principally through the medium of the Lungs or breathing organs, that all these febrile disease called contagious diseases, are propagated such as measles, small pox mumps-whooping cough and the like_ We come [cross out] next to take under consideration the liability of the system to take on febrile diseases, through the medium of the cutaneous surface 30 What is the skin- The skin is well known through its own inter extent to be an absorbing surface under certain exigencies of the animal economy- For example when the comunication to the stomach through the gullet, or oesophagus, is obstructed and The individual is suffering much from thirst then that want can be measurably supplied by sponging the surface, of the body with water of suitable temperature, or by bathing- It is by verture of this law that we are enabled, to reconcile the fact that poultry sheep, hogs and even cattle can live for some time and even fatten too. When cutt off from their regular supplies of Water to drink They then take is from the atmosphere from it four going examples or facts, we are led to the belief that malaria may in like manner, be imbibed by the skin, and this enter the Circulation when the such malaria be held in solution or in a state of suspension, merely, in water or in atmospheric air,- But the most frequent, the most common, and the most demonstrable way, in which febrile action is induced through the interrupted function of the skin, is the sudden transitions of temperature, particulary the impression of cold and humid atmospheres; these causes operate by putting a stop to both sensible and insensible perspiration, which we have already shown to be the most extensive, and as essential an outlet or was way for the redundant or useless matters of the system, as any excretory organ of the whole animal economy,, But happily for man, skin possesses within itself, the power a most eminent degree, of adopting itself to the surrounding circumstances in which it is placed- There are however constitutional, peculiarities in the textures and faculties of the Cutaneous surface of different races of men, hence the stronger the odor of the exhalation from their bodies even under the same clime and the same mode of living, 31 The African race for example have more highly reticulated surface than the Caucasian or other races of men- Hence in all probability their comparative immunity from the deleterious impressions of malaria; the depurative offices of their skin being more actively performed- We come to the consideration of the mouth, the stomach, and the intestines, as natural inlets of disease, particularly the seeds of febrile diseases this we shall trace through the medium of of the food- By this term we mean to now, to include all the necessary ingesta to sustain life both solid and liquid and aeroform fluids- Food although it be continually required to meet the exigencies of the system, maybe and frequently in instrumental in the production of disease in one or many of the following ways, ([to??] first by too long fasting or the scantiness of nutritious matter in the food taken or its indigestible form or nature; or again the want of the particular, elements most needed at the time by the particular individual the first impressions of long fasting is the sense of hunger, then in the stomach. Then of fullness and pain in the forehead, with a general sense of langor or debility next comes- the fever- c vas This fever is the result of simple irritation of the brain from not having received its accustomed stimuli; the same results we have frequently witnessed from the stomach not having received its accustomed kind of food- for example milk in the place of coffee for breakfast What now is best to be done? The Doctor comes bleed puke, purge, and sweat or administers a mess of meats soup tea or coffee as the accustomed habits say- The food the ingesta, the alimentaria may be production 32 of disease from mere quantity whither it be in a solid or liquid form. The over-distention simply may paralyze the action of the stomach- Again when ingesta is too much for the gastric secretion to same from the play of chemic laws; that is of natural decomposition in other words, of indigestion, then the food becomes a source of disease; now, this result may take place in the stomach, or it may not be felt until the food reaches the intestines, then you may look out for colics and for bowels complaints and lastly for fevers. such fevers would be strictly symptomatic; but of this we can say no more as our business is to explain idiopathic or essential fevers- The uses of the saliva and the objects be accomplished, by mastication, we think have been but imperfectly understood untill now The recent experiments of the professor Deniglinger of Philadelphia, have thrown much valuable new light on this subject- The learned professor asserts that the viscid nature of saliva is intended in the economy of nature to envelope globules of atmospheric air, and thus by masticating our food, we introduce qualities of oxygen [illegible] stomach, to pass from thence into the circulation to maintain the slow combustion so necessary for the production of animal heat the professor further states that one main object in ruminating Animals is to unite an additional quantity of oxygen with their food- Now if this be the fact and we do not question it, the reader can readily conceive how it is that malaria which is inseparably united with the atmosphere, finds its way, with the food into the circulation- Who ever has witnessed the ravages of what is called milk sickness on cattle, horses, hogs, dogs, men, and Vultures of the air also can readily conceive that poison may enter by the mouth and stomach into the whole organic, mass- We have witnessed it effects repeatedly, and on 33 a pretty liberal scale, but of this we may speak hereafter= It would be going beyond [cross out] the intended limits of this treaties to attempt to show the many elements, and the many ways in which diseases or even febrile diseases may be induced through the medium of the extended catalogue of drinks and aliments; yet we will make one other remake, before we have this division of the subject, it is that a mere deficiency in the liquid elements in the system, may prove a source of disease as we have repeatedly witnessed when water was scarce, or was of such quality, that it only taken when pressed by very imperious calls of nature to allay thirst- Water is known to be continually, required to maintain a proper fluidity in the blood- In warm weather particularly and to laboring men, it is constantly expended by the exhalations from the skin and lungs It is a fact well known to the profession, that when the serum, the fluid element of the blood been wasted through the stomach, the bowels and the skin during the reign of the recent epidemic Asiatic cholera, that many individuals who had this run into collapse, were again resuscitated restored to life, and to health, by merely injecting simple water, or salt and water into their veins I promised to explain the five senses in this chapter) as avenues of disease- This investigation involves all mental emotions and phenomena, or to speak now properly, all encephalic, which is the brain movements and perturbations and the laws of sympathy these unto belonging- First, then let us commence with the olfactories the nose and the lining membrane through- while none but the natural sound and healthy generations, from fruits from flowers, from men, and animals floating in the atmosphere impinge on the organ of scent, all is well 34 Indeed who is it that has not a pleasurable exaltation of brain, of thought, and through it of the whole organism from in holding the odors of nature's laboratory, at the opening of the spring or on a ramble over the spice islands of the South and east- Now should we but change the scene, and let the olfactories, meet on every hill and every plain, in street alley and the main, nought but mephitic gases of the dead, of men, of animals and plants of whatever kind, of whatever hue, then the perturbation of the brain delirium, first and fever next succeeds also creations wild and horned fill the whole machine, and onwards onwards moves to death, from whence he came- Taste comes next The [illegible] direct and sympathetic associations of taste are either or both very frequent causes of mental perturbations, and even of physical convulsions, as we have frequently witnessed, and occasionally experienced ourselves. Who is there that has never lost a meal from having swallowed, or even having imagined themselves to have swallowed, with their meats, milk, or other drinks a fly or some more loathsome object? I recollect once in the days of my boyhood, to have taken a few grains of Calomel and jalope in a piece of preserved fruit pears, and how this seemed while I labored under inflamation of the stomach more than fifteen years have elapsed and to this day my stomach would reject a preseved pear, and if the calomel were added probably a gastritis would ensue. we have heard a story of a learned medical professor, whose native modesty in the juvenile period of his life once compelled him while at the festive board of a friend, to take down a chick from the egg, that have been cooked through mistake 35 (and what is still more strange as the story goes) it stuck- But we question much if that stomach has ever has a fondness for eggs in any way sense- Hearing next in course- The sense of hearing comes next in order, which is the last to die- That is to leave us- This sense play an important part, in the drama of life_ The deaf man is always serious- for the most part melancholy; will the blind man plays the fiddle whistles, sings, dances and is talkative and gay- The immortal Homer, the blind poet of Greece, sang his Iliad and ossian Odyssey too long after he had lost his sight, Milton wrote his paradise Lost after he had become blinds- The ear, then, as a medium of intelligence is not less important than the eye- Through this channel [illegible] The passions, the emotions, the neutral perturbations yea- all the manned of physical and moral action either for good or for evil,- be produced- The tones of the orchestra falling on the ears of the auditory are made to elevate or depress at the will of the performers- Just so the power of speech The narrator or orator, now inspiries with hope now gladens with joy, anon, he fills with dispair or maddens into rage: Then comes the fever of combat, or the fever of disease- Touch So still another sense which claims our especial regard, we mean the sense of Touch or the impressibility of man by the surrounding circumstances of factitious Causes- Men in a state of nature and of nudity is a very different animal, from man dressed up and put in houses- The well-dressed light headed, civilian hears of or beholds with astonishment, the debaucheries and excesses of the naked aboriginal or debased African the brutal. [illegible] or the inhabitant of remote Polynesia_ But not so with the philosopher: he comprehends, the reasons for all these things, and wisely concludes, that whatever is, is right," that it is of necessity: and then your [illegible] civilian, would be astonished to find with a change or circumstances- how soon you would learn to drink brandy, eat fish blubber and horse beef and appreciate the dilacacies of train oil- But it is time to come a little nearer home to every day experience- There are varied grades and shades of susceptibility and impressibility among ourselves for example; the stings of venomous insects or the handling of posionous plants do not affect us all alike, for one man is proof against spiders wasps and bees while another is laid up with a [illegible] by black gnats and mosquitoes_ some handle the posionous oak (rus toxacadendron) with impunity while other one laid up with eruptive fever by it, but none entirely resist the posion of the rattle-snake the cotton mouth or the [illegible] mad dog- now this is all a mystery yet no mystery too- That which is to [?oma] mystery is still mystery is to you- Again we observe very different susceptibility and impressibility in different individuals, and indeed in whole families to contagious, and infectious diseases, some taking on diseased action from the slightes contact while other resist entirely- These facts we have known exemplified in an eminent degree in syphilis- But to offer explanations of these things would be going beyond the limits of this work Chapter 3 An this chapter we shall endeavor to explain the authors Views and opinions in regard to the common theories and 37 practices heretofore adopted in the treatment of fevers; [illegible] endeavor to demonstrate the folly and irrationality of the varied modes of practice pursued under the influence of these theories- We shall commence with same [com??] in the depletion remedies- First. The use and abuse of the lancet. Second. The use and abuse of emetics. Third. The use and abuse of cathartics. Fourth. The use and abuse of diaphoretics- and conclude this chapter with some comments, or moral and intellectual views on the use of stimulants- Having in the preceeding chapter given a brief summary of the animal economy and death somewhat on the offices of those organs [illegible] in the phenomena of fever all shall now attempt to [illegible] to the satisfaction of every imprejudice mind, the error [illegible] impropriety of attempting to cure fever, by depletion that is by bleeding, puking, purging, sweating, nauseating medicines and the like- It will not be denied by the followers of the anti-phlogistic, schools, that they [illegible] that fevers are almost all, more or less of an inflammation character; or that febrile existence in their estimation implies a state of exaltation of one or more of the [illegible] life: and that they consequently infer, from this view of the subject, that relief is to be sought for and obtained by and through the agency of remedies more or less [dep??] in their opperations, that is to say, bleeding, puking, purging, sweating, nauseating remedies and so on! Now while we are free to admit of a state of irritation, a state of perturbation and even more a state of exaltation for the time being in one or more tissues, we shall endeavour to show that it is not best to depend on depletive measures to restore the system to its last salutary balance and healthy tonic action- For while we admit a perturbed, and even accelerated arterial action to exist in some of the organs, some of the tissues, during the paroxysms of fever we contend that this accelerated local or local and general arterial, both combined, in the result of a loss of balance of the whole system accompanied by a more or less [su?fecbled] tone and debilitated action of a 38 parts or of the whole economy- While we believe the use of remedies and give our assent to the salutary influence of remedial agents of the varied kinds that have been heretofore brought into use- we [we??d] [?igh] never to misunderstand or to run counter to the indication the calls, the laws of nature, as enfolded in every individual case= We already comprehend from our knowledge of the laws of supply and water, in what way the followers of the depletive, the antiphlogistic schools have [illegible] achieved the restoration of the lost balance (the cessation of febrile diseases) but we contend that the depletive cause alone, is not the safest the best The surest and the shortest way to esestablish the normal action so also we stand opposed to all those enthusiasts in the healing [illegible] who have been so rash as to think and even to [illegible] we should take the case out of natures hand [illegible] own, and treat it according to the rules of [illegible] when the indications of cure are not strictly [illegible] to the understanding, we then hold it safest [illegible] to adopt the maxim of an aged medical friend, that the error of omission is less [illegible] than that, of commission- Then let us [illegible] and carefully observe until nature speaks out her wants- The depletists continue that their treatment is necessary, and proper if not to subdue inflammation to guard against it; hence they take blood- to febrile heat and hurried action still continuing they admister pukes, they say to expell the morbific matter, and thereby subdue the disease- The heat to the skin and perturbed actions still continuing they administer purgatives- still to redue the fever and to rid the system of morbific matters- The fever still runs on. They repeat their bleeding emetics, cathartics, still to redue or to elimanate morbific matters from the stomach bowels, or gall-bladder; under the little vitiated bile- Well what next! Now comes either a cause of nauseating and sweating drugs, or else alterative 79 cases of blue mass or calomel- By this time the race is nearly run; the patient either begins to mend in spite of the doctors, or retreats from their custody- But cause there is evidently a hot and dry skin, thirst, often heat and burning sensation in the stomach and bowels a quick, fretful, and irritated condition of the pulse with more or less of pain, they contend that there is more or less of an inflammatory diathesis,- As plausible as this argument may appear it proves but little in support in the position taken, even in a theoretical point of view, as we shall attempt to show- In the first place, we hold that no fever proper, is strictly of an active inflammatory character- Our proof is as follows= All real and acknowledged inflammatory [affections] in the natural and unbiassed order of such phenomenon- run their course come to a crisis niether more nor less than eight or ten days- this law is so precise and notorious that the ancients from their experience settled [down]; on the nineth day as the fixed period to [arrive] at a crisis- But when the old practitioner attempt to apply this law, to fever proper they erred- Hence at this period of time the idea of critical days has nearly run out of use- Now we [did] contend contend that this law hold good in acute pleurisies fractures, and in all cases of fever from mechanic violence- The same laws is manifested in the [exanthemata] (eruptive diseases) Such as small-pox measles, &c These diseases are known to all medical men to have a prescribed course to cure, and the intelligent practitioner aims to conduct them to a solutory crisis- But not so with fever proper- Yellow fever- plague, cold plague, Typhoid fevers, and other forms of putrid fever such as camp, jail hospital and ship fever and the like (to which might 40 be added (cholera morbus) are all the natural and legitimate offspring of human folly. often kill their subject in a day, or two, while again they run ten, fifteen or twenty days, or more before the attending physician can say whether the patient will recover or not- Milder grades of disease such as common bilious, and mild typhus fevers through they sometimes terminate life in a few days not unfrequently run a month or six weeks before any one can say, that they have even reached a crisis- Fevers then bear some analogy to ill-conditioned sores and ulcers having no fixed period for coming to a crisis- Fevers however are always of a general character, while these [illegible] and ulcers may be either of a general or local nature, or both combined- But their continuence most probably depends on a [??lilated] and abnormal, or irregular action in [illegible] depurative, process of the system that is, the play of the secretory and absorbent vessels, the vital force being enfeebled or the vital fluid (the blood,) not containing the proper elements or its elements not being in their natural and healthy ratio, the consequence will be inaction, that is effective vital secretion hence in such cases we rarely see a due proportion of animal heat, soreness or inflammation in those parts; never the proper quantity and quaility of well digested pus (matter) well formed granulations untill some favourable change is produced either by nature or by art and this change is much more certainly and speedly made by such agents as will equalize the excitement and purify the secretions without debilitating the general system than by bleeding puking purging and nauseating medicines-- When the sores and an ulcers are of a local character general 41 treatment may not be necessary- But the application should be alterative one deobstruent astringent tonics, or medicines more or less stimulant should be applied- But it will be asked, if fever is not inflammatory what it its character? We would say that fever is a disease of irritation; or if you prefer it, and and allow the expression, we would go so far as to admit that it may be a disease of subacute inflammation- But fever never runs up into active inflammation Secondly although there is a hot, dry skin, thirst after heat and burning sensations in the stomach and bowels, a quick fretful irritated condition of the pulse, with more or less pain, still [illegible] there is not a general preternatural excitement [illegible] system- On the contrary, that there is a [ge??] diminished action, and a general [a??] of tone- When the organs of supply that is the absorbent vessels, act with abnormal energy is an energy too great for the organic [illegible] that is the organs of elimination and of [illegible] viz: the skin kindneys, and lungs; then the phenomenon of fever takes place that is the circulation is perturbed and the skin becomes hot and dry, in other words, the equilibrium disturbed, the healthy balance lost- Now [illegible] this state of things occurs from the cause that produce fever proper we contend, that while the vital action is in excess in the one class of vessels it is in a proportionate, torpor in the other class and vice versa so these oscillations continue to take place- constituting the [re??ssious] of fever of diseased phenomena: untill, by the [??adiden] conservative, powers of nature or through the wisely constructed agencies of art, the whole economy settles down to the natural equilibrium, the healthy balance again- or else terminates in death- Now this vessels, that is the vessels of 41 supply and waste, are in one sense antegenistical in their action so that when the stomach and bowels are acted on by pukes and purges, the exhalants of the skin, lungs and kidneys too are proportionally inactive or Torpid- suppressions of their accustomed functions takes place for want of the matter to eliminate, they have been thus directed to another channel, indeed the prime elements are released by this process- that is the regular supply for the time being cut off- But it is further [illegible] that thirst is again a sign of inflammation- It were probably the existence of this symptom in the epidemic asiatic cholera which [illegible] Braussais to administer cold drinks, to [illegible] even ice, to his patients- To disprove this [??tion], it will only be necessary to cite a few common occurrences, familiar to the experience of almost every man, any one of which facts is worth more, than a thousand Theories- Whoever has suffered long in hot [crossed out] weather [illegible] want of water, as many travellers and soldiers have done have found their skins hot dry, and the sense of thirst inffusably great, so also, whoever has witnessed the war- worn soldier or the citizen [??ttering] in his own blood, and dying for want of it could not fail to observe the animal heat departing from his skin, with the failing of his pulse while at the same time his cries for water ice water becomes greater and greater to the last- Now could any one be so stupid as the think or to say, in either of these situations because the skin was hot and dry so the thirst great, or both or, thirst with neither with neither of the other conditions that the subject or sufferer [crossed out] the subject of inflammation of any kind or in any tissue The thirst on 43 either of these situations is demonstrably the consequence of a deficiency of the fluid elements of the Blood- Some as hot and dry skins as we ever felt, were in low protracted cases of fever, where there was evident debility, and much prostration in every part of the body- Every man familiar with fevers must have witness the same thing- The hot and burning sensation occasionally experienced in the stomach [illegible] bowels are often more distressing in the last than in the first stages of [illegible] when there is evidently general debility- It rarely happens in fevers that the pulse is any other than a fretful and irritated increased in frequency to be sure a quicker pulse in frequently, indicative of a general debility- the circulation have to make up in speed what is relents in volume and in it may be full and soft but is rarely [illegible] increased in force_ The pain ever attendant on fever is much more frequently the [congog??] of too little than of too much action in the general system- Witness the long train of painful nervous affections acknowledged to be the offspring of the irritable condition of the nervous system, attended with more or less debility of the muscular fibres- The neuralgia for example, such as chronic rheumatisms nervous colics, nervous sick headach, periodical headach or sun pain (tic doulaureux) et cetera all of which are of this class of disease constituting a very considerable proportion of the pain that we suffer, From what has been heretofore said useful a confident assurance that the attentive reader will concur with less in saying that to attempt to cure fever proper, exclusively, or mainly by 44 by bleeding, puking and purging in [in??] unphilosophical, and at variance with acknowledged principles of human physiology_ Now review it is admitted by all enlightened physilologists, what the skin kidneys, and the lungs, are the three greatest ways for the redundant matters of the system. Though there be several others of minor importance in point of amount or weight of matter, eliminated such as animal secretions and the matter of thought, the passions & that is the imponderable fluids expended in thought and the encephalic (of the brain) phenomena, we think that with these facts, these lase constantly in view [illegible] not be a difficult task to demonstrate the [illegible] heretofore commited by medical men in to treatment of fevers when they have relied mainly on bleeding puking or purging or a [illegible] of them all to cure fevers- While we admit the efficacy of all these classes of remedies, in certain cases, we wish to show the errors of all those to have depended on them as remedies exclusively Blood letting Let us commence with the use of the lancet; whoever will real in mind the Physiological View of supply and wast,, can readily preceive, that since the blood is both in the medium of supply and wast, it should be abstracted with great caution, and that as should never loose sight of the necessity of supply [cross out] it with new elements; that is we should look the proper supply of food and of drink and the necessary performance of the function of digestion in due time Or meet the demand of the economy that is to supply its waste- The proper use of the lancet in all fevers proper, we conceive to be restricted to plethoric subjects; we mean persons of vascular plethora- and young subjects, whose recuperative powers will the 45 better justify it;- in such subjects when the victims of fever, our practice has been- and our sitter convictions still are, that it is best to take off so much blood only as may be necessary to relieve the circulating system of abnormal tension; that is to give to the circulatory fluids their nature and accustomed free and easy play, and no more; and this should be done at as early a stage of the disease as the its necessities may be pointed out This opinion is the natural result of a combind experience for nearly twenty three years that is to say, fifteen for the one and eight for the other-- Emetics. The medications for the rise of emetics we hold [illegible] two and two only viz- First the evacuations [illegible] contents of the stomach, either on account [illegible] excessive fullness, or on account of the [illegible] nature of its contents; secondly, with [illegible] [cross out] revolutionizing and relaxing affects, [illegible] the waste way of the system are unlocked first time, and the general economy is thus [aff??] an opportunity of resuming the healthy last [illegible] Now, when fever is symptomatic or even when [illegible] in its proper character and the cause both [illegible] and proximate, have been slight or the [cross out] constitutional stamina in the individual is very good we have frequently found the diseased action cut short by the simple operation of a single emetic- when such results follow it the use of An emetic the patients needs no more But when an irration fails of the accomplishment of so disirable an end- We are opposed to its repetition, because it has achieved of all the good that we had a right to expect from it, and the system is now prepared for the use of other remedies more natural and for more efficient, or our abundantly testified we now mean the class of remedies called tonics and sodorifics- Whoever will hear 46 in mind the operations of the natural law, that the waste ways of morbific or redundant matters is through the lungs, the kidneys and the skin, and the skin in the most considerable and important of the three cannot fail to comprehend the propriety of these remarks for so long as you irritate the stomach by emetics and nauseating drugs just so long as you suspend the action of the natural law of depuration; and so long too do you cut off the neccessary supply of new element any matters which can only enter through the digestive process- In other words he who repeats improperly, prodigatlely sports with vital organization; and when this course is persisted in as we to our motification have been compelled Occasionally to witness; under the direction of our intermeddling brethern until the organic [cross out] tissues were so much exhausted and the stock of vital elements, one hand had become so much reduced for the recuperative powers of life to reinstate itself death becomes the inevitable consequence. If any one should feel disposed to question the comparative utility of the two systems of practice, we have only repeat to him the following question and at his own experience answer it, Have you ever witnessed a genial and general perspiration coming over your patient whether from spontaneous or from the interference of art and continunig for five or six hours without a sensible mitigation of the symptoms- that too, without half the distress and the prostration that would have ensued, from the same a reduction of fever. (Could it be achieved) by the use of nauseating and puking agents? We are well aware of the fact. That the 47 suppression of the healthy depurations through their natural waste say in fevers not unfrequently indeed very commonly became a cause of local irritation to the stomach and bowels; the morbific or redundant matters seeking an exit through this cannel rather than through their natural outlet In this way we can readily perceive how it that that which- The commencement of disease is merely irritation [???n] after a short continuance inflammation consisting what Broussais and his followers call gastritis, or [cross out] enteritis or gastroenteritis the case may be; which occurrences they gravely lay down in their writing as the cause of fever- But we contend that the fever exists before it inflames and that is always coexistent with the power of irritation If these views be correct then how absurd must it not appear to increase the local irritation of the stomach and bowels by the repetition of emetics? It is [cross out] not uncommon to see an attack of Autumnal fever of any kind commence with a spontaneous, and distressing vomiting Now, could any one acquanited with the laws of healthy actions, and at the same time with the laws of revulsion of the repurative functions under such circumstances as have been just cited think of administrating tarter emetic or active emetics of any kind? Would not common sense and reason instruct them to throw or cast off the redundant matters from the stomach by the mere use of [cross out] diluents and then imediately set about the quest at morbid irritation and throw the force of circulation to the 48 surface of the body as soon as possible and there by save the suffering organ from the danger of inflammation! By gently moving the bowels, in any Day, under such circumstances, you might diffuse the irritation over so extended a surface of the alimentary canal as to relieve any particular points or portions of it from the danger of great local distress- This course which in many cases is necessary, and even the best step to be taken in at all Times preferable to relying on the repetition of emetics or even nauseating drugs- There is still another idea in febrile diseas which has long haunted the minds of practitioners and the people, that is the quantity and quality of the bile- Having but some vague notions of diseased secretion of the liver,- which have been expressed by the terms [??liated], and redundant bile,- They imagine that the patient should be puked or purged So long as the liver continued its morbid secretions, or that some had consequence most inevitablly follow- The thought seems to have occurred to them, that the secretions are partly [cross out] up by the use of their medicine as [cross out] as of the continuance of the disease and that there are other means of relieving the patient besides those of puking and purging- But of this we shall speak, more fully under the next head- We might be charged with having too little regard for public opinion, if While on this point, of our subject, we should pass unnoticed the practice of the steamers- The Thompsonians- The followers of Thompson placed great reliance on the virtues of the lobelia inflata- With this article of materia medica we have long since, had some acquaintance 49 acquaintance more or less of personal intimacy- Besides its emetic properties it possesses more or less the properties of a Dialogue- In its effects, and its operation, it bears a striking analogy to tobacco- We think from what have witness, of its effects, that it is much better adopted to the treatment of cramp, and catarrhal affections than to febrile disease- As an emetic in fevers we should give a preference to Ipecacuanha- Cathartics Purgatives in all ages and in all countries have been justly enrolled in the list of important remedial agents and in the hands of different practioners, the different articles of this class of [re???] have obtained a varied celebrity- [illegible] Some have preferred individual articles in their simple, uncombined state- either [t??] exerted their ingenuity to find the best and make the best possible combinations of Them- Hence has resulted the long catalogues of patent purgatives and anti-bilious pills. Whose miraculous Virtues have filled our papers with certificates of their infallible cures; from the celebrated Lee's antibilious, Down to Cooh's R.A.C. We find one sect of docters deriding the use of the mineral cathartics while another sect are extolling them as the sampsons of the materia medica: some contending exclusively for the offspring of the [cross out] vegetable Kingdom are asserting that all things else are poisonous to the animal economy (such are the Botanic, doctors- One would think that 50 Such men had not exactly kept peace with progress of organic chemistry;- some there are again who give a decided preference in the saline cathartics- So we find one class of practioners( The Hamiltonians and the Cookites for example) promising the greater possible good in the treatment of fevers, from the use of purgatives alone; while many of the French medical writers [illegible], admit their efficacy at all- In this labyrinth of doubt, Who shall dare assert, I am the light I am the way." In a word mankind have projected almost as many ways to health as to heaven, while in truth there is but the one way to [illegible] If we were permitted to give our opinion on the use of cathartics in fibrile diseases, we would dwell less upon the particular article than upon its dose and its repetition- As most any article of the class may by suitable combinations made to set easy on the stomach, and operate gently on the bowels; yet any individual stomach especially if it has often been under the care of docters has its aversions (We could not say its partialities) and these circumstances we think alway worthy of attention- In our choice, then, we should be in a great measure guided by the antipathies of the patient, and the circumstances and symptoms at the time being sometimes the mercurials should be preferred sometimes the vegetable, at others saline and not unfrequently a combination would be preferable, according to the particular modified action desired to be produced in the case-. With our settled physiological and pathological 51 views, we have but little use for carthartics at all- and when used we would desire to have them operate efficiently, but as mildly (that is giving as little local irritation) as possible. To us the indications fur their use would seem to be first, where there was constipation of the bowels, or fulness of the alimentary canal than evacuate, secondly, when the irritation of fire was spending its force mainly on the brain, then we should use cathartics, with a view not merely to evacuate and to diffuse the irritation over a larger surface of the systems, but to produce revulsions from the brain to the alimentary canal, and then prepare the patient for the better operations [cross out] other remedies- We are not ignorant of the fact that fevers have been repeatedly cured by the mere repetition of cathartics, [illegible] we have had the same thing occure occasionly under our own experience; we know that with good constitutions, the work of depuration and the ultimate restoration of the equilibrium, may be achieved through the medium of the stomach bowels & liver- But to accomplish this much time must be consumed great suffering endured considerable emaciation, and consequent prostration of physical tone produced and the constitutional, stamina of individual is defective= death is not unfrequently the result of such a circutous rout to health- But the depletists especially the purging sectarians, contend that there is great acrimony, vitiation and redundancy of bilious matter, in the system, that can only be eliminated by purging- We will not deny that the secretions in fever are generally abnormal; but we do contend that the departure from the healthy action as 52 frequently consists in a defective as in a redundant secretion- We are even writting to admit that the bile formed under the febrile action is not often strictly healthy in is properties but the admission of this fact those not lead us to infer, with many who have expressed their opinions, that the acrid bile is the cause of fever are conceive that to be a clearly a consequense as is the inflammation of the mucus membrane of the stomach and bowels, so much relied on as a [illegible] of the soundness of their doctrines, by the layers of the autopsic mode of setting the laws of phenomena,- Much has been said of the necessity of discharging morbific matters and the liver has been much more censured for the part it plays in febrile diseases than it really deserves- the mass of mankind have been all most urged to the belief, that the existence of bile was inimical to health- and if to it should be added the qualifying expression vitiated, from the likes of the grave medical philosophers, then it becomes truly alarming now while we admit that the liver in the discharges of its functional duties frequently departs during fevers from it, healthy labors, and that sick stomach, head-ach and vomiting are sometimes occasioned from this cause yet we know that a regular and plentiful supply of bile is as necesary to the process of digestion and a healthy existence as any other names secretion for its distine office nor is it more liable to vitiation or decay than other secretions it is known in its natural envelope, the gallbladder, or in an inspissated, state, under favourable circumstances, to be preserved for any length of time; indeed it has long since been in use as a vulgar and popular remedy for colics, disspepsias 53 and fever and we have such faith in the efficacy of sound healthy bile as to believe that it will [illegible] long, find [jo??] even with the learned, The [illegible] of high-colored urine, and the yellow tinge of the skin so common in bilious fever, jaundice, and yellow fever should not be ascribed so much to the suspension of the secretions of the liver as to the invention or retrograde action of the absorbents,, The bile in these cases we conceive to pass directly from the liver and the gall bladder back into the circulation, instead of first entering the alimentary canal and then passing through the absorbents and lacteals, whose mouths are spread out on the surfaces of the stomach and intestines, the unpleasant symptoms attendant, in the conditions of the [???al] we are disposed to ascribe more to the loss of balance in the great function of organic life, and the enfeebled [illegible] of the brain and nervous system than to the mere presence of missplaced secretions- for bile misplaces in [illegilbe] than any other secretion or element,- and the only reason why it has attracted so much attention, we conceive to be because of its color it being the only one of the numerous secretions which in becoming misplaced in rendered visible to the eye. Every body is familiar with the retrograde action of the lacteals, and absorbents in cholera morbus and more especially in Asiatic cholera where the lacteals and absorbents were not only employed emptying their own contents but through them blood vessels themselves were 54 exhausted of their serum then fluid elements to be thrown off by the stomach and the bowels- Now having witnessed these facts and comprehending as we do the operation of the natural laws of health, we object to treating fevers mainly by cathartics and emetics, our reasons are, first, because such a course would be inventing natures, laws, and secondly because, we have found a much better and [illegible] way to arrive at the same desired result,, namely the use of tonics and sudorific, But that sect of partisans known to the public under the imposing tittle of mercurial doctors, will contend that they have and [illegible] more good by the judicious and of mercurials than any one can do with Tonics and sudorifics such more often deceive themselves and the public too, from vague notions connected with the color and consistency of the stools. Those who have observed them closely in the routine of their professional toils, have found them administering calomel for almost all purposes; for example, if, the operations are thin, they give calomel if otherwise they give calomel sill; if white calomel if black calomel if green calomel; if yellow calomel sill; in a word they seem to have the same blind attachment, to calomel that certain topers have for whisky it is their toy for joy, their remedy for grief, Many Valuable lives we have no doubt have been sacrificed to the erroneous ideas attached to dark discharges such appearances being as much the effect of Calomel as of the nature of the disease To us the color and consistence of the evacuations serves to throw some light 65 not only on the condition of the organs themselves involved but on the state of perturbation of the general system likewise. The olor of the evacuations is more or less modified by the operations of three causes, to wit the food we eat, the nature of the secretions, for the time being and the chemical charater of the drugs taken,, will cause pale on even white [illegible] changes, others brown or blacking [illegible] and some a yellowish cast [illegible] may still be equally healthy, while we admit the virtue of calomel and Blue mass, we would wish to [illegible] the abuse of them- The calomel Docters who has made the [illegible] the focus of all fevers and calomel the panacea while they condem The [illegible] alicon in medicine, still continue to [illegible] Mercury, in some shape or other, in some [illegible] or other every stage and every [illegible] it is their carthartic, their alterative, their salivant, their solvent, and even their tonic There is one disease and one only which we have not been able to treat satisfactorily without it we mean lues venerea of French [illegible] This disease it seems to exercise some specific Virtues; but even in this disease we have been accustomed to use it very [cross out] guardedly- The great facility with which doctors are fabricate in this our day and the innumerable swarms that are turned out every day or annually from the many factories more scatered over the whole surface of the globe, or the civilized world in one of the many reasons that have induced us to place in the hands of the people the results of our research and experiances that they may be the better 56 enabled to understand the laws of self preservation and may the better appreciate the comparative value of the labors of their medical advisers-But have not yet taken our leave of the mercurialists- The extent to which calomel and blue mass have been administered during the last twenty five or thirty years is so great, and the ratio that has been mal-administered so enormous that it is high Time for humanity to raise her voice either to disarm her heroes of the weapons of death, or to withdraw her subjects from the field- In what part of the vast continents can any man cast his eyes and not behold the grave of some victim of its pestilential powers. where can a social club convene that dose not contain some living monument [illegible] it is indeed the most insidious of all known poisons- the poison tree [illegible] the serpent the arsenic are the [illegible] acid either gives timely [hlor???] of their present or distory their [illegible] or since- But not so with there [???y] or [lus?ingtis], those who [cross out] [cross out] listen with credulity to their wispers of fancy or powers with alacrity their phantoms of hope are doomed sooner or later to awaken in the realities of despare; for when once the victim of their remorseless grasp, neither prayers tears, time, nor antidotes will ever remove the spell, for every rain that falls every wind that blows will ever tell through their aching bones_ So such of our readers, as have dived deep into that department of the arcana of nature called laws of propagation we may 69 [cross out] safely assert that mercurial diseases is not solely confined to the individual sufferers but its effects are in a greater or less degree revived in their offsprings- Every body knows that [illegible] like yet all do not know that this law holds good even to the particular [illegible] of body or mind (we had like to have [illegible] brain) at the particular moment of vivification- But these things we must leave to posterity to settle- Diaphoretics We come next to treat of that class [illegible] whose action on the animal economy is [illegible] union with natures laws- In [illegible] in our minds the great ruling and controlling powers of organic life, we discover two very important movements in vital phenomena the one we shall call the centripetal the other the centrifugal; the one a concentration of the energies of the vital forces to the internal surfaces of relation; the other the [illegible] of the same forces to the external surface or what might be more strictly speaking to the periphery of vital action) there to eliminate or to bid adieu to all those [illegible] which having served the purposes of life are no longer needed and whose continuance indeed would be oppressive to the system In the right knowledge, and the right exercise of a controlling power over these phenomena of vital action, consist all the secrets of health and disease- sudorifics, and diaphoretics are those medicines which being taken internally increase the sensible and insensible exhalation [cross out] 59 from the skin- This effect may be produced in any one of many ways or more certainly by a combination of means to exemplify external heat alone may produce the effect; the use of diluents the use of stimulants proper (we mean not irritants see chapter on medicine) The use of the vegetable, mineral, and alkaline diaphoretics proper and the many combinations that may be made of them, of this numerous class of remedial agents the discoveries now in progress in organic chemistry will lead us [cross out] to make the most judicious choice- Our past experience has led us to give a decided prejudice to the vegetable and alkaline as a union [illegible]- This class of remedies when rightly [illegible] comprise two others- classes of [???rmmae] [illegible] [illegible] of expectorants, [crossed out], diuretics, for collectively those agents are used for the same purposes namely to unlock and to maintain the [illegible] action of the three great waste ways the [illegible] the kidneys and the skin, that is to say in the natural, order they are but different members of the same family, hence under one set of circumstances diaphoretics are made to act diuretically and vice versa- under another set of circumstances diuretics act as diaphortics- To explain more fully: Squill, digitalis, the alkaline salts of Potash Soda and ammonia, Any one or a combination of these articles- in conjunction with warm diluents such as flaxseeds, or others simple herb-teas with warm atmosphere a warmly clad skin- But use the same articles and change the circumstance to a cold skin, cold extremities- a passive condition or passive exercise, such as a ride of a cold day,- and substitue malt liquor- Give cider or even the free use of weak wines- and you may expect an increased diuresis- Again if you place a 59 patient in a medium situation as [reg??] the protection and temperture of the body and use the same articles in such combinations as will cause the [???ating] drug to make a sensible impression again [illegible] expect to have the greater [illegible] then of the office of depuration- Thrown upon the lungs that is you will have the expectorant effect In certain healthy conditions and natural exigencies of the body simple cold water in the most prompt and salutary sudorific [illegible] for example: In hot weather, [illegible] of great labor and fatigue, [illegible] from regular suplies of water untill the skin becomes hot feverish and dry and the sense of suffering from thirst excessively great a pint of more of good cold water, promply alays all sense of distress, and it administation is promptly followed by a general flow of perspirable matter from every pore of the skin or of the whole surface of the body [illegible] case just cited, the experience of the [illegible] goes to prove that the remedy is not only prompt but pleasurable; just so should be [illegible] the remedial agents in the treatment of fevers under the guidance of wisdom- But the folly of man. And the madness of medicine, have ever caused him to be too local to [circum??] too bounded and too much inflated with a partial discovery of isolated truth to see the harmony of all the truth which belongs even to a single series in the phenomena of nature- Hence when Brown [cross out] had discovered an element of truth, in the use of stimulants he ran his theory, this element of truth to excess and fortunately for the world, he fell an early victim to his own partial discovery from the ashes of a Brown have arisen the Theories 60 of w [???ing] and a Thompson and other members of the same family, To play a more rational part, and to approch some nearer to the temple of truth, in a modified and an extended scale- Hence the application of stimulants both externally and internally by drugs and by fire; and these too, aided by their distressing and depressing yet efficient ally, the far famed lobelia- The [illegible] of the steamers to us seem to consist first [illegible] not being able to discover the particular [cases] to which their routine was best adapted and their indiscriminated application of their remedies to all manner of class; secondly in the excess to which their remedies have been used When in their faint glimpses of the laws of life they had learned how to make an impression on the skin, and observed the salutary result which occasonally, followed there from they immediately prescribed too much; and were [illegible] to take up erroneous idea that by forcing the living actions through the instrumentality of pepper brandy Myrrh, and external heat to achieve whatever they desired by the mere [illegible] Like unto some simple men in every country to be found) relying on the [illegible] and strength of their purses to make [illegible] [??ise] men of their fans, or gentlemen by the mere power of wealth-As though the God of Nature, could be bribed to [illegible] his eternal laws [cross out] [cross out] to please the geathers of gold- Now [??ile] we admit the essential differences that belong to [cross out] stimulants, tonics, and diaphoretics, we at the same Time contend that they all act in union with natures Laws and that under proper restriction and right circumstances they constitute our chief reliance for 61 restoring to last balance to the [illegible] used the play of healthy action are the function of organic life- Where rightly used they all tend to excite sustain the healthy coneglated [illegible] of action in the whole system and to direct the energies of the [illegible] the surface of the body that to [illegible] the action of the natural and beautiful depurations which being rightly maintend will in due time acheive through [illegible] deranged irritated febrile [illegible]- From an attentive view of the [illegible] explanations in connection with what [illegible] have already said in our chapters are the laws of the general [illegible] as we are led to believe that the- intelliget reader cannot fail to [illegible] and the comparative value of the several modes that have been resorted to for the cure of febrile diseases- All these who have relied on bleeding puking or purging by using [rep??] any one of them or resorting to the whole of those means, conjointly have [pr??] an unnecessary waste of the element of life, and not that alone: but by the improper repetition of emetics or cathartics they have reverted the natural action of the system; thus producing a retrograde action of the lacteals and absorbents which inverted action in connection with local irritation made on he mucous membranes of the stomach and bowels by their use we conceive to be the real causes of the congestion and inflammations so commonly to be found on post mortem examination Before we take leave of this subject, it would be well to make some remakes for the controlling 62 powers of the moral agencies on the secretions- is all who have been attentive observers of human phenomena, the fact must be notorious, that the impression of fear not only increases the urinary secretion, but not unfrequently result in untimely evacuation from the bladder and the bowels such spectacles have we repeatedly witnessed in by [illegible] day under the uplifted Rod of the school master or the dog whip of the sportsman- These phenomena and always attended with more or less of a temporary chill, contraction, and consequent suppression of the exhalations from the skin, [illegible] the fluids are thrown, more abundantly on the kidneys- But when this same impression is [illegible] and carried to the highest pitch than [illegible] called to witness an inverted action of the lacteals and absorbents which are promptly followed by copious and rapid evacuations from the stomach and bowels But of this we shall speak more fully under the head- of [illegible]- We can receive of but Two general causes of diseases, that is febrile proper, and one a particular condition of the system the other a particular state of the atmosphere, and it is to the modifying influence of these causes separatly and jointly that we are to look for the [cross out] shades and grades of fever- Many are the volumes that have been already written on the subject of Malaria and the other predisposing causes of disease, yet still has this subtile element eluded our grasp; of its intrinsic essence we know but little; of its modus operandi, on the animal economy we are likewise in the dark. with its sources that is the felicitous circumstance for generating deleterious gasses, we have formed some acquaintance, with its effects on the human frame- have all had some more or less of 63 personal intimacy- It may be that to know, the prime sources of disease are to understand its effect is all that is neccesary and proper that we should know- he [illegible] we flatter ourselves the chemical and philosophical researches will not [illegible] made, untill all these mysteries, and [illegible] up to our view- One thing certain in that every breath we breathe, every step we take and every evolution of the [illegible] or less predisposing or exciting cause to either healthy or unhealthy action in the system Nor do we often know with absolute certainty whether they are to be for the better or the Worse- It is from the lessons of wisdom and experience alone, that we [c?u??] how best to deport ourselves- [illegible] whether of body or mind- (and is taken the two to make the whole man) are much more closely allied and more inseparably linked together than the mass of mankind have ever yet thought- Either or both under the guidance of reason, will find the greater share of health and of happiness in [illegible] a just medium in all things- He who shuts himself up in a house, from fear of the influence of the sun, the wind &c is at least as subject to disease as he who regularly and fearlessly face them all, or he that dose not take bodily exercise or live on two spare and meagre, a diet from a fear of wearing himself out, or under the vain hope of prolonging his existence, is about as likely to cut short the thread of life, as he who obeys the instructive impulses of his animal desires- (Stimulants.( 64 Sudorifics, tonics and stimulant are all centrifugal at in their effects all having a tendency to facilitate and sustain the circulation of the blood to excite airs to maintain the natural secretion and exhalations from the body; and not that alone but to counteract the enfeebled the irritated the irregular and the spasmodic actions attendant on fevers of sudorifics we have already spoken of tonics we shall speak more fully in our next chapter; But of stimulants we must have something to say before we close the present- The present state of [cross out] knowledge as conveyed in classification of remedies and the use of terms renders it necessary for us to explain what we mean by the expression stimulants proper- The words stimuli or stimulant has by most writers been indiscriminately applied to whatever would excite the living tissue- In this sense- emetics cathartics cantharides &c, are all stimulants- But we shall confine the use of the term to those articles only, which excite or exalt the system, in a manner only congenial to its own healthy laws; all other excitants we shall consider as irrtants- When we look to the origin, the history of stimulants proper, we find them springing only from those elements, that are capable of sustaining Animal life; and the quality of the stimulus always modified by the quality of elements from which it is obtained and the chemical aptitude and skill with which it is elaborated- The grades of nutriment, of permanency, of diffusibility of stimuli, is the result, of the formative powers of the processes of fermentation and distiliation and 65 the elements used- Thus we obtain Wine cider Malt liquors, rum brandy whiskey and their subdivisions- But the weakness of man in by his approximation to [illegible] ever kept kind vacillating from one extreme to another from the extreme of confidence to that of [dist??] [illegible] hope to unnecessary fear- [illegible] the [p??] of distillation, was first [illegible] put in use, some of the philosophers of that day verily believed, that they have discovered he secret of human immortality- So [pac???] indeed are its effects that it readily found favour in every land- too [se??] the distilled liquors have troubled the [illegible] been tasted tried used and [illegible] nations now while we write all [illegible] organized and public speakers [illegible] to proclaim to their fellow men, the dangerous and the deleterious and the deadly [illegible] of intoxicating drinks; the drinks [illegible] themselves calumniate [illegible] to public view as man [illegible] and are societies former ready and willing to expunge from the best [illegible] discoveries and important [illegible] baunties the name the laws of [dist??] Thus verifying the word of [illegible] Chem stilted vetant alia vetce [illegible] Contrarea- Whenever man shall acquire wisdom and venture rightly to see, and rightly to appreciate, his own ignorance, and his own folly, then, and not till then, will he cease to abuse. The munificence of Deity,, The very reasons for which the civilized world is now toiling to put down the use of stimulants to wit,, its excessive use, its abuse is to us the strongest possiable proof of its, salubrity of its efficacy; for if its elements its action on the living atoms, had 66 not been congenial to the laws of his nature Man would have never learned to have loved it so= But out opponents may say that all this is habit if so will they be so kind as to tell us why their patients and the world have not yet in like manner contracted a fondness for calomel, tartar emetic ipec- or any other [cross out] of the numerous drugs we call irritants? Malt liquors wine cider, contain in addition to their stimulant properties their alchoholic elements some nutritious matter; and even the alchohol itself we have reason to believe is consumed in the living action no portions of it having yet been [di??cked] in the excrements the sercetion or exhalations from the body By [illegible] of the lights of chemical [illegible] are we now enabled to solve the [illegible] that has been so frequently pronounced [illegible] slow poison- A thorough [illegible] of its modus operandi in the [illegible] economy, has enabled us to comprehend [illegible] way it operated beneficially in [illegible] [???ased] condition, When the vital forces [illegible] much enfeebled by disease, and a [illegible] of elementary matter necessary for the support of life and animal heat is much diminished, then the prudent use of stimuti operated beneficially, by allying irritation directing the vital forces to the capillaries thereby restoring the last equilibrium, while at the same time it either nourishes the system or at lease prevents that waste of the animal matter that would otherwise result for the necessary maintenance of animal heat- We hope that no one will infer from what we have said of the use or the modus operandi 67 of stimulants in the diseased conditions that we are advocates for it as a luxury far from it, we use it not ourselves Nor have we ever advocated its use in others= the result of our experience further more is, that however greatful and [h???] beneficial it may be to the [?nfabled] the diseased and the convolescent from fever that they invariably lose their appetite for it with the return of strength and of health We would have it consumption strictly confined to remedial purposes- We are [illegible] aware of the fact that many unfortunate individuals, have an ungovernable propensity for its use, even in their best health- This state of thing we can readily to two sets of prime causes; the the organization of the brain and others the circumstance of education; both of which could be easily remedied by the united efforts of philanthropy- and wisdom Chapter 8th The Autho's practice and general treatment, in the cure of fevers- Having stated in the preceeding chapter our objections to all the various systems doctrines and modes of practice, [illegible] have been heretofore pursued and dwelt at some length on some of the particular errors introduced, into practice by our predecessors such as the errors in blood letting- Puking Purging, &c in the varied degrees and modes in which these measure have been applied to the treatment of fevers 68 We will now endeavor to unfold to our reader a very different and as we honestly believe, a far better plan of treating fever of all types- from whatever causes: They may have the origin and under whatever forms they may appear, for to us since we have learned to view more as a unit all general diseases seem but a unit so consequently to us fever is a unit- Now let us look back for a moment to what we have already said of health and disease- Health is but the harmonious play of all the solid structure- The equable and harmonious play of all the fluid [illegible] the natural response of every [illegible] every organ to its natural [illegible] healthy and its appropriate stimuli [illegible] is disease, but and interruption of this play, in some way, in any way or every way as the case maybe What then is fever? We conceive it to be an effect of the conservative powers of nature inherent in all Animated Creatures to sustain its own integrity from the deleterious, operations of causes of whatever kind, by which it may be assailed In this sense we make fever in its essence a unit, while in its phenomena, its physiognomy, it is multiform, and that multiformity of character proportionate to the peculiarity of constitutions and circumstances of existence and the nature of the varied cause or ''gents, that are made to stamp a diseased impression on individual sensibility, or the sensibility of particular organs 69 Particular tissues of his complicated Machinery, which machinery should ever be considered, as a unit, one whole, although, composed of many parts. united by indissoluble laws of unity, the nervous chords, the [t???] medium of that much used, much abused, and illy comprehended [h??] called sympathy Now if the reader is capable of comprehending what has been already said and will hold the truths already unfolded to his view ever present in his mind, he will find no difficulty in understanding and giving his assent to this which is to follow- The phenomenon of fever you will [illegible] we have said is the result of [illegible] debility, attended with a loss of balance in the functions of supply and [w??] This state of things impresses on [illegible] individual sensibility of the individual sufferer the assemblage of phenomena called fever, such as lassitude, heat, thirst, pain, restlessness, with more or less perturbed and interupted performance of all the functions of [illegible] vegetative, animal and intellectual in a word, a diseased of abnormal manifestation of some or all the function of organic life, For centuries past have the industry and ingenuity of man been fruitlessly essayed to fid the shortest, the safest and surest, way to remedy this state of things Born and raised as we have here under this state of collision of thought, 78 80 and decieved by our calling, as collaborators in the cause of science and of truth, we now find ourselves compelled by the lights both of experience and research, to fall confirmed in the the propriety of discarding the thoughts of every predcessor. and with them their practices also- [illegible] our investigation of the Laws of organic life, we think that we [illegible] some modifying or [???al] agent capable of making [illegible] prompt, more specific, and more salutary impressions, on the diseased subject than any of the numerous [illegible] measures heretofore relied on for the accomplishment of the same and [illegible] agents are called the vegetable [ahal??ids])- To this family belong [illegible] such as the sulphate of Quinine cinchonine, morphia, a class of remedies occupying the middle ground between that of the depletive and the [illegible], stimulating remedies= [??pent] the timely and judicious use of this class of remedies, do we chiefly rely on the cure of all fevers, not [d??yeting] [???eves], however, the benifit of any or all other remedies) That sciences or experience may have pointed out as salutary and proper. Thus you see that we have admitted the propriety of blood letting in certain cases, and under certain restrictions; so also have we admitted, and recommended the use emetics and cathartics, under, particular circumstances and with suitable restrictions)" 81 But our main auxilliaries to the use of quinine and the vegetable and alkaline diaphoretics [illegible] of extreme prostration the [illegible] stimulants with the [illegible] In all cases of local [illegible] inflammation, we have [illegible] acid advocated, the propriety of topical bleeding by cups or by leeches [illegible] the use of sinapisms and blisters still, however, holding on to the regular use of tonics with such [illegible] as might be indicated in the [pa??] case of state of the patients. The Gold pills which the author has prepared for sale, for [illegible] past and distributed under [illegible] name of Ward's Gold [illegible] And has deservally acquired for efficacy in the cure of fevers disease far surpassing that of [illegible] article ever offered to the public [illegible] plan of treatment before adopted [illegible] simply, composed of one grain of quinine to each pill three fourths of a grain of aloes and one fourth of a grain of Rheubarb to which was added just so much of the oil of cloves, as would gave them an agreeable odor) The aloes and Rheubarb, were cheap and convenient articles of which to make the mass= they were not intended as articles of medicine at all, nor could they have had any very material, the whole virture of the pills consisted in the quinine alone the The medium dose directed in his prescription being uniformly one grain of quinine to an adult, and in that proportion for children 82 [illegible] unpleasant effects have ever within [illegible] resulted resulted from [illegible] being made in the use of the [illegible] they have been placed in [illegible] all descriptions and [illegible] and used in all stages and in every form of fever to be met with in the [illegible] united states- particularly [illegible] states lying in the great valley of the [illegible] Mississippi for the space of eight [illegible] years- [illegible] author has vended pills to a larger [illegible] realized some money by his [illegible] have also saved a great many [illegible] by using them,, been relieved of much [illegible] suffering, and very many lives no [illegible] been saved and prolonged,, The [illegible] himself driven to this [illegible] more from motives of benevolence [illegible] than those of self interest= [illegible] as he did, the prejudices that existed against the medicine he also new that had he [illegible] his opinions to the world in any [illegible] than as he had done, and is now [illegible] neither the public nor himself would [illegible] [??ted] much, if any by it [illegible] the manner, that has been adopted the full benefit is now given to the world [illegible] with a great deal of other useful [illegible] that could not well have formed to place in a newspaper or common hand bill The obsticles with our predecessors cotemporaries to the discovery and adoption of what we hold to be truths, that is the aptitude, of quinine to the cure of fever are two fold, namely, a belief in the inflammatory nature of fever, in the first place, and, secondly of [ag??imutaing] 83 or inflammatory properly in the value of quinine, The error of their motion in [illegible] we hope, has already been [illegible] proven to the understanding of every [illegible] reader and it now only remains from to show the fallacy of the other imaginary obstacles, and then the whole [m??] [illegible] may be considered as [despe???] We know of but two ways by which [illegible] settle, or put to the test our [illegible] or our understanding- the properties of bodies of material things,, The one is the [im??] to be drawn from there [sen??] [imp??] on living matter the other is the chemical manifestations displayed in relation to or in conjunction with the other thing and circumstances,, suppose now, we submit the article of quinine to the tribunals, and see what will be [illegible] our examinations,, Let us first [illegible] in a chemical point of view. What is quinine? it is the salt of the [illegible] of a tree, indigenous to the elevated lands of Peru,,, in South America, It is obtained by the process of [illegible] desiccation and crystalization- but is not then a produce of [illegible] fermentation or of distillation it is [illegible] volatile; it is a fixed salt, not [tia??] waste by evaporation From where [illegible] stimulants proper derived. They are at either directly or indirectly the offspring [cross out] of nature, through the vegetable process; and are elaborated purified and concentrated by human contrivances under the natural Laws of fermentation and of destillation Hence comes camphor, porter ale, 84 Cider, Wine, rum, brandy whiskey the essential Oils of all scented plants of which might be added aumonia, all stimulating [a??ts], and all Votatile and [illegible] less [illegible] by evaporation, [illegible] the [???cal] view of the subject, [illegible] infer, from the processes of [illegible] and from the fact of its [illegible] exemption from change [illegible] common atmospheric influences [illegible] that passess those qualities, common to the list of articles universally [illegible] as stimulants,, But there is still another way by which to arrive at truth, it is the testimony of the facts of human experience, or of [illegible] observation on human sensibility alias the phenomena in living human matter, where we consult the pages of history, from the period of the first [illegible] of the virture of the peruvian [illegible] 1560,, we find febrifrege properties ascribed to it from that period to the present, in the hands of different chemists and different practitioners, have its properties and its varied remedial uses, been differently presented still we find that the sum of the testimony- the sum of the experiments [illegible] researches, up to this day, have tended rather, to advance, than to detract, from its virtues nearly all writers admiting its antiseptic, and its Tonic properties while some in a limited sense were willing to ascribe to it febrifuge and atterative Vitues for which it has, as yet, obtained credit and even more,, In our hands for years past, in some form or other 85 has it succeeded in a far more eminent degree then any other article of the whole materia medica in contending successfully with fever,, of whatever type and in whatever stage it has come before us = it would be respassing both in the patient and the good sense of the [illegible] reader to attempt to lay before him any thing like a detailed account of our personal experience,, But for the satisfaction of those [i??] [illegible] with the reports of cases, we have thought fit to cite the following, when we [c??] were attending medical lectures in the city of Philadelphia during the winter of 1834, +5, there was a man in the hospital laboring under simple bilous fever, the part [sy??] not severe I thought, this patient had been there at least four weeks, had no other disease, this case had been treated all the time with the [illegible] remedies; that is with occasonal pukes and purges, and with what [illegible] call refrigerating mixtures such as a solution of salts of tartar [cross out] or cream of tartar,, with nauseating doses of emetic tartar or Ipac, and when the fever, would somewhat abate, they would give, small doses of the, bark, and but seldom repeated for fear of aggravating the fever I do not recollect distinctly, but think it probable that the lance had been occasonally used also the Bark and laudanum were gradually increased the disease continued but not sufficiently to make a sensible 86 Impression on the system to as to obtain an ascendancy over the disease as should always be done in the treatment, of this fever The Hospital Physician, Sir R S Hartshorn [illegible] and evening, to take tea with him- In the [illegible] of our conversation he [illegible] had been practising medicine for several years) He then mentioned to me the [illegible] uncertainly of the cure of ague [illegible] general and named this case, [illegible] [part??],, was much pleased when he [illegible] and with some reserve, stated [illegible] his patient in North Carolina [illegible] lived that I thought I could [illegible] in forty eight, hours at furthest, [illegible] at me with some degree of astonish [illegible] said he if it is not a secret, [illegible] the case: I advised the [illegible] and Wine shortly after the sweating [illegible] and to use as much of the [illegible] as the stomach could bear, untill a short [illegible] [??or] the chill was expected to return [illegible] to increase the dose of laudanum [??pium] at least two or three fold= The [illegible] made,, the experiment (as he called it.) patient had no return of either fever or [illegible] he was cured immediately,, It should be recollected, that at that time quinine was not known, some time during the summer of 1850 and one I was called to see a Lady in to Town of Columbus Kentucky whose life was said to be disporic) of,, I found her the subject of a Typhoid fever of ten or twelve days standing, She was much emaciated, and very feeble and suffering with great restlessness, with 87 occasonal fits of delirium [illegible] tongue dry skin hot and dry thirst great, I learned that there were [illegible] physicians in attendance; they have been and were they giving of [illegible] historally blue mass) I [he??] [illegible] lady that could not wait [illegible] in attendance in [con??] might say to them that I [d??] [illegible] course of treatment,, that [illegible] the use of mercury and put [illegible] the use of tonics and [diaph??] [illegible] thought fit they could adopt that [illegible] not and she thought fit to [ad?p??] [illegible] send her the medicine and [illegible] the might treat the case herself Furthermore, that I was of opinion [illegible] presisted, in the corse, they [illegible] lose her daughter; but that if she in execution my prescription [illegible] mending in a few days,,, That pass [illegible] the good old lady and the [de??] little importance to the reader [illegible] say, that I was promptly applied [illegible] and prescription)) I simply [??hr?] of Quinine to be given every two [illegible] and a solution of the alkaline may [illegible] of the supercarbonate of potash and [s??] such quanties as would allay the patient a few hours use of these remedies [?x??] genial perspiration, with a return of healthy to the tongue and faces I learned that by the next morning all signs of fevers was entirely gone or fled, the patient commenced and continued to convalesce untill her health was entirely restored.. She has continued to enjoy good health ever sence up to this period Here there any motive or any utility in it. We could go on to fill thousands of pages with 88 [illegible] to similar cases) We have [illegible] [illegible] belief that the salt of [illegible] take was the best tonic, The be [auto??] [illegible] alterative and [deobst??] [illegible] acquanited and that [illegible] conjuction with [illegible] [??ies] to meet particular [illegible] achieved more good [illegible] of fevers, that with any [illegible] article of the whole materia [illegible] expressed an opinion [illegible] belief of its possessing [???ating] properties, its efficacy [illegible] resides purely in its tonic [illegible] other words,, in its aptitude [illegible] of the brain and the [illegible] system,, which in truth is the [illegible] mobile of all vital phenomena,, [illegible] possible that it may neutralize [illegible] of fever.) [illegible] desire a more extended view [illegible] understanding, of the part of our [illegible] consult the lights of organic [illegible] the recent labors of [illegible] Leibic) Before we take leave [illegible] general view of the subject, it would [illegible] to [add??] still another argument support of the correctness of the general [??ples] contended for)- The argument is this, [illegible] followers of the strictly depletive doctrines the [?liushits] and looking, have done much good, succeeded well in the treatment of fevers, and if also their antipates, the Brunonians, the Thompsonians &c have achieved half the wonders that they claim occupying as we do the middle ground, the Lust Millieue, so it not reasonable to infer that we who accept the lights of Both 89 extreams and of all extreams, but who tenaciously hold on for the middle course might be intitled to a modicum of the laurels [illegible] to be placed at the feet of tonics and [im?ho??] in the temples of Esculapius)- We are not only satisfied as to the curation [pa??] [illegible] quinine, but we are disposed to [illegible] preventive, Vitrus also) To this [con??] [illegible] led not only from experiments [illegible] author's own family; but from fact occurring in his experience in [illegible] in different portions of the united states [illegible] all seasons of the year, I generally [illegible] early in the spring, and seldom [illegible] than June or July and sometimes [illegible] August, and not unfrequently [illegible] set out again in the heat [illegible] to the most sickly region of country" I also had agent out at the same [illegible] They were all instructed to use the [illegible] occasonally as a means of protecting [illegible] the influence of Malaria, [illegible] yet occured a single instance [illegible] one of them has contracted a [illegible] kind), From There facts we are [illegible] than if quinine was judiciously [illegible] sickly countries, and in sickly [illegible] that such a thing as fevers, if any [illegible] would rarely if ever occur except circumstances of the combind [op??l] of the many causes)). When quinine is used as a preventive, and adult should take a dose three or four times a day untill he takes twenty five or thirty grains)) This quantity, should be taken every two three or four week untill the sickly season is over or the epidemic has subsided) 90 [illegible] should take less in proportion to [???age) Chapter 5 [Th??] Author's views on the subject of the [illegible] of fevers) [illegible] expresses the opinion that fever [illegible] some general reasons for [illegible] But we shall, in this chapter [illegible] into the details of the argument [illegible] show that all fevers are of one [illegible] the mildest form of intermittens [illegible] fever, down to the lowest [illegible] most malignant type, of yellow [illegible] nervous, typhous or whatever nomenclature, you may please to adopt [illegible] fevers as one continued chain [illegible] phenomena and the varied symptoms [illegible] [???ions] as only so many different [illegible] [???uced] by some particular conditions [illegible] [???pher], or state of the system [illegible] of these modifing causes are [???lly] changing and from these changes [??ate] all the apparent dissimilarity [illegible] the feature of disease, while in its essential [illegible] it is ever the same and every variety [illegible] should he treated pretty much alike, that is with the same classes of remedies, varing them only to suit the peculiarities of cases, with the grades of diseased manifestations)) We speak, here, of diseased manifestation when left unbiassed, under the controling agencies of natural causes, very many of the worst features assumed in fever 91 are the result of med [prac???] or hyper medication,, for are such [illegible] we have over been of opinion that the [illegible] should have fared [mu??] better [illegible] [??arels] of dame nature the [illegible] under the officiauness of [illegible] and inter medillering Doctors,) [illegible] immortal [Brou??ais] of [illegible] said that there is one disease at [illegible] which any practice is better [illegible] (Asiatic cholera) [illegible] speak hereafter, its a kind of [illegible] in fever, and that the reader may [illegible] satisfy himself of that fact,, we [illegible] summary of the most common and [illegible] symptoms in all fevers which [illegible] sevely, that the symptoms of all [illegible] sand, differing only in degrees of [illegible] that they are in proportion to the [illegible] severity of the causes, and the [illegible] impressibilities of the constitution are manifested, There are generally days of indisposition previous to [illegible] all fevers,, This is calld the premonitory [illegible] This state is known by the loss of appetite lassitude, a general restlessness [illegible] and an unusual drowsiness, [mor??] disturbed sleep with a disinclination [illegible] action of any kind,, In the [all??] in the onset of fevers, it rarely happens but that there are more or less of [illegible] sensation, attended with flushes of red, Sometimes these chilly feelings run into ague or shakes, but with the advance of disease or as the fever rises the chilly sensations subside) In the commencement of all fevers it rarely happens, that there is not more or less of aching pains over 92 the whole body predominating, however in [??cular] portions such as the head best [illegible] sometimes this pain is exquisite [illegible] is apt to moderate as the [illegible] as in the Language [illegible] reaction becomes establish [illegible] all fevers, there is more or [illegible] sometimes it is intensely [illegible] [??ptom] also continues as an [illegible] all fevers, but it is apt [illegible] disease progress although [illegible] and even fauces or throat [illegible] in such cases, the desire of [illegible] [???ings] more from the unpleasant [illegible] of dryness, or suspended [illegible] the structure just named [illegible] the actual cravings of [illegible] stomach, since patients in this [illegible] take only a swallow or two [illegible] while in some other conditions [illegible] that could be retained by [illegible] would satisfy by desire, [illegible] onset of all fevers there is [illegible] less appetite for food sometimes [??ior] as food, amounting to, [illegible] sick stomach without vomiting [illegible] times with vomiting and [???nally] with both puking and [???ing] [ar?el] it is well known, that there is little or no appetite for food during that time or the progress of fever In the first and earlier stages of all fevers except in the lowest grade of cold plague, yellow, putrid or typhous, fever, and even sometime in these, the pulse is apt to be not only quicker than natural, but irritated and fretful 93 giving often times the [illegible] ounce of increased force to [illegible] the force is diminished [illegible] action in such cases [b???] [illegible] up in frequency [illegible] wants in force,, [illegible] advances the patient [illegible] the pulse becomes, [st??] [illegible] and smaller, making, [illegible] resistance to the [pres??] [illegible] and evincing clearly [illegible] In the first stage of all [illegible] becomes covered with a whitish [illegible] fur) This however is not [illegible] in onset of the disease, but [illegible] observable, in the cause of [illegible] if the fever, is not checked, [illegible] to run into another stage, than [illegible] is apt to assume, a yellow [illegible] appearance,, But should [illegible] lower grade, or more [illegible] particuly, should it partake of [illegible] form such as yellow fever [illegible] or the like- then the tongue is apt to assume a dark brown to black [illegible] The casting off these apparent [illegible] coat from the tongue should [illegible] considered a favourable [illegible] In the last stages of all fevers [illegible] tongue teeth and lips are apt to [illegible] exceedingly dry, and oftentimes [illegible] with a dark stickey gummy Matter,, In some, more rare cases, the tongue assumes, a different appearance, from any of that have been mentioned that is it assumes a smooth glossy and appearance),, 94 This is apt to take place after many days continuance of [f??] [illegible] last stages of the disease [illegible] when ever this state [illgible] have generally [fa??] [illegible] tedious and more dangerous [illegible] [???nes] there is a roaring Laund [illegible] this is most common in [illegible] fevers but it daze [illegible] occur in any form of [illegible] is a common and a very [illegible] symptom in all fevers, this [illegible] symptom is more the offspring [illegible] organization, than the nature [illegible] cause, some individuals [illegible] whole famelies being prone [illegible] under fever from whatever [illegible] under whatever type; while [illegible] individuals are capable of [illegible] through any form of fever [illegible] much or any very [illegible] [???able] derangment of the function [illegible] organs of thought, [illegible] first stage of all fevers there is to be a kind or grade of destrubance [illegible] not amounting to delirium, that [illegible] slumbering or dozing condition, that the patient is more concious of than [???dant],, This symptom indicating [illegible] a slight departure, from the normal [illegible] is of but little consequense [illegible] as the disease progress in its stage and grades of prostration, the delirium assumes, a different, and more distressing character observing attended now discover a considerable derangement, in the faculties of the brain 95 the patient himself [illegible] conscious) the frequently [illegible] extent in a state of sleep [illegible] hard of hearing so much [illegible] efficent to arouse [illegible] make yourself [cou??][illegible] indifferent, to the [ex?e??][illegible] you short response [illegible] slumbers again) [illegible] stages you find him [illegible] fingers, and at the best [illegible] entirely stripping himself [illegible] again we hear him [illegible] [??ores] and manifesting [illegible] and going about, when [illegible] able to stand on his feet,, [illegible] patients we are apt to witness [illegible] twitching of the muscles of [illegible] legs) What is call'd sub [illegible] by the Doctors) the voice [be???] and sometimes unnatural [illegible] wild vacant expression of [illegible] There is still another form of [illegible] which also occasionally attend the [illegible] of fevers and indicates, a more [illegible] condition, than the one just [ment??] This is attended with [cross out] [illegible] watching the patient sleep leaves [illegible] this hearing becomes even more [ac??] than natural he is startled at [ev?y] and has imaginary and for the most [illegible] distressing images continually passing before his eyes) In all other particular his condition is pretty much the [?arn??] as in the state just before mentioned) Now as the delirium and Muscular agitations or twiching increase in proportion to the duration of the disease and physical 96 [illegible] of the patients these [illegible] to the general [illegible] [???ast] debility [illegible] organizations and no [illegible] of the brain, the head [illegible] other part of the [illegible] of the medical [illegible] have you to believe, [illegible] we observe some [illegible] of heat in the stomach and [illegible] also an increased color [illegible] [???ly] secretion of urine, [illegible] of all powers we occasionally [illegible] discharges by stool and by [illegible] forms of fevers these are alike [illegible] symptoms though not necessary [illegible] individuals have recovered [illegible] discharges from all manner [illegible] on all fevers the salutary changes [illegible] usually announced [illegible] very much the same [illegible] that is nearly all the cases yeild [illegible] of the salutary action of [illegible] deparative functions [illegible] the skin, Although the [illegible] [???tion] of the blood has been long under [illegible] and the indications to be drawn from [illegible] of the pulse long studied, and [illegible] grave lengthy and learned discourses delivered from pulpit of the schools yet still are the discrepancies of opinion upon this subject, as great even of this day, as at any former period of time) Such too must necessarily be the case, for two important reasons- The first is that the faculty have not yet agreed, even in the abstract, as to what constitutes the, 97 propriety or impropriety of [illegible] Blood; the second [illegible] the mass of practitioners [illegible] influence of physical, and [illegible] the phenomena, of [cir???] [illegible] patients) For want of [illegible] of all these things [illegible] and observant practitioners [illegible] blunders) In the [exam??] [illegible] with a view to the [ind??] [illegible] should never fail to [tak??] [illegible] all the symtoms of the [illegible] circumstances of causation) [illegible] signs which lead us to a [illegible] condition of the sick, [th??] [illegible] uniformly important, than [illegible] tongue, and the skin, [illegible] should therefore be paid to [th??] [illegible] condition) As a proof that [illegible] know less about fever than [illegible] supased, and less even than [illegible] imagine, all hear them continually [illegible] about the names of fevers of [illegible] or a season such as typhoid, [illegible] and billious fever, just [illegible] were all distinct, diseases and to be [illegible] widely varied remedies) The truth [illegible] the similarity of symptoms in the [illegible] of all fevers is so strikingly great not a matter of astonishment that to often dispute about their [class???] Many practitioners prescribe more from the appellation which they shall give the assemblage of symptoms than from a knowledge of what taking place in the economy of their patients [?bey] as often or oftener form their opinions as to the name or nature of a fever from the season 98 [illegible] in which it occurs [illegible] the symptoms which attend it, [illegible] known the fever of [sm??] [illegible] of malignant fever [illegible] healed for bilious fever [illegible] matter of supprise to us [illegible] mistaking one shade of [illegible] for another, nor [illegible] mistakes be a matter of [illegible] provided they under [illegible] of the fever in the general, [illegible] accostomed to see fevers assume [illegible] bilious in warm seasons and [illegible] countries, while typhoid fevers are [illegible] in the colder seasons and in the [illegible] Countries) We have thought that fever [illegible] its protoype, never stationary [illegible] in a state of progression or of [illegible] after saying very much in its [illegible] never fundamentally changing [illegible] running regularly through the different [illegible] of the particular type it may assume [illegible] and running from one type to [illegible] from a higher to a lower, or from [illegible] to a higher that is from the simple [???ing] form to bilious or even typhus [illegible] [???time] while at another time from [illegible] bilious, and finally ending in [illegible] and fevers) Such things are not [illegible] request occurrences in cases of relapses [???standing] our conviction as to the truth [illegible] the position, that there is a natural chain of connexion which bind all fevers together, yet still do we find it convenient for the purpose of making ourselves the easier understood), by the reader, to adopt the common classification of fevers) Hence 99 the succeeding chapters we shall treat of the several [illegible] commencing with the [illegible] of what is called summer [illegible] fevers and ending with [illegible] of fevers, called cold [plagu??] [illegible] fevers) The objects in [illegible] of this chapter, have [illegible] show by a brief summary of [illegible] symptoms attendant as [illegible] unity of disease and in a [illegible] the identity of all fever proper [illegible] attempt we have either failed [illegible] are still living and important [illegible] and will speak for themselves Chapter 6, Chapter 6 Of Intermitting or Ague and [illegible] We believe it is now universally [ad???] [illegible] low marshy lands, and all [illegible] or situation where the surface of the [illegible] such as to retain, the water that [illegible] either by virture of its depression it, [illegible] of surface, or by the impervious nature [illegible] clay or where the waters of creeks and [illegible] stagnated, either by artificial [illegible] obstructions, are ever fruitful source of [illegible] condition of atmosphere which [illegible] in the human subject the types of [illegible] called intermitting and remitting [illegible] as we are engaged in writing solely with a view to practical utility, we would consider it an unnecessary wate of the readers time, here to enter into any investigation of the laws of Malaria the laws of Vegetable and Animal decomposition 100 [illegible] the theories of the agency of water and calorie in disolving elevating the [???ing] the ultimate elements of with [illegible] the [illegible] matter) [illegible] or ague and fever is [illegible] which is characterized [illegible] [???ct] intermissions or pain [illegible] febrile symptoms,, [illegible] able to discover any [illegible] [??gant] time as was [illegible] verbal displays, which has [illegible] nosologists to affix a name [illegible] a little to every symptom [illegible] otherwise that might [illegible] accompany this form of fever [illegible] ourlves, with the interduc- [illegible] that are the most common [illegible] natural periodicity; such as [illegible] tertian quartan and their [illegible] into double trible and [illegible] and this divison even so far [illegible] alment is concurnece, for consider [??plance], since in whatever form it [illegible] appear its nature is the same, and the [illegible] treatment, with but slight all difientirn [illegible] ever be the same also,) We consider [???ers] at intermittent in character, which [??ally] coal off between each paroxysm [illegible] preceded by chill or not or [cross out] [illegible] chill and fever rise together [??s] a paroxysm of fever of this time continues not more than are four or two returning after a [cross out] lapse of about twenty four or forty eight hours without an intermission, and again, sometimes run on for three or four days but whenever a paroxysm continues for two or three days and then goes off entirely it is not apt to return 101 the most [commen??]/[???tel] of intermittents [h???] [illegible] chill or shake every day [illegible] every other day, or every [illegible] and if allowed by [illegible] two to ten or twenty [illegible] A large portion of [illegible] united states, [par??] [illegible] the intermittent [char???] [illegible] in the southern and [illegible] Symptoms, The symptoms or ague and [illegible] similar; to than of other [illegible] in the onset of the diseases [illegible] generally several day [illegible] or premonitory indicating [illegible] the attact unless in case [illegible] the attact usually commences [illegible] of lassitude and weakness [illegible] and stutering: quickly followed [illegible] rigors, and trembling; then [co??] [illegible] and lividily of the extremities [illegible] respiration anxity nausea, [illegible] vomiting, pulse frequent small [illegible] though sometimes more 'staw, [illegible] the skin generally sensibly [con???] and of a more or less livid pale and scanty,) these symptom [illegible] the first or cold stage, which often [illegible] for a longer or shorter time, is [suc???] by a heat, or redness of the skin particularly of the face, the respiration becomes fuller and stronger, these still great, with more of less pain of the head back and the limbs, this stage is again succeeded by the third or sweating stage when a remission of all 102 the symptoms takes place untill a [m??] abaundant perspiration [illegible] with an increase [illegible] and objections from [illegible] intermittent is justly consider [illegible] fever, and when rightly [illegible] [???cement] or before [illegible] many days is usually the [illegible] form of fever that we [illegible] with but when neglected [illegible] run its course for a [illegible] of formidable diseases [illegible] follow; in its train [illegible] [???nients] and enlargements [illegible] pancreas and liver attended [illegible] indigestions, and not unfrequent [illegible] [???ay] watery effusions of dropsies [illegible] [??en] and of the whole body,, [illegible] intermittent form of fever occupies [illegible] wider range than the medical [illegible] the populace have as yet been [illegible] of) This type of disease do we [illegible] the many anomalous cases of [??ical] pains in various parts of the [illegible] attended with more or less of [crossed out] [illegible] symptoms such as sore pain [illegible] very nearing muscular and [neur???] affection, of the limbs and other [illegible] of the body) Treatment,, Bleeding,, This remedy has at no period in the history of medicine found many [crossed out] advocates in the treatment of intermittents yet it has occasonally found favour with particular individuals, Dr. Rush, for example reports favourably of its use, and we are not sure, but that there are even at this 103 Time some individual practitioners who are [illegible] of this remedy) The can [illegible] of but a very few cases or [situa???] [illegible] it would be admissable [illegible] cases are when the [illegible] send plethoric individual [illegible] subjects as have a [constit??] [illegible] to particular congesting every [illegible] such as disposition to [illegible] congestion, of the lungs [illegible] we have thought it would be a [illegible] practice to abstract [crossed out] just [illegible] and no more as to take off [illegible] [????tion] in vascular system [illegible] be certainaly done by one [illegible] bleedings and then proceed to [illegible] with the proper doses of Tonics (Emetics and Cathatics) For these classes of remedies [illegible] find but little use in the [illegible] intermittents) should spontaneous [illegible] occur then we cause no necessity [illegible] tion of emetic forth stomach [?mp??] and when there is no sick stomach nor [illegible] are still unable to see any good reason [illegible] such symptoms) But whenever paroxysm occurs on a stomach overloaded with [illegible] a puking ensues There from, then is is [a???] The organ to empty itself before we attempt [illegible] compase it,) Tried to the use of cathartics we are well aware that some of the banned profession of the schools have strongly advocated and placed great reliance on them under a belief, that the disease was caused by a congestion in the liver and that the use on 104 [???stice] cathartics constituted the [illegible] [???ing] that viscus) bid [illegible] [illegible] [??ady] succeeded in [illegible] [???der] of the falacy of [illegible] principal inducement [illegible] the use of an aperient [illegible] the patient of constipation [illegible] of things exist for we [illegible] the proper treatment the [illegible] should be left or kept [illegible] the normal or healthy condition [illegible] in cases of looseness of [illegible] use small cases of laudanum [illegible] six [cross out] eight or ten drops of [illegible] six or eight hours until [illegible] an equivalent of paregorie, but [illegible] sick stomach or vomiting then use [illegible] peppermints or some other cordial) [illegible] we conceive necessary to be done [illegible] question) simply to abate the four [illegible] [??tiny] remedies) during the [illegible] For this purpose we have found [illegible] quinine, every two hours both way [illegible] regularly administered through [illegible] and by this course, the author has [illegible] [???ed] to releive, his patients in the course [illegible] three days) We have aided its [illegible] the skin, during the hot stage [illegible] of warm diaphoretic teas such [illegible] Virginia snake root, to which [illegible] added a little red pepper, or [??tinus] the alkaline salts) So soon as general perspiration in excited or the fibrile symptoms, are caused to abate than discontinue the use of the sudorifics and continue that of the tonic alone) it's this form of fever the patient is more liable to relapse, than in any other 109 When once the disease [illegible] he warned do well to take two or three [illegible] of quinine, a day united his strength complexion is restored) We have been [illegible] than suprise) at the very liberal, not to [illegible] uses that some of our [illegible] and even made of the [illegible] He born from the medical [illegible] that the sulphate of quinine has [illegible] in from fifty to one hundred grain [illegible] with a view to remove [illegible] spleen &c, for the cure of [intermi?], We consider this a [illegible] [illegible] of [illegible] of the best remedial agents [illegible] profession, We are at a loss to [illegible] On what grounds such [illegible] justified in any kind of cases, It reminds us of the [c???mours] [illegible] mass, and of calomel, that [w??] administered in many cases, and in many [p???] there united states, during the [illegible] of the Asiatic cholera,, Dr [?brite] [illegible] of 4320 grains of Calomel being given twenty four hours to one patient and the recommended [illegible] to be [???p??] in the next twenty four hours of cholera, Eberle's practice [p???] In a letter from Lewis to [prop???] [illegible] of Philadelphia dated Paris, character following interesting statement is [illegible] At the hospital of De La Petie, I [ha??] the sulphate of quinine uses in a wholesale manner, for the treatment of [inter???] fevers, supposed to be caused and dependent on the enlargement of the spleen. The doctrine is held that the fever cannot exist without the enlargement and derangement 106 of this [???s]) His theory has many disciples [illegible]) To relieve this state of things [illegible] to one hundred [illegible] given, and with [illegible] I have often very satisfed [illegible] and marked it [illegible] the administration of the [illegible] doses and in twenty [illegible] administration I have seen this organ very perceivably reduced in its whole circumstance, and the [illegible] or pattiated in an [illegible] short line) [illegible] wisdom to be drawn from [illegible] practice, yet to establish there very [illegible] first, the safty and [illegible] quinine, secondly a deobstruent [illegible] that drug, thirdly, that such is the [illegible] happy construction of the animal [illegible] that life is not necessarily the [illegible] not practice,, The immunity [illegible] in such cases, we would [???pt] to account for, on the supposition [illegible] force of the drug could not [illegible] once be brought into action on the [illegible] structure and in this the most [illegible] view that we can take of the [illegible] would seem (to say the least of [illegible] of economy, in the use of the [illegible] Chapter 7 Of Common Billious or Billious Remittent Fever From what has been already said of the unity of fever in Chapter 4th 107 the readers mind must be [illegible] prepared to receive the [??pertion] now sustained by [illegible] [illegible] [illegible] med practitioners, that all fevers are more or less liable to [illegible] according to the influence of [ex???] causes and the [susceptibilities] and imprissebilities of individual [illegible] that that observation, has [illegible] the fact, that intermittents [illegible] inflamatory, billious, [ci??] typhus, and malignant yellow fever have all in many instances [illegible] each, so also have [m??] in the [illegible] locality, and at the same time, the [s???] season different [individuals] the subjects of all the [???sities] of [illegible] example, one patient has intermitted another remittent, a third [illegible] a fourth typhus, and so on with the endless subdivisions, which [illegible] generally, [compression] [illegible] [cross out] is through [cross out] [cross out] From these remarks it will be readly inferred that fevers are almost infinite in the varieties of [shades] [illegible] which they assume= It is through the instrumentality of these truths that the world has been kept so long in the dark, by the wonderful fascinations of [illegible] (the magic of words:) while fever has [ever] been a unit, one and the same phenomenon from the days of Hippocrates, or even of Adam, down to the present time; with, in truth, but slight appreciable changes or shades of difference, to correspond with the development of humanity, man has created for it as many names, tittles and dress, as would fill the wardrobe of a modern city dandy- The doctors and dandies have both been laboring, to the maximum of their wits, but with this marked difference in the moving 108 spirit of their toils the one has even beer laboring to discover the truth while the other is laboring to discover the best mode to conceal it Now, this state of things has originated from the limited and banded nature of the human mind, which has ever compelled him first to toil to develope and to propagate isolated elements of truth, as a step preparatory to the ultimate explanation of the whole; since the harmony of these elements can only be seen by him who comprehends each and every individual atom or element of truth,, We come now to the consideration of that part of our theme which we have thought fit, to call the second link in the general chain of fever, viz: summer or autumnal fever There has been about as many names given to this link, in the chain as there have been modes of practice prescribed for its cure- It has been called bilious, malignant bilious &c Of late years we have seen it crowned with a new title, the congestive fever, or the congestive bilious or congestive intermittent, as though it were a new disease- The term congestive, used as a discriminating symptom, as though it did not belong to all other fevers for we cannot conceive of any fever without more or less congestion somewhere; the only difference then that we can perceive is that this particular feature is more marked, more prominent, than usual, for the disease all the time is the same old acquanitance, we recollect often times have not with on the lowlands of Maryland and Virginia, in the days of our boyhood The doctors then called it malignant intermittent This form of fever is most prevalent in the marshy situations of warm countries, and in the warm summer and autumnal seasons of all countries,, Like other fevers it is usually preceeded by more or less of premonitory symptoms such as are common to other fevers, The attact is usual announced by chilly sensations 109 more or less distinct of a longer or shorter duration sometimes [???ding] to an ague; these symptoms are suceeded by the ordinary symptoms of hurried inspiration pulse fretful and quick for the most part full and soft: pain of the head back and limbs a general restlessness nausea and sometimes a vomitting of bilious matter: this is sometimes quite an obstinate and distressing symptom The skin now becomes hot and dry the their considerable the patient usually desiring drink more than the stomach can bear)) Those symptoms remit or abate [illegible] twenty four hours, sometimes twice, but never go entirely off before a fresh attact ensues, so that the patient, is now without some fever, the remissions usually occur during the latter part of the night, or the early part of the day,, In the unbiased or natural order of things, this form of fever usually runs its course in ten or fifteen days,, but as we have said, we never have yet been able to satisfy, ourselves of the [illegible] of critical days in fever proper and are forced to believe, that his projections has arision from observance of such a law in the exanthemata, of eruptive fever such as most small pox and the like,, since this form of fever is most common, and from the the extended theatre of its action interesting a larger portion of our population than then other forms- being common not only to country situation in all climes, but also to cities, and to Towns, assailing all ages and all sexes- but we have thought proper for these reasons, to dwell more upon this than any other link in the chain)) causes It is partly produced from [o??arsh] 110 Exhalations, or from breathing an atmosphere impregnated with the exhalations arising from the decaying remains of vegetable and animal substances, and partly from the debilitating influences of excessive fatigue of any kind, the relaxing and debilitating effects of a meager or unwholesome diet, and partly from the relaxing influence of continued heat on our systems, and partly also from the sudden transitions of temperature,, hence, it is that this fever is more common and more fatal as we approach hot climates and low situations, and most prevalent in the hottest season of all climates,, This remitting or continued form of fever as you may please to call it, though the most common, is the least dangerous- or in other words, the most manageable, form of all the fevers except that of ague and fever, there are occasional cases and even occasional, seasons in which it assumes a violent or malignant, character from the commencement or cases and seasons, in which under our best effect, the disease is apt, to run into a low and dangerous grade,,) But the cause of these things being for the most part comprehended and more or less under our Controle might be obviated in due time to save the lives of the sufferers- To explain, the fatal tendencies in the most cases arising from malpractice of remedial [illegible] neglect neglect an error in diet, crowding the sick too much together, or the sick and well together, neglect of proper cleanliness [illegible] the want of a free circulation of wholesome air, and a proper attention to the release of the patient, sleep being as necessary for the well being of the sick as his food or his physic, since fever of all kind and grades, have been known to take life and are always attended with more or less danger they should 111 ever be promptly attended to and if possible fully managed for many cases that should yield under two or three days judicious management in the [???tic] disease something becoming manageable after [illegible] of that [illegible] [???naw] the [illegible] We are well aware of the fact that the fever of different seasons from the peculiar [illegible] defying influences of the producing causes, assume different types and different [??endi??] that is, that in some seasons the congestion or engorgement of the varied organs [neces???] the offspring of the febrile action, are more apt to result, in local congestions [illegible] other seasons, they are more prone to degenerate, into vitiations [p???] [illegible] in the secretions and ultimately to [illegible] in gangrene, or mortification [illegible] witness! in some fatal causes fevers Blood letting The propriety of abstract [illegible] judges of from the type of [illegible] the age and constitution [illegible] and the symptoms [illegible] For example when cases occur in young [illegible] subjects and the symptoms indicate such local [illegible] with a full free and active circulation [illegible] expect to practice one or two moderate [illegible] advantage; say Take just blood enough to [illegible] excess of toutione from the pulse) This we [ha??] [illegible] can be achieve by the lass of about three [illegible] more, of blood at a bleeding and should be [illegible] practice in the course of the first Two or three days from the attack; The use of this remedy we have confined to particular types, and particular discriptions of cases, If the general bleeding have 112 have been neglected at their proper [illegible] as if after having been [illegible] put in practice some local pain continues still [?aslress] the patient we should then seek further relief by the use of cups or blisters applied to the parts most affected as the judgement of the operator or practitioner the [ca??ects]) (Emetics Next to consider) In the early stages, and more especially in the onset, or forming stages of the fever, have we occasonally succeeded in cutting short, the disease by the use as simple emetic of ipecacuanha, is tarter emetic, antimonial wine, [illegible] be any choice, in the case, followed by the prompt, and [f???] of suitable diluent and diaphoretic drink, such as flax seed sage chamomile, or black snake root, Tea) We ascribe the efficacy of emetics in such cases more to the concusion or revolutionizing effects on the system whereby the circulation of the blood, and consequent equilibrium of animal [illegible] of the secection of the skin, [illegible] is effected, than to the [illegible] evacuation of any matter that may take [illegible] In most cases, it is best [illegible] of the action of the emetic by such auxiliaries as will unlock the pores of the skin and thereby mitigate the violence of the fever such as above cited but in those cases where we learn that the patient is in a state of greater or less constipation of the bowel, then we should endeavor to make a gentle impression on the bowels, by the use of little epsom salts and gruel the senna tea; Taking care at all, times, to guard against so great or so hurried an action of these organs as to produce much sensible debility in the patient; In the use of emetics as in every other step in the treatment, we should always look well to all the circumstances of the case not use them where peculiarity or 113 Idiosyncracy would forbid or when the delicacy of the constitution or the already irritated condition of the stomach would oppose it Cathartics Next in order While we stand opposed to the practice of attempting the care of bilious fever by the exclusive use of cathartics all are still willing to admit the fact that such thing have been repeatedly done,, But we do contend for the practicability of accomplishing the same thing by a less distressing, less debilitating and [illegible] them equally safe and short route,, In the early stages of the disease, we approve the use of one or two mercurial cathartics; especially if the stomach be too irritable to bear the administration of more bulky cathartic drugs. In those cases we recommend eight or ten grains of calomel with a half grain opium, or its equivalent in laudanum or paregoric or an equivalent of blue mass, in lieu of the calomel should the patient prefer it [cross out] [cross out] [cross out] [cross out] Such doses should or should not be repeated according to the exigencies of the case [illegible] or doses fail to operate in due time [illegible] with a dose of some more common [illegible] such as epsom salts, castor oil, [illegible] as such like) So soon as we shall [illegible] in evacuating the stomach and [illegible] the patient in a situation to [illegible] on the use of another class of remedies, vis, the use of [illegible] and sudorifics= The fact, the either, [illegible] had much experience in the treatment of that [illegible] of fever case not hesitate, to commence the Treatment by the immediate use of quinine, aided by sensible diaphoretics, at any stage and without preparatory depletion 114 the extended safe and the salutary response from those who have use the authors, gold pills throughout the southern and western states of this union, in all form and small stages, go to the facts repeated] from his own experience) Now Tonics and diaphoretics, Our objectives to depending on the depletive practice for the [illegible] billous fevers by repeated [illegible] purgings are first because we consider such practices contrary to an inverting the order [illegible] secondly if experience has taught [illegible] purges, when used in health [illegible] the individual, and bring on the necessary [illegible] [illegible] disease [illegible] drink, should, then be [illegible] [illegible] that these effects to a [illegible] [illegible] ensue on the use of [illegible] in a diseased conditions [illegible] the [illegible] [illegible] already great from [illegible] condition, to be still increased by the [illegible] irritation of the mucous membrane of the [illegible] [illegible] a consequence of the [illegible] [illegible] of the fluid elements [illegible] with this view of the subject, the [??one] of cure would seem to us to be [illegible] [illegible] to the circulation, reinstate [illegible] support the enfeebled system [illegible] morbid irritation,, [illegible] accomplishment of these desirable [illegible] [illegible] found the judicious and united [???tonics] a new diaphoretic remedies aided [illegible] [illegible] and properly combined opiate [???ing] in efficacy all other means,, [??ing] already stated the time increase and circumstances, under which we conceive bleeding puking or purging or any one or more of these remedies necessary, at the 120 discretion of the practitioner or attendant we will now proceed to say before the reader in as plain and simple terms as possible and a special plan of treatment We proceed at [once] with the administration of one grain of quinine every two hours, regardless of fever [regularly] by day and by night, after however the ceases with some suitable diaphoretic such as the vegetable sweating teas the virginia snake root, balm sage, or the like the sweet spirit of nitre, the supper carbonate of potash or soda, or a animal the alkalies with [some] one of the vegetable teas) These drinks [may] be used either warm or cold, as the [patient] appetite may prefer, watching the effect, of the diaphoretics and so regulate the [illegible] their repetitions, as to proceed a slight but general action on the skin, [illegible] [illegible] maintain such motion without running to any excess, Hence as should suspend the use of sudorifics whenever there was any [illegible] of excessive, perspiration, while we continued that of the tonics,, This course of treatment should be continued untill [illegible] crisis on a marked [auidi??] [illegible] [illegible] But it not unfrequently happens, [illegible] some unpleasant symptoms, in [illegible] with the state of the stomach and [illegible] occurs to interrupt the progress [illegible] [illegible] as intended course of treatment [so??] continuance of or a return of sick [illegible] and vomiting- symptoms constituting what the learned writers have been pleased to call a gastric fever, in such cases we [illegible] endeavour in the first place to correct or allay such morbid irritation before we can expect to obtain the benefits of the strictly febrifuge remedies,, continuing however; 116 the use of the quinine whenever the stomach will retain it This will be most effectually done by one or the other of following [desst?], should the patient be troubled the [illegible] sense of heat in the stomach with the casting of bilious or acid matter there administer what is called a saline mixture or effervescing draught a fallacy,, Take of saleratus, bicarbonate potash, a common salt to tartar have an ordinary tea-spoonful-fresh lemon juice or vinegar a moderate size tablespoonful,, Put the lemon juice or vinegar into a wine glass and fill it with water, then add, that saleratus, or bicarbonate of potash made fine, to immediately [illegible] or dress in the state of effervescence or foaming,, This dose may be repeated as often as necessary, to compose the stomach,, Should we fail by the case- to obtain the desired relief, Than we might make use of any one of the following remedies, such as essence of pepermint the aromatic spirits of parts from the compound spirits of lavender a few drops of the spirits of turpentine, taken in a little cold water, or on a lump of sugar, or an opiate portion of Morphine opium Laudanum or paregoric,, of these remedies we have the opiates most uniformly [cross out] successful, In all cases of irritation of the stomach more or less benefit maybe expected from exturnal applications such warm applications either wet or dry mustard, plasters blisters, cupping or leaching In some instances the irritation of the stomach is kept up or rendered more abstinate from a torpid or inactive State of the bowels,, in such cases we should not fast to make some impression on the bowels either by the 117 use of suitable aperients or by repeated use of injections,, If on the other hand, we should have to continue with a wasting from excessive looseness of the bowels then we restrain such evacuations by the use of small doses of Dover's powders paregoric compound spirits of lavender, tincture of kino are infusion of the root of dewberry or of the common blackberry or some other suitable astringent combind or not with a few drops of laudanum as the present or absence of pain might, indicate, In all stages of disease and under all circumstance of cases the practitioner should never lose sight of the utility and even importance of any minor consideration of comfort or of case, to the patient such as occasionally bathing the feet, especially at night in warm water, the application of cold cloths or cloths satuated with cold water and vinegar to the head while there is much excess of heat, and pain or occasionally springing for the same purpose, But this mode of palliating distress should be practiced, with caution and with judgement, for cold application are made in any part of the body at or about the [illegible] of the decline of fever or when the patient is [illegible] feeble, these unpleasant weaknesses restless and sometimes chilly sensations are the immediate consequences,, We should at all Times allow a reasonable indulgence in light and easy to digest food; when called for by the natural-sensation of the stomach Never officiously press the patient that which he dose not desire or more or even quite as much as he may desire to should pay some regard to the accustomed habits of individuals about taking nourishment as to point of time 118 administering our medicines so as to interfere a little as possible with the acustomed period of eating and sleeping,,, In this the reader will not fail to observe an [illegible] of an practice over that if the irritating piece of using emetics and cathartics, which are not only irritating to the digestive organ, exausting to the patient but at the same cutting off supply of the continually, require new element of life another very important requisite to the sick is that they be not molested by unnecessary conversation or even the presents of unnecessary company= carefully remove all among and of either sight or sound,,, give to them all proper opportunity of receiving the refreshing benefits of sleep,, and case of a loss of sleep from disease, or morbid vigilance or the annoyance a pain do not hesitate to procure natural rest by the use of a few drops of laudanum particular at sight, say twenty or twenty five drops,, the strength of the patient, the condition of the tongue, skin and of the pulse will ever in our surest and best guides as to the indications in the administerations of the remedies,,, The Tongue usually covered with a white coat, in the commencement of fever, with the progress of symptoms be comes yellow then brown, and sometimes dark brown, [??d] dry it sometimes sheds a first coat and then becomes red black and glossy, and in extreme cases becomes dry, and crack from a deficiancy of its natural secretion,,, [illegible] then unfavorable symptoms continue to manifest, themselves on the tongue a corresponding want of healthy action exists on the surface of the whole body the skin continuing for most part hot and dry as in a later or tenser stage becoming covered 119 with a more or profuse sticky and clammy perspirable matter with extremities frequently to cool. the pulse during the time becoming weaker with the decline of strength While in pregnancy is apt to be increased, whenever in the progressive course of a fever the attendant observes that the patient is declinig that is that he is sinking to a still lower grade in spite of the use of the quinine and the ordinary diaphoretics whether delirium exists or not the author has found great benefit result from the use of from three to five grains of camphor in union with a quarter of a grain of opium or six or eight drops of laudanum to be taken once in every six or eight hours in lieu of the other diaphoretic remedies already recommended adhering, however still to the regular use of the quinine and giving a moderate portion of toddy milk toddy or wine[illegible] every two or three hours,, Delirium,,, under our general view of fevers, we have already given some account of this symptoms as an occasional attendent on fevers,, It now becomes necessary to speak of it in particular form of fever with a view to the most appropriate mode of combatting it,, We have already conveyed the idea that [illegible] which arrest, the fever, arrest its individual manifestations or symptoms,, But this symptom has been shown to be partly the affect of [illegible] fever proper, and partly the result of a patient's organization, or particular temperment when it occurs in the first stage it is to be relieved as already directed in the first stage of fever and on the same general principle When this symptom, occurs in the later stage of the fever then we have found relief from the use of blisters to the back of the neck and the use of opiates while in all other respects 120 we continue to treat the case as though no such symptom has occured,,,, Deliarium varid and aggravated in its manifestations, and one in which little or no conciousness exits not unfrequently occurs at a later or in the last stage of the fever,,, Here is the result of prostration and irritation then the indications will be to sustain the vital energies and to [illegible] its irritations,, these indications can be best fulfilled by the use of suitable nourishment tonics, opiates, blisters, and lastly stimulants or nourishment, in the form of stimulating drinks such as wine whey milk toddy panada malt liquors and the like,, There is still another symptom which not infrequently occurs in this form of fever, that is internal irritation with or without more or less of wasting discharges from the [illegible] When such irritation exists without evacuation that is, when the natural evacuations are retained, then we should procure the necessary and healthy evacuations by the use of laxatives, or in case of such weakness by injections, alone,, But if on the other hand the patient is wasting from too frequent or too plentiful discharges There we should endeavor to correct such a state of things, by the use of small and repeated doses of opiates and astringents, such as small doses of laudanum paregoric tincture of kino or any of the vegetable astringent teas [illegible] there [cross out] cases of local distress in the bowels, we find warm application or application of mustard so used as to stimulate without blistering valuable agent In proportion, to the exaustion or depression of the patient is the liability to witching of of the muscles a kind of feeble spasmodic action What the medical writers called 121 sub suttus tendinum,, This symptom is the mere consequence of extreme weakness and we here draw the attention of the reader to the fact, that he may the more fully see the importance of sustaining his patient in this situation by all of this means in his power,, While we steadily aim to sustain we should be careful not to [co??] not, [st??] although a very dangerous symptom is not necessarily a dangerous case We have occasionally witnessed cases in which the patient passed no urine for eight or ten days, and still suffered no pain or inconvenience from it, in such cases the secretions are suspended or the absorbent and exhalants, take on an unusual and increased action- Involuntary discharges by stool or urine occasionally occur in low and protracted cases of fever, and although it is a dangrous symptom or circumstance it dose not necessarily follow that the case must prove fatal- Let your patient then just so much of the varied, stimuli that sustain life, as the judgement of the practitioners or attendant the organization in it pregnant state can manage, or requires and no more and careful so to time the repetition of your doses as to meet the continually [illegible] wants of the system- In case of coldness of the extremities we should maintain the natural heat by warm applications or the stimulus of mustard so used as to heat without blistering These remarks, applicable to the last stages of disease will be found equally applicable to all stages- 121 Before closing the present chapter we deem it proper to make some general remarks as and additional guide to whoever may attempt to put in execution our views to wit- They should ever bear in mind the healthy [?g?] [illegible] the healthy needs of the system, and let the object of every step, the use of every agent be to assist either directly or indirectly in bringing back [???inde] every organ of life to the discharge of its healthy function [illegible] all cases, which the sick are able and competent to give us clear and satisfactory responses as to their want [d??es] and sensations, we should never fail patiently to collect such information and apply it to the benefits of the patient and in case of mental alienation or such torpor of mind as cuts off the aid of the sufferer in explaining himself, then exercise your ouwn judgment on all such other lights, as may be brought before you-,,, [illegible] more full and explicit in the detail of [illegible] their applications, to particular symptoms, [illegible] any other chapters for reason already [illegible] we have thought it proper, hare, to remark, that [illegible] [???tions] with application of remedies to [illegible] symptoms, contained in this chapter [illegible] [??tted] in other chapters may with [illegible] be applied to the treatment of like [illegible] of system occurring in other fevers [illegible] the doses and modes of administering all the remedies recommended in this chapter. The [illegible] see in the last chapter, in This Work,, viii/,, 122 The authors Treatment on Cholera Infantum, The Author considers cholera Infantum as a species of fever peculiar to children say from six Months too two or three years old,, This he infers from the fact that children this age are seldom the Subjects of either bilious or typhus fevers, but are subject to ague and fever, and from the additional fact that cholera Infantum is much more common in the summer and fall months, and in sickly seasons-- When grown persons, suffer most from bilious affections The reasons for the occurrence of cholera Infantum in lieu of bilious fever, would to be the peculiar irritability of the stomach, and bowels of children at this period of life, being at this age more liable to take on unhealthy action, under any circumstance than at any other period of [illegible] affection of stomach and bowels, which take care in the winter months being usually slight, & of short duration [??it] those of the hot seasons are more protracted [illegible] serious in their nature, proving sometimes fatal in a short period, while in other cases they are protracted for many weeks, and even months untill the little suffers are reduced to mere living skeletons The puking and purging in cholera Infantum [illegible] some analogy to the cholera morbus of adults, but is not often so violent, so rapid in its progress or so fatal in its tendencies, although for the diseases [illegible] from the same or similar causes,, [illegible] infantum something the vomiting continues without purging but most generally the purging continues without vomiting, and it is not uncommon both symptoms to subside for six eight or ten days with every appearance of a speedy recovery and then return or relapse again after the manner of an [cross out] intermittent fevers As in other fevers the violence and the danger of the attack is proportioned to the circumstances of causation and the constitutions of the subjects hence its greater prevalence and greater 123 [illegible] fatality in [cross out] cities Towns and in [warm] climates, than in county situations and in more [salub??] [illegible],, In cholera Infantum as in other fevers and as in other [cases] of irritation of the stomach and [illegible] the sense of thirst is distroying [q???] the patient at as [d??ining] more [dim??] from the stomach [??ak] digest,, In the early [illegible] the disease the fevers [sometimes] considerable, the skin is [illegible] [illegible] in other fevers, the continued watery [illegible] [illegible] seem to suppress the natural [illegible] and moisture of the skin.) Towards the close of the disease, and when the patient is much [illegible] [illegible] are apt to be cold,, the [illegible] apt to be covered with a white fur and [illegible] [illegible]) It sometimes becomes [illegible] [illegible] it assumes a dark or [illegible] [illegible] as is more apt to prove fatal, [illegible] [illegible] Treatment) [illegible] [illegible] an attact, we deem it [illegible] see or the spontaneous evacuations to present [illegible], untill the stomach and [illegible] [emptied] themselves of their common [illegible] [such] generally accomplished in [illegible] [???ers],, something in a shorter [illegible] should proceed to allay the [illegible] stomach and bowels by means of [illegible] applied over the stomach so [illegible] blistering and the internal [illegible] [illegible] of small doses of paregoric essence [illegible] [illegible] laudanum or any greatful [illegible] should with the vomiting or purging [illegible] [???ss] than weeks such discharges, by the [illegible] of some astringent, that is should an [illegible] [illegible] of the bowels require it,) [illegible] unfrequently since then, pale and water discharges a very obstinate symptom,) In such cases in addition to translating the irritation the skins [illegible] plasters we have found it necessary to use 124 [??f??ted] [illegible] [illegible] such [illegible] the [illegible] [illegible] [illegible] [illegible] This [illegible] as [illegible] it may [illegible] [tak??] in toddy [illegible] [illegible] in [la??] if the [illegible] [illegible] [illegible] [illegible] [illegible] of [admi?t] [ag??] [illegible] [?ase?] able [illegible] again [illegible] [illegible] seldom intances, [ag??] [illegible] [illegible] prohibits the administration [illegible] [illegible] [illegible] [illegible] and bowels and [illegible] [illegible] a little starch and [laud??] [illegible] The teething process being [illegible] [illegible] mutch to the increased [illegible] [illegible] and whenever any tooth or both [illegible] [illegible] so as to be masked success of [illegible] [illegible] of a pen knife should [illegible] [illegible] so as to divide the natural [illegible] [illegible] tooth). The coldness the [extre??] [illegible] an attendant, should be [illegible] [illegible] covering or occasional friction [illegible] [illegible] on the skin,) If the patient [illegible] recover after using, the [forc??] [illegible] a few days, but continues to be [illegible] [illegible] suffering from a feverish state, or [illegible] exhausted, then [ca???nce] [illegible] [illegible] or tonics, such as quine peruvian [illegible] suitable Tonic, and repeat at [illegible] [illegible] hours, untill there is solution [illegible] [illegible] action- a complete crises) [she??] [illegible] between doses two or doses [illegible] its use in this way untill the little [illegible] [illegible] reinstated in health and strength- During the contiunance of the warmer season- children are very liable to relapses,) This [illegible] effectually guarded against by seeing a [purerat??] attention to cleanliness diet and exercise) 125 [illegible] [illegible] [??tion] [illegible] and [illegible] [illegible] [illegible] [illegible] and [illegible] [illegible] [???a] the [illegible] [illegible][illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [dis???] [illegible] [illegible] [illegible] [??a?i??] [illegible] [illegible] [???ag?]) [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] in the on [illegible] [illegible] [??ed] and [illegible] [illegible] teeth was natural [illegible] [illegible] growth of bones [illegible] [illegible] are produce) [illegible] [illegible] processes, if so [wh??] [illegible] [illegible] disease) [illegible] [illegible] would seem to us to be [illegible] [illegible] [??is], the other [illegible] [illegible] the [illegible] the makes its exit [illegible] [illegible] lasts but a few days, while [illegible] [illegible] liable to continue during the [illegible] [illegible] the opposition will say [illegible] [illegible] [??ies] too,) To this we reply [illegible] [illegible], dose not commence the [th?] winter season, or [?ven] run into the winter, months [illegible] [illegible] teething process is still going on, [illegible] [illegible] changes of, the seasons moreover [illegible] [illegible] children who get their teeth without [illegible] [illegible] [???laint] or indisposition of any [illegible] [??ular] those who pass through the [illegible] process while very young) again we hear [illegible] [??laint] about the stomach and bowels [??lant] in the sheding of teeth when there is not [illegible] a need growth, in process but the additional [illegible] of casting off the Hot ones) He readily admit the greater liability of children to disease and to [illegible] during the first two years of existence 126 than at an [illegible] [illegible] of time for the [illegible] [illegible] [??hi?] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [P???] as to the [illegible] [illegible] frequently to exist [illegible] [illegible] a [H???] [illegible] [illegible] sound and rigorous [illegible] [illegible] the [illegible] origin or [mad??] [illegible] [illegible] of [illegible], it is a matter [illegible] [illegible] The weight of [fest??] in [illegible] [illegible] favor of the idea [of??] [illegible] [illegible] in the human intesting, [illegible] [illegible] of life most, [illegible] such [illegible] would seem to be [??u??], [illegible] [illegible] more especially the use [o???] [illegible] indigestible food, [illegible] [illegible] that may tend to derang the [illegible] [illegible] digestion or of [asimil??] [th?] [illegible] view of the subject we are [illegible] that the existence of [illegible] [illegible] a result, than a cause disease) [illegible] when they have been generated [illegible] [illegible] when they exist, in great [munk??] that they then became an additional cause of [illegible] and ciation and of febrile disease [illegible] [illegible] not only so promptly, expelled [illegible] [illegible] suitable vermifuges, but that [illegible] [illegible] should afterwards be placed on the [illegible] of such remedies, as would most [illegible] prevent their return, as generational The symptoms ascribed to, and that [illegible] be attendant on worms in children, are almost as numerous and very much resembling the symptom of many their diseases to which they are subject; 127 [illegible] [illegible] [illegible] [chse??] [illegible] [illegible] from the symptoms [illegible] [illegible] [???ust] be left [illegible] [illegible] [???dant], and [illegible] [illegible] proof of it [illegible] [illegible] the presence of [illegible] [illegible] by variableness of [illegible] [illegible] [???ness] and [illegible] [illegible] the sleep picking of the [illegible] [illegible] of the upper lip, more or less of [illegible] [illegible] disturbance of bowell [illegible] [illegible] about the navel,, febrile [illegible] [illegible] of worms) When [illegible] [illegible] point to the presences [illegible] [illegible] administer, vemifuges [illegible] [illegible] of spigelia or Carolina [illegible] [illegible] two or more grains of Calomel [illegible] [illegible] the patient, Should be [illegible] [illegible] second morning for two doses [illegible] [illegible]; two or three times per day [illegible] [illegible] succession or a few drops of spirits [illegible] [illegible] a little sugar, and water two [illegible] [illegible] per day) Should there exist a costive [illegible] [illegible] while using, the warm Medicine [illegible] [illegible] purges gently with a little senna [illegible] [illegible] or a dose of calomel, provided [illegible] has not been used) in every case of worms [illegible] suceeding in expelling them the patient [illegible] [??ed] on the use of some better tonic [illegible] [illegible] to good health and to good digestion [illegible] suppose we know of nothing perferable [illegible] of suitable doses of quinine, in [illegible] we have reason to believe that it [itself] is itself a good vemifuge vither from its better principles or its tonic effects on the system The Some preparations of iron are also well suited to such cases.) The particulars as to remedies and their doses, the reader will see chap 16 128 Chapter ninth On yellow fever, description, [illegible] classification of fevers, this is the [illegible] and most malignant type of [illegible] disease it is to common [illegible] fever [illegible] plague or [illegible] fever is to typhus [illegible] fever, and much will [illegible] be called the typhoid bilious fever of cities [illegible] since it never appears in [illegible] in hot seasons and in crowded illy ventilated and filthy places, and even [illegible] tropical regions its ranges are checked by the coming on of the cold season of the year it is more violent in its attacks more rapid in its progress and more putressent and fatal in its [illegible] than any other form of bilious fevers Causes The concentrated virus of [illegible] with the exhalations from human [illegible] civic life that is to say, the debilitating [illegible] effects resulting from a violation of organic laws [illegible] by the continued and relaxing influence of [illegible] other words the external causes [illegible] influence of heat, with a peculiar vitiation [illegible] while the internal causes are violations of organic laws) The united effects of these are [illegible] modifying causes are to debilitate, to [illegible] and derange, the functional actions of [illegible] in brain nerves, muscles and all the glandular tissues) Hence, we see such rapid [illegible] secretions to vitiations and [illegible] in the solids, particularly in the stomach and [illegible] is a rapid running into gangrene, and [illegible] as is evinced by the black and putrid matters [illegible] from them, and the speedy triumphs of death and decomposition that we are occasionally called to witness) We are aware that a prejudice exists not only the minds of the populace but of the profession 129 [illegible] [illegible] of the [S???] [illegible] [illegible] [illegible] [illegible] [illegible] quantity [illegible] [illegible] [???ally] [dist??] [illegible] [illegible] [illegible] it [illegible] [illegible] [illegible] or [?iten] [illegible] [illegible] such [rapi?] [illegible] [illegible] jaundice evident [illegible] [illegible] yellow fever which [illegible] [illegible] all seasons is so [illegible] [illegible] or occurs in [illegible] [illegible] it [rea??y] produces [illegible] [illegible] freely [diffus??] [illegible] [illegible] system, the patient in [illegible] [illegible] [??ly] concious of being [illegible] [illegible] color of the skin, Symptoms, The [illegible] [illegible] most particulars like that [illegible] [illegible] ushered in by sensations of [illegible] [illegible] stiffiness or soreness of the [illegible] [illegible] head, back and limbs, generally [illegible] [illegible] degree of chilliness, these [illegible] [illegible] succeded increased pain of the [illegible] [illegible] sinuses, giddiness or dizziness [illegible] [illegible] face, a sense of fulness in the eye [illegible] [illegible] expression of distress in the countinence [illegible] [illegible] suffused, with tears a general [illegible] [illegible] with thirst, either great restlessness [illegible] delirium or a tendency to lethargy [illegible] [illegible] scanty and turbid perspiration [illegible] interrupted and diminished pulse irregular [illegible] [??izs] or too slow full fretful and [illegible] often giving a delusive feeling of [i??ased] force seldom strictly tense,, tongue covered [illegible] a whitish mucous coat great irritability of stomach, with nausea and vomiting of bilious matter usually found, epigastrium Tender 130 [??prepure]) [illegible] [illegible] [illegible] as [illegible] [illegible] first [para???] [illegible] [illegible] [???p] [illegible] [illegible] [illegible] [illegible] yellow [wh??] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??ter] [illegible] [illegible] [illegible] [??ll] the [dis?a??] [illegible] [illegible] [illegible] [??ih] generally [illegible] [illegible] [illegibe] hours, when an [illegible] [illegible] [illegible] times, which such [illegible] [illegible] [illegible] induce the patient [illegible] [illegible] [illegible] of danger. But [illegible] [illegible] [illegible] with an aggravation of symptoms [illegible] [illegible] [illegible] of this error) As the [disea??] [illegible] [illegible] more and more indicative [illegible] [illegible] [illegible] manifest themselves, the patients [illegible] [illegible] to decline, the Skin becomes [illegible] [illegible] and hue,, patches of livid spots [illegible] [illegible] different parts, of the body [de???] [illegible] [illegible] secreations begin to [illegible] [illegible] the tongue becomes dark and [illegible] [illegible] incrusted, with a dark [illegible] [illegible] hickups ensue haemorrages [illegible] [illegible] forth from the mouth, nostrils [illegible] [illegible] foetid and involuntary, discharge [illegible] [illegible] from the bowels, the pulse sinks [illegible] [illegible] closes the scene.) Such are the ordinary [illegible] [illegible] in those cases which [termi??] [illegible] [illegible] In this fever as in all fevers proper [illegible] [illegible] marked critical days the duration of [di???] terminating favorably or otherwise [illegible] [illegible] proportion to the violence of the causes and [illegible] constitutions of the subjects of disease) Being [illegible] malignant, disease it usually runs it [ca??] from two to five or seven days,, recovering from [illegible] protracted beyond this period are for the most part tardy and imperfect the patients suffering [m??] 131 from indgistion the necessary result of injuries [s???] [illegible] [illegible] [illegible] of the [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??pular] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] those who [illegible] [illegible] [??in] [sub??] [illegible] [illegible] of distinguished [illegible] [illegible] [??its] of illustrious [illegible] [illegible] unbiassed love of [illegible] [illegible] we have been forced [illegible] [illegible] a course ( [illegible] [illegible] is the exclusive property [illegible] [illegible] of thought either in [illegible] [illegible] [???ent] of human researcher [illegible] [illegible] [??hed], and that when reached [illegible] [illegible] forced to rest in simple [illegible] [illegible] [illegible] have ventured to raise [illegible] [illegible] [??ition] certanily in accordance [illegible] [illegible] [??ions] predecessors) We shall [illegible] [illegible] plain and simple view in [illegible] [illegible] disease, than any heretofore [illegible] [illegible] too, which we conceive to be [illegible] calculated cauintuact the virus [illegible] [illegible] in accordance with the [illegible] [illegible] life if In consulting the pages of [illegible] [illegible] we find the weight of authority [illegible] [illegible] favour of the depletive practice at least [illegible] of the [cross out] (immortal Rush,) [illegible] [???tal], because to him we are indebted [illegible] measure for the demonstration of its [illegible] origin, to him are we indebted for [illegible] [illegible] clearest lights, on the subject of contagin [illegible] the earliest the freest and the fullest [???ents] in the depletive practice. (When the [illegible] made its appearance in Philadelphia [illegible] Dr Rush seems to have been much at a less [illegible] that course of treatment, he should 132 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] give [illegible] [illegible] [illegible] distressed [illegible] [illegible] in the [???ment] of [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] happened, [illegible] [illegible] [illegible] advice and [illegible] [illegible] [illegible] disease as his [illegible] [illegible] [illegible] Indies, would [n???] [illegible] [illegible] me that he had [illegible] [illegible] [illegible] of all kinds, [illegible] [illegible] found to be hurtful, and that [illegible] [illegible] readily to bark, [illegible] and above [illegible] cold bath (He [ad??ed] the bark to [illegible] large quantities, by way of [illegible] [illegible] usual ways and he informed [illegible] [illegible] the cold bath should be used [illegible] [illegible] benefit from it (The made of [illegible] [illegible] appeared to be reasonable [illegible] [illegible] manner he had recommended it, [illegible] [illegible] sporadic yellow fever, with [illegible] [illegible] I had moreover the authority of [illegible] [illegible] of reputation in its favor) Dr [illegible] [illegible] sometimes gave the bark, when the [illegible] [illegible] vicious humors, these humor,, he says, [illegible] by the fault of the circulation,) The [illegible] [illegible] solids enables them to throw off [illegible] [illegible] excrementitious, fluids by their [illegible] [illegible] I began the use of Dr Strong, remedies [illegible] after my interview with him with [illegible] of their success,, I prescribed back in [fa??] [illegible] one case ordered it to be injected into the [illegible] four hours. (I directed buckets full of cold [illegible] to be thrown frequently upon my patients, ( The [illegible] was offensive to the stomach or rejected by it in every case in which I prescribed it, (The cold bath was greatful and produced relief in several cases 133 [illegible] [illegible] [??l] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??ment] [??und?] [illegible] [illegible] him in the course [illegible] [illegible] opposite extreme,, [illegible] [illegible] [??ely] of free and [illegible] [illegible] are, (One dose was [illegible] [illegible] bowels, but from [illegible] [illegible] [illegible] for that purpose,, [illegible] [illegible] were frequently rejected [illegible] [illegible] and inconvenience from [illegible] [illegible] [??lass] (It was always without [illegible] [illegible] and it served to discharge [illegible] [illegible] the stomach,, (Nor did I rest the [illegible] [illegible] the bowels on the issue of the one [illegible] [illegible] (There is in all bilious fevers, a [illegible] [illegible] life, as fast as it is discharged [illegible] [illegible] every day, while the fever continued [illegible] [illegible] from tartar and rhubarb, [illegible] [illegible] purges, had preformed their office [illegible] [illegible] of my patients, in all these cases [illegible] [illegible] easily moved,, when this was not the case [illegible] [illegible] dose of Calomel and jalap every day [illegible] [illegible] maybe supposed to be it was often [illegible] [illegible] especially after the 20th of September, [illegible] become neon obstinatly constipated of [illegible] place of the jalap I now added gamboge [illegible] [illegible] two grains and a half of each made into pills [illegible] to an adult, every six hours, until they [illegible] four or five stools) on the 133 page ( [illegible] doctor, we have said on abandoning the Tonic [illegible] of treatment, suggested by Dr Stevens, [???ty], [???pon] the opposite extream, (he now not 134 [illegible] practices [illegible] and [illegible] purgings [illegible] [illegible] [illegible] use of the lancet [illegible] [illegible] sage [illegible] in the [illegible] [illegible] thrown was [illegible] [illegible] temperature [illegible] [illegible] [??nd] one [illegible] [illegible] [??due] the [f???] [illegible] [illegible] the diminution [illegible] [illegible] fever put on [illegible] [illegible] diathesis more frequent [illegible] [illegible] I bled many patients [illegible] [illegible] a day,, (I prefered, [illegible] [illegible] bleedings, in the [illegible] [illegible] the hight and class of [illegible] [illegible] -nce, from the loss of a [illegible] [illegible] of blood at a time ([illegible] [illegible] seventy and eighty ounce [illegible] [illegible] a few much larger quantitys, [illegible] [illegible] in front street, last by ten bleeding [illegible] [illegible] blood Mr George a carter, in [illegible] [illegible] same quantity, in five bleedings, [illegible] [illegible] one hundred and fourteen [illegible] [illegible] in the last of the above named [illegible] taken it as determined by weight, ( [illegible] near Dock street, was eight times [illegible] seven days, the quantity taken [fro??] [illegible] hundred ounces.) The blood in all [illegible] and in the last, very sizy, (They [illegible] the month of October, and chiefly [illegible] [illegible] Mr Fisher,, and they were all year, [illegible] [illegible] and healthy instance, of the efficacy [illegible] [illegible] bloodleting, and of the intrepidity, and [illegible] this young Physician (Again [illegible] Vol 2, P.147, Now that we have patientaly [illegible] Doctor through, some of his Transitions of opinon [illegible] witnessed the processes by which he has been [illegible] erarers, we will next call the attention of the reader [illegible] 135 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [??set] the [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] stage [illegible] [illegible] [illegible] [ons?untly] [illegible] [illegible] in her stomach [illegible] [illegible] were prescribed [illegible] [illegible] [???ing] of the next [illegible] [illegible] discovered, to me at [illegible] [illegible] which Dr Faulke [illegible] [illegible] which had been [illegible] [illegible] the adjoining Hoch on [illegible] [illegible] with Mr Le Margre's [illegible] [illegible] [???fied], there to the great [illegible] [illegible] [???hood, (After this [illegible] [illegible] trace all the cases of fever [illegible] [illegible] to this cause of diseases ( [illegible] [illegible] a conviction, that the disease [illegible] [illegible] exhalations, from the damage [illegible] [illegible] American daily, advertiser to August [illegible] [illegible] citizens of Philadelphia with a [illegible] [illegible] attention to the spot where the [illegible] [illegible] checking the progress of the [illegible] [illegible] continued by the original caused [illegible] [illegible] when received into the body, were [illegible] [illegible] into action in a few days-(Im with [se??] cases, in which they acted so as to produce a fever [illegible] some day in which they were received into the [illegible] [illegible] I heard of two cases, in which they [illegible] [???ss], fainting and fever with in one hour, [illegible] [???ns] were exposed, (I met with no instant [illegible] [illegible] there was a longer, interval than sixteen [illegible] between their being received into the body, and [??tion] of the disease. This poison acted [illegible] different constitutions according to [illegible] the degree predisposing 136 [illegible] [ar?] the quanity [illegible] [???tin] of [cross out] [illegible] [illegible] [illegible] [illegible] [illegible] that in [illegible] the [pois??] [s??] the [??tmosphere] the [illegible] [??as] excited to [illegible] the [illegible] [illegible] upon the [dys???] [illegible] [illegible] [illegible] [illegible] [illegible] (first great [lat??] [illegible] [illegible] [illegible] [??din] walking [?idiny], [illegible] [illegible] [illegible] Second, ([illegible] from [illegible] [illegible] [illegible] heat of the sun; [illegible] [illegible] [illegible] of the [dis??] Third [int???] in [illegible] [illegible] [T???ion] (Tear ([illegible] [illegible] sudden [par??] of [illegible] [illegible] [illegible] seventh sleep right [illegible] [illegible] all these [illegible] [illegible] [illegible] debilitate, the body [a??] [illegible] [illegible] [illegible] purges, repeated [illegible] [illegible] [illegible] call it by what [nam??] [illegible] [illegible] putrifying, [vegat??], [a??] [illegible] [illegible] damaged [illegible] [illegible] [illegible] be the real cause and [p??] [ha??] [illegible] [illegible] than it most rational to [???t] [illegible] [illegible] infected, with such [p??] [illegible] [illegible] bleeding, and purging to [illegible] [illegible] such poison) But the [oppo??ion] [illegible] [illegible] are the attacks, so rapid the [pr??] [illegible] [illegible] to words a fatal [ex??e], that [les?] efficient [illegible] [illegible] remedies would be of [illegible] [illegible] [illegible] become the subjects of disease [fr??] [illegible] [illegible] exposure, to the infected almosphere, [illegible] [illegible] and frequently become its [vi?ting] in [illegible] [illegible] from the period of the attack, ([illegible] [illegible] The effects of poisons of many kinds and [inter????] upon the animal economy,) We here seen individuals suddenaly into fevers with vomiting into cramps [cons??] syncope or fainting, from breathing for a time [n?p??h] gases, of different kinds, such as whit the [illegible] call damps or damp airs, we have seen individuals [ferati?] 137 divested of all the ordinary signs of life, yet we have never relied in bleeding and purging for the restoration of such [p???] (We have been calld to witness the effects of animal poisons such as the life of spiders and venemous serpents (We have witnessed the rapid [tu??] faction, The sudden inflammended of you [illegible] the [exp??sint] the spasms (heard the oft repeated, cries of pain observed the tears of [illegible], yet still we have not relied on bleeding purging for the relief of such cases, and then vegetable animal, [???al] poisons have [illegible] [illegible] allowed, we have not relied on [illegible] or [???in], remedies, than the case of such [antidet??] known to neutralize or [illegible] [illegible] of the particular poisons taken [illegible] [illegible] chief reliance, upon these measures [illegible] [illegible] (Doctor Rush in the first [illegible] [illegible] [???enc?] of 1793, treated them with the [illegible] [illegible] swelling and purging with calomel [illegible] [illegible] Rush's Works page 41, Vol. 2 [illegible] [illegible] dose not say, but we find him [illegible] [illegible] [???ing], with ipecacuanha bark wine [illegible] [???ally], blankits dipped in warm vinegar [illegible] rubed on the right sides) his works [illegible] [illegible] him asking counsel of Dr Steven's [illegible] [illegible] St Orix, The recommended the [illegible] [cold bath],(This made of treating, The [illegible] [illegible] [???able], to the Dr,, he has use bark in the [illegible] [illegible] several cases of sporadic yellow fever [illegible] years, (In fact the Dr was so will pleased [illegible] [illegible] Stevens, that he proceeded to put his [illegible] [illegible] the very next days (Now to you it may [illegible] [illegible] Rush Should so soon change his opinion [illegible] Dr Stevens, so far as we know and to believe [illegible] (It may be that there is as much in the skill judgement, with which scientific, labors are [??ed], as in the power of intersect in which the truth of [illegible] conceived (In his first experiments with the [ten?] 138 [illegible] stimulating [illegible] [illegible] 123 vol [illegible] [illegible][illegible] seemed [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [???g] [illegible] [illegible] [illegible] [s?pp??] [illegible] [illegible] [illegible] [illegible] the reason [illegible] [illegible] [illegible] he did, [illegible] [illegible] [illegible] [??st?] experiments [illegible] [illegible] without judgement, ([illegible] [illegible] infer, that he [ex??] [illegible] [illegible] second experiments, [illegible] [illegible] [illegible] Dr,,Stevens he failed [illegible] [illegible] [illegible] the clear inference of his [illegible] [illegible] [illegible] paid no attention to the state [illegible] [illegible] [illegible] the consequences (The [?ark] [illegible] [illegible] [illegible] or rejected by it in every case [illegible] [illegible] [illegible] We have been taught to [beli??] [illegible] [illegible] [illegible] understand or not to read at all ([illegible] [illegible] [illegible] patent agent either for good [illegible] [illegible] [illegible] too carelessly, directed, (His [illegible] [illegible] cold water to be thrown frequently [illegible] [illegible] good could any one expect from [illegible] [illegible] [illegible] at most under such vague [instr???] [illegible] [illegible] baffled, in every atempt, to step the [?a??] [illegible] [illegible] took himself to intense study ([illegible] [illegible] [illegible] pored every book,, that treated of [illegible] [illegible] [illegible] overhauled, a manuscript, that had been [illegible] [illegible] by Dr Franklin, a short time before his [illegible] [illegible] [illegible] the aid of Dr Mitchell resulting in leading him [illegible] [illegible] [illegible] to the depletive, particularly the purgative [illegible] [illegible] [illegible] see him enraptured, with the virtues of [cal??][illegible] [illegible] [illegible] of ten and ten, are now, distributed in a wholesale [illegible] [illegible] the city, indeed so great in his confidence in the [illegible] [illegible] that he directed his patients, to be purged every day [illegible] [illegible] His next remedy in the lancet, he bled may patients [t??] [illegible] three times a day, he prefered frequent, and small to large [illegible] [illegible] in the month of September, but towards the height and [illegible] [illegible] 139 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [???tant] with [illegible] [illegible] [illegible] [???b??d] [illegible] [illegible] [??ssition], that, [illegible] [illegible] [illegible] basinss of they [illegible] [illegible] [??eto], to remove [illegible] [illegible] as the circumstances [illegible] [illegible] a assist nature, when [illegible] [illegible] [??ets], but never too officious [illegible] [illegible] nights, (But the Dr,, says [illegible] [illegible] hands, (Took in [illegible] [illegible] expressions like these to [illegible] [illegible] [??ltraism], such individuals [illegible] [illegible] natural law to maintain or [illegible] [illegible] (We have been induced to twice [illegible] [illegible] of yellow fever for the reason [illegible] [illegible] of the [??sudar] prejudices, that have [illegible] [illegible] stand opposed to us, but the names of [illegible] [illegible] in office, individually, whose named [illegible] [illegible] have been received as [illegible] [??tors] in the stage of usefulness [illegible] [illegible] (Dr James Johnson of London, who [illegible] [illegible] [???anc] of the soundest medical Philosopher [illegible] [illegible] [??ssicat] and talented author of Tropical [illegible] Change of Air, and some other works of [illegible] [illegible] as inn the tropical climates, Vol.2 [illegible] [illegible] signature of Archibald. Robertson [illegible] [illegible] Medica (society of Edinburgh as [illegible] [illegible] the [??al] treatment of the epidemic fever I [illegible] [illegible] [???ake,]regarding this disease to be all practical [illegible] [???oses], inflammatory and the affection of the head [illegible] and essential, which is evenced, by headach [??bir] lueis, and red eyes, is how generally an index state of the Brain in the same manner as the tongue is of 140 stomach, I have [illegible] [illegible] [illegible] [???ins] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [s???] [?nd] large [illegible] [illegible] [???a] ([illegible] [illegible] [illegible] the patients [illegible] [illegible] of the [illegible], I have generally [illegible] [illegible] [illegible] [illegible] can be [illegible] [illegible] [illegible] be [tak??] ought [illegible] [illegible] [illegible] [illegible] order to [illegible] [illegible] and induce a [sp??] [illegible] [illegible] that it is not only, by [illegible] [illegible] [s??] I cannot [exp??] it in [philoso??] [illegible] [illegible] to the whole system nervous [illegible] [illegible] letting efforts, the magical, [illegible] [illegible] [illegible] it is also cheifly, by the in [exp??] [illegible] [illegible] word shock, (That cold effusions [illegible] [illegible] from in tropical climaty, where the [illegible] [illegible] is generally from 80.to 82, its [s???ig??] [illegible] [illegible] much abated (The state of the [illegible] [illegible] than the urgency of the other [illegible] [illegible] imperiously, around renewed [de???] [illegible] [illegible] former is thready spreading, or [illegible] [illegible] demand must be complied with, [illegible] [illegible] An a disease like this, where the danger [illegible] [illegible] in twelve, or fifteen hours, it is often [illegible] [illegible] apparent character may be altered [illegible] [illegible] again he says (Is is a [hucul??] [illegible] [illegible] that almost omnimpotent, remedy, the [illegible] [illegible] said to in counter A remedy for all other [illegible] [illegible] second of force, (It requires all the [illegible] [illegible] [illegible] [illegible] will gain ground on uswith rapid strides, [illegible] [illegible] to bleed again and again this is the mainstay [illegible] [illegible] anchor of hope, (Without it many very [ma??] [illegible] infallibly be lost. (Would I could say [illegible] [illegible] The same writer further remakes. Page 341. [illegible] [illegible] [??urging] I have not hitherto, mentioned, the [illegible] [illegible] much a matter of course (A stimulus ought to be [illegible] [14?] [illegible] [illegible] than [illegible] [illegible] [illegible] [illegible] [illegible] [????tion] of fevers [illegible] [illegible] [illegible] [co???ted] [illegible] [illegible] [illegible] [a???] [illegible] [illegible] [illegible] [illegible] [illegible] [???ment] [ar???] [illegible] [illegible] that it is the [illegible] [illegible] [illegible] [???er] to result [illegible] [illegible] [illegible] [illegible] [confi?t??] [illegible] [illegible] [???illy] [sustained] [illegible] [illegible] make appeals, ( [illegible] [illegible] say [illegible] 335. Vol 2. Tropical [illegible] [illegible] he says, elsewhere is [illegible] [illegible] continues.) I found the vessels [illegible] [illegible] [???ous], than natural and filled [illegible] [illegible] an distinct traces of [illegible] [illegible] and other viscera of the thorax [illegible] [illegible] appearance of inflammation whatever [illegible] [illegible] ready be accounted for [illegible] [illegible] brain [illegible] membranes, I found [illegible] [illegible] action save in its basilar portion [illegible] [illegible] and adhered pretty firmly to the [illegible] [illegible] of coagulable lymph were [illegible] [illegible] living together, the inferior, convolution [illegible] [illegible] with dark colored, and appearently [illegible] [illegible] the other cerebral nerves from the [illegible] [illegible] the sustance of cerebrum pons and [illegible] [illegible] exit by the cranial foramina,(- [illegible] [illegible] has found in each one of the lateral [illegible] [illegible] was in the cerebellum, and medulla [illegible] [illegible] chief morbid appearances were directed [illegible] [illegible] a degree of vascularity, indicative of [illegible] [???irly] it was covered with a plexus of [illegible] [illegible] and the later together, with the pons varolii [illegible] medulla oblongata, was enveloped by tenacious [illegible] of fibres, which could scarcely be removed with [illegible] [illegible] substances, underneath,(about [illegible] spoonfuls of serum also were found effused in the fourth 142 [illegible] [illegible] [illegible] medulla [illegible] [???g] [illegible] [illegible] [illegible] [???tions] [illegible] [illegible] [illegible] of [illegible] [???p] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] less to know [illegible] [illegible] strictly [???able], to the [illegible] [illegible] [???pe?is] or [illegible] [illegible] [illegible] [???duced] by the [illegible] [illegible] we do know that [illegible] [illegible] [illegible] the laws of [illegible] [illegible] will die, in spite of [illegible] [illegible] [illegible] could be adopted; [illegible] [illegible] [illegible] of treatment might be [pur???] [illegible] [illegible] by him, (For if the danger of [illegible] [illegible] tendency to inflammation, and [illegible] [illegible] [illegible] and purged nearly to death, to [illegible] [illegible] the inference, seems at [illegible] [illegible] [illegible] is not the same, and [pre??] not [illegible] [illegible] it, (Dr. Rush we shown [illegible] [illegible] [illegible] and liberal depletion) and has [illegible] [illegible] several dissections made by Dr [illegible] [illegible] to sustain the doctrines-( [illegible] [illegible] [illegible] great importance, of the disease [illegible] [illegible] in the investigation of diseases, we [illegible] [illegible] [illegible] that some of these dead, of the present [illegible] [illegible] fevers should be examined, and [illegible] [illegible] observations, it appears at present [suff??] [illegible] [illegible] following facts, (Fast that the brain, in [illegible] [illegible] found in a natural condition, ([illegible] [illegible] viscera of the thorax are perfectly sound [illegible] [illegible] in the heart and veins, is fluid, similar [illegible] [illegible] of the blood of persons who have been [hang??] [illegible] [illegible] by electricity, (That the stomach, and [begin??] [illegible] [illegible] duodenum arc the parts that appear most [dis??] [illegible] in Two persons that have dies, of the disease on the [illegible] the villous membrane of the stomach especially [a???] 143 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [d???] [illegible] [illegible] [illegible] [sim??] [illegible] [illegible] [illegible] by [illegible] [illegible] [illegible] in a [f???] distroyed by it ([illegible] [illegible] of its [illegible] [illegible] [illegible] died [illegible] [illegible] [???ation] [illegible] [d???] [illegible] [illegible] [???arly] about [illegible] [illegible] [illegible] [???tion] of which [h???] [illegible] [illegible] [illegible] beginning of the [illegible] [illegible] [illegible] this part is as [illegible] [illegible] [illegible] at a more advanced [illegible] [illegible] inflammation disappeared [illegible] [illegible] [illegible] intestines, a black liquor, which [illegible] [illegible] [illegible] death, (This black liquor [illegible] [illegible] altered secretion from the liver [illegible] [illegible] [illegible] quality was found in the [illegible] [illegible] [illegible] [???s] acrid that it produced [illegible] [illegible] and swelling, on the operator's hand [illegible] [illegible] [illegible] (The villous membrane of the [illegible] [illegible] [???dis], was found inflamed in sever [illegible] [illegible] [illegible] its natural appearance, erupting [illegible] [illegible] the surface of which a very [illegible] [illegible] [illegible] seen all the other abdominal [illegible] [illegible] appearance, (The external surface of [illegible] [illegible] of the intestines, was quite free from [illegible] veins being distended with blood which [illegible] through, the transparent peritoneum gave [illegible] [illegible] (The stomach of those who died early in [illegible] [illegible] always contracted, but in those who died [illegible] [illegible] period of it, where extravasation appear [illegible] [illegible] with, air (Rush's works Page 92, Vol 2 [illegible] [illegible] Physick and P. Cathrall [illegible] [illegible] interduce, these reports of post mortem [illegible] [illegible] for purposes already mentioned, but further [illegible] [illegible] reports-(First that the disease in question has 144 fixed [illegible] [illegible] [illegible] [illegible] [illegible] [??ated], [illegible] [illegible] [illegible] be [illegible] [illegible] stomach and duodenum [illegible] [illegible] [illegible] organs, ( [illegible] that [illegible] strong indication of [putrese??] [illegible] decomposition and [illegible] [illegible] [illegible] sometimes procedes [illegible] [illegible] Healthy inflammation [illegible] [illegible] and the term inflammation [illegible] [illegible] be nightly used or the [illegible] [illegible] changes of structure [illegible] [illegible] we are well aware of [illegible] [illegible] the very many imposing [illegible] [illegible] addition to those already [cel???] [illegible] [illegible] still another of which standing [illegible] [illegible] [illegible] Surgeon Lawson (Pork, in [illegible] [illegible] [illegible] perpared under the [der???],of Surgeon General 2 OL) [illegible] [illegible] [illegible] appearance late in the season [illegible] [illegible] [illegible] character, but is in [illegible] [illegible] disease of highly arterial ([illegible] [illegible] at lease one more and [illegible] [illegible] medicine for four of five days [illegible] [illegible] Calomel is the cathartic [conn???] [illegible] [illegible] decidedly the most efficient [illegible] [illegible] of from sixteen to twenty ounces of [illegible] [illegible] the extent of twenty or twenty five [illegible] [illegible] for several days, the doss is repeated, [illegible] [illegible] oil and enemata according to [circu???] [illegible] [illegible] After the first day the calmel in [addi???] special administration as a purgative [illegible] [illegible] in doses of five grains every three hours [illegible] [illegible] irritating the salivary glands and this [illegible] [illegible] from more vital organs, (Those is no [dang??] [illegible] [illegible] the patient by excessive purgation, as it is very [di???] excite the intestinal cannal into action and 145 [illegible] [illegible] [illegible] [par??] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [d???] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] day [illegible] [illegible] [illegible] [stop???] [illegible] [illegible] [illegible] must [res??] [illegible] [illegible] [illegible] [???darble] our [illegible] [illegible] the lowest [illegible] [illegible] to employed with [illegible] [illegible] which is frequently [illegible] [illegible] symptom, to require [illegible] [illegible] [???sion] cerebral excitement [illegible] [illegible] [??ailed] in connection with [illegible] [illegible] constition; the main and [illegible] [illegible] in this fever, ( [illegible] [illegible] not necessary none but the [illegible] [illegible] infusion can be administered [illegible] [illegible] such as the sulphatic of quinine [illegible] [illegible] ( This disease runds its course [illegible] [illegible] fatal, in few days by a [illegible] [illegible] organ or being itself [illegible] [illegible] seventh day, having once [illegible] [illegible] the conflict, (The surgeon's [illegible] [illegible] use of quinine, stand in direct [illegible] [illegible] even Thinks quinine is inadmissible in [illegible] [illegible] the fever, while we use it in every stage [illegible] [illegible] inflammation or aggravating [illegible] [illegible] gives to it opposite effects( We [illegible] [illegible] [??fuige] antiseptic and touic vertues [illegible] [illegible] reliance, upon the [super??tion] of [??tydis?] [illegible] [illegible] witness, ( 147 148 148 149 150 153 157 158 159 160 161 162 163 164 188 Polish For Furniture In 1 quart Boil Lint seed oil 1 pt Alcohol One lb Gum Shelac 2/3 [illegible] Mix it as below When mixing this polish it must be warm, that is the oil And put in the other articles And the polish is ready to put on 187 A fine tonic for [illegible] Persons caused by chills and fever or otherwise R. hyposulfate of Soda 2 oz Elixer viteral 2oz Sulphate quinine 90 gr pure Aqua 1 [illegible] let it stand one hour and it is ready for use. Dose for an adult a table spoonfull 3 times a day Children in proportion- Fine Cement R 4 Tablespoonfulls of Salt; water 1 pt gum Shelac 1/2 lb let it boil Slow until all is melted and where it is about a consistency of Shoemakers wax draw it in long Strips and break it into six inch Sticks it is now ready to mend with by heating the stick and applying it to the glass as dish and pressing the parts together and then let stand 12 or 24 hours and the vessel is ready for use [1??] [illegible] [illegible] [illegible] [illegible] Tinc [comp??] [illegible] [illegible] [illegible] to be [app??] [illegible] per day, [illegible] be taken internalle in [illegible] 3 or 4 times [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] Acit 3X [illegible] [illegible] [illegible] 3ii Tinc Lavender [illegible] 3 [illegible] Aqua [illegible] 3XXi Muc gum [illegible] 3 [illegible] i Dose to [illegible] [illegible] Tonic [Al???] [illegible] [illegible] Rx Rad sarsaparilla [illegible] [illegible] xii sassafras cont-[g???] Rad Gb Mezeron Cont Dulcamara [Eupa??] [illegible] 3vi aqua congt to [illegible] [illegible] then boil half an [illegible] [illegible] mix with simple sys, [iilegible] [illegible] Anodyme, and 1/2 dz [illegible] [illegible] Cong-Dose 1 tablespoon [illegible] [illegible] a day- Rheamatic [m??] D. Tinct semini [Colc?ici] each 3Xvi tinc opii Tinc lavender Compound [illegible] Aqua cinnamon 365- spoonful every 4 [hou??] cases, a teaspoofull every [illegible] not so urgent 195 [Ha??] [W???] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [?his] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] Pills [illegible] [?il] [??t???th] [Comp] ℥i [illegible] [illegible] [illegible] Grs 20 [sub??] [illegible] grs 15 [illegible] [illegible] [illegible] gr i [illegible] [illegible] [illegible] gr3 [illegible] [illegible] [illegible] gr, 6 [illegible] [illegible] [illegible] pills [illegible] [illegible] [illegible] bed Time [8??] [illegible] the [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] 197 [illegible] [illegible] [illegible] 9 1/4 [y???] [illegible] [illegible] [illegible] 35 [illegible] [illegible] [illegible] 34 [illegible] [illegible] [illegible] 33 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] 37 [illegible] [illegible] [illegible] 36 [illegible] [illegible] [illegible] 41 [illegible] [illegible] 87 [illegible] [illegible] 20 [illegible] [illegible] 6,, 08 [illegible] [illegible] [illegible] '' "" 60 [illegible] [illegible] [illegible] Ru 80 [illegible] [illegible] [illegible] " 25 [illegible] [illegible] [illegible] " 60 [illegible] [illegible] [illegible] " 30 [illegible] [illegible] 16 2/3 1 00 [illegible] [illegible] 6 1/4 85 [illegible] [illegible] 61 21 [illegible] [illegible] [illegible] " 75 [illegible] [illegible] -2,25- 1" 13 [illegible] [???hs]-" 85 [illegible] [???e] 1 50 [illegible] [illegible] paper 2" 00 [illegible] [illegible] " 40 [illegible] 10 20 [illegible] [illegible] 12 1/2 " 25 [illegible] [???s] 18 3/4 " 37 [illegible] [illegible] 35 " 70 [illegible] [illegible] 50 c " 37 1/2 [illegible] [illegible] " 05 [illegible] [illegible] [???a], 25, " 25 [illegible] [illegible] 6, " 54 [illegible] [illegible] " 30 [illegible] [illegible] Buttons 3 " 45 [illegible] [illegible] 15 " 15 [illegible] [illegible] cutter 25 " 35 185/ 198 [illegible] [illegible] [illegible] [illegible] [illegible] 43 [illegible] [illegible] 25 [illegible] [illegible] 40 [illegible] [illegible] 25 [illegible] [illegible] 20 [illegible] [illegible] 30 [illegible] [illegible] 36 [illegible] [illegible] 85 [illegible] [illegible] [illegible] [illegible] [???d] [illegible] 60 1 [Bla???] [illegible] 0 1 [alue] [illegible] 6 [illegible] Red 48 15 1/ do Cofee- [illegible] 33 1 Whisky [o???] [illegible] [illegible] 2 do3 Butter 1 Powder Can 1 Load-haling Tb R. Guthbertseu [illegible] For Harrison [Hamil??] [illegible] 197 [pu???] [illegible] [illegible] [illegible] [B????] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [4??] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [5??] [illegible] [illegible] [illegible] [3??] [illegible] [illegible] [illegible] [4??] [illegible] [illegible] [illegible] [?1] [illegible] [illegible] [illegible] 12/ 400 [illegible] [illegible] [illegible] 1 369 [illegible] [illegible] II 308 [illegible] [illegible] 25 750 [illegible] [illegible] 20, 315 [illegible] [illegible] 10, 352 [?oe] Cure For, (?) Take [??rid] of [j??k] [illegible] [illegible] [illegible] Sanguinary [?earsa?ll??]) [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [Sli?k] [???her] Work it [illegible] [illegible] And [sp??d] it [illegible] a [p?ace] of strong [c??t] [?a???] [illegible] to easer the [(illegible)] [illegible] it remain [illegible] and [illegible] remove the plaster, [illegible] [illegible] (6) is dead, [???nce] [p??ing] and it will matter [cross out] and come out in a few days Paltice with flax [illegible] [illegible] day, and slippery [illegible] [illegible] the next day, and so an [illegible] [illegible] out then keep pathing untill it heals up [??ellard] 201 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [a???] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] glove, [illegible] [illegible] ratio of its [illegible] [illegible] rejected and [illegible] [illegible] [??ick], [illegible] [illegible] [??ghly] rubbed [illegible] [illegible] drops of water [illegible] [illegible] [??encis] more, [illegible] [illegible] [??ar], two teaspoonfuls [illegible] [illegible] adult, a child are [illegible] [illegible] [???ers.] and should the [illegible] [illegible] which is rarely ever the [illegible] [illegible] compound powder [illegible] [illegible] of the herb or fox glove [illegible] [illegible] given as above directed [illegible] [illegible] and soon as the pustules [illegible] [illegible] and clean off [illegible] [???pply] the liquid and your [illegible] [illegible] did put on as good a [illegible] [illegible] made of gun cotton and [20?] [illegible] [illegible] [per??] [illegible] [illegible] [illegible] you [?et] up in [illegible] [illegible] to what [illegible] to [d??] [illegible] must be [illegible] the break of [??ery] & [sin??] [illegible] [illegible] [illegible] straight [illegible] can to [illegible] [illegible] best to try [illegible] [illegible] [illegible] [d?y] [illegible] say exting [c???] you will [?ak?] [illegible] [illegible] a half of the [?ord] of the [c?d???] of the north east side of the [illegible] [illegible] take hold of the [li?t] [illegible] [illegible] [illegible] and in a [pi???] manner it would be well to have a place [illegible] [illegible] three feet square cleaned off the [illegible] side of the bush to throw your twig down, when [illegible] [illegible] step up to the [illegible] taking [illegible] [??g] say cedar brush have come [illegible] you through [illegible] to try to cure a blister [illegible] the [illegible] of WG. left hand, [illegible] [illegible] [illegible] Father the son and [illegible] [illegible] [illegible] the last word you [?ill] [p??] [illegible] [illegible] it down where you cleaned [illegible] [illegible] raunel to your right [han??] [illegible] [illegible] to act, as near as you [c??] [illegible] [illegible] started from,, it is of [illegible] [illegible] [illegible] or cloudy raining [illegible] [illegible] [illegible] warm it will do very well [illegible] [illegible] time, between the middle of [illegible] [illegible] if the day be very worm and [illegible] the same words in trying [illegible] [illegible] that you may try for, [illegible] [illegible] you try and find out the [illegible] [illegible] if you can. [20?] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] patient can [illegible] [illegible] [illegible] in the water, untill [illegible] [illegible] [??pply] [illegible] [illegible] [illegible] 4 [illegible] [illegible] [illegible] [illegible] [illegible] the [illegible] [illegible] [illegible] diet [illegible] [illegible] [illegible] of [illegible] [illegible] 2 or 3 [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] [illegible] and use [illegible] [illegible] [??nty] of loaf [illegible] [illegible] burnt allum [illegible] [illegible] [illegible] about 1 inch in [illegible] [illegible] [illegible] altogether and then [illegible] [illegible] [illegible] [???tion] and than [illegible] [illegible] [illegible] the juice, which [illegible] [illegible] 2 drops to each eye 3 times [illegible] [illegible] [illegible] [illegible] [illegible] Remedy [illegible] [illegible] quaciam [illegible] [illegible] and [illegible] [illegible], all put into [illegible] [illegible] whisky and take one [illegible] [illegible] [illegible] per day it is a very [illegible] [illegible] [illegible] GW Ward MD [??4] Hooping Cough Tincture Digitalis 2 dram Lobelia 2, do ℥ij opium- 1,gr ℥i syrup 1 oz ℥ss water 4, do ℥rv [illegible] [illegible] [illegible] [sp???] [illegible] [illegible] [C???] [illegible] [illegible] oil [p???] [illegible] [illegible] [camph???] [illegible] [illegible] Teething [illegible] [illegible] [illegible] [Cuast??t] [illegible] [illegible] [illegible] Aple Vinegar [illegible] [illegible] [illegible] Spts serpentine [illegible] [illegible] Again Creasote 1, 8 Suepleuric either 1 clo Laudnum 1 1/3 chloriform 1/2 spt niter 1, do Recept for [pr???] 20 prd, red 1 1/2 gallay [illegible] 1/2/[illegible] 1 pint oilum- hagus 11 handful Ban gelling- Mullin Leaves And Eldor, Cerid [illegible] [illegible] Black Salve take 3 quarts of Olive Oil Common Rasin 3 oz Beeswax 3 do Red precepitate 1/4 lb And Raise all to a boiling heat and then put 1/2 oz gum camphor into id Red just before the mixture get, Cold, put in the Red precipitate llued its then ready for use Caryophyllus Sweet Gum Bark 4 oz Red oak 40, d Caynrim Peper 1/4 S.S Laudnum 4 oz Cuminum 4,, Cloves 4, Brandy-from 1/2 to 1 pt Brandy Cough syrup squills paragoric Spt, neter equal parts, Tricopherous Alcohol 7 Pts Water 1 do Caster Oil 8 oz Tincture of Canthardies 3 oz Perfumery Tasting